What info should nurses let a PCT/CNA be aware of?

[sh_eany]

I am a nursing student and work as a MBT Mother Baby Technician in a hospital dealing with post partum mothers and babies. Amoung other things my duties are helping with breast feeding, peri care for c- section mothers, blood sugars, removing foleys and IV and taking care of the babies. My question is whenever we have patients with certain disease that can be transmitted by body fluid are the nurse suppose to let us know. I do know we are all suppose to follow HIPPA and Universal Protocols but at least they get that info in their reports from their peers. I don't get it why can't they just let us know to be a little more cautious. There was a incident recently where one of my collegaues had to do blood sugar on a patient every 2 hrs during a 12 hrs shift and the nurse NEVER mention to here this patient had HIV. I am concerned and just need to know what you guys think, should I ask for this info if it is not being pass on. HELP.

[Do-over, ASN, RN]

In my opinion, a patient's HIV status will not affect the care you (CNA,PCT, etc) provide in any way. You don't need to know, therefore it shouldn't be discussed with you.

As a nurse, a patient's HIV/hepatitis status is more important because I need to evaluate care/lab results / treatments in light of the overall health picture, if that makes sense.

As for standard precautions - I do nothing different with a patient with HIV/hepatitis than those presumed to not have HIV/hepatitis.

Edited to add: many times, the patients themselves warn me if they have a bloodborne pathogen.

[merlee]

HIPAA has nothing to do this. And all patients should be treated with universal precautions. Everyone should be considered 'at risk' for bloodborne pathogens.

Do you need to know? It would be appropriate, but really doesn't change anything.

[rn/writer, RN]

HIPAA has nothing to do this. And all patients should be treated with universal precautions. Everyone should be considered 'at risk' for bloodborne pathogens.

Do you need to know? It would be appropriate, but really doesn't change anything.

If it really doesn't change anything, why is it appropriate to know?

A heads up from the nurse might be nice, but should be kept general. "Pay close attention to universal precautions," would be a good reminder. A caution need not specify a particular patient or disease, but it does get the point across that we need to be careful.

Then again, we should always be careful. The absence of information about HIV, Hep C, MRSA, etc. in the patient's chart doesn't mean an absence of these things in the patient. It might mean they haven't yet been diagnosed.

[kool-aide, RN]

In my opinion, a patient's HIV status will not affect the care you (CNA,PCT, etc) provide in any way. You don't need to know, therefore it shouldn't be discussed with you.

As a nurse, a patient's HIV/hepatitis status is more important because I need to evaluate care/lab results / treatments in light of the overall health picture, if that makes sense.

Yeah yeah yeah, sure. Nurses withholding information like this isn't cool at all! You can argue until you're blue in the face that we don't NEED TO KNOW because it doesn't affect us, but I think that's a load of crap! What do you care? Tell the ******* CNA if the pt has a blood borne pathogen! This is no different than me asking a nurse what my pts are in isolation for! If a nurse EVER told me to "just follow posted precautions, you don't need to know what they're in isolation for," I'd be LIVID! Do you get your jollies off of withholding info from assistive personnel because you're the nurse?!

[rn/writer, RN]

This isn't about some power trip by nurses. We can get in trouble if we cross the line about giving information we're not supposed to be sharing. Does that mean it never happens? No, of course not. I'm sure it happens all the time. But that doesn't make it right.

If you want to go strictly by "need to know," the CNA does not need to know. Sorry, but if the information does not change the care, it isn't a necessary part of report.

In the OP's case, I can think of a situation where it might be important. If the mom wasn't clear on the implications of being HIV+ and no one had spoken to her about not breastfeeding her child because she had said she was going to bottle feed, it would be important for the CNA to know about her status in case the patient decided she wanted to try breastfeeding. BF is definitely a route for transmission and should not be done by an HIV+ mom (unless there are recent changes in this area that I don't know about).

[Do-over, ASN, RN]

I'd be LIVID! Do you get your jollies off of withholding info from assistive personnel because you're the nurse?!

Well, you wouldn't like me much then. Do you care about any other piece of the patient's history that doesn't impact your job? What are you going to do with that info other than discriminate, or needlessly treat that patient differently?

I still say its none of your business. And if its my patient, you won't hear that info from me.

[nursing81student]

I will have to disagree do-over. As a PCT, it is always clearly communicated to me by the nurses when a patient has HIV or AIDS. Of course, I always follow universal precautions but personally I appreciate knowing since I directly care for patients and I am in contact with their blood. Yes, as techs we are not responsible for the coordination and management of the pt's disease and treatments, but that doesn't mean we don't have the right to be aware.

[nursing81student]

Yeah yeah yeah, sure. Nurses withholding information like this isn't cool at all! You can argue until you're blue in the face that we don't NEED TO KNOW because it doesn't affect us, but I think that's a load of crap! What do you care? Tell the ******* CNA if the pt has a blood borne pathogen! This is no different than me asking a nurse what my pts are in isolation for! If a nurse EVER told me to "just follow posted precautions, you don't need to know what they're in isolation for," I'd be LIVID! Do you get your jollies off of withholding info from assistive personnel because you're the nurse?!

For some reason I can't give you kudos, Kool-Aide...so here are some kudos :)

[rn/writer, RN]

I will have to disagree do-over. As a PCT, it is always clearly communicated to me by the nurses when a patient has HIV or AIDS. Of course, I always follow universal precautions but personally I appreciate knowing since I directly care for patients and I am in contact with their blood. Yes, as techs we are not responsible for the coordination and management of the pt's disease and treatments, but that doesn't mean we don't have the right to be aware.

What would you do differently if you had this knowledge?

[misswhitney]

Yes, I don't hardly ever tell my techs about things to do with my patients that they don't need to know. If I ask a nurse to start an IV for me, I don't tell her anything except the veins roll, or she has a big vein in her AC that I was trying to avoid, etc. Patient history in that aspect is not relevant.

[Do-over, ASN, RN]

Yes, as techs we are not responsible for the coordination and management of the pt's disease and treatments, but that doesn't mean we don't have the right to be aware.

Bolding mine -

In my opinion, it means precisely that - you do not automatically have the right to know whatever you want about a patient.

And, neither do I. For example, if another nurse asks me to start an IV on his or her patient I do not need to know if that patient has HIV and it would not be appropriate for me to be told that.