Hello, I am in a dilemma. Ok here is the scoop: I am a public health nurse, and I work in Teen Health as well as Women's Health. Working in this role, I have expanded RN functions like I do Pap Smears, STD exams, Breast exams...etc. Anyhow, I also draw blood and order labs like HIV, RPR, etc. Well a client of mine is 16 years old and I just drew his blood Monday. Unfortunately, the HIV test came back reactive. I am so devastated. I look at the teens as my peers, yet my "babies" although I am not too much older than they are. (Im 24). I have only been a RN for a year, and this is my first case. I feel such dread and I even feel sadness about having to give this news. Of course, I will call for back up and have others there with me to handle to counseling piece. But, I am just so sad about this even though I know HIV is a reality and many people have it. I am just struggling because I know this client is going to have a severe meltdown and Im afraid I may react as well. Any thoughts, comments, or suggestions??!
Jun 17, '09
I strongly encourage you to contact HIV/AIDs treatment programs and support groups and others who will help you work through your own reactions before approaching this patient. Many years ago, the prognosis for HIV/AIDs patients was grim and the end usually came within months (or several years, at most) after diagnosis. Now, with proper treatment, seroconversion can be held off for a long, long time. The universal "death sentence" is not what it used to be.
Arm yourself with accurate information about life expectancy, treatment options, and support. You can't stop having your own emotions, but this isn't about you, and you owe your patient the most realistically optimistic outlook possible. Do your crying elsewhere. Then support this young person in getting help.
Living with HIV/AIDS is not always a walk in the park but the operative word is "living." There are HIV+ people around today who were diagnosed more than fifteen years ago. And new treatment regimens are being developed all the time.
You may find that you do better with your own feelings once you have a more positive impression. Whatever happens, please find a way to get your own reactions under control so you can help meet this patient's needs.
I wish you the best.
Last edit by rn/writer on Jun 17, '09
Jun 17, '09
As a person who has done this several times in my former life i recommend you have a person from your local HIV/AIDs organization there on site when you give this young man his results. That way you have resources at the ready for this person. The way i did it was i would walk in the room with the patient. Have them sit down, and tell them, "So & So, your results came back positive for HIV antibodies" and then be quiet. Do it gently, but don't build up to it...get to the point. Let there be silence so it sinks in and so you can allow the patient "room" to react. Be prepared for the worst reaction but mostly people are in shock and initially don't freak out like you would think at the news. And others already "kinda knew" that there was a good chance it would come back positive.
Nonetheless, after that the first thing i would ask is if they have a support person who KNEW they were getting tested? Do they have someone close to them who they can talk to the minute they leave the clinic? Allow them to call their support person if they wish. If you have a person there from the local AIDs organization they can "connect" them into support services immediately. If you do not have that resource at your disposal then i personally make an "appointment" with the patient to call them in 48hours to "check on them" and whether that would be ok. Gather yourself before you give the results but you should not put off giving the results any longer than your agency gives itself to deliver results. Good luck...this is never easy but you care, therefore you will do it right
Last edit by Mexarican on Jun 17, '09