skin exposure to HIV positive blood ;(

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I was doing an art project in a mental health setting with a non violent, but somewhat restless patient today. She had a one-on-one CNA attending who was helping out. I was told in advance of HIV status. She had no visible open wounds and I was not doing anything that would involve body fluids(or so I thought). Somewhere during our interaction, the CNA quickly excused herself to go wash her hands. I immediately noticed after that that there was a small blood smear on one of the papers we were working on together, as well as on some pens. I then look at my hands, and noticed what I thought was a small amount of blood on a couple of areas on my hands. One was on the side of my index finger, which was a chapped area(from washing) but not open, just dry. I kinda freaked out inside. It turns out this patient liked to stick her fingers in her nose, which evidently drew the blood, and got on the paper, and possible the pens we were using. I next went to wash my hands about 5 times. I am mad that the CNA didn't warn me because I normally didnt work with this patient. I am mad at myself for not wearing gloves, even though I thought it was not necessary and that it would dehumanize our interaction. Next, I report incident to my clincal instructor. She reassures a bit, that my chance of contraction is very small(I know this). Also she told me to go to my doctor(I really don't have insurance). Funny, she doesnt tell me that I should go immediately or w/i 24 hours. So I do my own research and find that I can use the workers comp from my school for care. I don't know if this warrants an incident report. I am a bit worried that my school will pull me from clinicals(I start med-surg again in a month) since my own health will be in question. Sorry for this ramble but I guess I would like to know if a small amount of blood exposure to intact skin(I will have the doctor confirm this tomorrow) warrants that I make sure the dean of nursing knows-as this might get me temporarily removed from the program. Why did this have to happen to me-I am so stressed out already!

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Specializes in Cardiac Telemetry, ED.

I don't see any reason why you should be pulled from clinicals for this. Hope everything works out.

BTW, your school doesn't require you to have health insurance?

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Thank you for your reply and good wishes. Our school does not require us to have health insurance but I do have insurance thru NSNA. It just really doesnt cover even half of the costs of things like ER visits; I'm really glad that workers comp will pay.

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School insurance is not the same as the regular worker's comp. You are at the facility as a student, not as an employee. So different rules are in place for you.

I notice that you mentioned that you contacted your instructor but did you complete any paper work on this? Just telling her does not cover you as something that happened while you were performing your clinical rotation. Same way that is this happened to an actual employee of that facility and there was no physical report filed, then it is not covered as something that happened at worl. This is usually required to be done immediately or within 24 hours of the incident for you to be covered.

Suggest that you just follow up with your country health dept if you are concerned.

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So, let me get this straight... you think you may have contracted HIV from a miniscule drop of blood through you're scaly, yet intact skin ???....and you need to find a suitable health insurance plan to cover this incident.

You know that your chances of contracting HIV is very small, but you are working yourself up over having to further investigate this exposure. On top of this you say as a (projected) result of getting your exposure checked out, your school may question your health status.

Please get FACTS about HIV exposure from your local health department for your own sanity. And for Goodness sake, get some health insurance while you are in clinicals !!!

Thank your lucky stars that this was not a significant exposure, ie. a needle stick or blood splash to the eyes.

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Suzanne I called occupational health at the clinical site and they are handling this at their office(tests, follow ups). INTERESTING-I was told by two students on unit of patient's HIV status; on the day I was exposed. When I got to occup. health this a.m., the nurses called the patient's unit to inquire about other possible health problems and guess what-the nursing staff on that particular unit says that the patient does not have HIV at all. Prob a communication error on someones part-the patient is "SIB" self injurous behavior, and I think the other students heard(and communicated to me) "HIV". Well, can you imagine if I wouldn't have reported to the occup. health at the clinical site? I might not have found this out at all. Thanks for your advice! I still need HIV testing since they cannot find that patient testing was ever done. Hopefully they can just test the patient now....anyway I feel a good deal better about the whole thing.

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Pogo, if you read my initial post, I stated that I know that chance of my infection from said exposure is miniscule. I also stated that I have insurance, albeit not the best. Pogo, have you checked out health insurance rates for a non-working person these days? It is very easy for you to say "go out and get somes suitable insurance", unless you are 43 years old with a family and no job. I have what I can afford; unfortunately they pay only half of cost on most things. In addition, last time I inquired about a hep b shot at my local health dept it was $125. That is alot to me.

One thing that I agree with you about is that I am really "worked up about this". It is my first exposure. I am of course questioning what I did wrong here. I also am not so worried about my own health, but passing on (even with the 0.3% or less chance) of contracting HIV to my husband. You can't understand that???? Maybe you have been in the health business for a while, but I am a newbie, so give me a break!

In the end, I looked up policy and protecol on my own, and did what I was supposed to to do as far as reporting to all interested parties and getting tested(I am covered under the clinical sites workers comp for this), even when others probably wouldn't have bothered. The nurses who handled this issue were very helpful and empathetic related to my first exposure to blood. In addition for being ever so glad that I was not actually drenched in blood, I thank God for medical personnel and peers who are kind to me. I hope that when I am a nurse I don't become jaded and mean to people who have fears of any kind. Thank for reading my post and taking the time to reply!

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CinCin--I agree with your opinon that chance of infection is minimal w/ blood on intact skin. Hopefully though, right after you noticed the smear you went right away to wash your hands well w/ soap and water and notify your instructor. They like to be in the know about those kinds of things.

If the incident happened exactly as you described--I think you have (God forbid) a better chance of getting hit by a plane falling from the sky tomorrow than coming up HIV+ from this incident. But just for your own peace of mind I would still get an HIV test in three weeks. (If you've been reading up on it you probably know that is the commonly recommended timeframe to wait before testing.)

But like I said, talk to your instructor and go with her recommendations.

Other than that just make sure you're careful and protect yourself at all times from here on out.

Right now paranoia is your worst enemy. Don't let that derail you from what you should be focusing on.

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