Thursday, March 27, 2008

The Price of Complacency..

This month we had a mandatory meeting on preventing injuries at work. This is always a big topic in health care. Health care workers (HCW) are at high risk for injury from their environment, ergonomics, patients, families and the tools we use. This meeting's topic was needlestick injuries.

Each year there are between 800,000-1,000,000 reported needle stick injuries to HCW. Out of that number it is estimated that 63% are incurred by nurses. With each injury there is the risk of exposure to Hep B/C, HIV, TB, Syphilis, Malaria and other infections. It is estimated that one in eight patients has one or more of these conditions.

HCW's are employed in an occupation that ranks second only to manufacturing in amount of time loss injuries. Every nurse in his/her career has a greater than 78% of getting a needle stick injury, from that stick they have a 30% of contracting Hep B, 3% Hep C, 0.3% HIV.

I have rolled that dice twice and won. My first stick was in the beginning of my career and the risk was minimal. My second was the one that took years off my life from the worrying.

I had a non English speaking undocumented homosexual Hispanic male patient in with high fever, sweats, one viral illness after another for months with large weight loss (Xray neg for TB) I was transferring blood from a syringe using an 18g needle (this is a big one) into a blood culture tube. For some reason I flinched and stuck the needle into my hand. I remember just staring in disbelief at the needle for what seemed like forever. When I return to reality I pulled the needle out, changed it, finished the transfer, then washed my hands and walked out of the room. I didn't mention it at all to the patient, and he didn't even realize it had happen until the Dr talk to him and asked for him to sign a release so that we could test him for diseases. I was so thankful that night that our Dr was Spanish speaking, and the patient agreed. I know of other nurses who's patient refused to allow the testing, and that nurse has been subjected to every 3 month blood testing for years.

My worrying was quite extended due to the fact that our employee health nurse was on vacation and I could only get the results from her. When the blood is drawn it is labeled with a number and not a patients name and we are not given the number. Only the employee health nurse has that information otherwise I would have just went to the lab and got the info I needed. I finally got the good news weeks later that the patient was negative for all tested. You should have seen the happy dance I did!

Since that stick 2 years ago I have had several bodily fluid splashes but nothing as serious as that incident. Working in the ER I know puts me at greater risk due to the type of patients that I deal with and the fact that I have often get into wrestling matches with them, and I never know what they have in their pockets until I get their clothes off. But I try to be more careful and more attentive when I have a sharp in my hand, where before I think I had become complacent.

A complacency that could have cost me everything.

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