the dreaded needle stick....

[kacs13]

I've been a nurse going on seven years. Ive had one needle stick a few years back with a used insulin syringe. Rapid hiv test was negative, hep c negative. I went on with my life. This past week, I was approached by a charge nurse on another unit to attempt a difficult IV. I had the time and Im a pretty good stick so I went over to do the favor. I had the IV in (a 20g) and when I hit the safety retraction I felt a little graze or maybe a scratch. Looked at my finger, it was intact, no signs of broken skin, bleeding etc. I went and washed my hands and thought nothing of it really. I at first thought it was probably just the plastic part. I realize everyone is on "standard precautions". When I put an IV in, I wear gloves, but I normally poke my index finger out to try and feel a vein. I realize I shouldn't do this. But i do. Im being honest. When it's a known hiv infected patient I dont. They told me she was here for a lap chole and was most likely being discharged later that day. No other info on her. Later when I returned back to my unit, my paranoia got the best of me and I looked up her hx. There it was: hep c and hiv +. I followed protocol as though I was stuck, although im not fully sure I was, maybe a graze? Last time I stuck myself, I jumped a mile and my finger bled, felt a little tender, etc. They started me on PEP (truvada and isentress ). After the first dose, I felt ok. No side effects. So I decided to go ahead and do the month course per protocol. The NP in the ER studied my finger under a bright light and seemed to think I was being paranoid. She didnt see any signs my skin was broken. Maybe I was being a little paranoid. But I haven't stopped thinking about it since. I realize its only a 0.3% chance, and even less so when taking PEP. But it still nags at me. I keep repeating the incident in my mind. I guess I came here for support. And to hear others stories. Thanks for listening (reading).

[been there,done it]

I for one think you are torturing yourself. Take a close look at the design of the device, focus on how the needle retracts into the plastic hub.

You've made your decision to do the PEP protocol. Keep your mind busy during the month, maintain your mental health any way you can.

My story may help. I was a brand new nurse, back in the day when we recapped needles. My patient was a heroin addict that had his arm amputated from infection due to dirty needles.

Yep, I stuck myself with a dirty needle from that guy ! (haha, I sure know how to "pick" 'em.) It get's better...

I was pregnant. We only had IgG at that time, went through painful injections. Many moons later... we both are fine, no transmission.

Now please.... go have a good day.

[Meriwhen, ASN, BSN, MSN, RN]

Your story is an excellent reminder to both old and new nurses to ALWAYS follow standard precautions. Just because a patient isn't known to have HIV, Hep, etc. or isn't at high-risk for these diseases doesn't guarantee anything. In fact, a patient may not even know they have it themselves.

The odds of escaping this are overwhelmingly in your favor, but I know that is small consolation when you're on the wrong end of the needlestick. What's done can't be undone--right now all you can do is continue the therapy, follow your provider's advice and try not to torment yourself. Take care of yourself during this time--even consider talking to a counselor if you feel it would help you cope while you're waiting.

I sincerely wish you all the best.

[FurBabyMom, MSN, RN]

I work in the OR. It happens, especially in an environment like ours. We deal with sharps and such that there are no safety features for as it would defeat the purpose of the instrument/device. 60-200 suture needles open and used in a procedure? No way to recap those - we do place them in the needle book with the sharp side down, but...it's not fool proof. Most of our surgeons/residents attempt to "hide" the sharp end with the needle driver when passing them back to us, but again. We have hypos without safety devices, we have blades, all kinds of things. We have a situational awareness to learn about and develop. The list could literally go on for forever. My specialty is unique - we often have patients whom we know literally nothing about (we're a level 1 trauma center - and it happens somewhat frequently to get patients without knowing even name/DOB, nevermind their history).

I don't know many people who haven't had an exposure working in the OR. One resident I know has had an exposure each year they've been a resident. I've had two exposures. One was a freak accident I couldn't make happen if I tried. The other was somewhat dumb, and I injured myself on an instrument that had already been used. That said - we could easily get particles of something in our eyes (around/despite protective eye wear) by mechanisms such as drilling/etc. I reported the incidents, we drew the labs and got the results back. Both were negative. But it serves as a reminder to be more aware/conscious of what we are doing.

Don't beat yourself up about it. Be more careful next time, and just relax a bit. I mean, you had a question/doubt, and handled it as if there was an incident which is probably smart. Better to be safe than sorry. That said, at least in the OR, we sometimes have things drag across our gloves that "feel" like it could have stuck us. Double gloving helps because if you wear an indicator glove holes are shown easily. If there's no holes in either glove you can be reasonably certain you did not stick yourself (to penetrate your skin it would have penetrated the gloves).

[xoemmylouox, ASN, RN]

This is a reminder for everyone.. You should treat EVERY patient the same. There are plenty of people out there with undiagnosed HIV, Hep C, etc - so you cannot trust the fact that they do not have the dx on the chart. Many of us have had sharps exposure during our careers. Luckily the transmission rate is very low. You should be just fine, I know that won't ease your concerns though.