refusing patients due to medical reasons.

[reallyagain7]

I have a letter from my doctor stating I cannot care for anything COVID 19 related patients because I am immunocompromised and pregnant (not so much this). My manager has received this and so has Human Resources. However, I do float to a unit that receives patients that are “covid 19 test pending” OR “needing covid 19 to be ruled out.”

My question is, how would you approach this? Do I refuse these patients? Do I tell the nursing supervision or/and manager when this happens? Do I tell that units’ manager? Etc? My issue is, this isn’t my normal unit so I do not know their policy.

[Jedrnurse, BSN, RN]

On any given day there is much more than just coronavirus floating around in a medical setting. How do you work being immunocompromised COVID-19 notwithstanding? Is your regular unit/job more administrative?

[macawake, MSN]

2 hours ago, reallyagain7 said:

I have a letter from my doctor stating I cannot care for anything COVID 19 related patients because I am immunocompromised and pregnant (not so much this). My manager has received this and so has Human Resources. However, I do float to a unit that receives patients that are “covid 19 test pending” OR “needing covid 19 to be ruled out.”

My question is, how would you approach this? Do I refuse these patients? Do I tell the nursing supervision or/and manager when this happens? Do I tell that units’ manager? Etc? My issue is, this isn’t my normal unit so I do not know their policy.

If I were you I’d start by finding out the policy of the unit I’m floated to, since you’ve identified this as a factor that makes it more difficult for you to choose how to act.

I’m European and if a nurse has a note from his/her physician saying not to work with Covid patients, that nurse will be given administrative duties. If the type of work they do so allows, they’re lent a work laptop so that they can work from home. I have two coworkers who haven’t set foot in the hospital I work in since mid-March.

My personal thoughts are that of you have community transmission, I’d consider every patient, as well as any other person, as potentially Covid+ Do you have access to adequate PPE? That would be important to me and probably the deciding factor.

I can’t say anything about your specific situation since I don’t have all the details and the internet isn’t the proper place for medical advice. But as I started out by saying, I think that you should find out what the policy on your float unit is, and go from there.

Best wishes!

[llg, PhD, RN]

You're in a difficult situation. There is no way your employer can guarantee that you will never come in contact with the Covid virus. Even someone who "tested negative" yesterday might have picked it up in the last 24 hours. And even if you are only doing administrative things, there is no guarantee that some of your co-workers or others that you have contact with won't have it. All your employer can do is minimize your risk by not assigning you to known Covid patients and people under investigation, and to provide you with the recommended PPE.

Given that reality (regardless of what your doctor's not says or any guarantees you may want), only you can decide if your want to go to work at this time or not.

[Wuzzie]

15 minutes ago, llg said:

All your employer can do is minimize your risk by not assigning you to known Covid patients and people under investigation, and to provide you with the recommended PPE.

After repeatedly being exposed to Covid + people (who did not know it but later became sick) while wearing a paper mask and goggles from Amazon I'm beginning to think that those actually working with Covid patients might have an advantage given the level of PPE they are provided. I am in no way dismissing the added risk my nurse colleagues are assuming when caring for such patients but to Macawake's point I now assume everyone I come in contact with in my professional and personal life is positive and protect myself as best I can.

[Sour Lemon]

A month ago, I worked on a unit where every patient has to test negative to be admitted. A few days later, a patient deteriorated to the point that a rapid response was called and she was transferred out. Guess what? ...and I was up in her face for a good part of the night because she was demanding, a total care patient, and hard of hearing.

A lot of patients on one of my regular units are also "covid rule out" due to the policies of the facilities they're transferring to. No one wants to accept a patient who has not had a very recent test.

I'm not someone who tends to worry excessively, but if I were pregnant, I'd probably take off for a while. It's a temporary condition, after all. The fact that you're immuno compromised is a bit trickier ...since caring for sick individuals is an integral part of bedside nursing.

[reallyagain7]

I work in a medical surgical telemetry setting. we have a floor that houses KNOWN covid patients. I was given the green light by HR and my manager to not have to float there because of my condition/doctors note. however the other floors I float to is where I am in a predicament. my manager is ignoring my emails when inquiring about what actions to take when the situation arises. should I just email the managers on those units? or refuse those patients? etc.

what would YOU do in this situation?

[Sour Lemon]

Just now, reallyagain7 said:

I work in a medical surgical telemetry setting. we have a floor that houses KNOWN covid patients. I was given the green light by HR and my manager to not have to float there because of my condition/doctors note. however the other floors I float to is where I am in a predicament. my manager is ignoring my emails when inquiring about what actions to take when the situation arises. should I just email the managers on those units? or refuse those patients? etc.

what would YOU do in this situation?

I would quit until after the baby was born.

[ruby_jane, BSN, RN]

So this is really a HR question. You are asking for assignment that minimizes risk. Lots of people are asking for the same assignment.

I agree with most of the previous posters that I just need to treat everyone like they have COVID-19. Reminds me of my early work with HIV. It's not the sick ones you should worry about now - it's the asymptomatic people. Research the proper PPE for your work assignment. Use it well.

I will also add that as a TB nurse I never did contract TB because I had proper equipment and used it the way I was instructed to. But I love @Wuzzie's comment. Because that's what we were legit doing back in March and April!!

[Flum Mox]

There are a lot more contagious illnesses than corona so you are limiting your ability. Take a maternity/family leave and consider your career options

[Chickenlady]

Quit. They can't guarantee you won't be exposed.

[reallyagain7]

My manager finally had a chat with me and told me to let the charge nurses know my situation but he couldn’t guarantee anything. meaning, they can still give me covid patients, if they pleased. however, my union representative has told me I should refuse to float BUT not refuse the patient, which confuses me somewhat. I have to float first before I retrieve my assignment. My hospital is accommodating certain nurses only. Lots of complaints of favoritism where I work.

how do I refuse to float but not refuse an assignment?