Being an HIV positive nurse

[piddlepong]

I am about to start nursing school and I am concerned about policies towards people with HIV. My partner is HIV positive and I am therefore at a relatively high risk for infection. If I become infected is my nursing career then over? I am hoping to be a traveling nurse and work in Australia and The UK. Has anyone ever heard of someone being denied a work visa because of their HIV status?

[MJ415]

U realize he posted that comment 2 years ago? Its like me saying the war on iraq is wrong when the war already started years ago.

Oh Darn! Does that mean it's too late for me to say that the Holocaust was wrong?

[Pacs, RN]

Regarding the main topic at hand, being a nurse with an HIV infection can be........dangerous for our patients. Now I don't have anything against people with HIV but you have to understand that the nature of our job increases the risk of spreading the infection. Yes, we can take the necessary precautions but the risks will always be there. We handle needles and body fluids in our line of work. Until a cure or a vaccine is developed, perhaps other fields in nursing will be much more appropriate. Perhaps those that do not involve bedside care and handling of body fluids?

Again, it's the welfare of our patients that I am thinking about. The risks are just too great even with proper preventive measures. (You never know when accidents could happen)

[DavidFR, BSN, MSN, RN]

Sex with an HIV positive person is surely less risky than sex with a person of unknown status - you know what you're dealing with and hence you're far less likely to cut corners where safer sex is concerned. Far too easy to assume somebody is probably negative and not bother with the condom, whereas you know your partner's positive, so with vigilance you're unlikely to slip up. Isn't the golden rule absolutely no exchange of blood/semen and no unprotected penetration, including oral?

Stick to sex with condoms, enjoy your lovemaking but be careful. You're likely to stay negative. And go commence your nursing career without obsessing on what might happen.

I knew several HIV positive nurses in the UK and their careers weren't affected. I can't speak for the US, but if you're negative, where's the issue? I have a positive close friend and by always practising safe sex, his long term partner has consistantly remained negative. And we're talking many years now.

[DavidFR, BSN, MSN, RN]

Regarding the main topic at hand, being a nurse with an HIV infection can be........dangerous for our patients. Now I don't have anything against people with HIV but you have to understand that the nature of our job increases the risk of spreading the infection. Yes, we can take the necessary precautions but the risks will always be there. We handle needles and body fluids in our line of work. Until a cure or a vaccine is developed, perhaps other fields in nursing will be much more appropriate. Perhaps those that do not involve bedside care and handling of body fluids?

Again, it's the welfare of our patients that I am thinking about. The risks are just too great even with proper preventive measures. (You never know when accidents could happen)

I personally can't think of any likely scenario where a nurse working correctly could possibly infect a patient, or a co-worker. I've worked alongside sero-positive nurses and it wasn't an issue.

[Pacs, RN]

I personally can't think of any likely scenario where a nurse working correctly could possibly infect a patient, or a co-worker. I've worked alongside sero-positive nurses and it wasn't an issue.

Yes I totally agree, DavidFR. But remember, accidents are just that: accidents. As I have said earlier, even with the necessary precautions, accidents can still happen (albeit at a much lower rate). Even if we are nurses, we are still after all, human. Therefore we are bound to slip up sooner or later (Heck, even really good doctors slip up once in a while). It's good that we have colleagues that are able to work as good nurses despite their condition. I'm really glad for them. I just hope someone finally finds a cure against this dreaded virus.

[DavidFR, BSN, MSN, RN]

Yes I totally agree, DavidFR. But remember, accidents are just that: accidents. As I have said earlier, even with the necessary precautions, accidents can still happen (albeit at a much lower rate). Even if we are nurses, we are still after all, human. Therefore we are bound to slip up sooner or later (Heck, even really good doctors slip up once in a while). It's good that we have colleagues that are able to work as good nurses despite their condition. I'm really glad for them. I just hope someone finally finds a cure against this dreaded virus.

Pacs, I understand your concern, however I really do have trouble envisaging just how such an accident might take place. An ungloved nurse accidentally cuts him/herself, and by chance bleeds into the IV line or the gaping, exposed wound of a patient. I see such a scenario as being so unlikely as to be virtually unimaginable, especially given that we should all be gloved for handling lines/doing dressings anyway. Given such a low risk of almost nil, should we really penalise all nurses who are positive for whatever blood borne virus, and by the same mentality, all nurses who aren't routinely and regularly tested for HIV and the Hepatitises B, C, D, G and TTV? We exclude alot of nursing talent for a highly irrational fear.

[Pacs, RN]

DavidFR, you don't have to envision or imagine it because accidents are unexpected and unimaginable no matter how well prepared someone is.

In any case, I agree with your point that it is unfair to penalize HIV positive nurses. That being said, the fear is well placed and very rational considering the nature of our jobs and the current standing of HIV as incurable. And while I do not doubt the capabilities of these nurses (I'm very sure a lot of them are good nurses), it is the disease that I am most concerned about and not the person. That's why I suggested other fields of nursing which includes the academe and other low risk nursing jobs.

[DavidFR, BSN, MSN, RN]

Pacs, as stated above, you would have to exclude not just every nurse with any known blood borne virus but also every nurse not being routinely tested every three months or so for every single blood borne virus known to man and testing consistantly negative. Otherwise you're not being consistent in your reasoning about what "might" happen.

I personally beieve we should concentrate on the real risks patients and nurses face and not give in to knee jerk reactions over the most unlikely, fantastic, imagined accidents. This is somewhat akin to "I won't cross the road today, I may get run over by a bus" and I find particularly distateful the irrational fears expressed over this, which feels like a throwback to the 1980s tabloid journalism we saw surrounding this subject.

Perhaps you could outine just how it's possible for the seropositive nurse to infect a patient?

[Pacs, RN]

Pacs, as stated above, you would have to exclude not just every nurse with any known blood borne virus but also every nurse not being routinely tested every three months or so for every single blood borne virus known to man and testing consistantly negative. Otherwise you're not being consistent in your reasoning about what "might" happen.

I personally beieve we should concentrate on the real risks patients and nurses face and not give in to knee jerk reactions over the most unlikely, fantastic, imagined accidents. This is somewhat akin to "I won't cross the road today, I may get run over by a bus" and I find particularly distateful the irrational fears expressed over this, which feels like a throwback to the 1980s tabloid journalism we saw surrounding this subject.

Perhaps you could outine just how it's possible for the seropositive nurse to infect a patient?

Dude, chill. We are only talking about confirmed HIV positive nurses here. As for the nurses who are not routinely tested for blood borne diseases, they are another story.

Anyway, it was already you who stated: "Given such a low risk of almost nil", which means you acknowledge the risk for transmission through accidents is still not zero. If you have read my posts, you'll remember that I already pointed out earlier the merits of adequate precautions. Again I repeat, the risk for transmission even with proper preventive measures may be very, very low but the fact is, it is still not zero.

I don't have to outline to you how an HIV positive nurse may infect a patient. As a fellow nurse, you should already know that. What I am referring to are the unforeseeable, unimaginable and completely unexpected accidents. As such, these are unknown circumstances that we cannot possibly fathom or imagine.

As for your analogy regarding the street and the probability of a bus hitting you, my response is this: Some of us take risks, others don't. Most of the time it goes well but there are times it goes horribly wrong. Numbers and probability may help us get an idea regarding the risks involved but it does not tell us precisely if something will definitely fail or not. There is still that "human" factor.

Also, I never said nurses who are HIV positive should leave nursing altogether. I merely suggested that they focus on fields in nursing which does not expose them too much on needles and handling of body fluids as I acknowledge as well that they'll be a waste of talent if they leave our profession. That being said, I am not totally against them working at the hospital setting. I know a lot of them are great nurses. But we must understand that as long as the disease is still incurable, the stigma will always be there.

To sum up, your professional opinion on this matter is to take the risk for our patients. My professional opinion, on the other hand, is to be more cautious for the sake of our patients.

[DavidFR, BSN, MSN, RN]

Dude, chill.

Patronising or what.

We are only talking about confirmed HIV positive nurses here. As for the nurses who are not routinely tested for blood borne diseases, they are another story.

Not at all. There wil be inevitaby numbers amongst them who are seropositive for HIV, Hep B, C, G etc. Your rationale is not consistant.

Anyway, it was already you who stated: "Given such a low risk of almost nil", which means you acknowledge the risk for transmission through accidents is still not zero. If you have read my posts, you'll remember that I already pointed out earlier the merits of adequate precautions. Again I repeat, the risk for transmission even with proper preventive measures may be very, very low but the fact is, it is still not zero.

There is rarely zero risk in anything we do as nurses, or in life.

I don't have to outline to you how an HIV positive nurse may infect a patient. As a fellow nurse, you should already know that. What I am referring to are the unforeseeable, unimaginable and completely unexpected accidents. As such, these are unknown circumstances that we cannot possibly fathom or imagine..

I suspect you refuse to outline such a scenario as you know it is so fantastically unlikey as to border on the ridiculous. "She cut her hand doing a dressing on, ooh I don't know what, and with her ungloved hand she dripped blood into the exposed wound" Maybe on ER, but otherwise..........

As for your analogy regarding the street and the probability of a bus hitting you, my response is this: Some of us take risks, others don't. Most of the time it goes well but there are times it goes horribly wrong. Numbers and probability may help us get an idea regarding the risks involved but it does not tell us precisely if something will definitely fail or not. There is still that "human" factor...

I would imagine the seropositive nurse would be so self concsious as to never cut corners in this respect, as we all should be since we don't know which as yes undiscovered pathogens our blood may be harbouring.

Also, I never said nurses who are HIV positive should leave nursing altogether. I merely suggested that they focus on fields in nursing which does not expose them too much on needles and handling of body fluids as I acknowledge as well that they'll be a waste of talent if they leave our profession. That being said, I am not totally against them working at the hospital setting. I know a lot of them are great nurses. But we must understand that as long as the disease is still incurable, the stigma will always be there. ...

What do you do if you sustain a needlestick? Do you not think the seropositive nurse does exactly the same?

To sum up, your professional opinion on this matter is to take the risk for our patients. My professional opinion, on the other hand, is to be more cautious for the sake of our patients.

Wrong I'm afraid. My professional opinion is to not give in to irrational hysteria and to concentrate on the real risks posed to all patients and staff alike. I'm more concerned by the "supernurses" who drag thmselves in to work coughing and sneezing than I ever am by HIV postive nurses exercising thier profession correctly.

[Pacs, RN]

Not at all. There wil be inevitaby numbers amongst them who are seropositive for HIV, Hep B, C, G etc. Your rationale is not consistant.

As I've said, we are talking about just the HIV positive nurses here. The other blood borne diseases are of different matters. For instance, Hepatitis B has a vaccine, unlike HIV which has no vaccines available whatsoever. Even then, immunocompetent patients can also clear up this virus on their own unlike HIV. Oh and don't forget that other forms of viral hepatitis are coinfective, meaning they only occur if you already have either Hepatitis A or B. And so, these diseases are already in a different ballgame unlike that of HIV.

There is rarely zero risk in anything we do as nurses, or in life.

I suspect you refuse to outline such a scenario as you know it is so fantastically unlikey as to border on the ridiculous. "She cut her hand doing a dressing on, ooh I don't know what, and with her ungloved hand she dripped blood into the exposed wound" Maybe on ER, but otherwise..........

And in life, things happen when we least expect it. So, it is best to expect the unexpected.

I would imagine the seropositive nurse would be so self concsious as to never cut corners in this respect, as we all should be since we don't know which as yes undiscovered pathogens our blood may be harbouring.

What do you do if you sustain a needlestick? Do you not think the seropositive nurse does exactly the same?

As do I. I would also imagine that to be but as I see it, not everything may go according to plan. Does every nursing care plan you do are executed perfectly and according to print? I think not.

Wrong I'm afraid. My professional opinion is to not give in to irrational hysteria and to concentrate on the real risks posed to all patients and staff alike. I'm more concerned by the "supernurses" who drag thmselves in to work coughing and sneezing than I ever am by HIV postive nurses exercising thier profession correctly.

Aren't we all concerned about the same issue? That being said, this thread is about HIV positive nurses and not the "supernurses". And so, it is best that we just focus on the topic at hand on this thread and discuss about the issue on "What needs more priority?" on another thread. We focus on the issue at hand and make a separate nursing diagnosis on the other problem we wish to address.

[DavidFR, BSN, MSN, RN]

As I've said, we are talking about just the HIV positive nurses here. The other blood borne diseases are of different matters. For instance, Hepatitis B has a vaccine, unlike HIV which has no vaccines available whatsoever. Even then, immunocompetent patients can also clear up this virus on their own unlike HIV. Oh and don't forget that other forms of viral hepatitis are coinfective, meaning they only occur if you already have either Hepatitis A or B. And so, these diseases are already in a different ballgame unlike that of HIV

The fact that a vaccine is available for Hep B doesn't mean you won't come accross unvaccinated patients. And your statement about the other hepatitis viruses is totally incorrect. You can contract Hepatitis C, E, G and TTV without already having hepatitis A or B. The only hepatitis virus that is exclusively co-infective is hepatitis D, which only occurs as co-infection or superinfection with hepatitis B. I'm afraid your facts are wrong. In any case, you singling out HIV in this way defies logic IMHO, as does ignoring the untested.

And in life, things happen when we least expect it. So, it is best to expect the unexpected.

As do I. I would also imagine that to be but as I see it, not everything may go according to plan. Does every nursing care plan you do are executed perfectly and according to print? I think not.

Aren't we all concerned about the same issue? That being said, this thread is about HIV positive nurses and not the "supernurses". And so, it is best that we just focus on the topic at hand on this thread and discuss about the issue on "What needs more priority?" on another thread. We focus on the issue at hand and make a separate nursing diagnosis on the other problem we wish to address.

Our arguments are becoming very circular so this will be my last post in this thread. However I will conclude by re-itearting that I believe you fall into a hysteria trap which stigmatises and punishes HIV positive nurses unneccessarily. There are seropositive health care personnel everywhere and do we hear of patient infection? Actually no, or extremely rarely. There was the case of the Spanish anaesthetist with Hep C who infected patients by injecting himself first and then injecting his patients with the same needle - that is a misconduct issue rather than a "being positive" issue. Sorry, but I find your reaction an over reaction, one you'd expect in the gutter press but not from supposedly informed heath care professionals.