Jump to content

Recommended Posts

This isn't particularly PA related beyond the fact we all probably have more information about COVID than the general public. Something happened and I am on a remote site for 5 weeks and it is stuck in my craw.

My wife is a nurse. She works for a large state medical teaching institution/hospital system on a physical rehab floor. Her patients are post-op, post-cardiac care, generally frail and often elderly.

Last Saturday she spent the day with our daughter-in-law. They did some shopping. They went to eat where they shared a basket of chips among other things during their meal, they each took a sip of a new coffee flavor from the same cup. Let's skip how foolish this was for now. They have heard it from me loud and clear and a lot since Saturday. Monday DIL is feeling a bit peckish and, ta-da!, COVID positive. I, by remote control, put everyone into quarantine mode and tell my wife to advise her employer. Occ med nurse calls yesterday and tells my wife since she and DIL don't live in the same household she is cleared to return to work. My wife is asymptomatic BTW not that it is particularly important to this story. Occ med nurse also tells her when she gets to work and answers the COVID screening questions she should say "no" to the exposure question because "you have already been cleared". My wife, fearful for her job, is afraid to push back and went to work today.

I am angry beyond description. These asshats are putting a high risk patient population at risk by ignoring guidelines because they are shot staffed. I want to shout it to the mountain tops but my wife is worried (probably correctly) that she will get fired. )At will state....gotta love it).

So I'm considering everything from calling occ med myself to calling the chief of staff to calling the newspaper and TV station. I'm having a hard time letting this happen despite the high chance of blowback. I kinda feel like these are the kinds of situations where one discovers if they are really honest and moral or are those just hollow words.

What say you mob of peers?

Link to post
Share on other sites

It seems to me that perhaps its not so much the lack of mask wearing, but the lack of honesty with screening, and the fact people could be asymptomatic but still be contagious.  I had a guy who was obviously sick get through screening, because the temperature sensor didn't show a "fever" of 100.4, and he basically lied on the rest. 

This kind of connects to another point I was thinking about.  Maybe its not so much the fault of any one person, but our medical system as a whole- you know, the system that prioritizes profits over common damn sense.  PPE cost money.   That's bonus money.

So, I say, call.  What have you got to lose? 

Link to post
Share on other sites
  • Moderator

last time I checked the hospital is following CDC guidelines,

post exposure - okay to work as long as no s/s

scary but true

 

 

I have not looked at the guidelines in a few weeks

 

But I would answer YES on the screen at least once to create a paper trail

Link to post
Share on other sites

People who have been in close contact with someone who has COVID-19—excluding people who have had COVID-19 within the past 3 months.

People who have tested positive for COVID-19 within the past 3 months and recovered do not have to quarantine or get tested again as long as they do not develop new symptoms. People who develop symptoms again within 3 months of their first bout of COVID-19 may need to be tested again if there is no other cause identified for their symptoms.

What counts as close contact?

  • You were within 6 feet of someone who has COVID-19 for a total of 15 minutes or more
  • You provided care at home to someone who is sick with COVID-19
  • You had direct physical contact with the person (hugged or kissed them)
  • You shared eating or drinking utensils
  • They sneezed, coughed, or somehow got respiratory droplets on you

Steps to take

Stay home and monitor your health

  • Stay home for 14 days after your last contact with a person who has COVID-19.
  • Watch for fever (100.4◦F), cough, shortness of breath, or other symptoms of COVID-19
  • If possible, stay away from others, especially people who are at higher risk for getting very sick from COVID-19
  • Like 1
  • Upvote 1
Link to post
Share on other sites

I am not up to date on all of the latest guidelines...but was all(told)owed to continue working after being diagnosed with asymptomatic covid.  Admin contacted me to get tested...at the end of a LONG day of surgery. About an hour later I received the positive result.  Within minutes I was called by our occ health nurse and told that since I didn't have symptoms I could continue working and if I didn't I was making a "choice" and therefore wouldn't qualify for workman's comp (our governor executive ordered COVID into workman's comp many months ago).  So I either use 10+ days of PTO or work...thankfully my manager has a soul and 100% of my appointments were changed to video and an "exception" was made to allow me to work from home.  I think the most patients I had were 2 in one day...

But, sas5814...I don't think this is following guidelines at ALL.

Link to post
Share on other sites
4 hours ago, mgriffiths said:

I am not up to date on all of the latest guidelines...but was all(told)owed to continue working after being diagnosed with asymptomatic covid.  Admin contacted me to get tested...at the end of a LONG day of surgery. About an hour later I received the positive result.  Within minutes I was called by our occ health nurse and told that since I didn't have symptoms I could continue working and if I didn't I was making a "choice" and therefore wouldn't qualify for workman's comp

What scummy people we all work for. 🤦‍♂️

Link to post
Share on other sites

Co worker tested positive 2 weeks ago.  We work in a very small lab close contact for 8 hours.  We wear masks except when eating.  He is coming back to work tomorrow although he is still positive (and still not feeling well).  HR cleared him to work.  Its all so frustrating and confusing.  To the OP call the occ health nurse and ask questions.  No harm in that.

 

 

Link to post
Share on other sites

This is disgusting, he is still contagious as long as he is Positive, maybe less than if he had severe s/sx but still contagious, I totally disagree w companies that don't request at least a negative test to come back, that is one of the reasons why this virus is exploding  and mutating fast.... It is sad the guy should stay at home until his test in negative

 

Link to post
Share on other sites

sas5814 please report the case to the health depart. they are attempting with weak elderly patient who could easily be our parents dont let them kill innocent people....Stop killing human beings!!! I really hope they get their own Karma and get bad covid themselves.

Link to post
Share on other sites

Very interesting reading this thread/forum:

Our hospital's Occupational Medicine department has a "Very High Risk Exposure" list.

If you meet the criteria "a high risk exposure" and are asymptomatic, they expect you to continue to work under the condition you are tested for COVID at day 2, 6, 10, and wear an N95 mask during your entire shift.

After reviewing the latest CDC guidance, this is against the guidance... Very interesting...

Link to post
Share on other sites

Huh. I'm too lazy to figure out what a "high risk exposure" is but find it funny that HCW are the ones being told that it's ok to not quarantine. I get it, already overwhelmed systems can't manage without people but ugh.

Although I've got to say I don't think the CDC is answering to our employers... probably.

Link to post
Share on other sites
  • Moderator
10 hours ago, Mayamom said:

Co worker tested positive 2 weeks ago.  We work in a very small lab close contact for 8 hours.  We wear masks except when eating.  He is coming back to work tomorrow although he is still positive (and still not feeling well).  HR cleared him to work.  Its all so frustrating and confusing.  To the OP call the occ health nurse and ask questions.  No harm in that.

 

 

Tested positive or tested positive and symptomatic?  

We have no test to see if someone is still contagious - last I read it was 14 days after Dx AND no symptoms you were considered not contagious

 

 

9 hours ago, Rose66 said:

This is disgusting, he is still contagious as long as he is Positive, maybe less than if he had severe s/sx but still contagious, I totally disagree w companies that don't request at least a negative test to come back, that is one of the reasons why this virus is exploding  and mutating fast.... It is sad the guy should stay at home until his test in negative

 

Ah NO!  Totally inaccurate - PCR will continue to be positive long after contagious - they think it is from virus particles, no viable virus - I have no idea, but I know that people still test positive long after getting the virus.  

 

18 minutes ago, MediMike said:

Huh. I'm too lazy to figure out what a "high risk exposure" is but find it funny that HCW are the ones being told that it's ok to not quarantine. I get it, already overwhelmed systems can't manage without people but ugh.

Although I've got to say I don't think the CDC is answering to our employers... probably.

This stems from the fact is we applied the general population rules to the health care setting there would be no workers left.  It is a hard pill to swallow but the right one for public health. Having served in the Air Force I had "mission first" drilled into me.  This is the first time the civilian sector has recently been told the same.  

 

 

14 minutes ago, Mayamom said:

My understanding is he is two weeks out and although still positive he is not shedding virus that can infect other people.  

correct

 

 

 

 

What I was afraid would happen has.   Remember these are the same tests that were allowed to be used under emergency authorization with out review.  They are riddled with problems (the one's congress just got a FDA notice for false positives).

We simply do not have a good test (PCR is 1-4% wrong) and the AB testing is ? how to interpret and apply. The rapid tests are even worse.   We should not make the error of assuming these tests are proven or reliable and we need to 1) continue to protect society 2) 100% ppe whenever possible 3) realize there is risk to our jobs and if you are unwilling to accept this risk complain loudly up the chain with as much scientific evidence as possible.    I brought up three confirmed false positive PCR tests to the chief of staff, with evidence to prove and he blew me off with a dodge of talking about false negatives. Clearly he did not want to talk about false positives.  This is due to pressures on him from higher up, combined with the fact we need to have a unified front to the non-health public that says wear PPE, remain vigilant, fight on till everyone gets vaccine, get the vaccine.  All this advice is the best we have at this time.

Be prepared to be stonewalled though.  There are forces much bigger than an individual provider at play (public health and finances) that will override an individual's concerns.  "Mission comes first" is unfortunately the rule at this time.  

Link to post
Share on other sites

Quick follow up.... Occ Med wouldn't budge and were quite annoyed I called and challenged their authority but did send my wife an email confirming she was clear to return to work and was to mark "no" on the exposure question at work. Short of quitting it was the best we could do.

My wife is wearing N-95 masks she bought rather than the regular paper masks the hospital issues and is taking all the precautions she can. The floor supervisor is also assigning her the lowest acuity patients for the next 10 days. This was a decision she made after hearing the entire story.

We are living in a different world these days.

  • Like 1
Link to post
Share on other sites

Just to potentially add to the confusion, I thought that the time interval had been decreased from 14 to 10 days post infection if now asx.  Daughter and fiancé were here this past weekend having become symptomatic 10 days prior with a positive swab test on that date (daughter had to bribe clinic with Starbuck's to allow her to be tested).  No facemasks and he talks loud enough to be a politician at a rally without a microphone.  So far, so good, aside from some post-nasal drip due to Mountain Cedar.  He still has altered taste.  She didn't lose taste or smell, only myalgias and elevated temp w/o frank fever.

Let's see Scott.  East Texas, state hospital system, hmm...University of Bevo strikes again it would seem.  Gov't agencies not exactly batting 1.000 the last couple of days/weeks.

With regard to positive tests and resolved sx., I called a well known lab test manufacturer a couple years back to ask how long their rapid streps stayed positive post treatment/sx. resolution?  You would've thought I was asking for access to Fort Knox.  Answer was finally provided by one of their medical staff to be two weeks.

Edited by GetMeOuttaThisMess
Link to post
Share on other sites

This is from NY State Dept of Health return to work for HCPs:
o HCPs must be asymptomatic. o HCPs must have a negative test (PCR or antigen) to return to work after an exposure and subsequently be tested every 2-3 days after the first test until Day 10 after exposure. o HCPs must self-monitor for symptoms and conduct daily temperature checks through Day 14. o HCPs must quarantine when not at work consistent with the Department’s guidance on quarantine. o At any time, if the HCPs working under these conditions develop symptoms consistent with COVID-19, they should immediately stop work and isolate at home. All staff with symptoms consistent with COVID-19 should be immediately referred for diagnostic testing for SARS-CoV-2.

 

https://apps.health.ny.gov/pub/ctrldocs/alrtview/postings/HCP_Return_to_Work_Exposed_Update_1_7_2021_1610041940729_0.pdf

Link to post
Share on other sites
13 hours ago, sas5814 said:

Quick follow up.... Occ Med wouldn't budge and were quite annoyed I called and challenged their authority but did send my wife an email confirming she was clear to return to work and was to mark "no" on the exposure question at work. Short of quitting it was the best we could do.

My wife is wearing N-95 masks she bought rather than the regular paper masks the hospital issues and is taking all the precautions she can. The floor supervisor is also assigning her the lowest acuity patients for the next 10 days. This was a decision she made after hearing the entire story.

We are living in a different world these days.

They put it in writing? 
 

Impressive... most impressive. 

Link to post
Share on other sites
1 hour ago, MedicinePower said:

One has to wonder why a nurse who is caring for such vulnerable patients is willing to ignore the CDC instructions of social distancing, etc. The loss of life from these sort of events are real and sad.

I think the OP acknowledged that it was a poor decision, let's not go after the guy's wife.

Link to post
Share on other sites
  • Moderator
On 1/7/2021 at 11:27 AM, GetMeOuttaThisMess said:

With regard to positive tests and resolved sx., I called a well known lab test manufacturer a couple years back to ask how long their rapid streps stayed positive post treatment/sx. resolution?  You would've thought I was asking for access to Fort Knox.  Answer was finally provided by one of their medical staff to be two weeks.

Sorry but I do not beleive anyone but the package insert and the web sites detailing the approval of the test

Just had the chief of staff (who I have a great amount of respect for) state that their really is not false positives to the PCR

Anyone and every single clinician should know that there is not a test out there that os 100% sensitive and specific, he dodge the question when pushed further and was obviously towing a pre canned statement stating the a positive is a positive. I get the public health side, and the need to instill confidence back in science but to simple be telling another provider they are 100% correct tests is simply a lie - PCR seems to have a 1-4% false positive, I know less on the false negative but I suspect it is a very real issue.  The whole pre-test probability issues is very very real.

 

On 1/7/2021 at 8:17 PM, CornellSPA said:

This is from NY State Dept of Health return to work for HCPs:
o HCPs must be asymptomatic. o HCPs must have a negative test (PCR or antigen) to return to work after an exposure and subsequently be tested every 2-3 days after the first test until Day 10 after exposure. o HCPs must self-monitor for symptoms and conduct daily temperature checks through Day 14. o HCPs must quarantine when not at work consistent with the Department’s guidance on quarantine. o At any time, if the HCPs working under these conditions develop symptoms consistent with COVID-19, they should immediately stop work and isolate at home. All staff with symptoms consistent with COVID-19 should be immediately referred for diagnostic testing for SARS-CoV-2.

 

https://apps.health.ny.gov/pub/ctrldocs/alrtview/postings/HCP_Return_to_Work_Exposed_Update_1_7_2021_1610041940729_0.pdf

 

https://apps.health.ny.gov/pub/ctrldocs/alrtview/postings/HCP_Return_to_Work_Exposed_Update_1_7_2021_1610041940729_0.pdf

This is the most accurate summary I have read to date - it explains it well

 

 

To the OP

Sorry it happened, but the fact of the matter is that the critical staffing fields have different rules then the rest of society.  Yup it sucks, but if everyone went out with a simple exposure there would literally be no people left to work.

 

Getting it in writing is great - that helps.

 

a few points

1-PPE works - by wearing a mask you really do stop transmission and they are highly effective.  WEAR MASKES and EYE PROTECTION and don't touch your face

2-there is risk in our field - accept it - it brings me back to the Air Force day of "mission first" and this has clearly but people in the medical fields at higher risk

3-we can not all simply take 2 weeks of due to an exposure - I have not missed even a single days work since this started, have continued to see out patients (PCP, occ health, UC clinic, and LTC.NH rounds) - it has been a nervous 10 months but surviving

4- and this is to EVERYONE - DO NOT LET YOUR GUARD DOWN NOW!  Remain strict in isolation and protection - even after vaccination!!!  Wait till the public health professionals state we can stop wearing masks before you even consider not wearing one.  I will likely where one for years to come is high risk settings i.e. shopping, and going inside to a restaurant is likely not gonna happen for years for me.  A meal is just not worth getting sick.  Outdoor dinning is the answer.

 

 

Link to post
Share on other sites
On 1/8/2021 at 1:08 AM, MedicinePower said:

One has to wonder why a nurse who is caring for such vulnerable patients is willing to ignore the CDC instructions of social distancing, etc. The loss of life from these sort of events are real and sad.

People have lives to live.  I don't think it was a poor decision at all.  If her daughter-in-law is in their "inner circle" I have no issues when them spending time together.  Because someone works with vulnerable patients, they are unable to see immediate family?  How long do you expect them to isolate and seclude themselves for?  3 months?  6 months?  1 year?  2 years?

 

Are medical clinicians and staff not allowed to go to grocery store?  Not everyone there wears full PPE.  Not everyone maintains 6 feet of distance in the aisles...

Plenty of people who are completely anal about social distancing, who have had COVID.

 

Pathetic post.

 

  • Upvote 2
  • Downvote 1
Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More