Protecting the patient already died does not make any sense! - page 3

My patients was HIV+ and he died during a central line insertion... It is tragic...but that is another story. What upset me the most is....his future wife came to the unit and she is pregnant. We... Read More

  1. by   chuck1234
    Quote from bigsyis
    No, according to the law you can't tell her. But what makes you think (or know) that she didn't already know? And, you OB nurses out there-isn't HIV something that preggo ladies are routinely tested for these days, as we were tested for syphylis and gonorrhea back in the 70's?
    Common sense...
    If your future husband gave you the virus...why would you go to the hospital to see him....the guy is giving you the disease which requires you to swallow a lot of pills that have a lot of side effects....making you suffering!
  2. by   chuck1234
    Quote from Bluehair
    I have probably read too many novels in my lifetime. I can see all sorts of possibilities in the couple's history that may be unknown to anyone but them. Like maybe she got pregnant by someone else and he offered to 'make her an honorable woman' as they used to say. Or they knew about his HIV status and had invitro fertilization from an anonymous sperm donor trying to have a family in hopes of hubbies long term survival. Toooo many unknowns from the sounds of things. There is a system in place in most states for dealing with STD's, notifying partners, etc. I haven't seen anything in this thread yet that says whether or not the regulatory agencies are or are not involved? Your compassion and desire to help is so admirable! It's hard to let things go that grab at your heart strings when you just want to help.
    In our area, no fancy way to have a baby...it is a city hospital covering mainly the poor neighborhoods...a lot a patients with hep C and HIV+.....
  3. by   chuck1234
    The main point is...it is not what you see in the T.V.
    Some doctors are good...while some are no good..
    If you wait for the doctors to initiate an action...sometimes it is going to be too late for anything....
    Nurses should be able to do more....
  4. by   justme1972
    Quote from kmoonshine
    Pregnant women don't get routinely tested for HIV. It's an option, but it seems like very few women take advantage of it.

    I'd suggest getting your hospital ethics committee involved. They should be the ones handeling this situation so you don't feel burdened by it.

    Does your hospital offer employee assistance? If so, perhaps you could talk to someone about the inner turmoil you are going through.
    My OB's office had a routine practice of testing all pregnant women for all sexually transmitted diseases, and it was a policy of the practice. HIV, herpes, everything.

    That's a good thing...a good doctor should be fully aware of anything that may crop up, to elect for a c-section to protect the infant if necessary.

    In the rural area that I live in, women come into the hospital alot to give birth with zero prenatal care...very scary thought.
  5. by   mercyteapot
    Out of curiosity, what was the official cause of death listed on the death certificate? I hope this woman does know; it is horrifying to know how dramatically she could reduce the risk to her unborn child but might not be doing so if she doesn't realize she's been exposed.
  6. by   chuck1234
    Quote from mercyteapot
    Out of curiosity, what was the official cause of death listed on the death certificate? I hope this woman does know; it is horrifying to know how dramatically she could reduce the risk to her unborn child but might not be doing so if she doesn't realize she's been exposed.
    They were not married...so...she has no right/access to the death certificate.
  7. by   justme1972
    Quote from chuck1234
    They were not married...so...she has no right/access to the death certificate.
    I thought that death certificates were public information? Along with birth certificates, marriage certificates, etc. People doing geneology searches, tabloid websites pulling them up on celebrities, etc...I think all you have to do is list a reason of why you are seeking it.
    Last edit by justme1972 on May 11, '07
  8. by   carolinapooh
    Quote from chuck1234
    They were not married...so...she has no right/access to the death certificate.
    Deaths, to my knowledge, are public record, and I think access to them (and lengths you may have to go to to get a copy of one) is individually controlled by the state/commonwealth.

    I would think - especially since this woman is pregnant - this would fall under "duty to warn". I'm not saying it does, I'm just saying you would think it would. To me, it's no different than if he'd told his care team he was going to kill his fiance/girlfriend/whatever and they had every reason to believe he'd do it. You have to report that. You should have to tell a pregnant woman her partner was HIV+.

    Sometimes ethics has to win out. If she doesn't know he was HIV+, she's pregnant and has every right to know. I don't know that pregnant women are routinely tested; I don't think you can test someone for HIV unless you have their consent to do so (at least here in NC I believe I'm right).
  9. by   mercyteapot
    Quote from chuck1234
    They were not married...so...she has no right/access to the death certificate.
    Oh yeah, I forgot you said they weren't married. Still, wouldn't you think that if they were engaged she'd have enough of a relationship with his next of kin to see the death certificate? She might be a bit curious what caused his death.
  10. by   chuck1234
    That patient went into a cardiac arrest after the central line was inserted.
    So...the cause of death would not be anything related to HIV+
  11. by   mercyteapot
    Oh, well then, her ability to see the death certificate is a non-issue. Let's just hope her betrothed told her the truth before he died.
    Last edit by mercyteapot on May 11, '07
  12. by   feisty_lpn
    Quote from carolinapooh
    Deaths, to my knowledge, are public record, and I think access to them (and lengths you may have to go to to get a copy of one) is individually controlled by the state/commonwealth.

    I would think - especially since this woman is pregnant - this would fall under "duty to warn". I'm not saying it does, I'm just saying you would think it would. To me, it's no different than if he'd told his care team he was going to kill his fiance/girlfriend/whatever and they had every reason to believe he'd do it. You have to report that. You should have to tell a pregnant woman her partner was HIV+.

    Sometimes ethics has to win out. If she doesn't know he was HIV+, she's pregnant and has every right to know. I don't know that pregnant women are routinely tested; I don't think you can test someone for HIV unless you have their consent to do so (at least here in NC I believe I'm right).

    I agree. There has to be a way to inform the fiancee. Maybe an anonymous call to the local health department and they could take it from there to counsel her? I know the health department here keeps track of all HIV, TB, etc patients. If the same is true for your area, they would have record of him.
  13. by   mercyteapot
    Quote from feisty_lpn
    I agree. There has to be a way to inform the fiancee. Maybe an anonymous call to the local health department and they could take it from there to counsel her? I know the health department here keeps track of all HIV, TB, etc patients. If the same is true for your area, they would have record of him.
    Unless the law allow providers to report HIV status to the health department, though, it doesn't make one bit of difference if it is done anonymously.

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