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

[JMed18]

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

[Rose_Queen, BSN, MSN, RN]

Working in the OR, we do notify staff in the room if a patient has a blood borne illness. However, the only additional precautions are taken by our surgeons who usually only single glove- for known infections, they will double glove for the surgery. Staff are strongly encouraged to double glove for all procedures, and there are only 1 or 2 who don't do so routinely. It just makes people more conscious of all of their needles and where they are.

[pixiestudent2]

I've seen people who don't adhere to universal precautions.

I'd tell my aide.

Plus, aides do BGMs around here.

[mercurysmom]

For every patient dx'ed with HIV, Hep B/C, there are several who have not yet been diagnosed. So, are you advocating that staff should be warned about patients with these diagnoses and practice "extra special, super-duper universal precautions," while the other patients are to be presumed safe enough to do a hemi-gluteal job protecting themselves from the rest of the patients?

My vote is for following proper PPE procedure for universal precautions. There's no such thing as sorta-kinda adhering to universal precautions.

Edit: stupid autocorrect!

[ixchel]

I don't treat them any differently at all, and yes, I tell the aide.

The only difference in care that I give them is I try EXTRA HARD not to share needles with them, make murals from their poop, or lick their plates clean. Gotta tell you, though. The struggle is real.

[ixchel]

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.

"Least of all"? Are you for real? Aides are potentially more hands-on with the patients in a given shift than the nurses are. They are also vitally important to the care team and SHOULD receive thorough communication from us.

Least of all?!

[KelRN215, BSN, RN]

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?

Well ANY TIME you are coming into contact with any bodily fluid, you should be wearing gloves so what different does it make if the patient is HIV positive? How, exactly, would someone contract HIV from a drop of blood on the floor though? The virus doesn't live long outside the body and no one is going to clean up this blood with their bare arm that has an open cut on it.

[AZQuik]

Not treated differently per day, but it can be a factor in care plans or diff dx. They way some of these things ravage a body is certainly a consideration as well as potential med issues.

Yes people are alerted who may come into contact with body fluids so they can make an informed decision on seeking tx quickly. If discrimination happens it is dealt with, but I have never seen it. That said we get A LOT of these type cases so it's pretty much a matter of fact attitude.

BSN GCU 2014.

Sent from my iPhone using allnurses

[canigraduate]

Yes. It makes me extra careful with my sharps. I also clean up any blood spills with hospital approved chemicals.

As far as treating the patient differently, heck to the NO. Professionalism, anyone?

Oh, and I definitely tell my CNAs. I'm not an elitist snob that holds back information from other parts of the treatment team.

Perhaps you didn't mean your post the way it sounded, but dang. You really come across as condescending.

[Farawyn]

Yes. It makes me extra careful with my sharps. I also clean up any blood spills with hospital approved chemicals.

As far as treating the patient differently, heck to the NO. Professionalism, anyone?

Oh, and I definitely tell my CNAs. I'm not an elitist snob that holds back information from other parts of the treatment team.

Perhaps you didn't mean your post the way it sounded, but dang. You really come across as condescending.

Miss you, girl.

[Glycerine82, LPN]

Not at all. Everyone gets the same treatment.

Except for the cute little old ladies, they get hugs. :-)

[imintrouble, BSN, RN]

I'm a little more careful when my care involves contact with the pts blood. That's it.

The last time I cared for an HIV positive patient, I paused and thought briefly that nothing about her care scared me.

It was nothing. I looked at them no differently than any other patient.

We didn't discuss it at the nurse's station. I didn't gossip about it with the CNAs.

None of us cared. It was unremarkable.

[vintagemother, BSN, CNA, LVN, RN]

I think all members of those providing care should be made aware of pts status with regard to even blood borne diseases.

I don't treat pts differently. I've hugged and provided peri care as well as routine care to pts with hiv/ hep. I intentionally go out of my way to touch, hug, provide care to those pts.

Yes, I have seen pts treated differently due to their status. I recall an hiv positive pt being left in his stool by the off going shift.

When I was a new CNA, a pt with hiv jumped up and gave me a kiss on the cheek before I could stop him. I wasn't worried.

I've also been a Cna who the nurse assigned to 1:1 who didn't know/failed to inform me of the pts status with regard to contact precautions.