Needlestick last night from +HepC pt

[LogCabinMom]

Hello everyone, I'm a second-year RN student in an ADN program, so this is my last semester. We just started clinicals again and last night I gave an insulin shot to a +HepC pt, was wearing gloves, *forgot* to push the safety up to cover the needle, walked over to the sharps box, went to drop it in, and it stuck to my glove somehow so that when I went to let go, the needle flew out to the side and stupid stupid me my left hand reflexively went up and of course, got stuck.

This was probably only my 3rd insulin shot I've given, my instructor was not in the room, and honestly I was nervous about this pt anyway because he was a cranky guy who obviously did not like being cared for by a student. I told my instructor right away, went down to the ER and got tested. The pt agreed to a HIV test, but the results aren't back yet. I feel badly that this guy might have this on his conscience, and

I am sick over this. Absolutely sick. I have a wonderful husband and 3 gorgeous children; firstly I am scared to death that I contracted anything, but also I am sick with the thought that I may give something to my family.

Please, anyone, any help, kind words, or advice will be appreciated.

thank you so much.

[NewWayofLife]

I have no additional information to present, but just want you to know you're in my thoughts. I know what a scary thing it is you're going through. Five years ago I had a (non-sharps related) exposure to HIV, and went through testing and prophylaxis. All the reassurance I was given through statistics could not give me the peace of mind that comes with negative testing. So while I'm sure your chances of converting are low, I know you're still going to be anxious. Needlesticks are called accidents for a reason, try not to beat yourself up over how it happened, and follow up as you've been instructed. Best wishes to you.

[LogCabinMom]

Hi everyone - here it is 6 days after the "incident," and I'm having a real hard time with this. I can't think straight, can barely sleep or eat, have constant diarrhea, and I am a wreck. I know I shouldn't worry, that there is absolutely nothing that can be done right now, but I am a worried mess. I just keep wishing it had never happened. I keep going back in my mind to that one second that I looked away as I was dropping the needle in the sharps box... and I so wish I had known about the safety.

I am thinking that maybe I shouldn't be a nurse at all. I just read in a previous post that a tiny amount of blood is all that is needed for hcv - so an insulin needle would be enough. Previously I had read that you need a lot of blood - what is true?

How am I going to last the next months? On top of all the other stress that is the last semester of nursing school, how do I cope with this?

[core0]

Hi everyone - here it is 6 days after the "incident," and I'm having a real hard time with this. I can't think straight, can barely sleep or eat, have constant diarrhea, and I am a wreck. I know I shouldn't worry, that there is absolutely nothing that can be done right now, but I am a worried mess. I just keep wishing it had never happened. I keep going back in my mind to that one second that I looked away as I was dropping the needle in the sharps box... and I so wish I had known about the safety.

I am thinking that maybe I shouldn't be a nurse at all. I just read in a previous post that a tiny amount of blood is all that is needed for hcv - so an insulin needle would be enough. Previously I had read that you need a lot of blood - what is true?

How am I going to last the next months? On top of all the other stress that is the last semester of nursing school, how do I cope with this?

Risk of infection is defined by a lot of things. It depends on the amount of blood, the amount of virus in the blood. It also depends on your immune system. To put it in perspective with a large bore needle the estimated risk of getting an active infection is less than 2%. It is proportionally less for a small needle such as an insulin needle. If you get an active infection 20% of people will clear the virus. So your risk of getting an active infection is less than 1/50 (probably substantially less).

Second you have to remember that HCV in the majority of patients is asymptomatic. Most people live their entire lives without having any symptoms or problems.

Third, for acute HCV we have excellent treatment. While there are no controlled studies there are a large number of uncontrolled studies that show the cure rate for acute HCV is greater than 90%.

If you integrate the treatment rate with the cure rate you come up with an overall infection rate of 2/1000 long term infections (using conservative projections). Those are pretty good odds. You are already doing what you need to to enhance those odds by following up on the virus.

I can't tell you not to worry. However, having been in the same place you are, I can tell you that I don't particularly obsess on this. Blood exposure is unfortunately part and parcel of working with patients. The best thing that you can do is remain vigilant but remember the odds are in your favor. You can second guess yourself all you want but that won't change the past. Its rarely productive.

Sometimes talking about this helps a lot. Your school or the hospital should make someone available.

Best wishes

David Carpenter, PA-C