First job - HIV unit

  1. Hi all,

    I graduated from my ADN program in May, passed Nclex in June and got a job offer, after much hunting, this past week. It's a full time position in a sub-acute nursing facility. The facility has an HIV unit and that's most likely where I'll be placed as per the DON. I'm just nervous working on the unit because the patients, according to people who worked there in the past, are not happy and agitated. I'll be working the night shift which will be just me and maybe 3 or 4 aides. I know I shouldn't be nervous but it's hard not to be coming outta school and having a job on a unit that I need to be very careful on. Any advice?
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  2. 13 Comments

  3. by   Zara, RN
    You need to be careful in every unit and setting you work in. Working with an HIV population is no different than working anywhere else. Also, in my experience, everyone who is sick miserable.
  4. by   BrittL&D
    What do you all think about double gloving? I saw nurses doing that for certain pts and I wonder if it makes a difference or is more dangerous? I'll be working with L&D eventually, so I'm worried about this issue too!
  5. by   twinkerrs
    At least you know they are HIV + you will encounter many patients who do not know their HIV status. Use your precautions like you are supposed to and you will be fine.

    I have never seen someone double glove it almost seems rude and disrespectful. Idk I am just a psych nurse and encounter HIV pts on a daily basis. But I am not in contact with bodily fluids
  6. by   MrChicagoRN
    You can encounter an HIV+ or person with hepatitis in any setting, and may not even be aware. As well as unhappy patients just about anywhere.

    I don't see any greater risk than anywhere else.

    Follow your precautions, and all will be fine.
  7. by   MXRobRN
    No need to double glove, it won't save you from a needle stick! Just utilizing universal precautions, being especially cautious with needles, will protect against transmission.
  8. by   Adonai Adonai
    The problem is that almost all of the patients are psych. From an LPN that works on that unit, she said there have been instances where certain patients have tried to transmit hiv to care providers due to the psych issues from the disease. Now that I think about it, this facility is the only one hiring new grads anywhere nearby. The interview was quick with no real nursing interview questions. Don't get me wrong, I want to start working and I know I can't pick and choose being that I'm a new grad but I'm actually scared working on a unit with these issues.
  9. by   BrittL&D
    During my first nursing clinical experience in LPN school, my old classmate had a HIV+ pt who deliberately tried to throw bodily secretions on her. It happens, and unfortunately from the effects of the disease. Personally, I wouldn't risk it; but that's because it's an entire unit with + pts.
  10. by   vintagemother
    I work psych and love it. We have a few Pts with blood borne communicable diseases. I'm not afraid of them at all and I go out of my way to touch them to show I care and I'm not scared.

    But, working in an complete HIV + unit would scare me a bit. But I guess if you religiously used universal precautions, it would be safe.

    For me, I get hung up on being compassionate, and disregard glove use sometimes.

    If my Pts pants are falling down and their crack is showing while she's waking down the hall or outside on the patio, I pull it up as long as the scene looks safe. I don't get gloves 1st. Or when a lady's arm got stuck on her coat, I reached in and pulled it out. I don't get gloves in those situations.

    But in an HIV + unit, you would need to unless you could see for sure that no body fluids were present. I'm not sure this makes sense. I'm saying that although they say you only need gloves when you're coming into contact with body fluids, there are many times as a nurse when you don't know exactly what's going on under their clothes or under their blanket and it's safest to put on gloves if there's any chance that fluids could be present.

    I had a geriatric pt with aids kiss me before I knew what was happening on the cheek and I wasn't worried at all.
  11. by   JenERally
    Quote from BrittL&D
    During my first nursing clinical experience in LPN school, my old classmate had a HIV+ pt who deliberately tried to throw bodily secretions on her. It happens, and unfortunately from the effects of the disease. Personally, I wouldn't risk it; but that's because it's an entire unit with + pts.
    I worked with another nurse who was bitten by a full blown AIDS pt suffering from AIDS-related dementia. The lady had no clue what she was doing, but broke skin nonetheless. My coworker was way more lax about seeking post-exposure prophylaxis than I would've been, citing well documented low transmission rates from human bites. I don't care what research says, I would've freaked! He literally acted like it was no more than a paper cut....
  12. by   WashYourPaws
    Soooo, how is your job going???
  13. by   jaluo2014
    I have worked in Africa with bedridden HIV and Aids pts. I handled them just like I do here with my LTC residents. No needs of gloves unless there is skin break or dealing with bodily fluids. Like in Africa, these pt's need more TLC. It might be different here, but over there, culture is the main worry of dealing with HIV and Aids pts.
    Just love them and handle them like any other pt.
  14. by   cayenne06
    Quote from vintagemother

    If my Pts pants are falling down and their crack is showing while she's waking down the hall or outside on the patio, I pull it up as long as the scene looks safe. I don't get gloves 1st. Or when a lady's arm got stuck on her coat, I reached in and pulled it out. I don't get gloves in those situations.

    But in an HIV + unit, you would need to unless you could see for sure that no body fluids were present.
    You absolutely do not have to put on gloves to help an HIV + patient with their clothes or whatever. The only exception would be if you have open wounds on your hand, and in that case you'd wear gloves for all patient contact, HIV or no. In the event that you help an HIV+ patient get their arm through their sleeve and you discover they were actually oozing some sort of body fluid out of said arm, then I would certainly recommend a good hand washing. But unless you are having sex or sharing needles with your patients, your risk is no higher than working with the general population, most of whom will have an unknown status.

    Don't let fear guide your care. Follow the evidence.

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