I'm working in the lab of a large hospital while waiting to start the nursing program at my local community college this fall.
I was on phlebotomy tonight and before one of my draws the patient's RN pulled me aside outside the room (in the hall) and told me to "be careful because she's HIV positive." Another phlebotomist related that the RN had also advised him of the patient's HIV status before he drew the patient earlier in the evening.
As a phlebotomist, you'd have to be point-blank stupid not to approach every draw as if the patient had a blood-borne pathogen. That's why we have things called personal protective equipment and universal precautions. A patient's HIV status is and should be irrelevant when it comes to drawing blood since you should be taking the same degree of precaution with every draw that you do.
I believe that the RN needlessly compromised the patient's right to confidentiality, especially with such a highly confidential diagnosis. In addition to what seems to be to be a serious breach of ethics on the part of the RN, it also sounds like a big, glaring HIPPA violation.
I'm not even in RN school yet and it's setting off alarms with me. Am I off base in my assessment of the situation? I'm seriously considering reporting it to our compliance officer, my motivation not being to "nail" the RN, but rather to take advantage of the situation as a teaching opportunity for the RN, and also advocate for the patient who probably has no idea that her confidentiality was breached.
Any thoughts from you seasoned professionals would be most appreciated!
AngelFireRN wrote: "Does their right to "privacy" negate my right to protect myself against someone who is a walking biological weapon?
I'm not as bad as some people I know, "put them all on an island and leave them", but I firmly believe that I have a right to know what I am walking in to."
Wow...you actually admit to knowing people who would advocate "putting them all on an island?" I think you own comments perfectly illustrate, in glaring terms I might add, exactly WHY that patient has a right to confidentiality - to protect them from the sort of blather and slander you illustrate in your own post!:angryfire
The added layer of protection is the knowledge that you must be VERY careful in dealing with an HIV infected patient. Universal precautions are followed with every patient, of course. However, needle sticks do happen.
Specializes in med-surg, psych, ER, school nurse-CRNP.
If you will note, I did say that I did not share in that particular sentiment, regarding the island. And as far as the walking biological weapon, I will thank you not to take my comments out of context. When a patient with a known infection tells me point-blank that he is going to "**** up as many people as I can before this thing gets me", well, what else can you say? What other name can you give to someone who deliberately sets out to inflict harm on innocent people he does not know just because he's angry he's sick?
The added layer of protection is the knowledge that you must be VERY careful in dealing with an HIV infected patient. Universal precautions are followed with every patient, of course. However, needle sticks do happen.
Here's hoping you are "VERY" careful when performing an invasive procedure on ANY patient.
Specializes in med-surg, psych, ER, school nurse-CRNP.
And why is is so bad to admit I know someone who's views I don't share? Still wondering about that one...... No one I know agrees with me about everything, but they still admit they know me. I would not advocate the island scenario, and in my defense, I did ask the person who has this view, "If I got HIV at work from a needle, would you want to ferry ME out to the island?"
Considering this was a friend, I think their view may be a bit different now. It's all in how you look at it.
Yes, needlesticks do happen. But knowledge of the presence or absence of blood-borne pathogens in a particular patient has no bearing on the factors that contribute to accidental needlesticks.
Being aware that someone has HIV, hepatitis, or any other blood bourne pathogen is an added layer of protection against accidental needlesticks. You can bet that I would be certain to make sure that an accidental needle stick did not happen with that patient :)But here's to not knowing the patient's status and walking in blindly! Hooray! (just for you, MLOS)
If you will note, I did say that I did not share in that particular sentiment, regarding the island. And as far as the walking biological weapon, I will thank you not to take my comments out of context. When a patient with a known infection tells me point-blank that he is going to "**** up as many people as I can before this thing gets me", well, what else can you say? What other name can you give to someone who deliberately sets out to inflict harm on innocent people he does not know just because he's angry he's sick?
Okay, I find it hard to understand that as a master's candidate (and as a nurse practioner, no less) you aren't grasping the bigger picture here. But let me try to explain it in simpler terms. What if I, as a phlebotomist, was someone who advocates "putting them all on an island" (and yes...it's perfectly clear you didn't say that, so simmer down). What level of care do you think I might give that patient while drawing their blood? If I was that regressive in my intelligence, I doubt I'd offer the patient much empathy, and my disgust would probably be thinly veiled to the patient.
While I don't doubt you had a patient who was out to be HIV's equivalent to Typhoid Mary, that had to do more with his mental health than his lack of bodily health due to his disease. I seriously doubt that there are many HIV-positive patients lying around hospitals plotting to infect anyone they can get their hands on. So because of this one experience you had with one patient, that means you feel you have the "right" to inform people about the status of all your future patients with HIV?
So, I stand by my original thoughts about "my right" to know about this patient's HIV status. You might THINK I have a right to know, but I really don't. I'm surprised...I would have thought having almost made it through a master's program you would have covered situations like this in, say....and ETHICS class?
Police officers deal with dangerous people every day, too. They never know when someone has a gun. Does that criminal's right to privacy trump that officer's right to know that he has a gun? Or should the policeman find another "less dangerous" job if he does not want to deal with that?
News flash... Unless you do something that would permit them to search you, they have NO right to know if you have a gun. Even if having a gun is illegal. The right of a person from unreasonable search and seizure overrides the right of the police officer to be safe.
Yes, the officer CHOSE to be a police man. If it's dangerous he can quit. I mean seriously!?!? In the military we never whined like this. Oh man why is war so unsafe!!! The government should do something!
Get Real. We chose to be soldiers and DEALT with it. Time for the supposed officer and nurses to start dealing with it. If you can't McDonald's always hires and they are pretty safe.
The law is meant to serve the WHOLE of the people, not just a few dissenters.
Being aware that someone has HIV, hepatitis, or any other blood bourne pathogen is an added layer of protection against accidental needlesticks. You can bet that I would be certain to make sure that an accidental needle stick did not happen with that patient
It is not an added layer of protection. You should ALWAYS be certain to avoid needlesticks. What? If they are undiagnosed you can do whatever you want and not be safe??? Like I said before... If you do your job PROPERLY knowing their HIV status will be a moot point. If you only use safe practices when you know they have HIV then, sorry, but you are an unsafe practitioner and I hope I don't ever get you.
Being aware that someone has HIV, hepatitis, or any other blood bourne pathogen is an added layer of protection against accidental needlesticks. You can bet that I would be certain to make sure that an accidental needle stick did not happen with that patient
You must have been taught something that the rest of us missed. Can you explain how you "be certain to make sure that an accidental needlestick" does not happen with the patients you care for who you happen to know carry a blood-borne pathogen vs. how you care for patients whom you *believe* to be free of these pathogens?
Specializes in med-surg, psych, ER, school nurse-CRNP.
Okay, I find it hard to understand that as a master's candidate (and as a nurse practioner, no less) you aren't grasping the bigger picture here. But let me try to explain it in simpler terms. What if I, as a phlebotomist, was someone who advocates "putting them all on an island" (and yes...it's perfectly clear you didn't say that, so simmer down). What level of care do you think I might give that patient while drawing their blood? If I was that regressive in my intelligence, I doubt I'd offer the patient much empathy, and my disgust would probably be thinly veiled to the patient.
While I don't doubt you had a patient who was out to be HIV's equivalent to Typhoid Mary, that had to do more with his mental health than his lack of bodily health due to his disease. I seriously doubt that there are many HIV-positive patients lying around hospitals plotting to infect anyone they can get their hands on. So because of this one experience you had with one patient, that means you feel you have the "right" to inform people about the status of all your future patients with HIV?
So, I stand by my original thoughts about "my right" to know about this patient's HIV status. You might THINK I have a right to know, but I really don't. I'm surprised...I would have thought having almost made it through a master's program you would have covered situations like this in, say....and ETHICS class?
I never said I took it upon myself to inform anyone of a patient's status. I never do. I did, however, pass it along in report, as it was passed to me. That's just how we did it in our hospital. But that was one of the deciding factors towards my getting my Master's and getting away from the bedside, the fact that nurses have NO protection against abuse, against poor staffing, or against walking into a situation like what is being debated here.
And, sorry, no ethics class, not part of the curriculum, unless you take it as an elective. Where I live, and where I will practice, it's not an issue....if you know about it, you pass it to whoever needs to know, end of story. Ethics be danged, I get tested every year, I am of the opinion that it should be mandatory, and since it's a reportable disease, it should be reported. I could care less about how you got it, makes no difference to me....and i don't care one whit to take care of you. I will not stride into your room wearing the "moon suit" as if i was headed into the cooling tower of a nuclear facility. I will protect myself and my family, though, and I don't think anyone should expect any less of a person.
As far as my intelligence goes, not seeing the big picture, I think I am, quite clearly. We've gotten so caught up in protecting the rights of some that the rights of others have been thrown under a bus. Hey, I am not going to agree with everything you do or say, nor you I. I have not challenged your intelligence or education, though. Please have the same respect.
But let me try to explain it in simpler terms. What if I, as a phlebotomist, was someone who advocates "putting them all on an island" (and yes...it's perfectly clear you didn't say that, so simmer down). What level of care do you think I might give that patient while drawing their blood? If I was that regressive in my intelligence, I doubt I'd offer the patient much empathy, and my disgust would probably be thinly veiled to the patient.
AZO49008
145 Posts
AngelFireRN wrote: "Does their right to "privacy" negate my right to protect myself against someone who is a walking biological weapon?
I'm not as bad as some people I know, "put them all on an island and leave them", but I firmly believe that I have a right to know what I am walking in to."
Wow...you actually admit to knowing people who would advocate "putting them all on an island?" I think you own comments perfectly illustrate, in glaring terms I might add, exactly WHY that patient has a right to confidentiality - to protect them from the sort of blather and slander you illustrate in your own post!:angryfire