6 weeks into school, I got stuck and i don't know what to do - page 3

Hi all...so, i'm in my 6th week of nursing school and i got stuck w/ a used diabetes lancet...my prof. rushed me to student health services where they took my blood to test for everything, gave me my... Read More

  1. by   beaRNwhenIgroUP
    howdy all...

    well, i saw the DR this afternoon and he is following the CDC protocol of recommending 4wks of PEP

    AZT and Epivir (don't know if i spelled that right) so i am going to do what he says! he also said that he was sure the college of nursing is obligated to pay for everything...

    I have contected the Director of the Undergrad Nursing Program to find out who will be paying my bills...sadly, she has not gotten back in touch w/ me, i addtionally contacted the clinical coordinator but again - nobody has gotten back to me....

    so - since it's friday, i guess i'll have to wait until monday...waahhh

    i am starting my antivirals today and i am scared of the side effects...

    oh - what do y'all think of this...do i have to "make-up" clinical hours spent dealing w/ this? or - since the injury occured at clinical and it was treatment of the injury that kept me out of clinicals should i be credited those hours? i realize i have to go to clincals and i can't just say "well i was sick from the PEP" and expect them to ctrdit my hours BUT i think dealing w/ the Dr and whatnot should apply to clinical time...


    anyhow, thanks again for all of the info - y'all have been very supportive and you have helped me realize that i need to stick up for myself! THANKS
    Sarah
  2. by   fulwood
    BeanRNwhenIgroup - I would be at Dir. of Undergrad Program's office first thing Monday am to get this all sorted out. from what I know as it is your stupid teacher's fault you should not be financially responsible for anything. Be there first thing Monday and make your presence known. Good luck...
  3. by   ICUBecky
    sarah,

    the side effects are hellish. i got stuck once and opted for the drug coctail, without knowing the side effects. they made me incredibly sick and quit taking them within a few days. now, if i ever get the option of taking them again...i honestly won't. also remember that it is a lot less common to get HIV from a needle stick than hep C. so make sure that you get tested for hepatitis too, since it sounds like your doctor seems more concerned about HIV. you will get through this! my prayers are with you.
  4. by   beaRNwhenIgroUP
    originally posted by icubecky
    sarah,

    the side effects are hellish. i got stuck once and opted for the drug coctail, without knowing the side effects. they made me incredibly sick and quit taking them within a few days. now, if i ever get the option of taking them again...i honestly won't. also remember that it is a lot less common to get hiv from a needle stick than hep c. so make sure that you get tested for hepatitis too, since it sounds like your doctor seems more concerned about hiv. you will get through this! my prayers are with you.
    becky...he's tested me for hep antigen and hep antibody, i got hep a&b immunization - he seems to be pretty thorough about all possibilities - although who am i to say - i'm a total novice

    thanks again to all!!! y'all have been great!!!:kiss

    sarah
  5. by   Youda
    I am sitting here totally stunned! Did I understand you to say that this yo-yo "instructor" TOLD you to recap a lancet by sticking it through the little little plastic piece and then putting it in a GLOVE? Is this instructor INSANE? OMG!!!!!

    It doesn't matter if you're in a low-risk area! You get a sharps container! Not a glove. Not a coke bottle! A SHARPS CONTAINER!!! OMG!!!! THIS WAS AN INSTRUCTOR!!!!!

    I can honestly say that this is the most outrageous thing I've ever, EVER heard of in my entire nursing career, and I've seen a lot of ignorance! BUT AN INSTRUCTOR?????? This wasn't a situation where a bunch of nurses showed up to do volunteer testing, but a CLINICAL EXPERIENCE while you're in school. And there is NO, NOOOOOOOO excuse for this instructor taking her students to do glucose testing without the PROPER equipment!

    Girl, you fight this one. You holler loud and long! You protect yourself in everyway possible. DEMAND the testing not just now, but in 6 months, and another in a year! Also, if they try to give you LEAST little bit of crap or run-around, then practice saying the words "lawyer" and "OSHA," They had better treat you like the Queen Mother herself for the rest of your studies. If they don't, practice saying the magic words!

    sjoe is right that there is probably no reason to get in a tizzie. The tizzie, for me, is that an INSTRUCTOR . . . OMG!!!!
    Last edit by Youda on Sep 27, '02
  6. by   ER hippie
    I am so sorry that happened to you. The prof should have known better! There should have been a sharps container available. What a mess. I would definitly consider post exposure prophylaxis (the cocktail, usually 2 NRTI's or 2 NNRTI's and a protease inhibitor). The facility or your school should definitely pay for it, and the sooner you start, the more effective it seems to be. On the plus side, the rate of seroconversion following occupational exposure is less than 1/2 of 1%. I'll say a prayer for you, and good luck with school, too!
  7. by   beaRNwhenIgroUP
    wow...y'all have been so supportive - i am so grateful

    i would just like to say that while i realize that my professor made some very poor choices...i also would like to accept some responsibility. i have taken microbiology, i have taken hiv/aids classes and i have been taught the proper way to handle needles - for me to just say that "i was just following instructions" is not fair. i am a thinking person and should have refused to work under such conditions...

    my greatest anger is with the program that gives the cnc coordinators 12 students to work in 6 clinical sites and doesn't provide these instructors with proper safety devices - especially since we are a "community oriented" program which, by definition, means we will be out in the community and therefore not have the usual supplies around us!

    all in all there were shortcomings on every level and as i look back over the last 6 weeks i can see the issue snowballing until yesterday...and i have learned that if any school or employer asks me to perform anything that will produce sharps and exposure that i will not participate unless proper precautions are in place!!!!

    thanks again to all - i feel so supported
    sarah
  8. by   Youda
    Sarah, while it is commendable that you are willing to accept some of the blame for the needle stick, don't be so quick on that one. You sound like a very mature, wonderful person and you're gonna be a great nurse. But, realize that you are unlicensed at this point. That means that EVERYTHING you do must be under the direct supervision of an instructor/RN. For an instructor to tell you to do this is inexcusable. And, yes, you could have refused. Hindsight is usually 100%. But, a student needs to trust her instructors to show the correct and proper ways to do things, and NOT put you in any kind of danger deliberately. You are not expected to EVER be put in situations where you need to tell an INSTRUCTOR that she is wrong! An instructor is there to protect the client and the students, to insure safety. Students look up to their mentors, and are at a disadvantage in the social hierarchy of things. It is totally beyond a reasonable person's ability to believe that a student should accept ANY of the blame here, or be expected to refuse a clinical experience because the instructor put you in a dangerous situation. Nursing school should show you the best of nursing, not the worse. Again, while I commend your willingness to accept some responsibility, the person who should be taking responsibility is NOT you!
    {{{{{{{{Sarah}}}}}}}}}
  9. by   beaRNwhenIgroUP
    originally posted by youda
    sarah, while it is commendable that you are willing to accept some of the blame for the needle stick, don't be so quick on that one. you sound like a very mature, wonderful person and you're gonna be a great nurse. but, realize that you are unlicensed at this point. that means that everything you do must be under the direct supervision of an instructor/rn. for an instructor to tell you to do this is inexcusable. and, yes, you could have refused. hindsight is usually 100%. but, a student needs to trust her instructors to show the correct and proper ways to do things, and not put you in any kind of danger deliberately. you are not expected to ever be put in situations where you need to tell an instructor that she is wrong! an instructor is there to protect the client and the students, to insure safety. students look up to their mentors, and are at a disadvantage in the social hierarchy of things. it is totally beyond a reasonable person's ability to believe that a student should accept any of the blame here, or be expected to refuse a clinical experience because the instructor put you in a dangerous situation. nursing school should show you the best of nursing, not the worse. again, while i commend your willingness to accept some responsibility, the person who should be taking responsibility is not you!
    {{{{{{{{sarah}}}}}}}}}


    i know you are right....and i appreciate everything - y'all are sooooooo great!!!!!!!
    (((((allnurses)))))
  10. by   Rustyhammer
    We don't even use those type of lancets anymore because of the possibility of a stick.
    Now we have these fancy lancets that pop back into place after doing a fingerstick. Not as good but I admit they are safer.
    I thought all places were using them OSHA and all. We even use safety syringes now too with a piece of plastic that slides over the needle.
    -Russell
  11. by   TracyB,RN
    Holy GOD!!!! I just can't even believe that I actually read that something so preventable happened. What an IDIOT instructor. Was her head not screwed on tight enough or what?!?!?!?
    The school that I went to had us sign waivers as part of the admission process, that we would accept financial responsibility for ANY medical expenses that may occur due to a needlestick or some other unforeseen event like that.
    Fortunately I have (knock on wood) only been stuck witha clean needle.
  12. by   globalRN
    Quote:
    The school that I went to had us sign waivers as part of the admission process, that we would accept financial responsibility for ANY medical expenses that may occur due to a needlestick or some other unforeseen event like that.
    TracyB,RN

    TracyB,RN: I don;t know if such a waiver is signed by all schools; heck, that is why the schools carry insurance!! That seems kinda
    tough, sticking it to the student!(no pun intended)

    However, the main thing to remember is that IT READS UNFORSEEN EVENTS...from all of us here on this board what the moron of an instructor told the students to do....was just a needle stick injury waiting to happen. Besides, there is definitely negligence here....she had a duty to protect the students and failed dismally(any reasonable nurse would NEVER have advised the students to do what she advised)AND AS A DIRECT CONSEQUENCE, there was an injury which neccessitates immediate and perhaps long term followup and care.

    Oh yeah, I 'd want a copy of my medical record and test results. The doctor should have tested for anti-HAV, HbsAg, HbsAb, anti-HCV and HIV testing. HIV retesting in 6 months and I am not sure about HCV but would need f/u too perhaps at the same time.
    This instructor should be reported to the BON.....what an idiot.
    This is really scary if this is the caliber of teacher teaching nursing. Shame on the school for not dealing directly and immediately with this issue and giving you more to worry about at this stressful time. They could take a page about ethical handling of negative news from J & J over the Tylenol poisoning case. How about a little more 'walk the walk' when it comes to caring for each other as nurses!!!
    __________________
    Last edit by globalRN on Sep 28, '02
  13. by   CaliNurse
    Sarah, (A few resources for you)

    I wish I was there in person to help you. I tried to get a copy of the inservice we had last week and the Infection Control Practioner at my facility told me it was on the CDC website. It would be easier for you to read it from there vs. me sending it to you.

    This is the name of the publication: "Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures
    to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis". Dated June 29th,2001. Since that date there are no new recommendations for follow up exposure.

    Here is the web address "http://www.cdc.gov/mmwr/PDF/rr/rr5011.pdf". It is a PDF file. You will need Adobe on your computer to read it. Let me know if you need help with that. The publication is 67 pages long.

    Pg.8.
    In the occupational setting, multiple doses of HBIG initiated within
    1 week following percutaneous exposure to HBsAg-positive blood provides an estimated 75% protection from HBV infection ( 47-49).

    Pg. 20.
    Employers are required to establish exposure-control plans that include postexposure follow-up for their employees and to comply with incident reporting requirements mandated by the 1992 OSHA bloodborne pathogen standard ( 2). Access to clinicians who can provide postexposure care should be available during all working hours, including nights and weekends. HBIG, hepatitis B vaccine, and antiretroviral agents for HIV PEP should be available for timely administration (i.e., either by providing access on-site or by creating linkages with other facilities or providers to make them available off-site). Persons responsible for providing postexposure management should be familiar with evaluation and treatment protocols and the facility's plans for accessing HBIG, hepatitis B vaccine, and antiretroviral drugs for HIV PEP.

    pg 21
    If an occupational exposure occurs, the circumstances and postexposure management should be recorded in the exposed person's confidential medical record (usually on a form the facility designates for this purpose) (Box 1). In addition, employers should follow all federal (including OSHA) and state requirements for recording and reporting occupational injuries and exposures.

    pg. 25
    When HBIG is indicated, it should be administered as soon as possible after exposure (preferably within 24 hours). For exposed persons who are in the process of being vaccinated but have not completed the vaccination series, vaccination should be completed as scheduled, and HBIG should be added as indicated.

    pg35 has other web addresses of resource agencies including one that guides the mangament of post exposure followup.

    pg 49. appendix B Management of Occupational Blood Exposure


    2 more agencies to look up on the web -
    National Surveillance System for Health Care Workers (NaSH) and the HIV Postexposure Registry

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