Risk assessment for pregnant nurse

RE: Risk assessment for pregnant nurse

Bob Russell — Mon, 18 Dec 2017 17:38:08 GMT

[quote user="Lucy Fleming"]

It does depend on where you are lifting from/to and how strong you are as well - I can shift about 25kg anaesthetised dog from table to table fairly easily, but would be unlikely to try to same with an awake patient or if lifting from the floor!

[/quote]

My experience has been that veterinary practices are full of bad backs! We had a receptionist that, to our bad luck, slipped a disc bending down to pick up a small bag of cat food. Why on earth it could not have happened in Tesco's or anywhere else I really don't know! Caused us no end of trouble before the problem disappeared.

RE: Risk assessment for pregnant nurse

Lucy Fleming — Mon, 18 Dec 2017 11:28:11 GMT

RE: Risk assessment for pregnant nurse

Sammy82 — Fri, 15 Dec 2017 17:44:06 GMT

[quote user="Bob Russell"]

Not sure where the heavy lifting has come from either!

[/quote]

It used to be assumed that heavy lifting can cause miscarriage. My midwife told me last year that this is not the case but that heavy lifting should be avoided/good technique used as women are much more prone to strains etc. due to lax ligaments. This goes for lifting just as much as for wrestling uncooperative KC vax patients. Your general weight limits sound fine Bob, but in most practices I know a 40+kg lab would usually be lugged around by 2 people due to lack of staff.

RE: Risk assessment for pregnant nurse

Nicola Cole — Fri, 15 Dec 2017 17:16:51 GMT

[quote user="Anthony Todd"]

[quote user="Martin Atkinson"]You should always assume everyone is at risk.[/quote]

Very, very good advice in this age of "where there's blame there's a claim" and "we'll fight it for you for 20%.....

When "fault" is advertised like Coke on TV you realise there's a lot of it about.

[/quote]

Slightly cynical reply!

It‘s very good advice because there’s always potential for pregnant staff, even if they don’t know it yet, and a chunk of the risk is during the period before most people would know they were pregnant.

RE: Risk assessment for pregnant nurse

Anthony Todd — Fri, 15 Dec 2017 16:44:05 GMT

[quote user="Martin Atkinson"]You should always assume everyone is at risk.[/quote]

Very, very good advice in this age of "where there's blame there's a claim" and "we'll fight it for you for 20%.....

When "fault" is advertised like Coke on TV you realise there's a lot of it about.

RE: Risk assessment for pregnant nurse

Martin Atkinson — Fri, 15 Dec 2017 13:04:26 GMT

No pregnant nurses at present (at least not knowingly) but as most nasty things happen in the first trimester, maybe before someone knows they're pregnant, as has already be said, we should assume sexually active women of child bearing age are at risk so normal protocols should take this into account. Also AFAIA anaesthetic gases are implicated in infertility not foetal abnormality so the bottom line is if your anaesthetic gas monitoring, X-ray machine servicing/RPA advisory protocol and handling protocols are current nothing really changes. You should always assume everyone is at risk.

RE: Risk assessment for pregnant nurse

Anthony Todd — Fri, 15 Dec 2017 09:20:40 GMT

[quote user="Bob Russell"]Pregnancy is not an illness therefore if someone feels they can do something then generally they probably can![/quote]

For sure, but if anything remotely linked to anything potentially causative has occurred an indignant friend or "interested" authority may start linking events.....

Better to give nobody any chance!

RE: Risk assessment for pregnant nurse

Bob Russell — Fri, 15 Dec 2017 09:15:35 GMT

Not sure where the heavy lifting has come from either!

You should have sensible rules in place to limit the risks associated with lifting. Technique plays a big part of course.

We have a golden "no more than 15Kg ever" rule and prefer no more than 12Kg. 30Kg dog is carried by two, 40Kg by three etc.

Obviously when a bump gets in the way the practicality alters!

My delightful ex-wife was chucking bales of hay at the horses until the week the boys were born. She would never listen to advice anyway!

Pregnancy is not an illness therefore if someone feels they can do something then generally they probably can!

RE: Risk assessment for pregnant nurse

Julie Innes — Fri, 15 Dec 2017 08:46:49 GMT

Our pregnant vets and nurses stay out of Xray, and we don't allow them to be involved in small furry ops which are masked down, or refill iso flo. We also keep them out of the recovery area, as there is apparently more iso being breathed out of recovering animals. Avoiding heavy lifting is also a no brainer. ( remembers rolling around on the floor trying to give a kennel cough vaccine to a crazy lab at 8 months pregnant....!)

RE: Risk assessment for pregnant nurse

Anthony Todd — Fri, 15 Dec 2017 05:38:24 GMT

I would be ultra-cautious and minimise, or eliminate, every possible risk including lifting heavy objects.

I had some, not many, incidents when doctors linked any medical condition to either Xrays or anaesthetic agents very casually, but with potential serious legal repercussions, in pregnant women.

Make sure all staff are mindful of her pregnancy and advise them to warn the pregnant one if they see her doing anything remotely "dangerous" or conceivably harmful.

Legal repercussions, I suggest, are becoming much more common these days and, even if unjustified, cause all sorts of serious upsets.

There will always be some "authority" who will casually link a "cause" to an effect and the aroma around "drugs", X-rays and manual exertion in pregnancy is not sweet.

RE: Risk assessment for pregnant nurse

Gillian Mostyn — Thu, 14 Dec 2017 23:16:08 GMT

Considering the demographic of veterinary staff, safety procedures should already be in place to protect everyone against risks such as waste anaesthetic drugs, animal handling, drugs, radiography etc. Afterall, all women of childbearing age have to be assumed to be pregnant!

As far as specifics, every woman and every workplace is different. The nurse needs to sit down with the head nurse/line manager and mutually decide on a plan that safeguards mum. This needs to reassessed regularly during the pregnancy. It should not be onerous, but rather be reassuring to both parties.

As far as anaesthesia, the feasibility of doing none and remain in their current position depends on the practice. Personally, I don't believe there is a risk from well scavenged anaesthesia but I certainly wouldn't force my nurses to do anaesthetics against their will. The repercussions if, God forbid, anything goes wrong, doesn't bear thinking about. I would have an evidence based discussion with the nurse but, ultimately, it would be her decision. I have employed a few pregnant nurses and vets, none of whom have refused to help with anaesthetics, but we do make some modifications. (No masking, no monitoring of recovery in the kennel room, ensure cuffs are checked etc.)

Bear in mind, however, that, the employer is in their rights to give an alternative role within the practice (such as paperwork, reception etc). In later pregnancy, if they are unable/unwilling to fulfil a job role (with or without medical justification), the employer can make them start maternity leave earlier than they had perhaps planned.

Pregnancy lasts a relatively short time and it should be possible for the nurse and employer to work together amicably to look after mum!

RE: Risk assessment for pregnant nurse

Iain Richards — Thu, 14 Dec 2017 22:21:47 GMT

No greater risks other than radiography. Anaesthetic risks are over exaggerated except for nitrous. However, there are instance of higher complications in human theatre nurses, where the anaesthetic gases had higher odds ratios. With proper scavenging, the levels should be way below any risks.

A good friend was human anaesthetist, worked to 38 weeks

RE: Risk assessment for pregnant nurse

Nicola Cole — Thu, 14 Dec 2017 22:05:03 GMT

Curious as to why methadone specifically?

RE: Risk assessment for pregnant nurse

cathvet — Thu, 14 Dec 2017 21:57:18 GMT

For out pregnant nurses we don't let them refill isoflurane or use a mask or chamber to anaesthatise small furries. Provided the patient is intubated then it is usually fine. They are also not allowed to administer methadone.