Student Nurse Needle Stick Scare

janice_c67, BSN, RN · Feb 26, 2011

Well, not to say that there is absolutely no reason to worry... I am a new grad and I have been a phlebotomist for 15 years, and in my time in the lab I have known 3 people who have been stuck (one of which jammed a glass capillary tube under her thumb nail) with sharps of confirmed AIDS patients, and none of them ever came HIV positive after many years. They of course were very lucky, but even with an exposure from an HIV+ person it's still a small percentage that you will contract it. Hepatitis is more transmittable though, are you able to find out the patients health history to see if they have any bloodborne pathogens since you had an exposure? i don't think it would be a HIPAA violation if it is because of an exposure, but may need the patient's consent.

BabyLady, BSN, RN · Feb 26, 2011

I am one of those ultra-paranoid people about things like that to...but honestly? You don't have anything to worry about. I wouldn't sweat this.

Insulin is subq injection...the blood supply in that area is minimal vs a vein or an IM. Even if you did have blood to blood contact...the chances of you contracting something is still less than 1% even on a patient with a known infection.

BabyLady, BSN, RN · Feb 26, 2011

Well, not to say that there is absolutely no reason to worry... I am a new grad and I have been a phlebotomist for 15 years, and in my time in the lab I have known 3 people who have been stuck (one of which jammed a glass capillary tube under her thumb nail) with sharps of confirmed AIDS patients, and none of them ever came HIV positive after many years. They of course were very lucky, but even with an exposure from an HIV+ person it's still a small percentage that you will contract it. Hepatitis is more transmittable though, are you able to find out the patients health history to see if they have any bloodborne pathogens since you had an exposure? i don't think it would be a HIPAA violation if it is because of an exposure, but may need the patient's consent.

Patients typically sign paperwork when they enter the hospital consenting to HIV testing, etc in the event of an exposure...so further consent is typically not obtained as it is obtained on admission.

janice_c67, BSN, RN · Feb 26, 2011

Patients typically sign paperwork when they enter the hospital consenting to HIV testing, etc in the event of an exposure...so further consent is typically not obtained as it is obtained on admission.

I don't think that is the case, at least not where I work. When an exposure happens, they obtain consent from the patient at that time.

BabyLady, BSN, RN · Feb 26, 2011

I don't think that is the case, at least not where I work. When an exposure happens, they obtain consent from the patient at that time.

The probably need to consider changing that. In most facilities it is required before they will treat you, barring the ER of course.

It is because legally, they can refuse to consent to testing.

evolvingrn, BSN, RN · Feb 26, 2011

The probably need to consider changing that. In most facilities it is required before they will treat you, barring the ER of course.
It is because legally, they can refuse to consent to testing.

I don't think that is standard, i just had to undergo testing after and exposure and had to obtain consent for the pt. (which they did)

janice_c67, BSN, RN · Feb 26, 2011

The probably need to consider changing that. In most facilities it is required before they will treat you, barring the ER of course.
It is because legally, they can refuse to consent to testing.

On the contrary, I think that a hospital that requires consenting to HIV testing on admission gives a feeling that exposures are anticipated and likely to happen, which in my opinion would decrease the feeling of confidnce a patient has in the facility. Getting consent on every admission is a bunch of paperwork that doesn't need to happen, it shouldn't be done unless there is a need for it.

Chin up · Feb 26, 2011

I was giving an insulin shot (with an insulin pen) today at my clinical site to a extremely skinny guy. He requested I uses his arm and not his abdomen. So - I did - he moved and I felt something prick my index finger that was on the underside of the skin fold I was holding. GREAT..... I checked my gloves - so signs of puncher, I also milked the crap out of the offended finger - I saw no blood. My prof knows and I eventually went to the hospitals clinic to figure out what to do. When I told the RN/MD there that I saw no blood - they decided not to test the patient I was exposed to since they said I technically didn't have blood to blood exposure.
Can I get some feedback on this? I am still slightly freaked out that there is some very small chance I was exposed to something. I get that no blood what exchanged, but still - this whole needle prick thing has me totally freaked out. Any thoughts and feedback would be great.

First off, always save the needle. They can test the needle if patient won't comply. Second, for piece of mind, get tested for everything, ESP hepatitis. I don't care if you saw blood or not, they have an obligation to test you. Then again in seven months, retest. Otherwise, you will never have piece of mind. I am speaking from experience. I had an HIV positive needle enter my index finger in the mid eighties. HIV had just burst on the scene and not much was known. I remember turning a patient in bed, when a needle used for blood gases by an Md and left there entered my finger. I remember bleeding, then screaming, then nurses spraying me all over with bleach. I remember being wisked off to emergency and I remember little to nothing else, for the next year except the feelings of dread that would wash over me at unexpected times. I did not believe I was negative until my third negative test. Of course our circumstances are different, but our minds are capable of taking over during uncertainty in a way, that completely paralyzes us. Good luck!

Horseshoe, BSN, RN · Feb 26, 2011

I have had one needle stick in my career; it was also an insulin syringe. My patient was a 90 y/o female with no known risk factors. I didn't request testing, but later on down the line I had myself tested, and then again a year later for insurance requirements. Every time was negative, and I hadn't been all that concerned, but yes, the testing gave me additional peace of mind.

I think you are probably okay, but if you're that concerned, you really do have a right to testing and follow up testing.

Skip219, BSN, RN · Feb 26, 2011

Hi, you are understandable scared by this incident. Likewise, your exposure is so meniscule. If the patient had no risk factors or nor current ongoing hepatic disorders, your exposure risk is very small. I poked myself 23 yrs ago in my last days of clincial. I flushed a heplock , give amed, and poke myself with that needle. It was an end stage AIDS patient, and my instructor flipped. She grabbed a hold of my finger and squeezed the everliving daylights out of it, She poured 1/2 strength bleach on it. I received gammaglobulin shot and my hep B immunizatiuon series. I was followed by the CDC for 3 yrs and never seroconverted. I had subsequent punctures but none scare as that first one! I know its scarey.., the risk is based on amount of blood and the pts risk factors. Every hospital should have a policy written for needle stick exposure and mandatory patient lab work as deemed necessary. Best wishes during this scarey time.

Skip

darren_callcareer18 · Feb 27, 2011

When needle pricks occurred u must wash it first in a free flowing water and milk it for blood. Secondly, U should have had the initiative to check your client's chart if he has any infectious diseases. After figuring it out, consult MDS team specialize in handling needle pricks. LASTLY make an incident report.

Well, in your case if there was no blood shows when you milked it that means it was jez superficial and there's nothing to worry about.

If u still feel being freaked out u can do some action all by yourself like consulting an MD in an outpatient basis. Good luck