Pregant nurse giving methotrexate?

[limonada]

Hi nurse friends. I need advice. I am a home health nurse and I am pregnant. A patient that I see regularly recently started methotrexate injections. The patient has multiple disabilities and is sometimes uncooperative for injections and the patient's mother needs to assist and try to hold the arm still so that no one gets hurt. I have always been a little nervous giving any injection to this patient. Sometimes the person is very cooperative, but sometimes they jerk their arm at the last second as you are giving the injection. I have always handled it though, and never had any issues. Now that methotrexate has been ordered, I am extremely nervous. There is a warning right on the label from the pharmacy saying to handle with caution and something along the lines of causing reproductive harm. Methotrexate can cause severe birth defects. I already lost a pregnancy due to severe, rare, birth defects of unknown cause, so maybe I am just overly paranoid now. Does anyone have experience with this? I don't think I can refuse to administer this drug? I could try to get a colleague to switch schedules with me so that I don't see this patient on days that this drug needs to be given, but I feel bad causing any inconvenience to my colleagues. Am I worrying too much?

[SmilingBluEyes]

Get with your OB for the right medical advice and proper exemption as soon as possible. 

[BSN-to-MSN, ADN, BSN, RN]

Hi,

Your worries are valid, especially when you've had a previous pregnancy lost due to birth defects.

Try to switch shifts with a coworker to avoid giving a shot. With a patient moving and unable to hold still, you risk accidental needle stick. I do not think the OB will give you an exemption, they will say: "follow precautions, blah, blah, blah." I have heard it before, but you can try and get a note and giving it to your employer.

Don't feel bad, you have to protect self and the baby.

[ivyleaf]

I think it is recommended to use chemo grade gloves to admin methotrexate. I think if you are wearing those, it should be fine- but always good to look @ a reputable online source and/or ask OB.