How to talk to my Clinical Instructors without insulting them?

JustBeachyNurse, LPN · Jul 24, 2016

HIV is not a hardy virulent pathogen and your classmate would have to work hard to contract HIV, hepatitis is a hardy virus that lives on contaminated surfaces and is much easier to contract. The only documentation I could find of a nursing student contracting HIV from a patient involved a hemorrhagic patient HIV+ and the student was exposed in multiple areas (oral, eyes, open cut, mucus membranes) by an actively bleeding patient thrashing around.

HIV+ is not an automatic exclusion from nursing in the US. The lack of jobs & visa sponsors for inexperienced new graduate nurses is more of a barrier

Choose your words wisely. Check school policy, facility policy and PRC/regulatory body

loriangel14, RN · Jul 24, 2016

And your Dad is an authority on this because...?

dishes, BSN, RN · Jul 24, 2016

The younger generation in the Philippines has access to information about international nursing job markets, they need to inform the older generation that there is no longer a global shortage of nurses and the developed countries are producing enough of their own grads for the forseeable future. The surplus of nurses in the Philippines means most graduates will not to be gainfully employed in the nursing profession. Parents should stop wasting good money on their children's nursing education not only because there is a high chance of unemployment or underemployment but also because the subpar schools are exposing the students to health risks by discouraging BSP.

Trauma Columnist · Jul 24, 2016

Moved to Nursing in the PI

Here.I.Stand, BSN, RN · Jul 24, 2016

The not wearing a mask if harboring a communicable illness is odd...should the locals get the wrong idea or sick? Whenever I have worn a mask at work, I have told the patient/family that I have "a little cold" and the mask is to prevent the spread-- they haven't been diagnosed with anything requiring the mask.

Gloves during injections really aren't necessary unless the patient requires contact precautions. Open cuts on the nurse's hand should be bandaged. You perform hand hygiene first to protect the patient. Your fingers touch their arm, the needle pierces their arm -- your fingers don't touch the needle.

If a your classmate contracted HIV through a contaminated needle, gloves wouldn't have protected him. A needle will easily pierce through a glove.

Also HIV status has no bearing on employment in the US. A saturated job market in which American new grad RNs have trouble finding jobs, does.

mikeru22 · Aug 7, 2016

Last week we went out to the community again, and I was really concerned for my friend and the family she was going to assess. She just got sick after the last visit and we can't miss a single day of duty of she'll be forced to make up for it during summer classes. And that's a no go since there's a lot to do during that time. We asked the professors if she can wear a mask the whole day since we'll be going to the health care center and the community. Here's exactly what she said, "You can wear it in the health care center but not in the community in order to avoid getting the wrong idea with the locals." In my mind I was just like 'Are you serious? We're trying to help them improve their health not make it worse by sending a sick person out there.' The whole point of using asepsis techniques is to protect both the patient and ourselves. And when it came to injecting multiple pregnant women, I asked if I can wear gloves my clinical instructor flat out told me not to and that it will make the client insecure. When I told her that it was my parents that strictly advised me to (mostly my dad since he told me he it's worse around them and that I should just wear them as a precaution). Now I didn't mention this in my last article because I was literally ranting about how my college is, but I'm really concerned and I think I should have expressed it a little bit more maturely. But I'm just really concerned for the students after a 4th year student contracted HIV and can't be accepted into any hospitals in the US now when he graduated. All because he was told not to wear any protection when injecting. Sanitazing hands between patients is okay, but does that also got for when your handling an HIV patient? Now I don't know if other Philippine colleges are the same, but I was just so shocked that I had to say something. This is a very concerning matter and I just don't know how to address this.

Hello Ava, I'm curious how "sick" is your friend? Did she catch simple colds or flu during the last visit? First, if you're really concerned about sending a sick person to the community, then I think it's best that you tell your friend to just stay at home until she gets better if she's really that sick. Wearing a surgical mask all day won't guarantee that she won't transmit infectious microorganisms to people around her. Likewise, if her immunity is low because of illness, she might get infected by Pneumonia or PTB or other opportunistic infections by the people she'll come face to face with.

Second, review your asepsis technique, is there a need to wear gloves when performing IM, SQ or ID injections? Unless there is an open wound or risk for exposure to secretions, excretions, blood etc., then there really isn't a need to wear gloves. If you insist on wearing gloves, don't you think it would be more appropriate that you change your gloves for every patient you will be handling for injection? Are you seriously thinking of wearing the same set of gloves for all your patients? Go back to the aseptic technique you first mentioned.

Third, schools and hospitals have different policies when it comes to patient assignment for student nurses. Letting any students perform high risk procedures (IV Insertion, parenteral medication administration, etc.) to certain groups of clients is a big NO in the institution I work in. I also don't recall any instances performing such procedures for high risk clients when I was a student. HIV transmission thru needle prick injury is very rare. Did you ask the student who got infected by HIV about other risk factors like multiple sexual encounters, sharing syringes, razors etc., with any person who are infected with HIV?

I'm concerned too, just as you are that you had to rant about not being allowed to wear PPIs by your school while it's clear that you are missing something. All the things you learn and experience as a student nurse are nothing compared to the things you would encounter in the field in the future but all the wisdom, understanding and knowledge you'll learn in nursing school will help you and even save your ass once you are already a practicing nurse.

So review your aseptic technique and PPI protocol carefully and stop ranting about not being allowed to use one, since there really wasn't a need to do so.