It has to do with privacy and that is why you need someone's consent to test for HIV. Also if you are using standard precautions than what extra protection do you need?
People don't want to be tested on a routine basis for HIV against their will. Always use caution. I remember how the first AIDS patients were treated. Home care workers refused to go into their homes. Hospital workers refused to to bring dinner trays to them. All for being HIV+. The staff were judgmental and treated them differently. This was one of the major incentives to enact the HIPPA law.
My friend who is a dentist said that she takes every precaution when working on every patient but that she definitely has a heightened awareness while working on her HIV patients.
Nothing wrong with a heightened awareness, nothing discriminatory about that.
No testing is done in any facility in any state without your consent.
Kinda falls under that "right to refuse" aspect of healthcare.
I had a nurse in the OR after I had major surgery to stick herself with a sharp and they came back into my room to do a blood draw for HIV testing. My veins were not good after the surgery and after they stuck me 3 times I refused to allow them to stick me any more. I told them that I would allow them to draw in a couple of days but right now, I was in so much pain I didn't need anymore...so they stopped.
So I allowed them to do the blood draw two days later. So yes, you have the right to refuse.
Actually in the District of Columbia where I practice now if I suffer a needlestick we are legally allowed to draw blood for HIV testing without pt consent. D.C. feels that with our higher than average rates of HIV/AIDS medical staff need to know if they are exposed, and pts don't always consent to testing if it is optional.
As recently as 2007, I was on an EMS program rotation at a large trauma center. I watched as an ER registration clerk donned gloves before approaching a patient (an HIV-positive patient very familiar to ER staff) to ask him for demographic information. After the patient signed some forms, the clerk held out a trash can so that the patient could throw away the pen without her touching it again.
I'm sure that this clerk was doing what seemed right to her, taking precautions above and beyond what was recommended by any training she might have received. But those extra precautions left me, the other students and surely the patient with bad tastes in our mouths.
What I mean by that is I take universal precautions on everyone. I always don gloves when starting IV's or drawing blood, even for a finger stick. I never recapped used sharps and when working in traumas, I always wear a face shield with goggles.
I always wear a long sleeve t-shirt under my scrubs and a cardigan over my scrubs to protect from any blood splashes.
I've seen a couple of nurses start IV's on pts where they will pull the index finger off the glove to get a better feel of the vein. A patient consented to a rapid HIV test and it was positive and the nurse who started the IV was freaking out because she pulled the index finger off the glove to start his IV.
Specializes in Acute Care Cardiac, Education, Prof Practice.
My friend who is a dentist said that she takes every precaution when working on every patient but that she definitely has a heightened awareness while working on her HIV patients.
Nothing wrong with a heightened awareness, nothing discriminatory about that.
As recently as 2007, I was on an EMS program rotation at a large trauma center. I watched as an ER registration clerk at a large trauma center donned gloves before approaching a patient (an HIV-positive patient very familiar to ER staff) to ask him for demographic information. After the patient signed some forms, the clerk held out a trash can so that the patient could throw away the pen without her touching it again.
I'm sure that this clerk was doing what seemed right to her, taking precautions above and beyond what was recommended by any training she might have received. But those extra precautions left me, the other students and surely the patient with bad tastes in our mouths.
Case in point. Extra precautions related to "knowing" can be misconstrued as discriminatory.
Specializes in Infectious Disease, Neuro, Research.
This was one of the major incentives to enact the HIPPA law.
Please don't ever be confused, HIPPA does nothing for your privacy (or your patients') it only limits the institutions' financial liability. Instead of paying $14 million to an individual whose "PHI" is lost/stolen/etc.,. the facility pays(maybe) $10k/violation, and you can go after the employee (whom we know has the resources to provide real restitution:rolleyes:) in civil court. It is settlement capping with a pretty, PC name.
Edit:
Oh, heck, I'll say it. "Discrimination" is not necessarily bad. If one is able to differentiate between emotional bias and reasoned decision making, one is using discrimination. Minority populations have protection in a democratic-republic; when they take control, they take their position at the expense of the majority.
I guess stuff like this continues to surprise me. Testing every patient that walks in the door for HIV is a waste of resources. As everyone have already pointed out, we should be taking the highest precaution for every patient to protect ourselves.
My friend who is a dentist said that she takes every precaution when working on every patient but that she definitely has a heightened awareness while working on her HIV patients.
Nothing wrong with a heightened awareness, nothing discriminatory about that.
There is if she doesn't have the same "heightened awareness" of hepatitis viruses, among other things. Hepatitis is far more widespread, easier to catch and just as deadly as HIV.
HIV testing is such a pain...paperwork, consent, and the attending has to sign off on the lab req at my hospital.... plus universal precautions are more than enough to protect yourself from blood born diseases.
Let's not forget the tricks your mind plays on you. If you are afraid of HIV pts and all you can think is "this person has HIV, this person has HIV" you are more likely to make a mistake than if you just approach them and treat them like any other pt. Use precautions, and if you are exposed follow procedure.
ckh23, BSN, RN
1,446 Posts
It has to do with privacy and that is why you need someone's consent to test for HIV. Also if you are using standard precautions than what extra protection do you need?