Telling a Client they have HIV

[BSN317]

Hello, I am in a dilemma. Ok here is the scoop: I am a public health nurse, and I work in Teen Health as well as Women's Health. Working in this role, I have expanded RN functions like I do Pap Smears, STD exams, Breast exams...etc. Anyhow, I also draw blood and order labs like HIV, RPR, etc. Well a client of mine is 16 years old and I just drew his blood Monday. Unfortunately, the HIV test came back reactive. I am so devastated. I look at the teens as my peers, yet my "babies" although I am not too much older than they are. (Im 24). I have only been a RN for a year, and this is my first case. I feel such dread and I even feel sadness about having to give this news. Of course, I will call for back up and have others there with me to handle to counseling piece. But, I am just so sad about this even though I know HIV is a reality and many people have it. I am just struggling because I know this client is going to have a severe meltdown and Im afraid I may react as well. Any thoughts, comments, or suggestions??!

[rn/writer, RN]

I think you are missing the point.

I am very shocked that with all of the specialized training and classes that you have had...that there didn't seem to be anything in the training as far as disclosing the status.

To me, that should have been a vital and integral part of the program, considering some individuals will commit suicide over a dx.

She said she had training in counseling, so that probably was covered. But there is a big difference between understanding the process intellectually and actually having to do it for the first time, especially when the client is only sixteen.

She said that there will be an experienced HIV/AIDs counselor present, so she will not be dealing with the entire responsibility of speaking with a vulnerable patient. And repeat testing is part of the protocol. But doing something like this for the first time and feeling a little nervous about it sounds normal to me.

She did right to come here and seek out the counsel and encouragement of more experienced nurses.

To the OP: Don't know when you plan to meet with the patient, but perhaps the counselor could come a little early and walk you through what you're going to say. Doing a "dress rehearsal" might help you feel more comfortable and choose what you do or do not want to say. And it might dispel some of the nervousness.

Please, let us know what happens.