Nurses: what do you do? - Page 2

[snuffles]

Thanks again for the responses. Keep them coming. I'm still really torn! I'm even questioning my decision to go to nursing school. When I first applied, I figured I would sign the waiver and go on. But by doing that, I could be putting myself and my family at risk. But on the other hand, I don't feel at all comfortable getting the vax while breastfeeding, and I don't want to wean when he's not ready.

Clinicals start in the hospital at the beginning of October.

[roxyrox]

I am at nursing school now. I really struggled with the decision, but in the end I opted for the vaccine. I have had 2 shots so far and have to have the third in a years time.

I personally wouldn't get it whilst bf though and I don't think you are putting your family at any risk at all by not getting the vax. It would only be you who is (theoretically)at risk. In your first year though, I can't see that you would be doing anything really risky. i think if I was you,I would wait until your child weaned and not worry about it.

[mamakay]

I can't really think of any mechanism by which the vax could be "bad" for bf'ing. All the "toxic" stuff you'd want to avoid for a baby (them getting 7 shots at once sometimes, no less) isn't really as big of a deal when it's being "diluted" in the body of a grown adult coming from a single vaccine.

I'd be more worried about being unvaccinated and transmitting HepB to the family, personally.
JMO.

[roxyrox]

Originally Posted by mamakay

I can't really think of any mechanism by which the vax could be "bad" for bf'ing. All the "toxic" stuff you'd want to avoid for a baby (them getting 7 shots at once sometimes, no less) isn't really as big of a deal when it's being "diluted" in the body of a grown adult coming from a single vaccine.

I'd be more worried about being unvaccinated and transmitting HepB to the family, personally.
JMO.

How likely do you think it is to transmit hep B to your child though? I looked into this and didn't find anything indicating a risk.

[mamakay]

Originally Posted by roxyrox

How likely do you think it is to transmit hep B to your child though? I looked into this and didn't find anything indicating a risk.

It's definitely unlikely. But if an adult becomes infected transiently, they'll shed at low levels for a while, and household transmission does happen (rarely)...but if your baby catches it young, they're then at a huge increased risk of never clearing it.
Those risks are small, but I think the risks of breastfeeding after vaccination are even smaller. I can't even think of a hypothetical way that the breastmilk would be "dangerous" at all after HepB vaccination.
Unless I missed something (which is possible).

[roxyrox]

Originally Posted by mamakay

It's definitely unlikely. But if an adult becomes infected transiently, they'll shed at low levels for a while, and household transmission does happen (rarely)...but if your baby catches it young, they're then at a huge increased risk of never clearing it.
Those risks are small, but I think the risks of breastfeeding after vaccination are even smaller. I can't even think of a hypothetical way that the breastmilk would be "dangerous" at all after HepB vaccination.
Unless I missed something (which is possible).

I think I may agree if you were actually working as a nurse. I just don't think students, especially in the first year, are really at any risk of contracting hep B though (this is just based on my experiences). I think the op would be safe to leave it until her child weaned and then get vaccinated.

[LotusBirthMama]

Originally Posted by roxyrox

I think I may agree if you were actually working as a nurse. I just don't think students, especially in the first year, are really at any risk of contracting hep B though (this is just based on my experiences). I think the op would be safe to leave it until her child weaned and then get vaccinated.

If you haven't started clinicals and aren't doing any patient care then , yeah, I think you could safely wait. But I would absolutely get it once my clinicals started.

[mamakay]

Originally Posted by roxyrox

I think I may agree if you were actually working as a nurse. I just don't think students, especially in the first year, are really at any risk of contracting hep B though (this is just based on my experiences). I think the op would be safe to leave it until her child weaned and then get vaccinated.

You're probably right.
I know nothing of the relative risks there, with students compared to working nurses.
I just know that I can't think of any way that bm from a recently HepB vaxed mom could be dangerous at all.

[snuffles]

Okay. Just got a letter in the mail and realized that I will need my Rubella titers checked. I had MMR back in 98? I think they checked my titers in 06 and they were still there (during pregnancy). If I am no longer showing titers, how the heck am I going to get out of that one?

[not now]

I got my Hep B series without thinking twice. I was a phlebotomist at the time so needle stick risk was really high. I totally don't regret it. I don't get the flu vax but I am current with all my boosters since I'm so frequently exposed to things.

As a nurse you'd be amazed at the things that just happen even to the most prepared. Two nurses were sprayed in the face with blood (of a HIV+ / Hep B&C+ patient) while assisting an MD with a central line placement. They were sick/nauseated for weeks while they took antiviarals.

[ldnurse]

I got HepB as a twelve year old...

Had I not gotten it then I would have gotten it in nursing school. Although we usually know when our pt's have HepB (screened prenatally), there is always a risk. I deal with a LOT of blood and would not wanna risk it.

[attachedmamaof3]

If I knew I would come into contact with blood/bodily fluids like this, I would opt for the vaccine.

It is unlikely that your reciept of this vaccine would have a negative impact on your nursling.

[snuffles]

Originally Posted by mamakay

If the HepB shot "works", it should prevent transmission, I think.

This part still bugs me. If I get the vaccine, I want to be sure my family is still protected if I'm exposed.

[Crazybean]

If I remember my classes correctly, your first set of clinicals has nothing to do with meds since we didn't take pharmacology yet. So a needle stick wasn't in the near future for us during our first clinicals. The first one was more pt care and reading charts and following other nurses. Until you take pharmacology, I'm pretty sure no school allows you to inject anything. Find out when you will take pharm and see if that is the 1st semester or not. If not, then you can probably wait until the new year before getting the vax if you choose to do it. And perhaps you can pump milk and store it since your DC will be older then?

[not now]

My program integrated pharmacology with all semesters. First semester was a lot of LTC and med/surg so we focused on common/standard meds that are used for chronic conditions. But we were also taught injections at that time so blood glucose checks, insulin, B12 shots, flu shots, TB tests, IM antibiotics in the LTC setting (rochephin being the most common) were fair game. Even if your just doing ADL's you run the risk of coming into contact with body fluids.

In all honesty I doubt a nursing school will take your word on getting vaxed in the second semester. Why take the gamble on one student when there is another waiting and more than willing to do the vax when the school asks that it be done? Nursing school can be competitive to get into. The other thing is that a hospital may require that all students get the vax before they let them in. I almost missed part of my ICU rotation because my TB test had expired, I had to beg my doc's office to get it on short notice. Also, CNA's don't give any injections at all yet those students all need the Hep B vax before they can start because the hospital requires it.

[Jazmommie]

I am wanting to get my RN soon -am an LPN now --but I am wondering about the MMR vax--I declined the Hep B series already twice for my last 2 jobs.

Checking titers will be the first thing I guess.
Is it required?

[marilynmama]

I am a new RN (I just graduated in May). Please don't second guess going to nursing school. I LOVE my job, I enjoyed nursing school. I am proud of what I do and the profession of nursing! Not many careers gives you the power to save lives and make an impact on people the way nurses do

The HepB vax is up to you. You just need to go with what your most comfortable with based upon your research. I declined the vax for nursing school. I work in the Pediatric ICU (PICU) and I'm not really at risk for HepB at work (though a nursing friend of mine did contract HepB from a needlestick from a neonate so it can and does happen anywhere). If I worked in our ER which is a level 1 trauma center that gets a LOT of homeless, prisoners, mentally ill patients I wouldn't think twice about getting the HepB series because of lot of those patients have HepB, C, HIV, etc. My husband is starting the police academy in January and I would expect him to get the HepB series, I would if I were him---way to much of a risk.

You should be able to decline HepB for school and work--a lot of people do for various reasons. MMR I would first get my titers checked. The hospitals will require you to have immunity for MMR and chickenpox for sure, no way around that--they don't want you to ever be at risk for transmitting those diseases to your patients, because your going to see some very very very sick patients who catch anything and everything. Titers will work and more than likely yours will still be positive (I was shocked that mine all were!).

I was giving SQ, IM, blood draws, etc my very first semester of nursing school! THe only thing we couldn't do were IV drips or IV push meds. Every school is different with that though. You will definitely be doing a lot of FSBS on all sorts of patients.

I don't worry about putting my children or husband at risk. I come in through my garage and I take off my scrubs in the laundry room as well as my shoes (which I only wear at work). I take a shower and I'm fine--family is not at risk. If you just do something simple like that your family will be fine.

[marilynmama]

Congrats on being accepted into nursing school btw!!! I know how hard it is to get accepted!!