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 Rehab, acute/critical care.

It does not change how I care for them. I use universal precautions for every patient no matter what they have in their blood. The patients seek medical help from caring people not to be judged. I will tell my co-workers (CNAs, on-coming nurses, etc) just so they are aware but they get the same respect as everyone else.

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Specializes in ICU.

This is 2015, not 1982. I don't think people discriminate against those with HIV anymore, especially the medical community. Wear gloves, it's that simple. It's not airborne, it's bloodborne. The chances of contracting it are very, very small. That is why universal precautions were put into place. Anywhere I have been the PCTs all wear gloves. In 1982, nobody understood how it was spread, now we do and how to protect ourselves against it.

Last spring, I went on a field trip with my son to the Children's Museum in Indianapolis. It is the absolute best children's museum in the country. It's huge. There was a big exhibit on Ryan White the little boy with Aids from Kokomo. The boys in my group were asking questions about him and we read the exhibit and I filled in the blanks as age appropriate as I could. I like to think we have come a very long way in 30 years and with the amount of education being given to the public, the discrimination has really dropped. I like to think that those of us in the heath care field are a little more educated and less discrimination happens.

Me thinks your homework project is a little outdated.

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Specializes in Hospice.

Didn't we recently see a thread started by a new-ish caregiver who was unable to stop panicking after she was exposed to HIV+ blood? The residual fear is still out there. We deal with the "worried well" all the time. It's never a surprise to me when it crops up among co-workers, especially students and those on their first healthcare job.

So, I guess since I'm still occasionally supervising co-workers who might easily treat people with blood-borne diseases quite differently, I don't find the OP outdated at all.

It's complicated.

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Didn't we recently see a thread started by a new-ish caregiver who was unable to stop panicking after she was exposed to HIV+ blood? The residual fear is still out there. We deal with the "worried well" all the time. It's never a surprise to me when it crops up among co-workers, especially students and those on their first healthcare job.

So, I guess since I'm still occasionally supervising co-workers who might easily treat people with blood-borne diseases quite differently, I don't find the OP outdated at all.

It's complicated.

OP didn't come in complicated and worried. OP came in as if he as just doing some research.

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Nope.

Yeah, I agree. It doesn't change my care.

What I'm curious about is the idea that we don't share medical information with our CNA's or Tech's. Where I work, they are part of the team and part of report. They need to know what the medical condition of the patient is so they can treat accordingly.

Would we not tell a CNA that a patient just returned from a total hip replacement?

I'm not understanding why everyone on the team doesn't share the same knowledge??

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Specializes in Hospice.

@farawyn: I think it's a valid research question, too. Throwing it out on an anonymous website, not so much.

It's worth thinking about.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

Homework assignment?

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Specializes in Critical Care.

Nope. I treat all my patients like they have killer cooties. Most of the time, they have super bugs, and who wants those? Keep 'em to yourself, dude.

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Specializes in critical care.
Yeah, I agree. It doesn't change my care.

What I'm curious about is the idea that we don't share medical information with our CNA's or Tech's. Where I work, they are part of the team and part of report. They need to know what the medical condition of the patient is so they can treat accordingly.

Would we not tell a CNA that a patient just returned from a total hip replacement?

I'm not understanding why everyone on the team doesn't share the same knowledge??

Our aides use report sheets on which they write down reason for admission and important details from the patient's history and behavior issues. This IS pertinent to their ability to provide care.

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Specializes in ORTHO, PCU, ED.

I don't treat them different. I treat me different. And I'm sorry to have to admit that. I should know better, but I can't help it. For example, an individual without any of these bloodborne diseases may not warrant me using gloves to change their pillowcase...someone with HIV, I may put gloves on to change their pillowcase. I know, it's overkill. I can't help it. And to be completely opposite than most of you, I'm not one to just follow crowds and post what everyone else likes to agree with, I would not hug an HIV positive pt. Nope. Sorry. Bash me if you please.

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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

There are generally no "unrelated" issues when a patient has AIDS or HIV, Hep C, etc. Especially in the case of AIDS, as the health of those patients is so fragile. Also, with many of the medication side effects, everything is related, tangled together, and cannot be compartmentalized.

I tell my aides if the patient has any communicable diseases. HIV/AIDS, Hep C/B/A, MRSA, VRE, CRE, shingles, TB, whatever. Often there are warning signs related to each dx that I want my aide to be on the look out. Or I want them to be extra vigilant in preventing immunosuppressed patients from coming in contact with pathogens. I want my liver failure Hep C patient watched for confusion, yellowing skin, bleeding.

If I EVER catch my aide giving my patient ANY kind of crap regarding their status, all Hell will rain down on that aide forever more. This goes for nurses I'm reporting off with as well. I've had nurses that double glove and full gown with AIDS patients, and I have flat out told them the AIDS patient is at higher risk from the nurse than anything else.

It's stupid and offensive to suggest that AIDS/HIV/HepC patients deserve some kind of super PPE. Bologna.

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Our cnas draw blood so yes, they may like to be aware

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