6 weeks into school, I got stuck and i don't know what to do

kittyw · Sep 27, 2002

Originally posted by beaRNwhenIgroUP
calinurse, well...the situation was a litle funny...

we were at a congregeate meal site for seniors in a medically underserved area...apparently we were providing more glucose monitoring than any group has done before (last 4 years)...so we weren't really prepared to handle it...

anyhow, our first week, the prof told us to just recap the little lancets (they have these little round caps that twist off and you can just stab them w/ the little needle end of the lancet when done) and put them in a glove. then, at the end of the day we gave them to our prof - who then put them in a sharps container...

so, TODAY, she came out to clinical site and said something about how using the glove was not the best thing and she had been digging through them to dispose of the sharps. so, w/out even thinking about it, i began to dig them out and put them in a coke bottle...(why we didn't think of this before is beyond me) so the LAST lancet of the last glove BIT me...It all sounds so crazy now looking back on it...

TO ALL:
thank you SO MUCH for all of the support - you guys are great and I know how fortunate I am to have found allnurses.com
Sarah

OH MY GOSH!!! What the heck was she thinking??? Recap a used lancet???????? No sharps container????? The prof should have known better!!!!!!

Based on what I've read, you have no clue which resident's lancet this one was - so you can't do the patient testing. I'd be pitching a fit - and demanding that the school handle the necessary costs of meds/treatment. The way the prof handled this situation (no sharps, recapping, putting them in gloves!! what kind of protection is that providing??) was very unprofessional and dangerous!

Kitty (((Hugs)))

Trauma Columnist · Sep 27, 2002

In the state of Illinois - you can test the pt w/o his permission. We do a rapid HIV which comes back in one hour. The HIV cocktail you are talking about has to be started within three hours of stick. Even if stuck with hollow-bore needle from HIV positive person you're risk of seroconversion is 0.03%.

Personally, I would get out of that school - its insane what they are having you do!!!!!! They are taking YOUR life in THEIR hands.

prn nurse · Sep 27, 2002

This is an outrageous and 100 % preventable incident.

And the prof is 100 % responsible .

She knew ahead of time what was going to take place ( the glucose testing) and not one person should have been tested until she had appropriate sharps containers!

Using GLOVES for discard containers?? How absurd !

How long has it been since this foolish prof has actually done real nursing care?

If she worked at our hospital she would be fired.

We have rules that anyone seen recapping anything will be discharged immediately. And these rules have been on the books since 1988.

Statistics support the largest % of sticks come from recapping. And that rule has been around at least a dozen years.

So, you aren't going to have a peaceful days /nights rest for how many years ???? Because of her carelessness, ignorance, and gross negligence !!

This is unexcusable in this day & age !

I'd take a few days off to think this through. The school is responsible for retaining an unqualified teacher.

Love-A-Nurse · Sep 27, 2002

sarah, (((((hugs))))) and i pray all goes well with this terrible accident and with you in general.

sjoe · Sep 27, 2002

1) Relax. This will happen again to you in the future, probably more than once, and there is nothing to be served by getting all in a tizzy.

2) Follow the advice of your doc (the cocktail seems most excessive, if not hysterical, at this point unless the client population was HIV+. Besides which you would want to get an HIV antibody test BEFORE taking these drugs anyway, for legal purposes. You might want to sue. ).

3) ALL reputable facilities and healthcare education organizations have WRITTEN needlestick policies.

4) However well-meaning, nice, etc. whatever your instructor is, she is incompetent and guilty of professional malpractice, if what you say is true. AND the school is legally liable as well. I can only assume that this school is NOT accredited and wonder why you are paying them when there are REAL nursing schools around.

5) Sharps containers in many different sizes can be obtained from any large pharmacy, often for free. And NO, a Coke bottle does not count as a sharps container (what happens when you drop and break it?)

6) Sharps containers, small or large, need to be nearby and need to be used whenever you are using sharp (duh!) objects like needles, IV catheters, lancettes, etc.

7) The learning messages from all of this: NEVER RECAP, ALWAYS use a sharps container, find a competent nursing school, and get private malpractice insurance for yourself.

fab4fan · Sep 27, 2002

Originally posted by CaliNurse
beaRNwhenIgroUP,

FIRST, THE PATIENT MUST BE TESTED. That is an automatic occurence at our facility. If their is a stick we have a preprinted doctors order sheet that patient is tested for EVERYTHING!

Cali

I'm not sure how you can get around getting permission from the pt to test for HIV. I thought if someone has a needlestick, the pt has to be asked if he/she will give permission to be tested, and if he/she says "no", then the "stickee" is out of luck.

Maybe this is just particular to PA.

Tim-GNP · Sep 27, 2002

Were you wearing gloves? One study I read suggested that individuals who were wearing gloves when they were stuck with a needle were actually better [i.e., had less incidence of hep B and HIV transmission]... I believe the premise was that the glove 'caught' some of the blood, thereby decreasing viral load [if any HBV/HIV present]. Of course, needle sticks from hollow-bore needles are always better than solid needles [again, according to the literature I have read].

Another study I read suggests that HIV can't surivive outside the body greater than 20 minutes [some studies I read stated 10 minutes].

The other posters are quite right. Consents must be obtained for HIV testing on source patients. If the 'source' patient says no, then it's no.

At any rate, it's all science 'bung'.... five years from now they will tell us they were wrong about everything. In the mean time, do what your Physician/PA tell you... and I will do something that will definitely help... I will say a prayer for you. The 'head nurse' in heaven will take care of you.

micro, RN · Sep 27, 2002

ditto, to what all said above

and also ditto to what sjoe said.....

yes, the worst can happen, but the odds are very low.....

it sounds like you are being covered and they are doing the necessary things to test and assess the situation.....

I am not discounting your anxiety or fear over what this could bring........but all you can do is what you are doing. Please do not overreact. This career field that you have chosen has risk factors........learn from the mistake and be aware of sharps.........

get tested.......you will feel better after knowing the results which are % going to be negative for anything that you are fearing......

be well and best thoughts to you

do not let this dissuade you from your chosen dream,

micro

deespoohbear · Sep 27, 2002

originally posted by bearnwhenigroup
calinurse, well...the situation was a litle funny...

we were at a congregeate meal site for seniors in a medically underserved area...apparently we were providing more glucose monitoring than any group has done before (last 4 years)...so we weren't really prepared to handle it...

anyhow, our first week, the prof told us to just recap the little lancets (they have these little round caps that twist off and you can just stab them w/ the little needle end of the lancet when done) and put them in a glove. then, at the end of the day we gave them to our prof - who then put them in a sharps container...

so, today, she came out to clinical site and said something about how using the glove was not the best thing and she had been digging through them to dispose of the sharps. so, w/out even thinking about it, i began to dig them out and put them in a coke bottle...(why we didn't think of this before is beyond me) so the last lancet of the last glove bit me...it all sounds so crazy now looking back on it...

to all:
thank you so much for all of the support - you guys are great and i know how fortunate i am to have found allnurses.com
sarah

omg!! what in the he** was this instructor thinking?

i would be at the dean's office first thing in the morning demanding this instructor be removed from her position instantly!!! i would be prepared to back it up with a call to your board of nursing, state board of health, osha, and jcaho!!! this instructor is incompetent, period. i would refuse to do any clinical under her supervision. if you don't get satisfication from the dean of the school, i would contact the medical chief and probably the head of the hospital board. if they refuse to remove this instructor now, i would prepare on hanging everyone involved in any way, shape, or form out to dry for a long, long, long, time. keep us posted and stick to your guns!! :devil:

i have been stuck a couple times, but fortunately i knew who the source patient was, and they were all low risk. did the testing thing for the prescribed year. didn't have to take any medication, but a co-worker of mine did because of a false-positive hiv. everything turned out okay in the end (the pt was hiv-). i would highly recommend that you do whatever it takes to keep yourself safe. best wishes. :kiss

deespoohbear · Sep 27, 2002

Here in Indiana we have to have the pt's or POA's consent to test for HIV or anything else. So far the few times I got stuck the pt and/or families were very nice about the whole thing and agreed to the testing. :) I know this will not always be the case with some patients. Here in the Hoosier state if the pt refuses to be tested, you're basically screwed. :eek:

globalRN · Sep 27, 2002

Quote:

anyhow, our first week, the prof told us to just recap the little lancets (they have these little round caps that twist off and you can just stab them w/ the little needle end of the lancet when done) and put them in a glove. then, at the end of the day we gave them to our prof - who then put them in a sharps container...

so, TODAY, she came out to clinical site and said something about how using the glove was not the best thing and she had been digging through them to dispose of the sharps. so, w/out even thinking about it, i began to dig them out and put them in a coke bottle...(why we didn't think of this before is beyond me) so the LAST lancet of the last glove BIT me...It all sounds so crazy now looking back on it...

I feel for you and would certainly recommend following the advice of your care provider. If you have HbsAb then you wouldn't need the HBIG but since you have only had 1/3 HB vaccinations, how likely is that? As for the antivirals, if I was in your shoes and the patients were marginalized individuals, I would take the antivirals but that is my own opinion. If in doubt, ask for a second opinion or consult a HIV medical specialist ...to help you make an informed decision.

Another thing, I don't think you should be out of pocket at all:

I am infuriated with the cavalier attitude towards sharps that your professor has: SHE SHOULD HAVE MADE SURE THERE WAS A SHARP CONTAINER FOR THE USED LANCETS. WHERE ARE HER BRAINS!!!!! And to dig through used sharps.....I am speechless with horror and disgust at this dangerous activity. The school is responsible for the consequences of her negligence and her incredibly unsafe and unprofessional recommendations/instructions to you poor students.

researchrabbit · Sep 27, 2002

I know you know this now, but just to reiterate for everyone --

NEVER EVER RECAP ANYTHING!!! AND NEVER PUT YOUR FINGERS ANYWHERE NEAR SHARPS!!!

Your instructor was VERY wrong. It was an automatic flunk on any skills test if we tried a recap. She should be reported to the head of your school. Your school should cover any medical expense, and if they refuse, then a lawyer should be contacted.

I've been stuck with a used needle with a high risk patient. Policy at my institution is that you go immediately to ER to be put on AZT; me & patient tested for Hep B, C, HIV immediately and repeat in 6 months. Workmen's comp covered any expense.

The AZT made me so sick I stopped it, but if the person had tested positive for HIV, I probably would have stuck with it.

One year later now and no adverse effects, which is what most people who have a needlestick experience.