Nurses Right to Know HIV/AIDS Positive Status

[stdntograd06, BSN, RN]

I have a question here. At the facility where I work, we have a recently new admit that by all accounts by the staff has symptoms of HIV/AIDS. I have not had to care for this person as yet, but I've been told (by my fellow nurses) that if he indeed does have it, we do not have to be informed!! His Dx. is pneumonia, and has open lesions on BLE, extensive hx. of drinking, smoking, and IV drug use. By appearances, he is the classic "hippy". I was inforned last week at work that if someone comes in with a Dx. of HIV/AIDS, we as staff are not required to be informed!! Is this a common practice where you are? We are made aware when someone has MRSA, VRE, C. diff, etc.. Why in the world are we allowed to be put at risk with this particular disease???

Any Thoughts,

Kelly

[leeae85]

I agree with what you are saying, but I know someone is going to throw in "Well, that's why we have Universal Precautions...blah, blah, blah". Which I'm sure everybody is aware of, but even knowing that rule I understand your feelings that you feel that you have a right to know. And thats a good point you make about the MRSA, and VRE, we always get that information, how come we don't get the HIV/AIDS info? I guess if he is taking meds for it that would be one red flag.

[flightnurse2b, LPN]

i worked in the ED where most of the people walking through the door with communicable and bloodborne diseases didn't find out they had them until after they were admitted to the floor.

sometimes people don't know they have HIV/AIDS and therefore don't disclose it.... and sometimes people who know they have it don't choose to disclose it.

if he has the s/sx of HIV/AIDS then maybe he needs to be tested, but you can't just walk up to him and say "mr. smith, i think you look like you have AIDS... can you sign this consent for a blood test?" a physician has to have a reasonable cause to order the tests and the patient has to agree to it.

just to be devil's advocate....there are numerous other reasons on why he would get pneumonia, why he would have lesions on his legs, and not all pt's with hx of IVDA have AIDS.

you do have the right to be informed.... but you are not caring for that patient, and you as of right now, have no right to this man's info. if you were to be assigned to this pt, then you would have the right to know whether or not he had HIV/AIDS if the information was available.

another reason why perhaps the info is not disclosed upfront is that HIV/AIDS is not very communicable to health care workers unless you are planning on sharing needles or having sex. you are much more likely to contract MRSA, C-Dif or hepatitis from a pt. and i know you don't want to hear it...... your employer does expect you to treat everyone as though they have AIDS anyway.

[Jolie, BSN]

Not trying to be argumentative, but genuinely curious: How would your care differ if you knew, rather than suspected that this patient was HIV (+)?

And how would your care differ from another patient also diagnosed with pneumonia who you did not suspect of having HIV?

[SuesquatchRN, BSN, RN]

How are you being put at risk by not caring for this patient?

The chart is available to anyone with a need to know. As his nurse you will have that.

But the bottom line is that you are clearly simply terrified of this disease. Well, you needn't be. It's largely because of this that the CDC adopted standard precautions and if followed they will protect you against contracting anything that is neither air- nor droplet- borne.

And watch out for needle sticks. Even if it's with a clean needle risk management will go ape.

[justme1972]

We are made aware when someone has MRSA, VRE, C. diff, etc.. Why in the world are we allowed to be put at risk with this particular disease???

Any Thoughts,

Kelly

My thought is that MRSA, VRE, C.diff are all curable diseases, and HIV/AIDS falls under ther American's with Disabilities Act.

I see it both ways...if everyone agrees that this patient is exhibiting S/Sx of AIDS...then why can't you just treat him as an AIDS patient and use the same precautions?

[stdntograd06, BSN, RN]

Thanks for all your input. I am not terrified of the disease but do feel that at this facility we have the right to be informed. My care for this particular resident is not going to be different than the others in the facility, when I get assigned to him. I also thought about his chart and that there may be flags in his H&P, but I won't see until I'm assigned to him. Unfortunately, there is the stigma still around regarding AIDS/HIV. My response was a pretty good example of that, and a kneejerk reaction. Thanks again for all the responses.

Kelly

[Goodrich]

I believe that this is a legal right that people with these diseases do not have to tell because of the stigma attached. I am a nurse in a manufacturing plant with the voluntary first aid team. We emphasis with each other that you plan on the worse.

As a personal note, I am a nurse who contracted Hepatitis in 1984 from a patient who did not know that he had the disease and Universal precautions were not in place. Gloves would have protected me because my source was an open wound on my hand from a hang nail. Very Interesting huh?

Lessons Learned: Use universal precautions as if everyone is infected.