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?

Wednesday's news

I love Wednesdays for news because so many stories come out on Tuesdays. There is so much to choose from. I try to pick things that are not as clinical as interesting as they may be, but what I think my readers may find applicable and interesting.

Blood test predicts onset of Alzheimer's is interesting because Alzheimer’s is such a devastating disease. Of course, detecting it doesn’t mean that there is a cure, but it is a good step in that direction. Plus, researchers are finding ways to slow down the progress of the disease, so early detection would be a great plus.

Canada approves first new HIV drug in 10 years and Study examines AIDS patients in Africa seem ironic, to me, that they show up in the same week. It’s known how difficult it is for people in so-called Third World countries to get HIV medications and now we learn (although it’s not surprising) that many don’t take them as they should. Very sad.

This story A low prevalence of H pylori in HIV-positive patients was just interesting to me.

Now, I guess we shouldn’t be surprised with this story: Severely mentally ill at high risk for cardiovascular disease. I’m thinking of it from the point of view that a psychiatric illness must be stressful on the body – that was always my amateur take on this type of thing. I believe that psychiatric illnesses have a much greater impact on the physical body than the medical community has realized.

Potentially deadly staph superbug spreading faster than ever is an important story. We hear a lot about some problems that may never affect us, but this is a biggie. We need to be more aware of this. Interestingly, this story also appeared at the same time: Simple measures can reduce spread of respiratory viruses. Handwashing is our number one defense against spreading germs and getting sick ourselves.

Sometimes, the stories hit home because of issues that I’ve gone through or had. I’ve had a few gastroscopies so this story definitely caught my eye: Patients may have sweet and effective way to prepare for upper GI endoscopy: an anesthetic lollipop. I can do a lot of things without freaking, but I just can’t tolerate upper GI endoscopies. I have a very strong gag reflex and it’s not easy for me to imagine one of those scopes going down my throat.

A few others that were interesting because of professional or personal experience were these ones: Chinese herbal medicine may help relieve painful menstrual cramps, No evidence that insoles prevent general back pain, Stretching out does not prevent soreness after exercise, Don't routinely use enemas during labor, and Don't 'break the waters' during labor without good clinical reason, concludes Cochrane Review.

Most women who have had painful menstrual cramps can definitely understand the interest in such a finding. If you don’t get a good effect from the available treatments, it really is miserable having to experience that cramping every month. The story about insoles is interesting. As a nurse, I have that age-old nurse problem, a sore back. I never thought of trying special insoles though.

Now, the stretching story really caught my eye because I’d read that before. And you know what? Even though they have the findings, I have to disagree with them. I know that if I do any type of exercise, be it on my elliptical, raking leaves, shoveling snow, or golfing, and I haven’t stretched first, my muscles hurt. However, if I stretch before (and after if I think of it), there is minimal, if any, muscle pain.

The next two stories about labour are also interesting. I thought that they didn’t do enemas to labouring mothers any more. I guess I was wrong. As for breaking the water – that one makes a lot of sense because we really should be limiting any type of medical intervention in labour and delivery unless it is really necessary, in my opinion.

And that is the news for today!