Ethics: Does knowledge of a patient's blood borne pathogen change your care?

Nurses General Nursing

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I'm sure we have all had patients with various blood borne pathogens... HIV, AIDS, Hep B, etc.

If the patient is under your care for an unrelated issue, do you find that they may generally be treated any differently? Do you aware the CNA/PCA who also may be working with the patient?

Just looking for different view points from a bed-side nursing perspective.

Thanks

Specializes in HH, Peds, Rehab, Clinical.

Is this what your homework question is asking?

You don't think that there is an inherent bias created when disclosing PHI that isn't relevant? Given universal precautions, why should it matter?
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Specializes in HH, Peds, Rehab, Clinical.

CNA's would not be "cleaning up blood" after an IV pull. As Farawyn asked, what exactly are you getting at?

CNAs at your location don't do 1:1 protocol sits with violet/suicidal/confused patients? What about cleaning up blood on the flow from a patient who just yanked their IV out?
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Well, look at a majority of the other posts here. The point I am trying to make is that if universal precautions were taken, there is no need to disclose the PHI... Least of all to PCAs/CNAs. There is no way around the bias and it introduces a very real possibility for discrimination whether intentional or non-intentional.

What have you observed in your role, whatever that may be?

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CNA's would not be "cleaning up blood" after an IV pull. As Farawyn asked, what exactly are you getting at?

I can definitely count more than 5 times that I have cleaned up blood from a confused patient when I worked as a PCA.

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What have you observed in your role, whatever that may be?

From the medical side (as opposed to the nursing model, I guess) I don't really observe this much any more. A few of my colleagues were discussing whether or not it is appropriate for all members of the team to disclose this type of health information if universal precautions should be protecting against it in the first place.

From my year and a half of being a PCA quite a long time ago, I can still remember the strong feelings I had against nurses or PCAs whispering to the effect of "watch out for the patient in [12], he has HIV/abc/xyz".

This obviously is a controversial question and I thought what better a place to ask than the nursing forum. I don't think my credentials really matter.

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Specializes in Emergency, ICU.

To answer the OP:

I don't treat patients differently based on their illness, but I admit that although I always follow universal precautions, when I have a known positive patient (of whatever virus it may be) I am more careful. It makes me wonder about all the people I may not even know who are positive and if I truly follow those precautions all the time. My reaction always surprises me because I consider myself to be very educated on these issues and know the risks well, but still, I cringe inside a little and that upsets me.

I do tell everyone involved in the patient's care what medical conditions they have if they will need to know in order to perform their duties safely.

So I guess I don't trust that we all follow universal precautions to a T.

Sent from my iPhone -- blame all errors on spellchecker 😉

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From the medical side (as opposed to the nursing model, I guess) I don't really observe this much any more. A few of my colleagues were discussing whether or not it is appropriate for all members of the team to disclose this type of health information if universal precautions should be protecting against it in the first place.

From my year and a half of being a PCA quite a long time ago, I can still remember the strong feelings I had against nurses or PCAs whispering to the effect of "watch out for the patient in [12], he has HIV/abc/xyz".

This obviously is a controversial question and I thought what better a place to ask than the nursing forum. I don't think my credentials really matter.

You are trying to make it controversial. All of us have been in agreement. Good luck!

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Specializes in HH, Peds, Rehab, Clinical.

Treat everyone you come into contact with as thought they are infected with HIV or another blood borne pathogen. THAT'S what's safe and falls under the umbrella of "universal precautions"

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Specializes in SICU, trauma, neuro.
CNAs at your location don't do 1:1 protocol sits with violet/suicidal/confused patients? What about cleaning up blood on the floor from a patient who just yanked their IV out?

Of course CNAs do 1:1s with danger to self pts. But the CNA and the patient aren't having sex or shooting up together in there. Danger to others patients are 4 point leather restrained. No blood cleanup they do involves sharps -- IVs included.

I swear, some of these posts here lately make me think I've died and gone to 1985.

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Specializes in Hospice.

I was working in a student health service in 1985 in a University in Boston. I worked with many potentially HIV positive people in a panicky community well into the initial epidemic. i went from there to a dedicated AIDS unit through the end of the nineties. The issue came up a lot.

I feel that anyone providing hands-on care should be informed of any infection hazards. Staff have a right to be safe on the job. Also, it's a great opportunity to reinforce standard precautions.

I also pay attention to staff who may be uncomfortable but too shy to admit it. Sometimes, a little validation, updated information and good modeling works wonders.

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Specializes in Hospice.
There are so many blood borne illnesses floating around that I treat everyone as is they have HIV/AIDS, Hep C, etc. No reason to treat them differently, though. I have never witnessed a nurse or health care professional treat a client "differently" because of their status.

That's why it's called "Universal Precautions".

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No, I treat all my patients the same (aka Universal Precautions), regardless if they have HIV, AIDS, Hep C....Unless it's told to me in report by the nurse, I won't know if the patient has a blood-borne illness anyway. Personally, I'd be more worried about getting C-diff or MRSA (or heck, even the flu!), because I'm usually with patients (using standard precautions, of course) before they are put on isolation :yuck:

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