Any other RN's out there?

Aeml1985 · July 2014

I'm an ICU RN and I haven't had a dr appt yet so I don't know what kinds of things/patients I should be avoiding. It's not fair to not have ANY isolation but I know some are worse than others, and what about cytotoxics? We're exposed to so much working in healthcare and normally it doesn't bug me but after almost 2 years TTC I don't want to do anything to jeopardize this pregnancy.

AshleighW13 · July 2014

I'm a BSN (trauma nurse), I was working in an ER when I was pregnant with DD and wound care when pregnant with DS. My Dr. said as long as all vaccines were all up to date and I wore proper safety gear (gown and glove up, mask) that I should be fine. I did constantly wear masks due to not being able to have the pertussis vaccine but that was it. As far as cytotoxics there is a study that the ACOG did involving 7500 pregnant nurses. It pretty much states in the first trimester to avoid as much as possible, and in the second and third to use all proper safety measures.

thejucheidea · July 2014

I'm an RN working in phase I cancer research. I haven't changed anything about my job, and it includes administering chemotherapy. Four other nurses in my clinic have had six children among them in the last six years -- all normal, healthy children -- so I'm not concerned. I always double glove and gown when administering chemo.

Aeml1985 · July 2014

Thank you ladies for the reassurance. What about CMV, measles, TB etc?

AshleighW13 · July 2014

CMV is spread through contact with bodily fluid, measles through droplets, and TB is also droplet but is transmitted more easily than measles. Honestly PPE's gown, gloves, mask. I can't have the MMR either so I wore the mask alot.

Klarosa12 · July 2014

I'm an ICU nurse too and I was thinking the same thing. There are so many patients that you would think u should not take care of because of the fear of catching something, but it makes sense as long as u wear PPE you should be good. I did hear though you should never care of someone with active shingles or chicken pox. Have you heard that too?

nannabee21 · July 2014

I am a RN in well baby nursery so I'm not in contact with too much sickness, but we do get the occasional mom with shingles or mrsa or what not. I always wear my ppe when dealing with nastiness though and also with our cleaners we have here.

mangomimosa · July 2014

No cytotoxic meds. I would refuse CMV, shingles/varicella, & rubella pts for sure. Those are so devastating to the fetus it wouldn't be worth the risk to me. I've seen a CMV baby... Not good. You should talk to employee health or infection control to get details on job safety; hospitals are serious about protecting your/baby's health in pregnancy. At least the few I've worked at were....

@thejucheidea I would never, EVER administer chemo while pregnant. That was STRICTLY prohibited when I worked in oncology, and you could even decline chemo pts while TTC. You do your best to avoid exposure, but you can't fully prevent it. Chemo infusion nurses have higher rates of cancer because of the chemo exposure, and that's enough to make me concerned about fetal risks even if it wasn't strictly prohibited. Just because other nurses have done it doesn't mean it's smart or safe--chemo nurses often get lax on the rules over time (at least that's what I've seen). Obviously it's your body, your baby, your choice, but your comment made my jaw hit the floor.

mrsIgoe · July 2014

I'm an RN in the OR. Was previously an L&D RN for 7+ years
I'm also still nursing #1. Agree 100% with @mangomimosa‌
Id also avoid PTs who have had chemo drugs/ radiation therapy within 14 days
(In the OR I avoid PTs who will receive nitrous or extensive ortho surgeries and duh the x rays!)

Aeml1985 · July 2014

SO many X-rays! We do them all on the unit so I try my best to run far but the techs aren't always the best at letting people know when they're going to shoot.
In icu we don't have too much iv chemo, patients are too sick, but we have a lot of transplant patients so lots of oral cytotoxics (not necessarily chemo).
Looks like I'll have a few things to ask my OB next week. Thanks ladies!

lnguyen07 · July 2014

That is good to know! I'm an RN on the med surg unit in a small hospital so we get a little bit of everything

klax4 · July 2014

I'm in psychiatry but we have a ton of mrsa and vre patients. Not to mention that most of them are too sick to tend to personal hygiene. I always use ppe when indicated and practice good hand hygiene on the regular. Our cytotoxics are all clearly labeled "do not handle while pregnant". I wouldn't risk it.

Edit: spelling

myjessesgirl · July 2014

As a nurse practitioner, I had to break down and tell the staff at five weeks. We had about four cases of hand, foot, and mouth disease and all on my schedule. Now they're instructed to keep rashes with the male physician in my office. Otherwise, most infections are fine. I don't have the luxury of wearing PPE into suspected MRSA or TB rooms, but I also don't spend nearly as much time in rooms as I would as a floor nurse!

shouzlow · July 2014

With my 1st pregnancy I worked in ICU, I told them about the pregnancy almost right away so that they were more accommodating. I avoided pts with shingles, TB, H1N1. Most other ISO pts I would take if needed though (MRSA, cdif, etc) as long as PPE is used it shouldn't be an issue. The hard part is when they get put on ISO after you have had them, I never had any issues though. I was extra thorough with hand hygiene and make sure to get immunizations when you can- flu shot, tdap, etc

cina1980 · July 2014

I'm only an LVN , but I work in a prison which is filled with disease

as far as I know , if you use universal precautions , don PPE when necessary , you should be ok. I do know it is best to avoid patients with shingles while pregnant altogether tho.

cina1980 · July 2014

Is it necessary to avoid patients on chemo ? I have a few, I assist provider with their follow up appointments when they return from tx. I also see them directly after they return to make sure they are stable before going to their cell. Now I'm worried

jenieu · July 2014

I am so glad I saw this post! I am a new grad and just landed my first job as an OT in acute care and start in 2 weeks. I just found out last wk that I am 5 weeks pregnant and have my health screening tomorrow. My first appointment is in 2 wks ( the week I start my job) andI was worried that I would loose my job bc of restrictions. I'm planning I letting the nurse know tomorrow during the screening bc I don't want to lie about it or put my little one in danger, but I'm really nervous they will let me go bc of it. I was hoping to chat with my doc before letting work know, but time doesn't allow it.

jenieu · July 2014

Does anyone have any words of wisdom or advice for me? Thanks☺️

hughek3 · July 2014

I'm an OR nurse and I feel your pain! It's VERY challenging trying to keep your baby safe and still do your job. There are TONS of dangers and some people who just don't care/understand why you are refusing certain things. I feel guilty as well refusing big XR cases and cases with bone cement but I try to remember it's not for me and it's not forever.

anfranklin2 · July 2014

Not a nurse but I am an Surg tech and I just told the charge nurse and she's been fantastic about keeping me away from total joints and the long ortho cases, even though I'm typically in those cases! It's been a big change for me trying to learn new doctors but it's what's best for the baby so I'm fine with it

and I do extra precautions for pts with infectious diseases

kkRNmomto3 · July 2014

L&D RN and the only patients I stay far far far away from are CMV.

KentuckyKate · July 2014

Another nurse here! There is a thread a few days ago called "Healthcare workers" that has similar responses in it if you wanted to check it out! Like I said in my post there, I have already refused a shingles patient, and I will also refuse active flu and CMV.

jduganrn · July 2014

Another nurse

work in open heart, I stay away from chemo drugs, E. coli or vre, h1n1, shingles, X-ray, flu and I think that's all I've encountered. I don't deal with cmv ever or I guess I haven't yet . Congratulations to everyone

merc5411 · July 2014

mangomimosa said:

No cytotoxic meds. I would refuse CMV, shingles/varicella, & rubella pts for sure. Those are so devastating to the fetus it wouldn't be worth the risk to me. I've seen a CMV baby... Not good. You should talk to employee health or infection control to get details on job safety; hospitals are serious about protecting your/baby's health in pregnancy. At least the few I've worked at were.... @thejucheidea I would never, EVER administer chemo while pregnant. That was STRICTLY prohibited when I worked in oncology, and you could even decline chemo pts while TTC. You do your best to avoid exposure, but you can't fully prevent it. Chemo infusion nurses have higher rates of cancer because of the chemo exposure, and that's enough to make me concerned about fetal risks even if it wasn't strictly prohibited. Just because other nurses have done it doesn't mean it's smart or safe--chemo nurses often get lax on the rules over time (at least that's what I've seen). Obviously it's your body, your baby, your choice, but your comment made my jaw hit the floor.

This.

NikkiRN08 · July 2014

Nurse educator on a med-surg unit, but prior to this I was charge/staff nurse on a CV unit.. never assigned prego nurses to chemo patients, ANY airborne isolation patients, shingles patients, didn't see too much of CMV, and/or didn't assign to morbidly obese patients.

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