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

To add to how appalled some of you are that I would not hug an HIV+ pt, I don't generally hug my pt's period. What do yall do? Just go around loving on strangers with diseases? I don't hug patients hardly ever unless they reach out to hug me then certainly I hug them back and show a caring shoulder.

So...what do you think would happen if your hugged a patient who had HIV?

I generally don't hug my patients either. But I don't hug them all equally

If someone in your family had HIV, would you hug them?

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Specializes in critical care.

I got the diabeetus from a toilet seat once. Worst day ever.

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I got the diabeetus from a toilet seat once. Worst day ever.

I got GERD from my cat.

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Specializes in Neuro ICU and Med Surg.
No and no. Pt's status isn't need-to-know for the CNAs' care. I mean, the CNAs aren't doing anything that would but themselves at risk.

Our nurse assistants draw blood so they do need to know.

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Our nurse assistants draw blood so they do need to know.

If they draw blood they DEFINITELY need to know ... about precautions for EVERY patient, no exceptions, no exceptional circumstances.

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Specializes in Post Acute, Med/Surg, ED, Nurse Manager.

I am a CNA, and a Nursing student. I really appreciate it when a Nurse tells me the status of something contagious. Even though we always use standard precautions, there are times when things are messier than usual and it gives me the opportunity to perhaps leave a few PPE gowns in an accessible location if I might need them or want them. After all As a CNA I am probably the one cleaning up more feces, blood, urine, and possibly dealing with an unpredictable situation (like combative patients).

At my LTC facility only a few diagnosis warrant PPE. I had one resident with Hep C. The upper level nursing management felt no need to let anyone know of his diagnosis. However, the floor nurse let me know. He was confused and got out of bed and urinated on the floor there was also feces and blood involved. It was messy. I was very careful cleaning Like usual but having PPE was nice. I felt better for it. But I had to grab it myself and use it. The resident was spitting and it was just messy. They still received excellent unbiased care.

I wouldn't have grabbed PPE normally because it is not standard precautions, and it is frowned upon unless it is set up in the room by management for Cdiff or MRSA or the like.

I think communication with CNA staff is important. If you have good CNA's then you should be able to trust the standard of care won't be compromised but instead you are making sure your staff is careful and takes the time to fully protect themselves. They should be anyway but even with gloves things happen. Good communication is appreciated.

Maybe even make it a teaching moment. Remind your staff for every one you know about... there are so many more. How careful are you?

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I'm still not clear on why we wouldn't include the CNA's in the information about our patients?

Diagnosis, blood borne pathogen; post-op instructions regarding moving, getting out of bed; timing of VS; I&O status; F/C; IV placement; orientation; dementia; postpartum instructions regarding epidural or lady partsl tears or incision care, etc.

Why would blood borne pathogens be a special case? It is part and parcel of the patient report.

Why keep staff in the dark?

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Specializes in critical care.
I got GERD from my cat.

My condolences, friend.

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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.

I understand where you're coming from.

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At my LTC facility only a few diagnosis warrant PPE. I had one resident with Hep C. The upper level nursing management felt no need to let anyone know of his diagnosis. However, the floor nurse let me know. He was confused and got out of bed and urinated on the floor there was also feces and blood involved. It was messy. I was very careful cleaning Like usual but having PPE was nice. I felt better for it. But I had to grab it myself and use it. The resident was spitting and it was just messy. They still received excellent unbiased care.

I wouldn't have grabbed PPE normally because it is not standard precautions, and it is frowned upon unless it is set up in the room by management for Cdiff or MRSA or the like.

I know this is a bit late, but I felt the strong need to state that Hep C is a blood-born pathogen, and is not spread through urine, feces, or saliva. Even if you were to have intercourse with someone positive for Hep C, your chances of contracting it are extremely low, less than 1%.

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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.

I can not like this enough. HIV/Hep C are lower on the scale of things that one "catches" than C-diff, MRSA, heck for some even an active flu!!

There are policies and protocols. If you are cleaning up copious amounts of blood, then one needs to use to product designed to contain said fluid, need to gown and glove per protocol.

If a 1:1 person is getting dangerous, you need to ask for assistance. And sometimes that means security, restraints, etc.

No one that I have heard of in the past 20 plus years has said "watch out for such and so, as they have HIV!!" More than likely it is "watch out for such and so, as they ring their bell constantly, and will mark on the survey that you did not respond quick enough."

And OP, for your homework, you need to be sure that you reference recent and relevant information for your assignments. The viewpoints you are referencing may have been thought processes many years ago, but not currently.

Tonight I'm gonna party like it's 1999...

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