We encourage nurses to always follow facility guidelines with regard to COVID, which may differ from ESHYFT’s guidelines. If you are unsure about a facility’s guidelines you can chat with a manager through the ESHYFT nurse app or call the facility before your shift.
For those EXPOSED to COVID-19
If you do not have symptoms:
Work restriction is not necessary for most asymptomatic nurses following a higher-risk exposure, regardless of vaccination status.
Work restriction may be recommended if you:
Are unable to be tested or wear source control as recommended for the 10 days following your exposure
Are moderately to severely immunocompromised
Are caring for or working on a unit with patients who are moderately to severely immunocompromised
Are working on a unit experiencing ongoing SARS-CoV-2 transmission that is not controlled with initial interventions
If you have symptoms:
Have a series of three viral tests for SARS-CoV-2 infection.
Testing is recommended immediately (but not earlier than 24 hours after the exposure) and, if negative, again 48 hours after the first negative test and, if negative, again 48 hours after the second negative test. This will typically be on day 1 (where the day of exposure is day 0), day 3, and day 5.
Due to challenges in interpreting the result, testing is generally not recommended for asymptomatic people who have recovered from SARS-CoV-2 infection in the prior 30 days. Testing should be considered for those who have recovered in the prior 31-90 days; however, an antigen test instead of NAAT is recommended. This is because some people may remain NAAT positive but not be infectious during this period.
Follow all recommended infection prevention and control practices, including wearing well-fitting source control, monitoring themselves for fever or symptoms consistent with COVID-19, and not reporting to work when ill or if testing positive for SARS-CoV-2 infection.
Any healthcare provider who develops fever or symptoms consistent with COVID-19 should immediately self-isolate and contact their established point of contact to arrange for medical evaluation and testing.
For those who tested POSITIVE for COVID-19
Your return to work should be determined by the severity of symptoms and the presence of immunocompromising conditions. Below we provide some guidelines based on the CDC guidance:
If you are NOT immunocompromised AND asymptomatic:
At least 7 days have passed since the date of their first positive viral test if a negative viral test is obtained within 48 hours prior to returning to work (or 10 days if testing is not performed or if there is a positive test at day 5-7).
If you are NOT immunocompromised AND are experiencing mild to moderate symptoms:
At least 7 days have passed since symptoms first appeared if a negative viral test is obtained within 48 hours prior to returning to work (or 10 days if testing is not performed or if a positive test at day 5-7), and at least 24 hours have passed since last fever without the use of fever-reducing medications, and symptoms (e.g., cough, shortness of breath) have improved.
If you are NOT immunocompromised AND are experiencing severe to critical symptoms:
At least 10 days and up to 20 days have passed since symptoms first appeared, and
At least 24 hours have passed since last fever without the use of fever-reducing medications, and symptoms (e.g., cough, shortness of breath) have improved.
If you are immunocompromised AND asymptomatic:
A nurse who is immunocompromised, but was asymptomatic throughout their infection, may return to work the day after their first negative viral test.
If you are immunocompromised AND are experiencing mild to moderate symptoms:
A nurse who is immunocompromised and experiencing mild to moderate symptoms may produce a replication-competent virus beyond 20 days after symptom onset.
A symptomatic nurse could return to work after the following criteria are met:
Resolution of fever without the use of fever-reducing medications
Improvement in symptoms (e.g., cough, shortness of breath)
Results are negative from at least two consecutive respiratory specimens collected 48 hours apart tested using an antigen test or NAAT
If you are immunocompromised AND are experiencing severe to critical symptoms:
A nurse who is immunocompromised and experiencing severe to critical symptoms may produce a replication-competent virus beyond 20 days after symptom onset.
A symptomatic nurse could return to work after the following criteria are met:
Resolution of fever without the use of fever-reducing medications
Improvement in symptoms (e.g., cough, shortness of breath)
Results are negative from at least two consecutive respiratory specimens collected 48 hours apart tested using an antigen test or NAAT