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As a little background.. I work in an LTAC in a very rural area. My situation involves an elderly man who has a terminal illness and is vent dependant. His family wants him to take "herbal medications" in belief that it will cure him. Now I really don't have anything against alternative treatment but these herbs are two trashbags full of glass bottles with papers tapes labeled "AM herbs" and "PM herbs". Now there are bottles like you would get from GNC but they want you to give 4* the amount as recommended on the bottle. When I looked closer at who prescribed these meds I saw it was from a Phd in South America. So anyway, I approached the MD who approved these "herbs" and all he said was "look, I just wanted the daughter to shut up". I asked "Well, do you think their safe?" and he said "I don't know". So with that, I refused to give. I told the CN I wasn't comfertable giving this stuff but if she was, go right ahead. So anyway, I got a lecture on how alt therapy has healed grandma and grandpa and I shouldn't judge. I tried telling them it wasn't that I didn't believe in alt therapy, my problem was I didn't know what I was giving and how it was going to affect the patient or interact with his other meds (heart meds, seizure meds..) Furthermore, this man is a full code and his family does not believe he will die anytime in the near future. So its a mess... I am catching grief at work about how I am making things too complicated and that I should just give the meds to make the family happy. What do ya think? Allison

I have gone through the ADN program, waiting to sit for the NCLEX and I really don't want to be a nurse. I haven't liked any of my clinicals except psych , L&D, and newborn. I had a close call needlestick incident (I don't "think" it punctured my skin) with a hepC+ patient, which has made me realize that I shouldn't be in this profession if I don't want to take this kind of risk. I don't like the thought of making an error where I could really harm someone or even kill them and I am thinking "what a mistake this was?" Is anyone else in the same boat? I am trying to think of other areas I can go into. I already have a degree in Finance, but I didn't utilize it due to having young kids and the cost of childcare. I can't believe I have a BS in Finance, an ADN, soon to have RN and I still don't know what I want to be when I grow up? The clock is ticking because I have to start working soon. Any advice would be appreciated:) . Allison

I had a scare with hep C + patient 5 weeks ago. I was giving insulin and I felt the needle when I injected it into the patients arm. I milked my finger and didn't get any blood and I think I only cought the side of the needle not the tip end, but its nerve wracking. When you stuck yourself, did it draw blood or did the needle just bounce? There has to be blood to blood transmission for there to be a hep c exposure. Even if that does occur, the chances of you getting hep c are small. My doctor told me she once cut herself to the bone with a razor doing surgery on a hep c patient and she still didn't get it. I took a antibody test at 5wks and it was negative, I go back in the middle of February for the 3m test. The good news is you know your patient didn't have HIV, I don't know that about mine and I wish I did:) Allison

Hi, I'm a new graduate and I have an interview tomorrow for an internship in L&D. I'm excited, but I am not sure what questions to ask and I am not sure what questions they will ask me? Can somebody give me some tips on interviewing for this position so I can be more prepared? Allison

Not to long ago, I gave insulin to a man who was extremely thin. I pinched up the skin on his arm and literally felt the side of the needle when I injected. I didn't scratch or puncture myself, but he was shaking so I think thats why I felt it. There has to be a safer way to give insulin that I don't know about. I don't like the thought of being that close to a needle stick which was the first thing I thought when I felt the needle. I have asked other nurses about this and they just told me not to give it in the stomach on thin patients because of the lack of fat but no other advice. Does anyone know a safer way to do this? Allison

I felt the needle after I went in. I pinched up the skin on an emancipated patient and apparently the needle was longer than the fatty skin I pinched and the needle went all the way through. I really thought I was being careful when I pinched, I actually remeber thinking that should be enough fat for the needle. Aack. Thanks for all the input so far, I really appreciate it:) Allison

Just to give a recap if you didn't see my post earlier, I was giving a sq injection of insulin and I felt the needle touch my glove while injecting the insulin. I wasn't sure if I pricked myself so I took off my glove, milked my finger and there wasn't any blood to be seen. This patient was hep c +, so I went down to infection control, then to my student center. It was unanimous that they didn't feel I had any real risk in the situation even if the needle braised my finger. I try not to second guess them, but I can't help it because I'm a nursing student and just haven't been around enough to know. I am having labs drawn in a couple weeks and thereafter for peace of mind. So down to my question. The explaination given to me was "because I was not accessing a vein or artery and I didn't have any blood on my finger, my chances of transmission are negligable." There has to be blood from the patient, mixed with my blood for transmission to occcur which would be unlikely in this situation. Is this true? Any input would be appreciated. I would love to sleep a little better at night:) Allison

Well, I have contacted everyone under the sun and it is unanimous that we are not going to do antiviarals because I am pregnant (sorry forgot to mention that) and they do not think there is any risk of exposure. However, for peace of mind blood draws will be done. I also didn't mention before that I am a nursing student about two weeks away from graduating. Apparently as a student, I must go by whatever the hospital says and the ER will only treat me if they believe its necessary. If I disagree, I can go to my regular doctor. Furthermore, there is some controversy over "what a puncture is?." Some people believe it is a wound penetrating to the point a mark is made and blood is able to be produced. Others believe it can just be a scratch. They said they would be worried if I was drawing up blood or just gave an IM and scratched myself with a needle, but that is not the case. In my case I pinched up skin inserted the needle and felt the needle on the other side. The chances of contracted Hep C, etc.. from a nonvascular area and an insulin syringe is really low and compounded with the fact that there is no mark, blood, or bruising-pain puts my risk basically at zero because that is not classified as a penetrating wound. All I can do now is trust what 7 people who deal with this stuff as a full time job believe. I tend to worry more than I should and I am trying my best not to let it get the best of me. So thanks for all your responses and I will keep you updated with my lab results:)

Its crazy, you would think I would know if I had a needlestick, but I don't. I was giving insulin and while pinching the skin, I felt the needle. I don't remember flinching, but I withdrew the needle-took off my glove and milked my finger. There was no blood, no mark, but I still have the fear because this is a hep c patient and who knows what else? The hospital staff for environmental exposure didn't seem concerned and said that it very very unlikely that I would of contracted anything because there was no blood or mark. Therefore, no treatment was initiated. What do yall think? I thought even superficial sticks pose a risk? Any advice would be appreciated