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"You put me and my unborn child's life at risk"

Nurses   (11,710 Views 75 Comments)

TigerGalLE is a BSN, RN and specializes in ICU, Med/Surg.

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You are reading page 2 of "You put me and my unborn child's life at risk". If you want to start from the beginning Go to First Page.

2,999 Posts; 14,933 Profile Views

I agree 100%... I told her he had a rash that was on his abd... he is a r/o cancer pt who is immunocompromised..
Hmmm...

I'm wondering if Dr. QueenBee was smart enough to place that patient on airborne isolation.

;)

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pagandeva2000 is a LPN and specializes in Community Health, Med-Surg, Home Health.

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Screw her...it is up to HER to diagnose, NOT you...you did your job, you assessed, and you reported. Even if you suspected that the patient had shingles and told her, it sounds like she would have said that you had no right as a lowly nurse to do her job. While I hope nothing happens to her child, I say that she needs to choke on her own words.

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TigerGalLE is a BSN, RN and specializes in ICU, Med/Surg.

712 Posts; 11,981 Profile Views

NOPE she wasn't... just place on contact... hope it isn't disseminated

But I've had chickenpox....

Are pregnant women at risk if they've had chicken pox? Or only if they haven't had it?

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2,999 Posts; 14,933 Profile Views

NOPE she wasn't... just place on contact... hope it isn't disseminated
Doesn't matter. Immunocompromised = airborne and contact precautions.

Herpes zoster (varicella-zoster) (shingles):

Disseminated disease in any patient

Localized disease in immunocompromised patient until disseminated infection ruled out--- A,C

http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/Isolation2007_appendixA.pdf

BTW, if I were pregnant (perish the thought!) and someone reported "a rash" I think I'd damned well protect myself until I knew just what I was dealing with; she wasn't too smart to go in to examine that patient without taking the proper precautions. She has no one to blame but herself.

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2,999 Posts; 14,933 Profile Views

nope she wasn't... just place on contact... hope it isn't disseminated

but i've had chickenpox....

are pregnant women at risk if they've had chicken pox? or only if they haven't had it?

judging from her reaction, it sounds as though she isn't immune.

during the acute phase, patients should be counseled to avoid direct skin contact with immunocompromised persons, pregnant women, and individuals with no history of chickenpox infection.

varicella is a common, highly contagious, self-limited disease of childhood that is transmitted by respiratory droplets or close contact. it is usually acquired by 90% of persons in the united states before the reproductive age. thus most women are immune before they become pregnant.[2] the incidence of varicella in pregnancy is 0.7/1000. should varicella pneumonia develop during pregnancy, however, it can run a more fulminant course. maternal varicella infection in the first 20 weeks of pregnancy can cause varicella embryopathy, also called congenital varicella syndrome, in approximately 1%-2% of cases.[2] this syndrome consists of the hallmark cicatricial skin lesions that present in a dermatomal distribution, limb hypoplasia, and contractures and can also involve the eye and central nervous system. the prognosis is poor should an infant be infected.[3]

the fetus

the effect of maternal infection on the fetus or neonate depends on the timing of the infection. the risk of congenital varicella syndrome is some 1% in the first 12 weeks, and around 2% between weeks 13-20 of pregnancy. infection from the beginning of the second trimester up to one week from delivery may lead to herpes zoster in an otherwise healthy infant. infection from one week before to one week after delivery can lead to severe neonatal varicella.

women who are exposed to varicella or herpes-zoster in pregnancy should seek medical attention as soon as possible.

a significant contact is defined as being in the same room (eg house or classroom or 2-4 bed hospital bay) for a significant period of time (15 minutes or more) or face-to-face contact.

if the woman has a past history of varicella or zoster, protection can be assumed and reassurance given.

if there is no history of past varicella or zoster, the woman's susceptibility should be determined urgently and if they are varicella-zoster igg negative then they may be offered vzig if they are within 10 days of the exposure (21). for continuous household exposure (for example when a child in the household is infected), vzig should be offered within 10 days of the onset of rash in the index case.

aciclovir and valaciclovir are not licensed to be used prophylactically and so cannot yet be recommended for this purpose.

the risk appears to be minimal, but our protocol is to keep all pregnant (and potentially pregnant) staff away from these patients.

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dream'n has 26 years experience as a BSN, RN and specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

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I guess since she is pregnant you are her health screener now? Where I used to work the Dr., when pregnant, was smart enough to look out for HERSELF and get a physician collegue to exam a patient with a rash.

Sorry you have to work with such a rude person.

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388 Posts; 6,263 Profile Views

I agree with everyone else. She sounds rude and dumb.

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191 Posts; 3,052 Profile Views

Oh man, this doctor is completely whacky! :bugeyes: Good for you for standing up for yourself though!!!

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2,999 Posts; 14,933 Profile Views

NOPE she wasn't... just place on contact... hope it isn't disseminated

But I've had chickenpox....

By the way, my travel company required I have my titers checked (even though I told them I'd had chicken pox as a child). Their explanation was that some who have milder cases don't necessarily develop full immunity. Not entirely sure how accurate that is, but it made sense to me.

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labcat01 is a BSN, RN and specializes in ICU, CVICU.

629 Posts; 6,419 Profile Views

I've never heard that chickenpox/shingles poses a threat to pregnant women. UGH- It scares me what I don't know!!!!

Edited to say: Everyone else is right! That doctor was out of line and rude! I'm glad that the DON stood up for you.

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nrsang97 has 18 years experience as a BSN, RN and specializes in Neuro ICU and Med Surg.

2,589 Posts; 37,212 Profile Views

Doc was WAYYYYYYY out of line. Glad to hear that the DON stood up for you. Some people just amaze me.

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2,227 Posts; 19,942 Profile Views

Good response!

She was totally out of line.

Think she would have said the same thing to the patient if he was the one who pointed it out to her????

Maybe the witch should stay home for her entire pregnancy.

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