Needlestick from a HIV+ Patient.....I am so upset :(

ajaxgirl · Jun 16, 2007

Okay here is my story as unbelievable as it may seem. I am always so careful I never thought this could happen. I am a new nurse(just under 4 months) I was working on my floor and we were so shortstaffed (even more than usual). So I was running around doing 3 things at once. I was giving a SC Heparin shot to my new admission (in the arm, she was thin but she wouldnt agree to anywhere else) anyway she jumped and shook her arm it was quick but for a second i thought "did that stick me?" subconciously but had gloves on and didnt really feel pain. I forgot about it with all the confusion. Anyway I noticed a couple of days later that i thought i had a splinter and the skin is like drying up and peeling a bit. Then I remember what had happened a couple of days before and realize that the needle probably did stick me! The worst part is that pt is confirmed HIV+ and had a high viral load. Now its too late to take ARV prophylaxsis and too late to tell anyone at work. I feel like such an idiot! I am terrified to think this stupid careless mistake could affect my life forever. I don't even want to go to work today because the past couple of days have been a nightmare. Sometimes I think that although I love nursing, days like that make it so dangerous and not worth it. I am at a loss, so sad and upset to think I have to wait 3 to 6 months to find out if this truely will affect me or not. I truely don't know what to think or do......

I dont have the stats in front of me but it would be very rare to contract HIV this way. It something like a 0.3 % chance.

caldje · Jun 16, 2007

I am sure you are going through a lot, and I feel for you. You're chances of getting HIV are still low, though, around a 0.3% chances for a percutaneous exsposure through a glove. Also, the fact that it was a SubQ injection is very good news for you because there might not have even been frank blood visible on the needle. HIV really is not as infective as most people think/make it out to be. I hope that is reassuring.

Also, do you know what her viral load was? CD4? What was she in the hospital for? Was she on ART? and most importantly EXACTLY how long ago was this? 72 hours is the "cut-off" but if I were you I would beg for the drugs even if it has been 4-5 days... chances are someone will give them to you.

I really wish you the best of luck and remember to get tested at 6 and 12 weeks, then 6 months and a year. The testing can be completely painless by using an oral swab and the results come back in 20 minutes. Find a place that offers the rapid testing, it is a very good test and you shouldn't have to wait days to find out the results. Again, I hope all of this helps and the chances are, you will be just fine.

maxsmom · Jun 16, 2007

Why can't you tell anyone at work? You need to report the incident to protect yourself.

Have you ever been HIV tested? If not, do it immediately to confirm that you are indeed NOT infected and then report the incident. You will be entitled to support/services from the hospital. They should do free testing for you, assist with medications if necessary (in the event you become positive), etc. It's not like the patient needs to be tested - her status is known.

I know this is a very scary thing. Take care of yourself.

Agnus · Jun 16, 2007

Been there. A new grad. stuck with a dirty needle. Now let me jump ahead and come back to this after.

IT IS NOT TOO LATE TO REPORT IT TO WORK. It is in your best interest to report it as soon as possible but it is NOT too late. You should and must report it. OK it is too late for the propholaxsis.

If anyone gives you a hard time about reporting this now you stand your ground. Regardless of what any employer tells you what the insurance co tells you you have a perfect right to report it now and to hold this out as a work related injury. It makes it a bit more complicated but they can not refuse you.

They need to test you immediately for any and all blood borne infections. You will prove negative at this time. You have reported it and documented it. So in 6 months when they retest you and you show positive then you have a case. If you ignore this and do not report it even though it is late you have no claim period.

Given you did not recognize the injury when it happened it is reasonable that you did not report it. Also given that you believed (because the employer told you or in some way implied you could not report it later) or for what ever reason you believed this you delayed further.

All of it must be documented. Including the reasons for the delay.

Now here is the good news. Even though I was stuck with a dirty needle I was informed that even with a heavy viral load that unless the needle contained actual blood it was very very slim chance that I would ever be positive. The needle had come from an vein in the pt but miraculously there was not any blood in it.

Long story 8 years later I am fine.

colleennurse, ASN, RN · Jun 16, 2007

RiaRN...I know what you are going through. I also stuck myself while giving a SQ heparin on a very old man who also jerked as I was withdrawing the needle and I also did not report. That was the dumbest thing I could have ever done. I was scared to tell and I am not sure why, I was brand new off of orientation when it happened. I will never do that again, if I ever have a stick. Like other posters have said the chances are very low especially since you were gloved and it was SQ. Go find a clinic where they offer the 20 minute test. I thanked my lucky stars when I had my 6 month test and it was neg for HIV and Hep. I ended up going to my doctor and telling her what happened, becuase I wanted to be tested for Hep as well as HIV. You are not alone, this happens to a lot of us. Try not to drive yourself crazy, I know it is hard. I will be thinking of you!

RiaRN · Jun 16, 2007

Thank you for all of your responses... I appreciate your help. I feel a little bit better after researching because it was a Sub Q and it was superficial i think but then again its hard to tell with those thin needles. To respond to your questions she was in for a fever, r/o tb which was proved negative by 3 sputums. She was not on ARV.Her viral count was high I think like 150,000 and her CD4 count was low, i think like 150-200. I feel like it is stupid to even go to anyone about it because it has already been 4 days and I am embarrassed I didn't realize it sooner. I have had an HIV test less than 6 months ago and it was negative. Some things are in my favor I guess and others are not. I tried to call employee health to beg them for help but the woman said they are closed because it is a saturday. I guess I just have to wait it out and get tested and see what happens. The anxiety alone is going to kill me.

I appreciate all of your responses more than you know. :) Thank you for the support.

Spritenurse1210, BSN, RN · Jun 16, 2007

Oh my god i'm so sorry!!!! did they put you on prophylaxis (i'm horrible at spelling that word) i'll keep you in my thoughts and prayers.

HM2VikingRN, RN · Jun 16, 2007

please report it. I agree with asking for ARV anyway. I would run not walk to employee health and fill out all of the injury reports etc.

Trauma Columnist · Jun 16, 2007

I too would advise reporting it and getting re-tested for HIV and hep. Chances are slim that you contracted anything but it is always better to report these incidents.

GilaRRT · Jun 16, 2007

You need to report this period. You stuck yourself, nothing you can do about that now. You must take care of your self. who cares if you are new or what people think. This is about getting the care and follow up you need. I undersand you must feel horrible, but this is something you need to do. Good luck.

Agnus · Jun 16, 2007

I also one time stuck my self with clean Lovenox or heparin syringe (to long age to recall) If I had not seen it go in my arm I would not ever know it happened.

You just do not feel those needles.

As far as feeling stupid. I did not tell you that the reason I got stuck with the dirty needle (previous post) was because I reached into a sharps box that was over my head trying to get a guide wire from a central line to drop down into the box. the syringe that I had just put in was laying in the tray and it had not dropped either because of the wire. I was protecting my CNA because he was going to do it.

Believe me I never did that again and I will not let anyone else do it in my sight. But I will not play the hero again.

Now are we not always told never ever put your hand into a sharps box. and stupid me I had to do it. That is stupid. You are not.