Exposed to HIV, HBV, HCV - page 2

My coworkers did not alert me to the dx and I answered a coworker's vent alarm without PPE. As I approached the pt the tubing disconnected spewing mist and blood tinged secretions in my face. 24 hrs... Read More

  1. by   dianah
    Just wanted to add my words of support for you. What a scary thing to have happen, and the circumstances and f/u are unacceptable (implying it's YOUR fault, unavailable ppes, etc). Sometimes I think we should get "hazard pay" to do what we do. Keep us informed, hang in there. I like the advice to see an atty . . .
  2. by   WalkingInTheRain
    Make sure they follow up with it. If no one at your facility doesn't help you report it to the State Board of your state maybe they can help you. Stay strong and I hope everything turns out all right.
  3. by   BabyRN2Be
    MattsMom

    I'm so sorry this has happened to you. *HUGS* I've been in your shoes before, but more of an independent contractor role - I was working as a doula (professional childbirth assistant) for a woman I had met the previous day. I was scheduled to do her pt hx form the next day, but she went into labor the night before. I was helping her with counterpressure/massage on a labor ball and she SROMed. I have an auto-immune disorder myself and had open ulcerations on my hands and some of her amniotic fluid got into the cuts on my fingertips. I didn't get to the gloves in time, but put some on and didn't think of it until the next day.

    I happened to be in with her when one of the residents came by and asked about her HIV, HCV, and HBV status. Neg for HIV and HBV, but pos for HCV. I really liked the woman, but panicked immediately while I CALMLY asked her why she didn't tell me. Well, my fault, I didn't ask. Big lesson for me. BIG lesson as I was a fairly new doula and we didn't cover this in training. :angryfire I've asked my doctor and she said that it's a very, very remote chance that I could have contracted anything. I've asked her to test me, and it's been 4 years out and I'm still negative for anything.

    I am rather outraged at your employer's response. That's terrible that they are pointing the accusatory finger at you rather than themselves. I just pray that everything goes OK, and please let us know how you are (feel free to contact me privately - I know that sometimes you need to talk with someone who's been there).

    *HUGS*
    Katherine
  4. by   Tweety
    mattsmom, sorry this happened. I can't believe they are drug testing you.

    Hope things work out for you. Best wishes.
  5. by   gypsyatheart
    (((((((((((((((((Mattsmom))))))))))))))))))))!
    You have gotten some great advice here, I just wanted to add my support and let you know I'll keep you in my prayers! I know how it feels to have an exposure and not have the facility be up to par! It sucks! I am sooo mad they are drug testing you! :angryfire That is so ridiculous!
    And people wonder why nurses leave??!!
    Well, hang in there...we're all rooting for you!
  6. by   Marie_LPN, RN
    Drug testing at my facility is mandatory for any sort of 'employee incident' no matter what the incident is.

    IOW, they're covering their butts. Make sure to document EVERYTHING for yourself.




    (edited, wrong smiley)
  7. by   P_RN
    I'm really sorry this happened. I dont understand how the hospital can say they arent covered by WC? Isn't that a state agency? And certainly OSHA would love to know their attitude. Keep on them and if they give you any static you need to get some big guns behind you. I got stuck w/ Hep B patient needle and the hosp wouldn't pay for the injections, they BILLED ME $400!!......all it took was my telling them they'll not get paid by me and not by my lawyer either. I got the shots and so did every employee after me.

    Did the co-workers not tell you because of Hippa? Our NM tried telling us that we were not to know anything about any patient save the ones we were assigned.
  8. by   Vsummer1
    Having been Hep C positive, going through 48 weeks of HELL for therapy and coming out PCR negative, I understand how frightened you are. BUT

    Your coworkers are not responsible for alerting you to a patient's status. It is up to you to treat every patient the same --ALL ARE POSITIVE!! Your facility needs to get on the ball and provide the safeguards you need to protect yourself BEFORE exposure, and any and ALL meds after exposure. And YOU need to protect yourself first and foremost.

    One thing that really makes me mad is when a coworker comes up and says "oh, that person has a hx of drug abuse and is ABC (insert dx) positive." My reply is that I go by the ANA's code of ethics-- I treat ALL patient's exactly the same -- as if they were all POSITIVE. How many times have you been in a patient's room then all of the sudden you find out they need to transfer to isolation? It comes with the job and YOU have to protect yourself. Your employer can't pre-screen every patient so you MUST prescreen them all as infectious. Harsh, but true. That innocent LOL may have had a blood transfusion. Bingo, infected with ABC.

    Let's all pray that you are NOT infected, and chances are you aren't!
  9. by   mattsmom81
    Quote from Vsummer1
    Having been Hep C positive, going through 48 weeks of HELL for therapy and coming out PCR negative, I understand how frightened you are. BUT

    Your coworkers are not responsible for alerting you to a patient's status. It is up to you to treat every patient the same --ALL ARE POSITIVE!!
    In order to use PPE effectively we make decisions on the level of PPE used BASED on the diagnoses and condition of the patient. If we are not provided this info (due to HIPAA or whatever) then in my mind we are not being given info to protect ourselves.

    Who here thinks ICU nurses should walk into EVERY vented patient's room wearing full PPE including masks and eye shields? Anybody do this? SHOULD we do this?

    I feel I have some duty to protect others who go in my infectious patient's he room. I keep the appropriate PPE outside their room on a cart. Perhaps I'm hypervigilant but this is critical care so it is a necessity IMO....we all work together in close proximity.

    But with HIPAA perhaps I should no longer enter a patient's room unless it is mine. This will be a hard habit to break as I tend to be helpful/team player type.

    We don't 'isolate' per se anymore unless its TB or VRE.

    How is everybody else handling these issues...I'm curious.

    I appreciate all the kind words of support.
  10. by   fergus51
    Unfortunately we are expected to this because of situations like what happened to you and the fact that there are a lot of positive people out there who don't know they are positive yet. Any time we think we will have contact with bodily fluids we are expected to use PPE and that includes all suctioning and bloodwork. It isn't isolation protocols, it's universal precautions and we have to do the same thing cause there is no way for me to know the status of every patient in the unit. Since SARS, people don't object to this like they used to.

    I am so sorry you had to go through this. I know from personal experience how scary it is and hope everything works out ok for you.
  11. by   mattsmom81
    Quote from fergus51
    Unfortunately we are expected to this because of situations like what happened to you and the fact that there are a lot of positive people out there who don't know they are positive yet. Any time we think we will have contact with bodily fluids we are expected to use PPE and that includes all suctioning and bloodwork. It isn't isolation protocols, it's universal precautions and we have to do the same thing cause there is no way for me to know the status of every patient in the unit. Since SARS, people don't object to this like they used to.

    I am so sorry you had to go through this. I know from personal experience how scary it is and hope everything works out ok for you.
    So everytime you enter a room you wear full PPE now including mask and goggles? Any room or just vents? Anticipating they may spew body fluids in your face, etc.? I've always worn gloves and used caution but....wow. I'm starting to wonder if my area of the country is very lax on this issue. I can't even FIND the whole range of PPE many days. Maybe this is something I need to bring up at the next nurse practice committee meeting.
  12. by   fergus51
    Quote from mattsmom81
    So everytime you enter a room you wear full PPE now including mask and goggles? Any room or just vents? Anticipating they may spew body fluids in your face, etc.? I've always worn gloves and used caution but....wow. I'm starting to wonder if my area of the country is very lax on this issue. I can't even FIND the whole range of PPE many days. Maybe this is something I need to bring up at the next nurse practice committee meeting.
    Not every time we enter a room (unless they are on contact or isolation precautions, but that obviously doesn't cover HIV or Hep), but yes every time we can anticipate the possibility of being hit with bodily fluids, like in the case of a patient who is intubated (though gowning is not considered necessary since your uniform provides the same protection and same goes for gloves if your skin is intact, it's the faceshield that really matters). A face shield is preferable to me, cause I HATE the masks (wearing it 12 hours a day every day during SARS has caused some strong dislikes for me) and it's easy to just slip it on if it's sitting at the door. We don't have to do it in the NICU if the kid is in an isolette, because that acts as a barrier, but we do if they are in a crib and vented. And people with glasses still have to wear the goggles or a faceshield because glasses provide no protection from the sides.

    I can't really say what it used to be like because SARS hit just after I arrived, but now they are HARDCORE about ppe. Every staff member had to go to a mask fitting session and an infection control session (2 hours and 8 hours long). People are so careful about intubated patients in particular because that is how some health care workers aquired SARS and a few died. In order to intubate adults at the time, I believe they were wearing the whole spacesuit, not just a faceshield. I would STRONGLY encourage you to press for PPE on the floors. Our union was instrumental in this, but as SARS showed us, it is SO important. I mean two nurses here are dead because they didn't use ppe, cause they were told it wasn't necessary. It was really sobering for a lot of us.
    Last edit by fergus51 on Mar 11, '04
  13. by   caroladybelle
    I have always treated EVERYONE as though they are positive for bloodbourne illness. But then, I started out in ID.

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