Needle stick - pt refusing testing

[EllyElephant]

I feel so frustrated! I've only been orienting for 2 weeks. I've been feeling like I am barely treading water and then I stick myself with a used needle today!

On top of it the patient refused testing. Their right, just frustrating for me.

I'm also breastfeeding. The Nurse Practitioner in employee health told me I should be fine to breastfeed because I wouldn't seroconvert for 6 weeks, but I still don't feel comfortable doing that.

I want to just give up and not go to work tomorrow. Any advice on sticking it out? Does it get better?

[BecomingNursey]

Listen, you are going through some big changes right now. I'm assuming this is your first nursing job as you posted in the "First year after nursing" forum and said its your second week of orientation....anyhow.

Yes. It will get better. Breathe. :) Speaking from experience here...It took me around 6-8 months in a busy level II trauma ER to feel like I kinda knew what I was doing. Lol Somedays I still don't know what I'm doing, but I know who to go ask.

Stick with it. It will get better! Just try to be more careful. We work with needles on a daily basis. It's bound to happen. Just be as careful as you can. Take deep breaths and remember why you became a nurse.

[BuckyBadgerRN, ASN, RN]

The chances of "catching" something are pretty small, I would not stop breastfeeding at this point. May I ask how it happened?

[AJJKRN]

How can the Pt refuse? I'm pretty sure at my hospital, if a staff member is exposed then lab comes in to collect blood work on the Pt (and the staff member) but doesn't disclose what the blood works for. I'm assuming something like this is covered when the Pt signs a general consent for treatment since there's a "clause" briefly covered about appropriate Pt behavior, emergency care, etc. Especially since we are bound by HIPPA laws and are putting our lives/livelihood on the lines each shirt for our Pt's! The Pt doesn't have to know the result anyway...

[emmy27]

How can the Pt refuse? I'm pretty sure at my hospital, if a staff member is exposed then lab comes in to collect blood work on the Pt (and the staff member) but doesn't disclose what the blood works for. I'm assuming something like this is covered when the Pt signs a general consent for treatment since there's a "clause" briefly covered about appropriate Pt behavior, emergency care, etc. Especially since we are bound by HIPPA laws and are putting our lives/livelihood on the lines each shirt for our Pt's! The Pt doesn't have to know the result anyway...

In the majority of states, patients have the right to refuse HIV testing even in needlestick/occupational exposure cases. In some states this can be overridden with a court order, in a few states it can be performed without consent *if* blood is already available but the patient cannot be compelled to provide it after the fact, and in a few states it can be performed without consent even if the blood is not already available. It's a highly contentious issue, and it's really unlikely that the hospital is drawing blood without at least informing the patient of the situation and attempting to gain consent. At least, if they are, they're setting themselves up for huge potential legal headaches.

The patient signs a general consent for treatment but is not signing away their right to be informed of and consent to individual invasive procedures.

It's really awful for the staffer who got stuck, but in most jurisdictions it doesn't change their right to refuse- and under no ethical standard does it change their right to be informed regarding testing and procedures.

Unconsented HIV Testing in Cases of Occupational Exposure: Ethics, Law, and Policy

[Bob Loblaw]

My hospital everyone gets labs drawn (for diagnosis)- needle stick and non-compliance then tests are run on those drawn samples.