Should People With Infectious Diseases Be Allowed in EMS?

[tniuqs]

I am a bit tnuiqs(sic)

OUCH, you know I am sensitive about my spelling .... ! I am a bit cixelsyd, argh again.

Just what are the healthcare workers rights when it comes to having an infectious disease.

They have the same rights as everyone else does, they are allowed to be sick like everyone else.

Besides health care workers have a right to earn a paycheck, if it is deemed they are not a signifigant risk to patients then the ID experts have spoken, not my call. ps have worked with a few RNs that had been treated for Hep B and eyedawn posted something about Hep C it is being cured these days with Interferon and AZT ..... whoo hoo, a couple of health care workers were the first to be the guinea pigs.

Does the patient have a right to know?

No this is Private Confidencial Information, hell, I don't even tell the patients my last name ...

Does the employer have a right to know?

No, (again a risk assesment) does the employer test you for any diseases? If they do a screening process and find misinformation well then thats one thing, but if one discloses prior, the employer may be looking at a discrimination investigation and human rights issue, no different than not hiring a visible minority, really, I can't see any difference here at all.

Ok one exception, blind people should not drive ambulances, dispatching is cool.

The question does need to be asked.

Agreed but the experts in ID, Ethics, and Labour Law should be the ones that are consulted, I personally have no issues with working with ANYONE as long as they know their job and do it well ..... ok they have to buy me coffee too, I am cranky in the mornings, best they suck up a bit.

cheers

[ccmedoc]

Good lord, I've explained myself already. I'm not gonna do it again. It's my opinion and belief and that's all it is.

This is all that needs to be said at this point..

This is a highly emotionally and politically (are they different?) charged argument. As it should be. This is serious, not some 'do you use paddles or pads' argument..This has real repercussions, and goes further than someones pocketbook. An individual with a position on either side will most likely not, nor should not, be easily swayed away from their beliefs. Do not chastise Ruff for this.

We disagree on this topic fundamentally, among other things I'm sure, but I have a HUGE amount of respect for him and the way he handled his argument for his beliefs. Some good questions have been asked, and many excellent answers have been given. This will most likely be a black and white issue, so leave the small fry attacks home.

It has to be understood that, not believing individuals with these diseases should work in EMS or other health fields, this does not put individuals with these beliefs in the dark ages, this is real world thinking, and they have a good reason most likely.

Just because there's only 9 posts behind the name doesn't make the poster worthless.

It's not the 9 post that make this comment worthless or lack credibility, it is the tone, and lack of substantial argument to back it up. Although it conveys a similar message, I don't consider this comment to bolster my position in the least.

Like I said, its a heated argument, and is probably going to stay black and white...Just a good topic for good discussion, and maybe a huge learning experience, both philosophically and scientifically if you let it be..

I have not changed my stance on the subject, Only tired of the same old attacks on one person from the smallfrys of the world.....

By the way..good topic, but the OP has 2 posts in this fray..How distressed about the subject was he really??

edited for a "d" and format

[Just Plain Ruff]

smallfry I apologize for the 9 post comment, it was a kneejerk reaction but did you really read what I have posted over and over. I have given my views on the subject.

You come in here after nearly a year or so between postings and proceed to insult and call me prejudiced and living in the dark ages. I took offense to that.

I for one do not believe you've read anything I said. All you did was come in here and call those of us who don't agree with your views (I assume those views are that those with infectious diseases should be allowed to work) and call us prejudiced and in the dark ages.

You did not give any rebuttal to anything that those you hold in such disdain said but you started the insults.

You know what, my views are what they are, I have posted my reasons. If you cannot respect my right to have them then are you sure that we're the only narrow minded people on this board? I would look to yourself my friend.

Ruff out

[mrmeaner]

Someone who chooses to put their opinion forth and defend it has credibility. This poster said he/she perceives prejudices, and thinks some people need a pathology refresher. They were just a smidge blunt about it- bluntness that we tolerate and make excuses for in other posters with "more credibility".

Just because there's only 9 posts behind the name doesn't make the poster worthless. Low shot, Ruff.

I'd have to disagree. Considering that credibility is a placed value of a person's believablility, I'd have to say that's tough to attain in 9 posts in almost 2 years. He is certainly entitled to his opinion and has the freedom to express it in most cases. However, if you "lurk" for a year or so without contributing to conversations, don't be surprised when your word isn't taken as gospel.

As far as becoming versed in the common opinions of certain users, if that were true, he would have known that who was and was not narrow minded. I'm actually surprised that you're defending that sort of statement.

To the original post, it has been stated that their rights are being defended by the Americans with Disabilities Act, so no one is at danger of losing their jobs at this point. It is ironic, however, that the defense that they should be able to do the job as a healthy person would be able to is because they can't do the job as a healthy person would be able.

As long as were talking about rights, shouldn't the pt. have some say in this? When a person calls 911, I believe there is an expectation by the patient that they will be cared for by competent professionals and their acute and long term health are as important to the healthcare provider as it is to the patient. I know it's rarely true, but that's the expectation. At the very least, the expectation is to come out of the journey in better shape than when you went in.

Whether or not the law agrees, I also belive it's the right of the patient to know that their care giver has an infectious and possibly lethal disease. The odds of transmission may be 1.8% or 0.3%. You know what number I like? 0%. Especially if it's my family member on the cot. When you come to work with any disease you put your patients at risk. You are making the decision weather or not the risk is significant for the patient. The patient doesn't get to be involved in making this decision. That is wrong. Whether it's HIV, Hep C, or explosive diarrhea; it's wrong.

I can't imagine the personal hell someone with HIV or AIDS goes through. It must be one of the most painful realizations to wake up to everyday. There are very few, if any, people who deserve to wonder whether or not they'll be around to renew a one-year lease or even if it's worth it to buy green bananas. I feel sorry for anyone who lives this life.

I also can't imagine the amount of hate I would have for someone who inflicted one of my family members with the disease and put them in that same position because they didn't want to change jobs.

[Just Plain Ruff]

I have no issues with the person with the disease. The issue I have is the disease.

If you come to work with an infectious disease then you put the patients safety at risk.

You can cut it so many ways and say there is only a .3% chance or a 1.8% chance but the chance is still there.

I know many people with HIV, several with Hepatitis and two with TB. I am great friends with some of them. I do not have an issue nor do I have any problem eating with them drinking with them or going out and doing things with them but that's the end of it.

I do have the problem with them working and being infected.

Oh well, this issue is soooooooooooo charged that I think any more discussion on this will only lead to more hurt feelings and the like.

Has anyone figured out what the employer's liability is in letting someong infected work?

[Eydawn]

Look. I won't name names here, but how many other users do we have that are as blunt as this guy was, that we make excuses for or even encourage? Sorry... I smell hypocrisy!

Don't get me wrong. I luvs Ruff! Ruff is incredibly intelligent and very articulate. I don't think anyone should jump all over him for not wanting to further discuss the issue, since he's given his reasons for his standpoint and now chooses to back off some.

I didn't see anything particularly derogative or inflammatory in smallfry's post. Didn't see him label ANYONE in particular as being small minded or living in the dark ages. Was it a polite post? Certainly not. Was it an invalid post, lacking complete credibility? Not as it stands. Should he choose not to come back and further discuss the topic, then yes, it seems pretty minimal.

How many folks have we had with small post numbers and a lack of experience/contribution on this forum turn into articulate, valuable contributors? How many had the potential, but chose not to remain?

Back to your regularly scheduled thread...

Wendy

CO EMT-B

[mrmeaner]

How many folks have we had with small post numbers and a lack of experience/contribution on this forum turn into articulate, valuable contributors?

I hope that's the case here.

[Lone Star]

Just what are the healthcare workers rights when it comes to having an infectious disease?

Does the patient have a right to know?

Does the employer have a right to know?

The question does need to be asked.

As it stands, the infected health care provider is NOT obligated by law to divulge the nature of their disease, so in the event of the transmission of an infectious disease, the recipient of such a 'gift' is pretty well screwed! There will be nothing that they can do, no recourse for the victim!

Since the infected person has no obligation to divulge this information, the employer is also kept 'in the dark' on this, and IF it comes to light, there's nothing the employer can do to protect themselves, because the infected employee is protected by the AwDA. An infectious disease is considered a 'disability' and therefore, to fire the employee is considered 'discrimination', and the employer will not only pay for the discrimination lawsuit, if it come to light that the employee was the source of the transmission of an infectious disease, they'll be paying for that as well.

By the way..good topic, but the OP has 2 posts in this fray..How distressed about the subject was he really??

One reason I only have '2 posts in this fray' is because I have other responsibilities that prevent Me from responding to every post in this discussion, not to mention that up until last night(while I was sleeping), not many had really posted to this thread, so I'm allowed some time to read and respond!

This IS a REAL issue to me, and further, I am VERY concerned about it! Sometimes I need a little time to sit down, cool off and gather my thoughts so that I might post something that appears to be reasonably intelligent, based on logic and fact, as opposed to some 'knee-jerk response'.

If this weren't such a 'real issue' with 'real concerns', I surely wouldn't have taken the time to do what research I have done, nor would I even be 'bothered' with posting it in the first place!

In MY opinion, even a 'negligible risk' is too high in this field! Having had to go through the whole process of testing, and the worry, fear and depression that goes along with an 'exposure incident', and I wouldn't want to put ANY patient of mine through that! Not to mention the absolute HATRED that goes along with the above feelings. These aren't the only emotions you'll feel, but they're the easiest ones to put into words.

Whether or not the law agrees, I also belive it's the right of the patient to know that their care giver has an infectious and possibly lethal disease. The odds of transmission may be 1.8% or 0.3%. You know what number I like? 0%. Especially if it's my family member on the cot. When you come to work with any disease you put your patients at risk. You are making the decision weather or not the risk is significant for the patient. The patient doesn't get to be involved in making this decision. That is wrong. Whether it's HIV, Hep C, or explosive diarrhea; it's wrong.

Even as a member of this 'misguided camp', I am firm in MY beliefs that while the infected health care provider may not be required by statute to divulge this information, they should at least have the MORALS and ETHICS to be RESPONSIBLE enough about their disease to take EVERY precaution available to PREVENT the transmission of this disease to some innocent patient! Being RESPONSIBLE should include 'self exclusion' from activities that clearly could promote the chances of even an 'accidental transmission'!

Since we are part of the medical community, shouldn't the Hippocratic Oath apply to us as well (even if loosely applied)?

There is a line in the Hippocratic oath that I think applies here:

I will prevent disease whenever I can, for prevention is preferable to cure.

How can we honor this line, when we're putting the patients at risk (however 'small' that risk might be) by potentially exposing them to something that they can't ever be cured of?

The person that inspired this whole thread (no names given), stated that they're using 'tear proof gloves'.....

I've heard of gloves that are "RESISTANT" to puncture, ripping and other breeches of the universal precautions, but even those are not 'BREECH PROOF', they're just a bit thicker to be more resistant to the effects of puncture, ripping, cuts, etc.

I stated above that I had an 'exposure incident' on scene. The REALLY frightening thing was that it occured while working an MVA, with multiple patitents, and it wasnt discovered until AFTER the call had been dealt with! There was no way to guarantee that the blood inside and OUTSIDE My glove hadnt been mixed, nor was it any 'consolation' that there was a 'low risk' of infection!

Another 'frightening aspect' of this is the knowledge that while the 'normal incubation period' (as explained by the doctor that was doing the testing) is 6 months to 5 years....that is no guarantee that the disease isn't just lying dormant, only to present later in life, when I have quite possibly 'forgotten' all about the exposure incident!

[gvandellen]

My biggest beef with the whole argument isn't the specific diseases listed. HIV and HepB/C are all horrible diseases and anyone that contracts them is pretty much given a death sentence. The issue that we all are fighting about is the risk off US as health care workers infecting OUR patients. We know the risk the patient posses to us and we take universal precautions for this reason. Now let me make this point perfectly clear.....

If the universal precautions we take are reasonable in our mind to protect US from THEM then why are they not good enough to protect THEM from US?

Gloves, gowns, glasses, masks, and hand washing are our tools to protect ourselves from each other. So unless you walk into every patients house with an N95 mask every time you have a hint of a sniffle then that makes you a hypocrite and you potentially endanger my family the same as if you had HIV.

If your against disease then be against it. Tell your employer that your sick and refuse to work. If they threaten to fire you for to many occasions then get a lawyer. There is not one health care worker is the US that hasn't worked at least one day with a cold because they felt they could get by. Not once does it pop into your head they you may harm a patient, do it expect it to be any different for someone that is a non symptomatic HIV worker? It's a job. Life is risky? So what? We all know that death can get us at anytime. The drinking and driving that didn't kill them in the MVC and damn we might expose them? Whatever!

[Lone Star]

If the universal precautions we take are reasonable in our mind to protect US from THEM then why are they not good enough to protect THEM from US?

First off, those 'universal precautions' aren't a guarantee that 'we' are protected from 'them'! If that were the case, I wouldn't have had to go through the testing, the worry, the fear and all the other emotions I had to deal with. Remember how it happened....I got cut on a piece of metal or plastic while attending to, and helping extricate patients involved in a MVA. Since my hand got cut, guess its pretty safe to say that the glove on that hand was also compromised....thereby negating ANY 'precautionary' effect that glove had when I first put it on!

Now...with that fresh in your mind.....if the infected EMT were to go through the same type of situation.....

It's not that much of a 'leap' to figure out that the infected EMT is now at risk of transmitting his disease to the patient, a situation that could have and SHOULD have been avoided in the first place!