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HIV Anxiety
I've had a rough last 2 months. I had 2 exposures at work, getting blood on hand and a needlestick. This has never happened to me before. I was scared about getting blood on my hand because I did not know the HIV status of the patient. I really wasn't scared about needlestick because the patient tested negative for HIV and I was told I did not need PEP. I started to get worried when I started thinking about the window period and if this patient could have possibly been in the window period. I don't think I would be so scared if I wasn't worried about hurting my baby, because I'm breastfeeding, or hurting my husband. I talked to physicians at length at the PEPline and the nurse at my pediatrician's, and I was told I could breastfeed. I'm still anxious though. This has caused me a lot of anxiety. I can't sleep, can't think about anything else, wake up in middle of night crying, and can barely eat sometimes. I just wish I knew what made some needlesticks a risk and others not. I hope and pray the anxiety will go away.
Yes, I had baseline testing. And the patient was tested. Patient was HIV negative, hep c positive, and had the Hepatitis B vaccination. I'm worried about hep c too, I'm not ongoing that. My concern was breastfeeding, but I was by the physician at PEPline and my pediatrician if patient tested negative for HIV I could resume breastfeeding, but of course I started reading about window periods and that's when I got scared I was hurting her or my husband because the patient could have been recently infected, but I was told that was unlikely and that no one has transmitted HIV to healthcare worker in the window period. I'm just overly stressed about the whole incident.
We were told in nursing school that you could get HIV if you had chapped hands and I believed that!
You're absolutely right. Even many doctors aren't properly educated about the REAL risks of HIV and it's a shame. It just fosters more fear and a deeper misunderstanding about HIV.
Typically, after a needle stick injury, most facilities have a protocol in place (usually a baseline HIV test if you haven't had one in the past 3 months), then a series of tests, usually up to 3 months, although a lot of places are still behind in the times and require testing to 6 months which is totally outdated. Also, if possible, the patient is asked for consent to test for HIV, Hep B, Hep C. Those are greater risks than HIV. Did you do any of that?
When I was first out of nursing school (before I really understood all of this) I had a needle stick (SQ needle) and the patient ended up testing + for Hep C, so I had to get a series of gamma globulin shots to be cautious. OUCH. If I knew then what I knew now, I would have probably just refused that.
You will be fine I'm sure. Follow your employer's protocol just because you have to, and plus it will make you feel better. Also, since you've been struggling with a lot of anxiety anyway, I would recommend seeing a professional about that. Could be post-partum anxiety or depression, but it seems to be affecting you pretty significantly.
Take care!
You're absolutely right. Even many doctors aren't properly educated about the REAL risks of HIV and it's a shame. It just fosters more fear and a deeper misunderstanding about HIV.
Typically, after a needle stick injury, most facilities have a protocol in place (usually a baseline HIV test if you haven't had one in the past 3 months), then a series of tests, usually up to 3 months, although a lot of places are still behind in the times and require testing to 6 months which is totally outdated. Also, if possible, the patient is asked for consent to test for HIV, Hep B, Hep C. Those are greater risks than HIV. Did you do any of that?
When I was first out of nursing school (before I really understood all of this) I had a needle stick (SQ needle) and the patient ended up testing + for Hep C, so I had to get a series of gamma globulin shots to be cautious. OUCH. If I knew then what I knew now, I would have probably just refused that.
You will be fine I'm sure. Follow your employer's protocol just because you have to, and plus it will make you feel better. Also, since you've been struggling with a lot of anxiety anyway, I would recommend seeing a professional about that. Could be post-partum anxiety or depression, but it seems to be affecting you pretty significantly.
Take care!
Thank you so much. Wow, I wish we had someone like you where I work. I didn't get any information when this happened. And I had to find resources on my own, like PEPline. Very scary to go through alone. I have absolutely no knowledge regarding transmission of HIV. And I'm ashamed of that. You are right about how school educates about HIV. We were told in nursing school that you could get HIV if you had chapped hands and I believed that! A lot of nurses believe that, at least where I work. You know, no one even knew how to pull up the forms needed to report the exposure. I had to look for it for an hour before I found it. The house supervisor didn't even know. I went to the ER and was told just to fill out an incident report, but I located the forms and called lab myself. I work in a really small hospital. I have shown the other nurses I work with where to find the forms and what to do.
The IV I was inserting was a 20 Gauge. The physician at the PEPline said that no one in a window period has transmitted HIV to date. And my stick wasn't deep. And he said it wasn't a large needle. I appreciate your help greatly and I promise that I'm going to continue to educate myself better about HIV. I don't want to be an uninformed nurse. What good is that? And I will look for someone to talk to about anxiety. I can't function like this and it's not fair to do that to my family or patients.
God Bless you for all you do.
The IV I was inserting was a 20 Gauge. The physician at the PEPline said that no one in a window period has transmitted HIV to date. And my stick wasn't deep. And he said it wasn't a large needle. I appreciate your help greatly and I promise that I'm going to continue to educate myself better about HIV. I don't want to be an uninformed nurse. What good is that? And I will look for someone to talk to about anxiety. I can't function like this and it's not fair to do that to my family or patients.
God Bless you for all you do.
Yes, I would be comfortable with a negative result.
I actually have a lot of education in exposure management and employee health. I helped in that dept at one of my jobs, so I got a decent amount of additional education about infectious diseases, blood borne pathogens and occupational exposures.
The facts are, occupational transmission of HIV is EXTREMELY rare. MOST incidents do not even constitute a risk. For instance, needle stick injuries with small bore SQ type needles are basically non risk events (even though to be cautious, a person is still advised to report it and go through the process). The only occupational injuries that result in a real risk and possible transmission would be with large bore needles, deep, significant injuries with large tools, or incidents with exposure to large amounts of very fresh blood (think OR scalpel injury).
I also have a good bit of experience working with HIV+ patients and additional education in that area, so I'm lucky enough not to just be stuck with ONLY the fear mongering type of education most people receive in school (and even nursing school). I have a much more realistic view of actual risk events.
You have nothing to worry about. Just continue to follow your facility's recommendations and get some help for the anxiety.
I actually have a lot of education in exposure management and employee health. I helped in that dept at one of my jobs, so I got a decent amount of additional education about infectious diseases, blood borne pathogens and occupational exposures.
The facts are, occupational transmission of HIV is EXTREMELY rare. MOST incidents do not even constitute a risk. For instance, needle stick injuries with small bore SQ type needles are basically non risk events (even though to be cautious, a person is still advised to report it and go through the process). The only occupational injuries that result in a real risk and possible transmission would be with large bore needles, deep, significant injuries with large tools, or incidents with exposure to large amounts of very fresh blood (think OR scalpel injury).
I also have a good bit of experience working with HIV+ patients and additional education in that area, so I'm lucky enough not to just be stuck with ONLY the fear mongering type of education most people receive in school (and even nursing school). I have a much more realistic view of actual risk events.
You have nothing to worry about. Just continue to follow your facility's recommendations and get some help for the anxiety.
Do you think this could possibly be related to post partum depression, nursegirl? I was so nervous after she was born and she is my third baby. But I have been so overwhelmed and scared that something is going to happen to her. It consumes my whole day. Would you be comfortable with a patient's negative result? I don't even know if I could take something for postpartum depression and anxiety while breastfeeding.
The smartest thing to do is to get professsional help so you can put this behind you once and for all.
Good luck to you!
Good luck to you!
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