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!
I still stand by the fact that if a patient has a known infection of HIV, I want to know! Yes, even if we treat everyone with universal precautions! sheeesh. And just on a side note, I think in every report I have been given, the nurse had mentioned the HIV status if there was a known diagnoses. I always appreciate the heads up!
I agree that we should be treating any patient as if they might have HIV (as in always using universal precautions).
Concerning legality, I don't believe that the nurse was in the wrong. It isn't a breach of patient confidentiality to tell members of the care team.
FTR there have been instances of HIV+ people infecting others on purpose.
Editing to add that I am surprised that some of you aren't allowed to know status. We are.
Only people that need to know to provide proper care has a right to know. A phlebotomist does not NEED to know. His nurse may depending on the circumstance.
The amount of people here sayin 'I don't care!!! I WANT TO KNOW!!!' are starting to remind me of the spoiled children you see at the supermarket. You can't always get what you want...
Yes, the phleb should know. Especially doing something invasive as drawing blood. They don't wear eye protection, and this is a time when they should!
If the phleb is worried they can always wear eye masks. These arguments make no sense. Everyone is at risk of giving you HIV. Universal precautions. Knowing solely to protect yourself is NOT a right. Maybe it should be but it isn't.
The only people that LEGALLY have a right to know are those that need it to provide proper care for the patient. Period. Read your law. If you don't like it the write your congressman.
If the patient has HIV, I want to know. It's my right to protect myself beyond universal precautions from something that could very well kill me in the long haul. PERIOD.
(insert your reply about universal precautions (blah blah blah) for all patients here).
If the patient has HIV, I want to know. It's my right to protect myself beyond universal precautions from something that could very well kill me in the long haul. PERIOD.
(insert your reply about universal precautions (blah blah blah) for all patients here).
Maybe you are missing the point. You have no right to know. The law says you have no right, I'm pretty sure your hospital policy says you have no right. You can't make up a right.
Are you a troll??? Starting to sound like it... No point in arguing with a troll. I'm done with this one...
Specializes in med-surg, psych, ER, school nurse-CRNP.
Are you a troll??? ...
Now, that kills it. Didn't your mother teach you that it's not polite to call names? I didn't see that poster say anything about you. That was uncalled for. Even if you don't share her (or his) opinion, be civil. That was just plain mean.
Now, that kills it. Didn't your mother teach you that it's not polite to call names? I didn't see that poster say anything about you. That was uncalled for. Even if you don't share her (or his) opinion, be civil. That was just plain mean.
Are you a troll? is a question, not a statement. My mother also taught me that...
(insert your reply about universal precautions (blah blah blah) for all patients here).
sarcasm is rude in general. Also not to assume as that makes u and me something I'd rather not be.
My valid question was in response to a post that obviously lowered itself below the level of debate and was aimed at being purely sarcastic. So my question still stands. Are they a troll?
BTW Troll - refers to someone arguing just to cause discourse... not an actual troll... in case you misunderstood.
Good grief, I never imagined I was opening up such a pesky can of worms by starting this thread! As Artie Johnson's German soldier character on Laugh In used to say peering from between the weeds: "Veddy, veddy intereshting!"
So anyway, an update:
I shared my concerns with my hospital's director of nursing yesterday afternoon. I declined to identify the floor or the specific nurse (I couldn't remember the nurse's name anyway).
For the record, the director of nursing was very concerned that this had happened. As a matter of fact, he said there have been other recent complaints about this very issue (I think they were incidents with patients other than the one I encountered). He said the complaints had come from other RNs.
He agreed with my assessment of the situation and said I was correct to report it. He said they are planning to address this issue with all RNs very soon and clarify with them when it is and is not prudent and legal to disclose patient diagnoses with other members of the care team.
I think that the reason it seems as if a 'pesky can of worms' was opened is because it sometimes feels like HIV+ people have more rights than those who are HIV-. IMHO it should not be that way. HIV- people aren't the carriers of a pandemic virus.
We are protecting people with HIV too much. We can't even let their SOs know. I have taken care of pts that refuse to disclose HIV status to their sexual partners. I have a problem with that. AIDS is going to continue to be a serious public health problem as long as we protect the infected more than we protect the un-infected.
JMO, no need to argue because you won't change my opinions. I have a background in public health and I can tell you that we aren't doing anything to make our (global) AIDS problem any better.
I think that the reason it seems as if a 'pesky can of worms' was opened is because it sometimes feels like HIV+ people have more rights than those who are HIV-. IMHO it should not be that way. HIV- people aren't the carriers of a pandemic virus.
We are protecting people with HIV too much. We can't even let their SOs know. I have taken care of pts that refuse to disclose HIV status to their sexual partners. I have a problem with that. AIDS is going to continue to be a serious public health problem as long as we protect the infected more than we protect the un-infected.
JMO, no need to argue because you won't change my opinions. I have a background in public health and I can tell you that we aren't doing anything to make our (global) AIDS problem any better.
People with HIV need protection from discrimination. By forcing people to disclose their private medical information in the name of the public good, fewer people will be tested because they will fear the stigmatization that HIV+ status carries.
uscstu4lfe
467 Posts
I still stand by the fact that if a patient has a known infection of HIV, I want to know! Yes, even if we treat everyone with universal precautions! sheeesh. And just on a side note, I think in every report I have been given, the nurse had mentioned the HIV status if there was a known diagnoses. I always appreciate the heads up!