Working as a nurse while pregnant

Laura - posted on 10/10/2011

I know you posted this a long time ago, but I couldn't help but respond. I have been a pediatric nurse for over 3 years now, and I am appalled at the responses to your concern. In no way were you demanding to do less work, you were just being a mother and protecting your unborn child from harm. There are definitely more things you should avoid when you are pregnant - as you referenced the CDC list- and just because we are nurses who constantly sacrifice for our patients, does not mean that I will ever put the future health of my child at risk because of it. It saddens me that nurses don't watch out for each other a little better than I'm hearing. I am lucky to work at a facility who has such a "team" attitude that when a member of the team is pregnant everyone else is happy to help out and trade assignments in order to protect her and her unborn child. I am never going to risk something happening to my baby in order to just "do my job" - when it is just as easy to switch assignments. I'm sorry that you all don't work in a facility that will protect you as much as they are willing to protect their patients!

La - posted on 01/19/2010

I see what both of you are saying. I'm not trying to get out of doing patient work. I have been caring for patients with HIV, MRSA, c-diff, pneumonia, flu, etc with no problem or complaints. Like I said though, my instructor tried to insist on me caring for the TB patient even though pregnant women were specifically warned not to enter the isolation room and tried to make me dress a wound on another patient BEFORE the patient was sedated and was still violent (I don't think it was safe for ANYONE pregnant or not to care for this patient until he was sedated). My instructor could have easily changed my patient assignment in these two cases. If I was a nurse working at the facility and could not have my assignments switched I would take a leave of absence, but being that we are only assigned 2 patients a day at clinicals there is no reason she couldn't switch me to ANY OTHER PATIENT on the unit. She made a point of assigning me to the ONLY isolation room on the unit even after the charge nurse at the facility told her not to.

I tried to do some research and found this: "According to the CDC (Center for Disease Control) pregnant health care workers should be restricted from caring for patients with the following diseases. These patients should also be isolated."

Syphilis
Rubella
Mumps
Measles
Chickenpox (if mother not immune)
Mycobacterium tuberculosis (TB)
Cytomegalovirus
Ebola
Parvovirus B19 (Fifth's Disease)
Listereosis

Amanda - posted on 01/19/2010

I agree with Mary. Nursing is hard, often thankless work, and you are expected to be able to do your job whether you're pregnant or not.... Sorry, I know this is not what you want to hear. I think the only things you really can refuse to treat (because they are a documented danger to your unborn baby) are chemo/radiation, TB, shingles, & rubella. I worried incessantly when I was working full-time as an RN and I was pregnant. Unfortunately I had hyperemesis during my pregnancy, so I had to go on unpaid leave for the duration of my pregnancy. My FMLA was long since used up by the time I had my baby, so I lost my job and had to find a new one after I had my son and returned to work. Unfortuantely, your only options as a nurse are to continue to do your job or to go on unpaid leave and use up your FMLA. As far as nursing school, if you are that concerned, you might want to stay back a semester and try your clinicals after you have your baby. Bear in mind though, that a lot of the things that are unsafe for your baby when you are pregnant are also unsafe if you are breastfeeding. It's a tough decision to make. Good luck to you!

Mary - posted on 01/19/2010

I know that I am not giving you the validation that you are looking for. What I am doing is being honest about what being a nurse in the bedside setting is all about. I understand YOUR concerns for your unborn child...while trying to remind you that you are the only one that has them, and you are in for a bit of a rude awakening if you think that any future employer or co-worker is necessarily going to share them. I'm not claiming that it's right/wrong/indifferent; it simply is the reality of the job. The combativie patient you mentioned is the same threat to you as he is to anyother nurse, being pregnant does not make you special or exempt from difficult patient assignments. Truth is, ANY patient can become combative, at any time, without warning (trust me, laboring women can be the worst, I've been kicked at more than once). At least with him, you KNEW what ot expect, and he was sedated.



You really don't have too many options to pursue. You can review the policies of your school and those of the facilities where you are doing clinicals, to see if they specify any patient conditions or dianoses that a pregnant woman cannot care for. You can discuss your concerns with your OB, and see if they will give you a list of things that you cannot do, although I would be cautious with that....your instructor may then claim that you are unable to fufill your course requirements. If you are really that nervous about placing your unborn child in harms way by being in clincals, than you may want to reconsider whether or not this is the right time for you to be in school. Sorry, I know this sounds unsympathetic; it really isn't meant to be. I have watched many a co-worker think that pregnancy exonerated them form caring from a multitude of patient conditions (MRSA, VRE, HIV, H1N1 to name a few) only to be told that if they were following proper precautions, it should not be any undue risk. If they refused, they were told to seek out taking an unpaid leave, as they were unfit to fufill their job requirements completely.

La - posted on 01/19/2010

Well I am still a student and at clinicals my instructor assigned me to a TB patient in isolation. The warning sign on the patient's door specifically indicated that pregnant women should not enter. When I brought this to the attention of my instructor she refused to change my patient assignment until the charge nurse for that unit told my teacher that I'm not allowed to go in there. My instructor also tried to order me to clean and dress the wound of an actively psychotic patient who had a fork in his hand that he was using as a weapon to stab before the patient was sedated or the weapon was confiscated. I don't know about you but I was not willing to get stabbed in the stomach and risk having my baby hurt. It's not even like I'm an employee of that facility and would be covered by their insurance if anything happened.

Mary - posted on 01/19/2010

Well, I am a nurse (L&D) and I worked full time, nights, up until I delivered at 39 4/7. There really is very little that you can refuse to care for, other than handling things such as chemo/radiation. Pregnancy is NOT a disability, and as women, we need to be very careful about demanding a reduced workload or special assignments. Unless otherwse specified by your OB (in writing), it's pretty hard to come into your workplace, expect to get paid your full salary, and not do your job completely. Your co-workers, who are not getting paid anything additional to pick up your slack, will NOT appreciate it. If your are using proper universal/and or isolation precautions as warranted, it should not be an issue. If you become very insistent about your assignments, and claim pregnancy as an excuse, your manager may suggest you need to pursue early disabilty leave. Here in the States, FMLA is only 12 weeks, so you will greatly reduce the amount of time you can spend at home after the baby's birth.



I can tell you that the only patients I really could not care for were those with a fetal loss, and that was only after I became obviously, visibly pregnant (in scrubs, that wasn't until about 30 weeks for me), and that was because of how it would impact the PATIENT, not me. I think they TRIED not to give me the really obese girls at the end, because it was more physically challenging (and I usually needed a little more help than I did pre-pregnant), but that was a kindness I appreciated, but never demanded.