vent about work assignment

[treeye]

I am 10 weeks pregnant and trying to wait till 2nd trimester to announce my pregnancy. I continue to take care of pts with MRSA VRE C-diff, I seldom refuse to help to pull a patient unless they are very obese. I try my best not to be treated differently just because I am pregnant.

I emailed my director and supervisors and request not to work on the oncology floor. After two weeks I received an email back stating that the only thing they can promise is that I will not be assigned to a patient actively receiving chemo (well, thanks for the big favor!) . Last week, I was assigned on the oncology floor with a TB patient. When I ask the supervisor whether I can take care of such patient, she said "well, I guess, it should be fine"(Will she be so ambiguous if she is pregnant?). I called my OB doctor and was told that someone else should take that assignment.

Just want to vent that you have to stand up for yourself. Management only cares about numbers, they don't give a ** about you.

[OCNRN63, RN]

So for the next 9 months, Pregnant Nurses' co-workers get heavier assignments, take all the isolation pts, do all the heavy lifting, while Pregnant Nurse gets all the walky talkees? No way.

There would be days on my unit that Pregnant Nurse wouldn't have an assignment.

More likely than not, there will be at least one or two nurses who are pregnant, making it difficult for the non-pregnant nurses.

I haven't seen "walky talky" patients in the hospital in a long, long, time.

[Here.I.Stand, BSN, RN]

I would talk to infection control and your own provider, and get in writing what you truly should not be exposed to for safety reasons (chemo precautions, CMV, shingles and the like). Then talk to your manager and give her a copy of your limitations. They can't put you on light duty for 9 months based on pregnancy alone, but they CAN and MUST make reasonable accommodations.

Congratulations, btw!!

[MunoRN, RN]

There are CDC guidelines on exposure precautions for pregnant HCWs, in general it would appear you've placed far more restrictions on yourself than the CDC does which is going to make it hard for you to get the accommodations you appear to be seeking.

[Gabby-RN]

http://text.apic.org/item-115/chapter-109-the-pregnant-healthcare-worker

The CDC website says basically the same thing.

Following Standard Precautions (i.e., consider all body fluids except sweat potentially infectious and use personal protective equipment [PPE] when exposure to blood or body fluids is anticipated), as recommended by the Centers for Disease Control and Prevention (CDC) for all healthcare workers (HCWs), will protect pregnant HCWs against most infectious agents to which they may be exposed. However, because some infectious agents can cause congenital syndromes in the fetus when primary infection is acquired during pregnancy, there are additional concerns in pregnant or potentially pregnant HCWs. For practical purposes, immunologic function is normal during pregnancy, and an otherwise healthy woman is not considered to be an immunocompromised host. Pregnancy does not increase the risk of acquisition of infections, and, for most infectious agents, clinical manifestations of infections are no more severe in pregnant women than in those who are not pregnant. In view of the routes of transmission and ubiquity of some infectious agents (e.g., cytomegalovirus [CMV]), restricting pregnant women from caring for patients with potentially transmissible infections is considered only for patients infected with parvovirus B19 and for patients with respiratory syncytial virus (RSV) infections who are receiving ribavirin aerosol. Because patients with vaccine-preventable diseases should be cared for by only immune HCWs, it is especially important for women contemplating pregnancy to obtain the needed vaccines before conception. Similar to nonpregnant HCWs, susceptible pregnant HCWs should be restricted from contact with patients with rubeola, rubella, varicella, and smallpox. Much anxiety among pregnant HCWs results from misinformation concerning epidemiology and transmission of infectious agents. The emphasis must be on eduction of all HCWs of childbearing age, ideally before pregnancy, or at least as soon as pregnancy is diagnosed. It is important to note that the incidence of CMV and parvovirus infection is not increased among HCWs compared with other occupations, especially day care center workers and school teacher.

[Gabby-RN]

As much as you don't want "everyone" to know, your coworkers will probably be more understanding if they know why you do not want to care for certain patients. I also wanted to add that YOU should know for your own piece of mind which patient conditions are safe for you to care for since it is your body and your baby. I would never rely on my boss telling me it is probably safe if I was worried about it. Talk to your doctor, the infection control nurse, do your own research on the CDC website. Know some of the common medications that pregnant women should avoid handling and if they are safe for you to pass if you wear gloves, if you only need to avoid them when they are crushed, or if you need to completely stay away from them. When I worked in urology, Proscar was a common med on the unit and was a med that pregnant women (or women who could become pregnant) weren't supposed to touch. Find out if your pharmacy or computer system alerts you if the drug is unsafe to be handled by pregnant workers-it does at my hospital. Be informed. I am sure you will feel better knowing for sure what is safe than worrying what may or may not be.

Congrats btw!

[Ginger's Mom, MSN, RN]

Check with your OB, if he has issues with your current work assignment, ask to go out on short term disability. Also ask to be in charge, that way your assignment can be done with no questions asked. I worked both my pregnancies without any limitations of course with the approval of my ob.

[wooh, BSN, RN]

I still remember how most days you don't even want to get out of bed much less go take care of other people.....

Then don't. But don't expect a paycheck. People with depression don't feel like getting out bed either. Should they get a cushy assignment too?

[toomuchbaloney]

Why refuse to care for a TB patient?

[NicuGal, MSN, RN]

We have a list of patients that should not be given to pregnant staff. Any patient with TORCH illnesses, chemo patients, implanted radiation, a few other certain meds, chickenpox/shingles, patients on nitric oxide therapy are the most common ones.

[Not_A_Hat_Person, RN]

If you can't work with certain patients due to a medical issue, why not get a doctor's note detailing your restrictions? I'm a home health RN currently on maternity leave. When I was put on lifting restrictions, my employer wanted something in writing.

[Ruby Vee, BSN]

IMO I feel that pregnant nurses should have special considerations. I would never give an assignment to a pregnant nurse that included isolation patients or someone who is known to be a dead lift. Those of us nurses that have been pregnant before already have a real fear of what can go wrong so why make it worse. Let the prego's have the walky talkees for gosh sakes! BTW I haven't been pregnant for 17 years but I still remember how most days you don't even want to get out of bed much less go take care of other people.....

If a pregnant nurse needs special considerations, that can be accomodated, fine. Often times, however, half of the staff is either pregnant, trying to get pregnant or breast feeding. It's difficult then to make assignments that are fair without giving patients on isolation, obese or dead lifts to pregnant people. Or are you saying that we should dump on those employees who aren't pregnant, trying to get pregnant or breastfeeding?

[Ruby Vee, BSN]

I don't understand how I am asking too much. I never refused pts with MRSA,VRE, C-diff, never avoided lifting pts because I am familiar with these types of limitations. When it comes to iffy issues such as TB, radiation, would you risk your baby when you are not sure?

I have no problem with floor nurses since they are not aware of my situation. However, as a supervisor/manager( who I informed my pregnancy 5 weeks ago), if you are not sure about whether a pregnant nurse can take care of certain types of pt, don't say "probably it's safe". Give her a pt that is "for sure safe" for her to take care of. I am sure she wouldn't want to take that risk if she is pregnant. I don't think I am asking for special treatment, just some common courtesy.

In your original post, you said:

I seldom refuse to help to pull a patient unless they are very obese. I try my best not to be treated differently just because I am pregnant.

Seldom refusing to help pull up a patient unless they are very obese isn't the same as never avoiding lifting patients. If a patient is very obese, get more help. Don't just refuse to help. You are asking for special treatment. I didn't think pregnancy was a disease.