New LNA having a hard time


Hi all,

A few months ago I got my LNA certification and was just accepted into a nursing program. Recently, I started working at a nursing home. I don't mind cleaning, changing, feeding people, etc. but I am having a MAJOR problem. There is a patient in the nursing home that has HIV. I am absolutely terrified to go into her room, be near her, change her, etc. She can be violent, she spits, and scratches. My main concern is becoming a victim of one of her fits and possibly contracting HIV.

Is this a common reaction for a new nursing assistant to have? How do I get over my fear? I read all of the statistics that say that it is very rare to contract it if you use gloves and wash your hands. I am just so nervous that I am going to get HIV and it will ruin my life.

Can someone please help me and give me some advice? If I am this scared, is this the field I should be in? Any help or advice would be much appreciated.


Sarah :confused:


99 Posts

Specializes in Pediatrics, Step-Down. Has 5 years experience.

Your fear is unfortunately common but based in the societal stigma surrounding HIV rather than scientific evidence. That stigma developed early on in the 80s when people knew very little about the disease and were not sure how you could contract it. Since then, that stigma has somewhat decreased but still exists because people still do not understand the disease. I say this because your fear has developed from society's perception of HIV more so than from fact. I encourage you to try to push that misperception aside and remind yourself of this when you care for this patient.

What you should NOT be concerned about: You won't contract HIV from being near her. HIV never spreads through the air and it is actually a very fragile virus that dies very quickly outside the body. You also will not contract HIV from touching her. Using standard precautions (hand washing and gloves) is enough prevention when dealing with body fluids (ie changing her). It is also nearly impossible for you to contract HIV from her saliva. If you want to be extra cautious, you are always entitled to wear as much personal protective equipment as you want. For example, if you have a hang nail and are worried she might spit then you could wear gloves when taking care of her. If she starts scratching, back away and have someone come in to help you. If she does happen to scratch you she will not give you HIV because she probably does not have body fluids on her hands (such as fresh blood). Of course, you should let the charge nurse know and she will determine appropriate actions. Only a small number of health care workers have contracted HIV from patients and almost all of them were through needle stick injuries. You will not be working with needles as an LNA and in school you will learn safe needle techniques and that there are safety features nowadays on needles to prevent injury.

To sum up, the ONLY way you can contract HIV from this patient is if your body fluids come into contact with hers. For you, this really only means if your blood comes into contact with her blood. I understand that this post likely will not completely subside your fears. So I will tell you that in the incredibly unlikely chance that you have blood-to-blood contact with this patient, you will be sent to the hospital to receive a very effective medicine that prevents the virus from replicating and spreading in your body.

What you SHOULD be concerned about: You should be more concerned about this patient contracting something from you than you from her. She has a weak immune system and things that don't make you sick could kill her. Anyone coming into her room could be carrying germs that they are not even aware of but her immune system would not be able to fight. It is so important that you and anyone else entering her room for any reason thoroughly wash your hands.

This fear should not deter you from nursing. Your school should teach you a lot about HIV and I think your fear will dissolve over time. It is common for people to feel this way about HIV, but remember that it is not based in fact. Hospitals do not want to put you at risk and they do not want to put your life in jeopardy.

I encourage you to read Ryan White: My Own Story by Ryan White. He was a boy with hemophilia who contracted HIV because of blood transfusions in the early 80s. Before dieing he wrote this autobiography. It is a very quick and easy read but I think it will help you understand HIV much better.

Don't forget that you are never alone at work. There are always other nurses and nursing assistants with a lot of experience who are there to help you.


852 Posts

Specializes in none.

Back in the psychic hospital we dealt with this all of the time. Patients would spit, and bite, We never went in without gowns glasses, double gloves and help. We weren't only dealing with HIV but full blown AIDS. If there was a chance of spitting we would put a mask over the patient mouth. This was policy, I don't know the policy in LTC but check it out.

Hey Sarah

You need not worry about the getting the HIV contamination. You must be knowing that it doesn't spread by touching or through air. These all things must have been covered during your nursing training. But may be because you are new to this profession, you are getting scared of all these things. You shouldn't worry at all. And if needed you can call some of your colleagues when she gets violent. Just give yourself some time to get accustomed with this career, and if then also you aren't comfortable then give it a second thought.