Unreported Needle Stick

[Alex_RN, BSN]

First off, this wasn't me so please don't yell at ME. I had a conversation with an acquaintance from my program. She got her license a few years after the rest of us, after several attempts, and is struggling in her first RN position. I have been supportive of her on social media. We do not work at the same facility or anything.

She had a needle stick 3 weeks ago and did not report it. As I understand it, she had been counseled that morning on some issues she was having, then made a mistake that required she waste some narcotics. Her witness for the narc waste was the same supervisor that counseled her and she was feeling frazzled and embarrassed. Later, she was administering insulin to a hemodialysis patient and that same supervisor was available to verify her administration. As she was disposing her supplies, she stuck herself in finger with the used needle. She was going to tell her Charge later in her shift but never did. The patient discharged home the next day. She continued to procrastinate and has yet to tell anyone except me, via text, a few days ago.

If we worked together, I'd take her to the Charge or Supervisor and get everything out in the open, which was my advice to her. She is worried that her procrastination/fear of reporting indicates some bad decision making and she will be terminated. It does sound like she is already on thin ice.

I honestly don't have a strong opinion here, but I am curious as to what AllNurses members have to say.

[Lunah, MSN, RN]

Not following policies for needlestick reporting is bad decision-making, period, not to mention the risk to her health. She may be too late for prophylaxis now as well. She should speak to her supervisors, but somehow I doubt she will.

[kp2016]

It would seem that your friend has very poor judgment which means there is very little you can do or say that would help. But I do have some advise for you.

From what you have said my guess is that your friend will be looking for a new job in the very near future. Do not be tempted to be a good friend and help her in any way to find employment where you work.

[cleback]

Ughhh... I feel for her. Not wanting to speak up about a mistake in light of the others for fear of losing her job. Not worth her health, but I'm sad she felt the need to cover it up.

If she won't speak up at work, she should at least talk with her pcp, but that is out of the scope of this forum.

[TrashPanda]

Wow! That is just poor judgement no matter how you look at it. Every facility I have ever worked for requires reporting within 24 hours of an incident (barring some extraneous circumstance). While I doubt she will follow up, she should report this immediately and take the hit. She has put herself at great risk in more ways than one!

[Double-Helix, BSN, RN]

First, let me say that no one should ever feel like they are going to get in trouble for reporting a needle stick. Mistakes happen and no employee is going to stick themselves intentionally. Any facility that would punish a nurse for an accidental needle stick is not a facility I would want to work for. While, obviously, not reporting a needle stick is a bad decision, it's been three weeks since it happened. If she were that concerned about her health than she would have reported it already or told her primary doctor. The fact that she hasn't reported it to anyone inside or outside of work tells me that she's still more concerned about getting in trouble than she is her potential exposure to any blood borne pathogen. And the longer she waits, the greater the chance she'll will get in trouble, and the lower the chances she's going to report it. She's reaching out to you because she wants someone to reassure her that she did the right thing. The type of needle stick you describe carries an extremely low risk of transmission of any disease, but, as a friend, you should encourage her to discuss this with her primary doctor and follow his/her recommendations.

[Scottishtape]

First, let me say that no one should ever feel like they are going to get in trouble for reporting a needle stick. Mistakes happen and no employee is going to stick themselves intentionally. Any facility that would punish a nurse for an accidental needle stick is not a facility I would want to work for. While, obviously, not reporting a needle stick is a bad decision, it's been three weeks since it happened. If she were that concerned about her health than she would have reported it already or told her primary doctor. The fact that she hasn't reported it to anyone inside or outside of work tells me that she's still more concerned about getting in trouble than she is her potential exposure to any blood borne pathogen. And the longer she waits, the greater the chance she'll will get in trouble, and the lower the chances she's going to report it. She's reaching out to you because she wants someone to reassure her that she did the right thing. The type of needle stick you describe carries an extremely low risk of transmission of any disease, but, as a friend, you should encourage her to discuss this with her primary doctor and follow his/her recommendations.

This. Also pass on that even though it's a low risk, it CAN happen to her.

It happened to me in my first year of nursing. I contracted Hepatitis C from a dirty needle stick after an insulin injection. It was a horrifying experience.

I was one of the lucky ones who was able to fight it off and I've been clear of it for many many years, but it still sticks with me.

The longer she lingers without at least seeing her PCP, the worse it could be if she did in fact contract something.

Best of luck to her.