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#31 of 59 Old 06-23-2007, 10:31 PM - Thread Starter
 
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Thanks, everyone. This is great help.




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Originally Posted by Artisan View Post
I believe one of the studies of the safety of HepB was done on nurses, because they were an available vaccinated adult population. They found that the nurses had much higher rates of autoimmune disease after getting the vax. I'll see if I can find the study.
YES! Id LOVE to see that!!!
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#32 of 59 Old 06-23-2007, 10:32 PM - Thread Starter
 
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Originally Posted by KJoslyn78 View Post
i also worked with folks with developmental disabilities - those were the folks who would bite ... they also offered the Hep B vax. I had a Hep B lady i worked with - but the only thing the poor woman could do was drool

I agree with the PPs about those who are in law enforcement and health care need to Heb B vax to protect themselves... and their familes (esp if kids are delayed/non-vaxed).. just my 2 cents
:
OH I hadn't thought of that!! Since my children are NOT Vaxed.... if I refuse the vax for HepB, I wonder if that would increase the risk for THEM through Me??
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#33 of 59 Old 06-23-2007, 11:32 PM
 
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I work in long term care and honestly it is the CNAs in LTC that come in contact with the majority of bodily fluids as the brunt of that sort of patient care is on them. They are the ones changing pts, cleaning up when they vomit, etc
I have come in contact with my fair share of urine, blood, vomit, feces, gastric juice FLOWING from a pegsite as if it was tap water from a faucet, etc. I have given many injections. I have 3 uncles who are living with/dying from Hep C as a result of a single shared needle as teenagers.
I guess my take is this - there are so many nasty things that I *could* get from fluids. Honestly - the other stuff you can catch scares me more than Hep B. Hep B is just one of them. Hep C is worse. HIV is much worse. MRSA, ESLB, VRE, etc are horrible too. I took care of many pt with Hep C, both in nursing school and in LTC. Many pts with MRSA or other nasty super bugs. Protection, prevention, and good handwashing is critical.
Needle sticks are preventable. Do not EVER recap a needle. Most now come with the special little guard that locks up over the needle once used to eliminate the desire/need to recap and dramatically reduce the chance of an accidental stick. NEVER put it in your pocket, etc. Carry it, use it, and discard it into a sharps IMMEDIATELY. In LTC most of the time there is a sharps bin in the room and also on your medcart. In hospitals, there is a sharps in every room. If a pt is agitated or really moving around/jerky - wait. Yes, you are busy but it is safer to wait the few minutes until it can be done safely for you and then - or get assistance if it needs to be done right then and there.
Gloving is a biggie for me. Yes, like someone else said sometimes you go in and there are none left. I solved that little problem by always having a pocketful of extras. One pocket of my scrubs is my extra glove pocket - I carry 2-3 pairs of extra gloves in my pocket and anytime I use a pair, I replace it on my way out the door. Then you are never without gloves. I use gloves for EVERYTHING. Many nurses who have been practicing a while, especially in LTC, get complacent and don't use gloves except for "big stuff". I was horrified to see nurses giving meds via pegsites and doing peg site care without gloves - but it is a regular occurence in many places. I also gown up - even for colonized MRSA. I am not taking any chances. I don't care that it takes extra time, effort and is hot as hades. It is a extra layer of protection.
Plus the problem isn't touching the fluids. Okay so vomit or urine or blood gets on your clothes. Gross, but not going to make you get Hep B or anything else. Now if you have a cut on your leg under those scrubs, okay maybe. If you put your hands in your mouth after touching it, then you are just stupid. This isn't something that simply gets absorbed thru your skin. You must have a cut of some sort or get it into a mucus membrane like eyes, nose, mouth, etc.
I figure that Hep B isn't as common (from my own experience anyway) as Hep C or anything else that I mentioned - I have heard many HCP complain of autoimmune problems after getting the HepB, and I already have a finicky immune system. Plus I was pregnant and then nursing DS. To me, the vax didn't seem necessary or worth the risks. I honestly believe that being aware and proactive in protecting yourself thru your actions makes more of a difference than a vax, especially when there is so much out there that you need to protect yourself from. (it is like the HPV vax instead of teaching kids about safe sex so they don't get HPV or anything else like get pregnant, get HIV, Hep C, clamydia, herpes, etc)
I wash my hands constantly - scrub them like they teach you in school, up to the elbows, under the nails, between the fingers, LOTS of friction to kill everything. I wash a quick soapy rinse to get the uck off, a scrub to kill the germs, and then another quick less detailed scrub to make sure it is "safe clean" as DH calls it. Lotion becomes your best friend. LOL But I wash before and after each pt. I will go thru this process twice before going on breaks or going home, and I won't touch surfaces like doorknobs, etc afterwards.
I am terrified of bringing anything home, especially to my son. I have a coat for work, shoes for work , purse/pump bag - they don't come into my house, they stay out in the hallway. I strip down in our entryway, dump my clothes directly into the washer, and get into the shower to scrub down. My clothes get washed on hot with TTO to kill off anything I may bring home, they are dried, and then hung in their own closet just in case the TTO couldn't kill something. THEN and only then do I kiss my baby and hold him.

As far as passing it to your kids. My 3 uncles all have Hep C, since they were teens. Upon diagnosis, they also tested their families, their past partners, other people my one uncle shared other needles with, etc. None of my aunts got it. None of their kids got it (there's a total of 7 kids between them). Only one of my uncles "buddies" had also gotten it (probably who he got it from and then passed it to my other 2 uncles). Blood born pathogens are not that easily passed from family member to family member - unless you plan on sharing needles or bleeding profusely all over your children. You are putting them more at risk for stuff like MRSA, ESLB, etc.

HTH!
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#34 of 59 Old 06-24-2007, 03:03 AM
 
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"Do not EVER recap a needle. "

We HCPs could have a lively debate about this one. I'm an RN in a Neonatal ICU and I recap needles ALL THE TIME (not once I've used them to inject into a patient or a line, only after drawing up/ mixing a med). And so do all of the 100+ nurses who work on my floor-- granted, we use a lot of the blunt plastic and blunt metal needles for meds, so even if they touch you, they aren't likely to break skin). I could go into why it isn't practical on our floor, though I see that it would be more practical in other units, and I also see that having the attitude of "I should never recap needles" might make you more prone to be extremely careful in the rare situation where you find it necessary/ more safe-- just as, on my floor we double check ALL MEDS with a 2nd RN before giving them, so on the very rare occasion it isn't feasible (stuck in isolation, unable to flag someone down) I find myself double and triple checking the med.

Even though the practicality of the "never recap" party line might be debatable, naturegirl7 gives a lot of good advice-- though I might question the practice of carrying gloves, but that may be just because the babies I work with are generally so immunosupressed that the gloves are there to protect them, as well as me. I would worry that the gloves would become more contaminated riding around in my pockets, rather than taking them straight out of the box, but different populations have different needs/priorities.

Me, personally, I got the Hep B series prior to nursing school. It sounds like there is no easy answer, each of us has to weigh the benefits and risks and decide what's right for us.
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#35 of 59 Old 06-24-2007, 03:09 AM
 
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those were the folks who would bite ...
School children bite also, but HepB is not required for school entrance nor for the teachers who may be bitten.

Not yet anyway. :

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#36 of 59 Old 06-24-2007, 03:33 AM
 
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I'm an RN and have just spent the last 15 months chelating and detoxing after getting all my amalgams out. I've had incredible healing in my body - may issues I thought were just normal for me until they resolved with chelation. I know that a good part of my mercury load is due to childhood vax in the 70s/80s plus all the vax in nursing school (early 90s). I also received vaxes at many of my jobs. I'm just began chelating my daughter who has medical issues and is mercury toxic. She is finally improving slowly as we pull the metals out. Babies absorb mercury from their mothers while in utero www.iaomt.com
I've always been amazed at how many health issues and high infertility rates the nurses I have worked with suffer from. I never realized what the big contributors were until I started researching vaccines when my daughter's health deteriorated. We're mostly dealing with mercury, but there are so many other issues with vaccines.
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#37 of 59 Old 06-24-2007, 10:07 AM
 
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physical therapist in an acute/snf setting, with a large component of IVDA clientele. i had the hep b vax series as a requirement for entry to PT school in the early 90's, and a later titer showed antibodies.

i agree with much of naturegirl's post, and i too leave shoes at work and bring a change of clothes to work to go home in (i change at work, because i don't want to wear the work clothes in the car), with my scrubs in a plastic bag for direct loading into the washer by themselves. but this is more for scabies, after 2 cases a few years back (we PT's literally crawl into bed and hug pt's). while at work if i need to scratch my nose, i grab the neckline of my shirt, and lift it up so i can rub my nose on the inside part of the fabric. i grab and fold toilet paper so as to never touch with my hands the part that will touch my mucous membranes.

but i wouldn't vax. i believe the vaxes are damaging to my immune system. i would rather rely on limiting my exposure by following universal precautions, than to assume a vax will protect me. especially in the cases of DPaT, hep A, flu, etc.. for hep b, if i knew what i knew now, i would look further to see exactly how "mandatory" it was.

and in reality, i know i am probably colonized with mrsa. i've watched rooms get "project"ed after isolation pts leave. the housekeepers clean like you or i would: they spray on cleaner, then wipe. well, read the instructions on the bottle, and it says that to kill the germs, the surface must be saturated AND KEPT WET FOR A FULL FIVE MINUTES. same as with newer "wipes" left out on every counter. the cleaner evaporates in a few seconds. to keep it wet for 5min requires draping a wipe onto the object, and then going back 5 min later. nobody's doing that. and meanwhile, visitors go in and out of isolation rooms and lean on the counter, touch the elevator... that's why some hospitals don't even isolate for mrsa anymore. it's everywhere! my hope is that it's helping me USE and strengthen my immune system, so as to better fight off the next exposure (when i grab the chart and then touch my nose without realizing it...).

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#38 of 59 Old 06-24-2007, 03:07 PM - Thread Starter
 
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Wow, you are all amazing wealths of personal information.
THANK YOU SO MUCH for contributing!

This is a tough one.

Im wondering how many cases of HepB are reported among HCP that *ARE* vaxinated?? Anyone know where I can find this information?


And Im still looking for info on weither I can be a 'carrier' of sorts for these things to my UNvaxed children.



One thing is for certain, I will need to step up my preventative measures. I think I should commit now to ALWAYS bring a change of clothes/shoes in a plastic bag to work ( or school for when Im at clinicals) as to not bring anything home to my family!
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#39 of 59 Old 06-24-2007, 03:28 PM - Thread Starter
 
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Also Im now wondering if there is any sense in getting vaxed for HepB only, concidering there are so many *OTHER* icky things out there! Like where would I draw the line kwim? It seems like a slippery slope concidering that I will be weakening my immune system as a whole, with each vax I accept, and there are alot of things there are no vax's for! Therefor how would I fight effectively when/if exposed to these OTHER things!?? UGH!!

Then there is the chance that after the HepB series, I wont have the immunity anyway (I seem to be hearing alot of people getting the titer & finding they are still not being immune after a full series or more! OR testing positive for Hep anyway, even after the series!)

OH I keep going back & forth!
I was sure last night that I WOULD get them....... now I am back to square one. :
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#40 of 59 Old 06-24-2007, 03:44 PM
 
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I think them advising you to get the HPV is insulting. WTF does that have to do with your work?!

As for Hep B, yeah I would do it. I worked as a travel nurse for a while in some of the worst hospitals in the country. Converstion rates were astrinomical and down right dangerous and yet the down played the numbers and blaming employee personal lives. (Um, when you have a 50% conversion rate of employees (in this case TB) within 6m of working at the facility, it is NOT personal lifestyle).

My point being, don't trust the hospitals that say, well its a low risk area, because its a lie. Dealing with patients is dangerous, period. Hep B can be prevented and I couldn't live with myself if I contracted it from work and passed it onto my kids or husband.

(BTW, I am NOT a crazy vaxer, we selectively vax our children)
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#41 of 59 Old 06-24-2007, 05:07 PM
 
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Originally Posted by zoesmummy View Post
For me, the differnce in vaccinating myself was that *I* was consenting to it, I did the research, and I decided what I could live with.
: If my field was healthcare I would get the hepb shot.

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#42 of 59 Old 06-24-2007, 05:34 PM
 
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Originally Posted by Artisan View Post
I believe one of the studies of the safety of HepB was done on nurses, because they were an available vaccinated adult population. They found that the nurses had much higher rates of autoimmune disease after getting the vax. I'll see if I can find the study.
It was MS.



http://scholar.google.com/scholar?q=...=1&oi=scholart


http://nvic.org/Diseases/hepbnlr.htm


.
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#43 of 59 Old 06-24-2007, 06:05 PM
 
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I think I should commit now to ALWAYS bring a change of clothes/shoes in a plastic bag to work ( or school for when Im at clinicals) as to not bring anything home to my family!
This is really, really important, and key to preventing transmission of really icky things home to the kiddoes. Especially if they throw themselves at you the way mine does.

We're allowed to wear our scrubs to the hospital, shoes in a separate bag, street clothes for home in a school bag. After some days I'd like to just light the bag on fire when I get home.

Thanks for the articles Gitti, off to read!

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#44 of 59 Old 06-24-2007, 07:01 PM
 
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I'd be more worried about HIV than HepB. But you can't vaccinate for that. So what does the industry have to say about that? Probably something like "follow universal precautions and hope for the best", eh? But they want you to take a different attitude regarding diseases that have vaccines available.
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#45 of 59 Old 06-24-2007, 07:07 PM
 
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I'd be more worried about HIV than HepB. But you can't vaccinate for that. So what does the industry have to say about that? Probably something like "follow universal precautions and hope for the best", eh? But they want you to take a different attitude regarding diseases that have vaccines available.
In this particular case, where exposure is more likely, getting a vax isn't so irrational. It would be nice if more accurate risk/benefit info were commonly available though. As it is, it is damned hard for someone to figure out:

how effective the vax actually is

how likely severe reactions might be

how likely chronic health problems might be

The current situation is a long ways from informed consent.:
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#46 of 59 Old 06-24-2007, 07:49 PM - Thread Starter
 
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Amen Deborah! That the problem here! :
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#47 of 59 Old 06-24-2007, 08:10 PM
 
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I did work in healthcare...
I would get titers first (luckily one of my jobs offered it when I couldn't find my records), and get the Hep B if you are going to be in DIRECT contact with blood. Nowadays, I would be super careful with it. I know a lot of employers will NOT hire you if you do not have proof of hep B immunity and a TB test for liabilty reasons.

However, I believe I was vax-damaged by my multiple hep B vaxes, and wish I could go back and take them back sometimes. And I think all of us healthcare workers are most definitely MRSA positive for just about everything. It is spreading everywhere, so the scary thing is that it's really becoming the norm.

Protect your immune system the very best you can, and I wish you the best!

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#48 of 59 Old 06-24-2007, 08:14 PM
 
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Ya know, the other thing I'm getting out of this thread is that going to a hospital is really dangerous--for the patients. Here you are, with a serious health problem, and you will be going into an environment where various diseases are running around the place unchecked. Yikes. Hopefully not all hospitals are that challenging.

I haven't personally needed to go to a hospital in a few years. Last time was an ER visit for a horrendous bout of stomach flu (what is the proper name for that illness, since it ain't flu?) and luckily I survived both the stomach pain and the hospital visit. Only real problem was sorting out my Canadian Health Insurance stuff, cause I was living in Canada going to graduate school and spending the summer in the U.S. to do internships. Sorry, way OT
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#49 of 59 Old 06-24-2007, 08:35 PM
 
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Here you are, with a serious health problem, and you will be going into an environment where various diseases are running around the place unchecked. Yikes. Hopefully not all hospitals are that challenging.
Not to be O/T (again!) but it's less that the viruses/diseases are running around the place unchecked (at least where I'm working); it's just that the vast majority of patients/visitors aren't aware of the precautions staff take (understandably) and are sometimes (not always) the key to bringing infection into the hospital, or passing it between patients.

When I was on L&D during winter semester, we had families coming in to visit recent postpartum mums and babes - while they were sick with the flu, or some other godforsaken respiratory disease... despite *very* obviously posted signage clearly stating (at the entrances to the hospital and on every floor) to please, please stay out of the hospital (to visit!) if you were ill.

It goes on and on from there...

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#50 of 59 Old 06-24-2007, 10:02 PM
 
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Originally Posted by paquerette View Post
I'd be more worried about HIV than HepB. But you can't vaccinate for that. So what does the industry have to say about that? Probably something like "follow universal precautions and hope for the best", eh? But they want you to take a different attitude regarding diseases that have vaccines available.
HIV isn't as communicable as HepB, nor does it live as long on contaminated surfaces as HepB. You're more likely to be infected by HepB then HIV if you're exposed.
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#51 of 59 Old 06-24-2007, 10:14 PM
 
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Originally Posted by zoesmummy View Post
Not to be O/T (again!) but it's less that the viruses/diseases are running around the place unchecked (at least where I'm working); it's just that the vast majority of patients/visitors aren't aware of the precautions staff take (understandably) and are sometimes (not always) the key to bringing infection into the hospital, or passing it between patients.

When I was on L&D during winter semester, we had families coming in to visit recent postpartum mums and babes - while they were sick with the flu, or some other godforsaken respiratory disease... despite *very* obviously posted signage clearly stating (at the entrances to the hospital and on every floor) to please, please stay out of the hospital (to visit!) if you were ill.

It goes on and on from there...
I agree. It was an everyday occurence on my med/surg floor to have Isolation patients with MRSA or worse and have visitors refuse to wear masks or other protective wear and then walk the halls passing out goodness knows what to everyone. Especially when you are down the hall with someone with leukemia or post-surg, it always made me FUME. We would lecture, beg, try to get admin. involved to no avail.

Workers were *always* careful about germs, handwashing, isolation, etc. on my floor. We were probably too paranoid, actually. It's people who don't care/don't know better that are the ones spreading the MRSA or meningitis down the hall.

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#52 of 59 Old 06-25-2007, 02:05 AM
 
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I work in mental health (FWIW the highest of the high risk catagories) I have not nor will ever get a vax for hep b or anything else for that matter.
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#53 of 59 Old 06-25-2007, 04:01 AM - Thread Starter
 
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What does MRSA stand for?
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#54 of 59 Old 06-25-2007, 11:36 AM
 
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What does MRSA stand for?
Methicillin Resistant Staphylococcus aureus

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#55 of 59 Old 06-25-2007, 07:50 PM
 
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Methicillin Resistant Staphylococcus aureus
Just seeing it written out gives me the willies... : :

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#56 of 59 Old 06-26-2007, 05:19 AM
 
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mrsa is a problem in terms of getting RID of it when someone has it, because it is resistant to the antibiotic methicillan. but it is not a "superbug," ie it has no more virulance than the usual staph aureus that the lysol ads were forever warning us about.

now, c-dif (clostridum difficile for you students...) is a different ball game. like some of the e-coli that have been killing meat and spinach eaters over the past few years, it IS evolving into more virulent forms, and can live through "cleaning" procedures, even supposedly isn't killed by the alcohol hand cleaners (foams, gels) that many hospitals keep available. THAT'S the one i hope not to bring home to the family. (and, as i said before, scabies, ick, itch, ick).

OTOH, the more we are exposed to pathogens, the more prepared we are to fight the next one. personally i'd be interested to see if anyone has researched health care workers' immune systems. in general the "dirtier" one's environment is, the stronger that person's immune system (and less likely to go haywire and turn on itself with autoimmune disorders), because the FULL immune system is being used: including the complement system, leukocyes, etc. i personally jump at the chance to work with shingles patients, since i know this will give me chance to "boost" my immunity, and lessen my own risk of shingles.

btw, have you seen this tribe: Nurses, Student Nurses, Pre-req takers? for your further questions in your journey...

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#57 of 59 Old 06-26-2007, 09:13 AM
 
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I work in Healthcare and I have been vaccinated for Hep B. Since I was a traveller, I had to go through health screenings and TB tests every couple of months. I finally had titers drawn and had all of my records together. I was unaware that you had the right to refuse such vaccines. If you refuse, can't they refuse employment?
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#58 of 59 Old 07-13-2007, 02:54 PM
 
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HPV? For nursing school?

I have to get Hep B for med school, and I am going to opt to get it. I am a little worried about exposing my non vaccinated kids to my reaction to the vaxs. Anyone heard anything about this?
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#59 of 59 Old 07-13-2007, 05:23 PM
 
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Oh yes, the yucky c-diff. We have 4 patients with it on our floor right now. Sometimes patients do not comply with treatment and hand washing. We have one man right now who leaves his room (which is allowed) but then uses the toilet in the activities room. Then of course, touches the door, sink, etc. He was told multiple times to only use the toilet in his room, but he doesn't listen. Last week he was found wandering around in the hospital kitchen. Who knows what he was touching and if he washed his hands well. (its spread fecal-oral route) So yes, there probably is c-diff floating around where it doesn't belong right now in the hospital where I work. The main thing is to always wash your hands well after touching ANYTHING (even the buttons in the elevator!) in a hospital. Sorry, off topic!
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