azverte

Thanks colleagues! I am so glad to see realistic concern. On the cost: The procedure to test baseline for the minimal three diseases at time of injury and to one year is a mandatory federal law, as well as offering the post-exposure cocktail. So there is no decision to be made - it has to be done. While we cannot worry about every little thing (Hey- I drive on the interstate!) disease transmission knowledge is so important. We can 1..prevent disease progression, 2..treat the disease and 3..very importantly, keep from spreading it. I know a nurse who spread HepC to her children and even grandchildren (childbirth and sharing razors) before she had symptoms and a test for HCV was available. I think she suffers more now from guilt than the disease. What if the disease was to incapacitate the nurse? How could it be proven that he/she got it from a needlestick injury unless testing was done? So many of the diseases take decades to manifest. Just from the reported injuries and the minimal testing done, more than 300 nurses die each year. That is more than a jumbo jet! Imagine what the FAA would do if a jumbo jet a year kept crashing from the same cause?!?!?! Safety sharps are a good effort, but not the whole thing. And we need to make sure that the specific safety sharp isn't just a sharp with the word "safety" printed on the package. Some supposedly safety sharps are actually responsible for INCREASED injuries! My favorite (NOT!) is the one where you slide your finger up a dirty needle! Hey manufacturers (especially that one in NJ) Nurses are not one-a-day disposable items! Colleagues: I love you all so STAY SAFE!

Your're it now - perhaps. On your last exposure, were you tested for everthing? Even prion disease which will incubate for up to 40 years? How about Hepatitis C? Average time from exposure to onset of symptoms is 20 years. Most West Nile Carriers are asymptomatic, but could transmit to you with a blood-borne path exposure. A report just came out that tetorifice is on the rise with parental drug users. Let's face it. HBV, HCV and HIV aren't the only BBP. There are too many BBP to count and many do not show up for years. Zero tolerance for sharps exposures and we need to up the post-exposure care and testing. We are putting our families at risk if we don't. Discussion anyone?

http://www.ena.org Type"latex" in the search screen. They have loads of info, position statements, etc. Hope you feel better.

In my state there are statutes against nurses working in facilities without a bonafide employee-employer relationship with the employer. This way responsibility for "checking out" the nurse falls on someone. Also, the feds are assured they get their peice because if the nurse fails to send it in, the feds go for the bigger pocket (the facility). It has all happened and I researched this same issue VERY thoroughly here. Like ALL laws, I found loopholes to squeeze through though. Hope this helps

Thank you so much for your post Cyber! I appreciate it. However, it is not the dying process or end-of-life-decisions about what therapies to employ. It is about how to explain the difference between comatose/ventilated/alive and dead/ventilated/should-we-call-the-transplant-team. How do you help families understand the definition of death? What is the definition of "dead?" Tough one? C'mon - if we can't - who can?

C'mon all you reading - please help! If a neighbor came to you for advice on making a decision regarding organ donation, what would you say regarding when the time is right? How do you get them to understand in terms they can understand? Thank you!

There are times when we must discuss with family members the concept of organ donation. Like all end-of-life issues, this is a process for most family members. Life support issues can be confusing for them and the family must feel confident that their family member is actually dead before organs are taken. There is no "just a little bit dead." There is life and there is death. So, how do you define death to them and how do you prove it to them? What are your stories and experiences with this issue? Thank you.

What part of "safety" includes sliding one's finger up a dirty needle? The added manipulation alone, not to mention the added time in one's hand is PROVEN in multiple studies to INCREASE needle stick injuries! The major manufacturer of needles and syringes was highlighted on the 60 Minutes show. They had made binding, long term and exclusive contracts with a majority of the nation's hospitals as a response to REAL safety products coming on the market. An example of a REAL safety needle is one that retracts into the barrel of the syringe upon completion of the dose. The needle is retracted right out of the patient's skin (passive retraction). The fast and stright removal is even more comfortable for EVERY patient I have injected with them. I had a prison nurse report to me that she injected a violent inmate, partially held by 5 deputies and after the injection, the syringe went flying therough the air. No-one was upset - they all heard the "click" of safety. There was the needle, on the floor safely well within its own sharps container (the syringe) unable to hurt anybody. There has NEVER been a needlestick injury with these needles used around the world, in health departments, prisons, etc and not even introduced to almost all hospitals due to these exclusive big-business-as-usual contracts. I guess I can't mantion these life-saving needles due to TOS but PM me and I will share. Be safe! Az

The AVERAGE time form the exposure to onset of symptoms for Hepatitis C is 20 years. Average! Yet testing for HCV after exposure is recent. Were you tested for HCV? HCV is chronic in almost every case - but takes decades to manifest symptoms. What about all the other blood borne diseases? An asymptomatic West Nile Patient (and MOST WNV is asymptomatic) could be your source patient. I could go on and on. "60 Minutes" did a great show on why hospitals are not consistently using all real safety products. The reasons are between shameful and criminal. "Real safety products" as opposed to those that are still causing needlesticks but DO have the word "safety" on the packaging. Testing for reasonable bloodborne diseases after exposure would not only be "expensive" but may just expose the truth! Imagine construction workers not being issued hardhats, police officers not issued vests, firefighters not issued breathing apparatus. Thanks for letting me rant! I just care so much about my colleagues - and me too. Be safe colleagues!

Absolutely, Lilgirl! I agree. Yet four times as many nurses die from job related injuries than police officers. Where is the outcry? Where are the public motorcades? Trouble is - there is not the drama of dying slowly from diseases than the drama of a police chase/shootout/whatever. Some people think the difference is a function of the general gender makeup of the professions. Can you imagine if a police professional died every day from job incidents (like the death rate for nurses?) Point is, working conditions and safety should be optimal for all of us - firefighters, police, nurses and everyone else too. A friend sent an article from today's paper to me. It is on a police shortage near her town. The public got involved and started a petition. This is the SAME community where weeks ago, in a unit with a staffing shortage that night, a nurse was found unconscious - strangled by her patient (she survived). But the police shortage gets the public attention. Anyway, here is the article on the police shortage: http://www.palmbeachpost.com/localnews/content/auto/epaper/editions/saturday/local_news_f35b1b6ff206c09b1071.html Be safe and well Az

Thank you Raduda. I really appreciate through researchers! I was concerned during my planning period that the program could be scrapped but relatively few programs are scrapped once initiated - but nothing is for certain but death and taxes. I have many more articles in peer reviewed journals which site an outcome improvement and cost savings using the Diabetes Shoe Program. The article you cited is with the VA. I have taken care of ex-VA patients. The VA provides one set of medical grade inserts, instead of the three provided by the Medicare program. Each Veteran I saw was wearing the lowest grade of extra-depth shoes made (and NOT in the patient's measured size!). I asked each Veteran how their feet were measured for their VA provided Diabetes Shoes and each one said, "Um...they asked me my size." Non reported professional measuring. The you cited article was published 18 months ago and in that time, the program has grown exponentially. Lastly, the article you cited (and I do appreciate it) described that all three groups were provided certain inserts, none of which are the inserts provided in the Medicare's Diabetes Shoe Program which has specific descriptions on medical grading. The medical grade, custom heat moldable (plastizote or similar) inserts will conform to the patient's foot and minimize pressure. The cork ones described in the study will not. So, I wouldn't consider it valid. Still, what I think has NEVER mattered! LOL! It is what the legislature passes and the legislators are hired by voters - so VOTE! Thank you once again for your research and comments. Every single law, program and thought in the legislature has at least 2 sides. The most compelling one prevails. Thanks, Az PS: It is a sad commentary on quality of care to our veterans!

Anyone want to answer the question on lack of nursing inter-support for this student nurse? (K_wagner) because after 25+ years of nursing - I still don't have a clue why it is like that. God knows I've tried!

Shoes are DME, but you can elect to, instead of full DME povider status, only request Diabetic Shoes supplier status. It is easier. Depending on which state you are in, the federal Medicare will require criteria such as pedorthic (like my state). Maybe not yours. There are many good suppliers. You can deal directly with multiple manufacturers or deal with distributers. I do both. PM me if you need more info. You go! And good luck.

Thanks for your support. The press was notified - print and TV. They confronted the facility who DENIED any incident. The victim is too shaken to act now. Multiple letters were sent. We are all not sure why the police etc have not acted - or maybe they have quietly. We are all under the impression that the very large hospital system is using their clout to minimize this. After reviewing the 60 Minutes report on all the wrangling going on with the result being nursing danger - I am fed up. Until nurses really put their brain power (and we are all very smart!) behind the issues and care for ourselves and each other as much as we care for our patients, the current status will prevail.

A month ago, a nurse was found unconscious in an ICU room in this county. The patient had strangled her with a BP cuff. The nurse survived but was admitted to the hospital. Except for nurses in the community talking about it, no coverage existed. There was reported short staffing that shift. What an opportunity for the facility to step forward and declare their support of nurses and plans for prevention of future dangers. Instead, they buried it, minimized it. No respect. In an average year (excepting 2001), more nurses die from job related injuries than police officers and firefighters combined.