Pt told me... why didn't anyone else?

Nurses General Nursing

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I work for a Home health agency, I take care of pts in assisted living facilites. Generally I am given an oral report on pt's condition, medication, needs etc. However this time I was not told that the patient had Hep B&C and Aids.... I have been told these conditions on previous patients in the past. The Pt is the one that told me, and the pt also told me the he was told not to tell anyone...

I feel that this was deliberate and I no longer feel safe in my work enviorment. What should I do?

Specializes in LTC, Pediatrics, Renal Med/Surg.
I'm curious.......Does home health have computer systems?

I have a feeling most home health agencies/companies do not have the funds for such.

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I don't understand why you feel unsafe. I do understand why you may be upset with your employer.

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Specializes in Maternal - Child Health.

In what capacity are you caring for this individual? Is the diagnosis of HIV/Hepatitis pertinent to the care you are providing?

Information is appropriately shared on a need to know basis. If your care of the individual does not involve the potential for blood/body fluid contact (for example, if you are a dining assistant or if your role is limited to passing oral meds) you do not need to know the person's HIV status to safely provide care.

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It is best to utilize standard precautions for all patients, regardless of whether or not they have a diagnosis of Hep C, HIV, etc. After all, there are probably a lot of people who have it and have not yet been diagnosed. Act as though all of your patients have Hep C and/or HIV, and you will always be safe.

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I thought that aids/HIV is considered a disability, not a disease in the eyes of the law, and is therefore not required to be disclosed if positive for this.....?

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In what capacity are you caring for this individual? Is the diagnosis of HIV/Hepatitis pertinent to the care you are providing?

Information is appropriately shared on a need to know basis. If your care of the individual does not involve the potential for blood/body fluid contact (for example, if you are a dining assistant or if your role is limited to passing oral meds) you do not need to know the person's HIV status to safely provide care.

This was my thought as well. :)

As well as Universal Precautions.

Before assuming someone deliberately withheld information, ask yourself how you would change your care with that knowledge. :confused: Is it nice to know the information- sure. But it may not have been part of the information put together if there wasn't even a HH chart available.

I also remember the beginning HIV/AIDs . Back then, gloves were kept in a box on the nursing station desk- one box for the entire floor. Mask/gowns were only used for really skanky wounds/respiratory infections/etc. You cleaned up ANY poop with a bare hand and a washcloth and had non-antibacterial soap, and NO hand gel. The most common form of isolation I saw was "Enteric Precautions" for viral meningitis. (I worked neuro- and we got the AIDS overflow from the respiratory side of the floor we shared- "H" shaped building). I'd been a nurse for about 10 years before gloves were required for ALL IV/lab sticks.

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I thought that aids/HIV is considered a disability, not a disease in the eyes of the law, and is therefore not required to be disclosed if positive for this.....?

It's a disease. That law more than likely refers to something else... although in the situation the OP refers to, 'need to know' MAY apply... their chart wasn't even done yet....

Closest thing I could find- ASYMPTOMATIC HIV is a disability for disability purposes (not healthcare; it's a medical diagnosis for health reasons; AIDS is a disease... )

https://litigation-essentials.lexisnexis.com/webcd/app?action=DocumentDisplay&crawlid=1&doctype=cite&docid=3+J.+Health+Care+L.+%26+Pol%27y+382&srctype=smi&srcid=3B15&key=2fed692b02fc3f4484d045daa65ddea4

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Specializes in Acute Mental Health.

Some places only give you the need-to-know information. I hate that. When I have a pt with AIDS (not HIV+), I need to know this. I'm more concerned with sniffles and coughing because of the compromised immune system then I would be with one of my other not-so-ill pts. I tend to get my radar up and going so I can be more aware of increasing temps etc.

Do you have access to the chart? If so, take some time to read what the listed dx's are. They should be easily found just in case someone needs to be sent out via ambulance. I agree with others that if you're following universal precautions then you really will be fine.

I work with a nurse who is AIDS phobic. I've had her do most of the tx's on our compromised pts to get her more comfortable with the fact that they are all human and need compassion. She's come a long way but I still accompany her during IM's per her request.

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Some places only give you the need-to-know information. I hate that. When I have a pt with AIDS (not HIV+), I need to know this. I'm more concerned with sniffles and coughing because of the compromised immune system then I would be with one of my other not-so-ill pts. I tend to get my radar up and going so I can be more aware of increasing temps etc.

Do you have access to the chart? If so, take some time to read what the listed dx's are. They should be easily found just in case someone needs to be sent out via ambulance. I agree with others that if you're following universal precautions then you really will be fine.

I work with a nurse who is AIDS phobic. I've had her do most of the tx's on our compromised pts to get her more comfortable with the fact that they are all human and need compassion. She's come a long way but I still accompany her during IM's per her request.

Well, that's incredibly sad, and IDK, ignorant?

jmho.... I'm sorry you have to compensate for her insecurity and ignorance- but glad the patients get the care they need.

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Specializes in Emergency, Telemetry, Transplant.
I don't understand why you feel unsafe. I do understand why you may be upset with your employer.

My thoughts exactly...I take care of HIV+ pts on a weekly basis. Sometimes I know their status, sometimes I don't. That does not change what precautions I take.

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Specializes in Acute Mental Health.
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Well, that's incredibly sad, and IDK, ignorant?

jmho.... I'm sorry you have to compensate for her insecurity and ignorance- but glad the patients get the care they need.

At least she was honest with me when I asked. Over the years, I've found my coworkers uncomfortable with everything from vomit, ng goodies, to now this. I'd rather someone be honest and willing to overcome than to ignore a patient or pawn them off on everyone else. It's a great time to teach and learn as well.

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At least she was honest with me when I asked. Over the years, I've found my coworkers uncomfortable with everything from vomit, ng goodies, to now this. I'd rather someone be honest and willing to overcome than to ignore a patient or pawn them off on everyone else. It's a great time to teach and learn as well.

That's a good way to look at it.... and I'm glad you're able to do that :up:

I think my mouth would overrun my butt, and I'd be incredibly angry :o

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