Resident with STD

[erika89]

The other day i was at my lunch break with several other cnas. I was telling one of them how much of a monster one of the residents is she then told me that this resident had herpes and to wear gloves when ever I took care of her. Later that day I asked the Rn if it was true and she looked me in the eye and said no so that was that. A couple days later I was mentioning to her that I had applied to the nursing program at my school and for some reason I was nervous about doing care plans so she told me I should go through some of the resident's charts and check some out. So there i am going through the monsters chart and there it says along with some other conditions genital herpes. So my question is did she have the right to lie to me. Oh by the way i told all the other cnas on the unit about the monsters little problem.

[Okami_CCRN, BSN, RN]

technically the RN did not have to inform you of the STD because of universal and standard precautions stating that when in contact with a patient you should always wear gloves.

You also violated HIPPA law by sharing confidential information with other people.

[Candy303]

First of all I find it appalling that you would call your patient a "monster". Second of all, regardless of what "disease" your patient may or may not have, you should ALWAYS wear gloves. That said, the RN does NOT have to share this information with you. You're not in charge of her medical care, therefore you do not need to know. You also must realize that you and the other CNAs are violating hippa code sitting around and talking about what this and that patient has.

Think of it this way. How would you feel if you found out others were talking about what problems you had?

[skittlebear]

I don't believe the RN had any obligation to inform you of this. You should treat everyone as if they have an STD and follow universal precautions. I also believe you violated HIPPA by telling all the other CNA's about "the monsters problem". In addition, I feel that this is a very disrespectful and unprofessional way to act. I think it's downright sad that you would refer to one of your patients as a "monster". Maybe you need to rethink your career choice!!!

[Okami_CCRN, BSN, RN]

Actually Reyna88 you could be terminated because you have violated federal law by discussing this patients information in public with other people.

I hope that you understand how serious this situation is and refrain from making that mistake again.

Also we all have our good and bad patients and you just have to take it one grain at a time. Good Luck with your future endeavors

[caliotter3]

One of the CNAs told me about a resident who was positive for HIV or had AIDS outright. This info was not passed on to personnel so that they could take extra precautions. This CNA called the State and asked about it. She was told that she should have been told. The reason behind this answer was because there had been body fluid contact. The CNA had to go and get tested for HIV. She was angry as could be. She said it almost cost her her job (and of course she was worried about her health). She tried to make the call to the State anonymously but was forced to give her name. At any rate she was irate that this info had been kept from the caregivers and to be frank about it, I agreed with her. I was doing clinicals at an acute care hospital where HIV status was part of report. If a patient has a condition that could be potentially harmful to caregivers, then they should be informed in a professional manner. Not informing people sets up a situation where the info gets out as gossip, and just makes matters worse.

[Virgo_RN, BSN, RN]

To answer your question, you do not have a need to know this medical information in order to do your job. It is the resident's personal medical information that is protected by federal law. As long as you use standard precautions, you have little to fear as far as contracting this illness. It's not like it's airborne.

As for the rest....let me share a little story. I once worked in LTC as a CNA. On my shift, me and another CNA split a wing, each taking a hall. There was one resident the other CNA openly expressed dislike for. Whenever I went into the resident's room after the other CNA had been in there, the resident was always in a foul mood. I could usually manage to defuse it by being pleasant and agreeable. I noticed that if I walked into the room calmly and with a smile, the resident was never unpleasant to me. One night the CNA was griping about the resident, when the nurse overheard her and looked at her point blank and said "She can't help the way she acts. She has brain cancer.". That shut the CNA right up.

[Virgo_RN, BSN, RN]

One of the CNAs told me about a resident who was positive for HIV or had AIDS outright. This info was not passed on to personnel so that they could take extra precautions. This CNA called the State and asked about it. She was told that she should have been told. The reason behind this answer was because there had been body fluid contact. The CNA had to go and get tested for HIV. She was angry as could be. She said it almost cost her her job (and of course she was worried about her health). She tried to make the call to the State anonymously but was forced to give her name. At any rate she was irate that this info had been kept from the caregivers and to be frank about it, I agreed with her. I was doing clinicals at an acute care hospital where HIV status was part of report. If a patient has a condition that could be potentially harmful to caregivers, then they should be informed in a professional manner. Not informing people sets up a situation where the info gets out as gossip, and just makes matters worse.

What extra precautions other than standard precautions would one take knowing a patient is HIV positive?

As far as the CNA who had body fluid contact, what kind of body fluid was it? Basically, unless you get the person's blood, semen, or lady partsl secretions splashed into your eyes, mucous membranes, or non-intact skin, the likelihood of transmission is so low that you are not legally entitled to that confidential medical information.

[BrnEyedGirl, BSN, MSN, RN, APRN]

caliotter3,. with all due respect, I believe you and your CNA friend are misinformed. HIV status is not something that under normal circumstances would be included in report to CNA staff.

The precautions for a pt with HIV are standard precautions that should be taken with every pt, all of them, no matter what the diagnosis is.

Any case of "body fluid exposure" should be covered under policy and be reported and worked up the same. HIV as well as Herpes are not airborne, and cannot be passed on by casual contact, ie helping a pt to dinner, assisting a pt to eat, assisting a pt to the bathroom etc. For cares such as bathing, cleaning peri area, wound care etc, you should always wear gloves anyway so you are protected.

Talking about a pts protected health information with your friends is a good way to loose your job and to have legal action taken against you. If you have questions about infection control policies or are concerned about keeping yourself safe, read your policies, ask questions, educate yourself, don't gossip in the breakroom.

[Virgo_RN, BSN, RN]

My understanding is that a health care worker only has the right to know a person's HIV status if they have experienced an exposure with a high likelihood of transmission, such as a blood splash into the eye.

[danissa, LPN, LVN]

A couple days later I was mentioning to her that I had applied to the nursing program at my school and for some reason I was nervous about doing care plans so she told me I should go through some of the resident's charts and check some out. So there i am going through the monsters chart and there it says along with some other conditions genital herpes. So my question is did she have the right to lie to me. Oh by the way i told all the other cnas on the unit about the monsters little problem.

For SOME reason??? You just had to check that particular patients notes out???WHY that patient????

Your question should be with yourself, and your suitability for the job you are doing.

If that patient had genital herpes, you were at no risk unless you were touching the afflicted area..(during a herpes crisis) with no gloves or indulging in intimate contact with the patient!! (again during a herpes flare up!!!)

And you told the other Cna's...Words fail me, at your lack of discretion and your violation of patient confidentiality!

Finally...your description of that patient as "the Monster" :angryfire........

I can only answer your question with...go find yourself a job which does not require you to uphold and respect the privacy of your fellow human being.

Hope you never find yourself in a situation where your privacy needs to be respected! Patients are not in our care to fulfill empty gossip mongering!!!:angryfire

[slsampson]

{QUOTE]"One of the CNAs told me about a resident who was positive for HIV or had AIDS outright. This info was not passed on to personnel so that they could take extra precautions. This CNA called the State and asked about it. She was told that she should have been told. The reason behind this answer was because there had been body fluid contact. The CNA had to go and get tested for HIV. She was angry as could be. She said it almost cost her her job (and of course she was worried about her health). She tried to make the call to the State anonymously but was forced to give her name. At any rate she was irate that this info had been kept from the caregivers and to be frank about it, I agreed with her. I was doing clinicals at an acute care hospital where HIV status was part of report. If a patient has a condition that could be potentially harmful to caregivers, then they should be informed in a professional manner. Not informing people sets up a situation where the info gets out as gossip, and just makes matters worse.

No offense, but as a CNA and a nursing student, i do agree that even CNA's should be informed that extra precautions should be taken with certain residents or patients. I know this first hand because I was exposed to Tuberculosis and I found out later that it was from a patient coughing around me repeatedly. I don't have active TB, but I do have a positive result from skin tests and have to take a yearly x-ray of my lungs because of it. And that's not even as bad as the 9 months of TB medicine I had to take to keep the TB dormant. I was miserable during the whole course of treatment. I've finished it, but if i had been given a heads up about the pts. condition, i could have worn a facial mask to prevent exposure to coughs and sputum. Thanks to someone not giving me the info i needed, i suffered for 9 months on medication that made me sick. I think that Nurses, CNA's, PT's and any other people involved in someone's care should be warned when they need to take more precautions than the usual universal precautions. I would appreciate any feedback i get on this. I also have to add that the person involved with starting the thread should have excercised more discretion in the situation they were in and should not have shared a pts. information with people that were not involved. HIPPA laws are very strict, as well they should be, but I don't think that people so closely involved are recieving all the pertinent infomation that they deserve.