New here - ethics question

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Babs62
Brand New Poster
Posts: 4
Joined: Sun Apr 08, 2018 8:39 am

New here - ethics question

Postby Babs62 » Sun Apr 08, 2018 9:37 am

I am on round 2 of C-diff. Went through a round of metronidazole, and then relapsed. Now on day 5 of Vancomycin. My dilemma is this: I am a home daycare provider and concerned about passing it on to the kids. I have checked laws and regulations on reportable diseases and this is not one. However, if I were the parent of a child, I would want to know that this was going on. On the other hand, if I tell the parents, I could lose clients. AND, since I am self-employed, I have no health insurance.( If C-diff doesn't kill me, stress will.) Oh, and when I went for my last check-up, one of my daycare moms was my nurse.......
Just looking for advice from others, so I can figure out what to do.

AllisS
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Joined: Fri Sep 07, 2012 10:52 pm

Re: New here - ethics question

Postby AllisS » Mon Apr 09, 2018 12:53 am

Hi Babs. Welcome to the site. When you have a chance, please take a look at guidelines for all new posters on the intro page.

I can appreciate the dilemma you find yourself in, as well as the stress, which is an almost inevitable "side effect" of C. diff. No ready answer springs to mind; hopefully, others will weigh in shortly. A few of our moderators work in healthcare, so their perspective would be useful. Are you currently symptomatic? Do you share a bathroom with the kids in the daycare program?

My personal (nonmedical) advice would be to suspend the daycare services until the C. diff has definitely resolved. It seems risky to continue without the parents' knowledge of the situation. Being self-employed would seem to add to the possibility of blame from parents on the off-chance that a child might develop C. diff, even if coincidentally from another source. I don't think the risk of losing clients outweighs the duty to divulge.

Perhaps there's a middle ground whereby you could just suspend the daycare until you've recovered without sharing the C. diff diagnosis. An explanation to the effect that you have an infection that *might* be contagious, so you're choosing to err on the side of caution, could well be sufficient.
If your illness was preceded by use of a medication, e.g., an antibiotic, please fill out an FDA Adverse Event Report at http://www.fda.gov/Safety/MedWatch/default.htm

Bobbie
Administrator
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Joined: Sat Aug 06, 2005 8:00 pm

Re: New here - ethics question

Postby Bobbie » Mon Apr 09, 2018 3:03 am

Babe,
I agree with Allis. Give yourself and your daycare kids some time. This will give you some time to recover. I would get a letter from your doctor saying when you are well and share it and some info about c diff with your parents especially the importance of hand washing.

Good luck and good health. Bless you for your concern about "'your kids."

roy
Administrator
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Joined: Sat Aug 02, 2014 1:05 am

Re: New here - ethics question

Postby roy » Mon Apr 09, 2018 4:11 am

C.diff is a VERY common bacteria that we come into contact with almost daily.
It's in the soil, on surfaces, in our food, and often in our gut flora where it just lives alongside the other 500 or so resident species and causes no harm.
A recent study found it on 26% of our shoes!
NONE of the above is a disease!
It only becomes a disease if something disturbs the balance of the gut flora and the bacteria called clostridium difficile overgrows.
Even then it only becomes a disease if the hosts (your) immune system reacts against it.
Unfortunately the name given to the disease has been shortened to the name of the bacteria and people/public do not realise that they are two separate conditions.
A lot of emphasis is put on stopping the spread of infection by thorough cleaning, ALL that emphasis was aimed at hospital and Care homes where there's sick and vulnerable people on antibiotics that predispose them to OVERGROWTH of c.diff.
Hospitals are places where we expect to be safe, somewhere that's germ free and thourougly cleaned but the high incidence of infection proves the cleaning has not been good enough.
In your home, where your not likely to poo the bed, not likely to have poo on your hands, not likely to spread particles of your poo to other people and not likely to have sick people with compromised immune systems C.diff is not a massive infectious disease.

Infection guidlines in hospital say a c.diff patient can be removed from isolation 48 hours after D has resolved and after 2 formed BMs.
A nurse with active c.diff resumes work when D has resolved and there's no such thing as a test to see if its gone.

In your specific situation my (I think also a doctors) opinion would be that if your not having D then your able to resume your normal work routine and there's no need to mention anything.
If it makes you feel better just say you took a few days off because you had infectious diarrhea!
That's EXACTLY what they call it in hospital! and it does not prompt people to Google about this horrendous (not) new (not) exotic (not) infection.


PS
You probably got it from one of the kids!
If you care for kids under 1 year old 3 out of 4 of them will be carrying c.diff.
By 2 years old that reduces to 1 in 20 and that's the same as normal carrier status in the general population.
To put it into perspective, if everyone in the US were to have a c.diff test today AT LEAST sixteen million of them would test positive!


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