Tuesday, November 17, 2009

Needle Picks and Nurse Fears

I've been a nurse for over 25 years. While I've picked myself occasionally with clean needles, ones that I was preparing to use (and then tossed), up until now I could say I'd never had a serious needle stick. Unfortunately, I can't make that claim any longer.

After taking blood from a patient this morning, I was trying to retract the butterfly needle into the plastic protective cover, only to have it jam. When that happened, my hand came off the plastic and then kind of rebounded back, embedding the needle into my thumb. Ouch. Blood. Ouch.

So, of course, off for blood tests, paperwork and more. I'm fine; I know I'm fine. The patient is in a low-risk category (probably as low-risk as they come), so I'm confident. But only to a point. You never really know someone and you never know what could show up. So, I wait.

No prophylactic (preventative) medication for me. If the patient had been high-risk, I would have taken the medications. Those things can have nasty side effects though.

But you know what's the worst part about stuff like this? Believe it or not, patient rights. I was lucky. The patient's family was very understanding and gave me permission to get blood samples for HIV and hepatitis. But, they also had the legal right to refuse this.

Years ago, when I worked at an acute care hospital, one of the nurses on my floor had a needle stick from someone who was very high risk. The doctor went in to ask the patient for permission to draw blood for HIV testing and he refused. He refused the next day and the day after that. He never ended up agreeing to it, despite being told why it was being requested.

As a result, my colleague had to take the antiretrovirals for a set period of time, to prevent the possibility of contracting HIV. The law was on the patient's side. But when a the health of a healthcare worker is at risk, shouldn't that trump the rights of the hospitalized patient?


Katelyn said...

I never thought about people refusing to be tested, but I guess if someone was in denial, he or she wouldn't want to face the truth on the lab report. Still, that is a really rotten thing to do to the nurse. Glad your patient turned out to understand the need for tests.

Michelle Seitzer said...

This is an intriguing post, Marijke. Your posts always make me think about things in different ways. I'm also glad that the patient understood the need for tests, but wow, you really could end up in a difficult position there. Not sure I know how to answer the question at the end - it's not really so black and white, is it? Thanks for keeping us on our toes.

Marijke Vroomen-Durning said...

Thanks Katelyn and Michelle.

My blood tests turned out ok, as did the patient's. The only thing is that I'm not allowed to donate blood for six months.

Michelle, I'm glad my posts present different ways of looking at things. Thanks!

Slava Rybalka said...

Marijke that's a very thoughtful post. Thank you for it.
Like you say: "you never know.."
And still there are some stubborn people that just either not understand or are just complete idiots who refuse to help others in that kind of situation...
Anyway, thank you for a good portion of emotions!

Ar you on Twitter? I am @slavarybalka You are also heartly welcome to visit my blog on Personal Effectiveness and my friend's one about going green. Both have some useful tips and advice.

Take care! )