Being an HIV positive nurse - page 3

by piddlepong 32,630 Views | 28 Comments

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... Read More


  1. 1
    Quote from DavidFR
    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.
    samirish likes this.
  2. 3
    Quote from Pacs, RN
    Dude, chill.
    Patronising or what.
    Quote from Pacs, RN
    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.
    Quote from Pacs, RN
    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.
    Quote from Pacs, RN
    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..........
    Quote from Pacs, RN
    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.
    Quote from Pacs, RN

    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?
    Quote from Pacs, RN

    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.
    achotio, heron, and ChelseaLynn1623 like this.
  3. 0
    Quote from DavidFR
    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.

    Quote from DavidFR
    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.

    Quote from DavidFR
    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.

    Quote from DavidFR
    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.
  4. 2
    Quote from Pacs, 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.

    Quote from Pacs, RN
    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.
    Last edit by DavidFR on Nov 22, '11
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  5. 0
    Quote from DavidFR
    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.
    It is not uncommon to have a coinfection with hepatitis A and E.

    In any case, I was simply making a point that we are discussing HIV here and not the other blood borne diseases. If you wish to discuss about those diseases, we can do so elsewhere on another thread and not here since this thread is just about HIV. Again, I am simply focusing on the topic presented in this thread and not the other issues that plague our profession. Don't get me wrong though, I completely understand your point.

    Quote from DavidFR
    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.
    I guess we'll have to agree to disagree. Doctors have different opinions regarding medical matters so it's only fair to have nurses having different opinions regarding nursing matters. If you think my reaction is an overreaction, then so be it (we obviously have very different opinions regarding what constitutes an overreaction) but I am entitled to my opinion. Personally, if I found out that I am positive with HIV, I'll gladly leave the profession to reduce the risk of myself infecting my patients. That being said, it doesn't mean I'll avoid a person who has HIV and run as if the disease spreads through the air or upon contact. I'll greet one walking in the street and shake their hands. But a person with HIV spitting or holding something sharp? Well, that's another story.
  6. 5
    Quote from Pacs, RN
    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)
    Erm, handling body fluids is a potential risk to the health worker rather than the patient, surely?

    There are a small number of specific procedures that health workers with certain infections (including HIV) should probably not carry out. Suturing, for example. But to put a blanket ban on all nurses with HIV from being involved in direct patient care sounds like out and out descrimination if you ask me.

    I have been a nurse for 26 years and HIV positive for 25 of them and I can assure you that absolutely NO patient has ever been put at risk by me.
    Last edit by Positive Attitude on Nov 23, '11 : Reason: Bad spelling: the REAL reason I shouldn't be a nurse!
    achotio, heron, Pacs, RN, and 2 others like this.
  7. 0
    Quote from Positive Attitude
    Erm, handling body fluids is a potential risk to the health worker rather than the patient, surely?

    There are a small number of specific procedures that health workers with certain infections (including HIV) should probably not carry out. Suturing, for example. But to put a blanket ban on all nurses with HIV from being involved in direct patient care sounds like out and out descrimination if you ask me.

    I have been a nurse for 26 years and HIV positive for 25 of them and I can assure you that absolutely NO patient has ever been put at risk by me.
    Well now, what you have said is a great compromise if you ask me. Good for you. What concerned me the most was us handling sharp needles in the first place. With a nurse like you, I'm now certain our patients will be safe from the spread of this virus. Thank you Positive Attitude.
  8. 1
    Provider to patient transmission appears to almost non-existent in the developed world. The one or two cases that may have happened were in a surgical setting. There is no evidence (to my knowledge) that suggests HIV+ nurses cannot safely practice.

    Patient to provider transmission is, however, a very real risk.

    Here is a link to an excellent editorial on this subject in the Annals of Internal Medicine by Julie Gerberding.

    http://www.annals.org/content/130/1/64.full

    Pacs- I welcome any contrary evidence you might have.
    achotio likes this.
  9. 0
    Quote from czyja
    Provider to patient transmission appears to almost non-existent in the developed world. The one or two cases that may have happened were in a surgical setting. There is no evidence (to my knowledge) that suggests HIV+ nurses cannot safely practice.

    Patient to provider transmission is, however, a very real risk.

    Here is a link to an excellent editorial on this subject in the Annals of Internal Medicine by Julie Gerberding.

    http://www.annals.org/content/130/1/64.full

    Pacs- I welcome any contrary evidence you might have.
    Interesting article, czyja. However, I'd like to quote a line from that article: "Despite a very thorough investigation, the mechanism and date of transmission could not be established with certainty, and the patient had had dental care in a region where HIV is highly prevalent before her infection was documented." Which means that the results of the study is not without its loopholes. Nevertheless, we must not forget that the Human Immunodeficiency Virus can remain dormant for years before it can be detected by standard screening. Also, the cost of advanced procedures to detect HIV infection with certainty can be very impractical.

    Still, I have to agree that with proper precautions, one can prevent transmissions risks at about 3-1% (again, still not zero). Also worth noting that while the study may be true for developed countries, the same may not be true for underdeveloped countries where clinical settings are......less than ideal. In any case, I already agreed with Positive Attitude's compromise regarding certain specific procedures a nurse with an HIV infection should not carry out. So I don't think it's of any issue anymore.


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