HIV in LTC

Hi, I have been lurking here for some time now and have decided to jump in. I am an LPN and work in a sub-acute/ltc facility. I really enjoy my work and very rarely do i ever disagree with my DON on an issue. Except for this...New admit over the weekend who is hiv pos.(I have no problems there). The nurses were told by DON under no circumstances are we to tell our cna's that this pt. is hiv pos. I have a real problem with that. i feel they have a right to know, especially because they are direct care providers. Our DON feels that our cna's may refuse to care for this pt. i think that is a bunch of crap. She hired these cna's on their ability and integrity, and she is not giving them the benifit of the doubt. To keep a secret like this is crazy. It will eventually leak out and then the sh** will hit the fan!! I hate not being honest with my cna's, I have such respect for their work and dedication to their jobs.

What is everyones opinion on this issue. I am really angry at my DON, and am at a loss. Any help would be greatly apreciated.

I am not sure of the legalities but I am pretty sure you can't tell the CNAs. However if they happen to be looking in the charts and find that particular note or lab slip you can't really stop them from knowing. A few CNA's will be weird about providing care to HIV+ residents most will be their wonderful selves. I would want to know because sometimes there are blood and body fluid spills and with HIV they need to be taken a little more seriously. In a perfect world all of us CNAs wear gloves for every resident contact but this isn't perfect. I'll admit I don't always wear gloves (very very rarely).

Because of hippa we aren't supposed to tell the cna's if a pt has mrsa or c-diff either. We only tell them to make sure to use universal precautions. Of course they usually guess what they have, when we have the gowns outside the pt's room. In nursing school, our teacher told us we would not know if our pt is Hiv positive but told us to look for certain medications to clue you in on the status. Too bad I can't for the life of me remember what those drugs were!! I guess i should look back in my piles of papers in the closet.