HIV+ and dialysis

[zazenboy]

Here's a fun conundrum:  Conventional wisdom would place dialysis health care pros at risk from blood borne pathogens like hepatitis, HIV, etc. from patients with these viruses.  Here's the twist: last week I discovered via a different public website that the charge nurse at my unit is HIV+, which once I got over my sensation of ickiness, I still felt physically sick from allowing someone with HIV to have access to my blood.  I have a catheter so only the RNs are qualified to put me on and remove me from the dialyzer.  I am stunned that someone with such a condition could consider such risky patient facing profession and not feel there was some violation of a ethical code of conduct, plus this puts the best practices of being 'clean' at risk for the unit as a whole. Given that this condition was not disclosed to me, I don't feel its my duty to bring it up to the center director - I have a feeling she knows about it and probably think the safety practices are in place and there is only the slimmest chance of transmission.  The only thing I have done so far is to request the back up nurse to attend to me instead of the charge nurse.  It never occurred to me to ask any of my health care team if they HIV poz or not, the assumption being that they are in a clean profession, they must be free of viruses.  And that would make the difference between life and death.  This center worries about H1N1, Hep A/B/C, but not a word about HIV... When my case manager rolls around again, I'll ask her to authorize a HIV test.  Just ICKY!!! As if kidney failure was not enough to contend with...

[Rerun]

1. You live in SAN FRANCISCO!!!!  Move!

2.  Where do you think they hire people with needle sticking experience?? 

3.  How much do you think these idiots get paid??

4.  I hate to tell you but these technicians have no medical experience when hired.

5.  Best of Luck.......         

[Jean]

OHHHHHHHHHHHHHHHH Crap!!!!!

[kristina]

Gosh I feel so sorry for you and I understand your conundrum.

It is now almost 6 years ago that I had my very last blood-test taken in a NHS-GP’s Surgery by a nurse.  She did NOT wear gloves and she put her UNWASHED finger on my skin before inserting the needle. She did NOT even disinfect my skin before putting the needle in. Thinking about it, I do not even remember if she REALLY used a new needle for my blood test because I do not remember her unwrapping the needle. Her strange behaviour frightened me and I asked her why she did not wear gloves or wiped my skin with disinfectant wipes? Her answer was that they had no money for gloves or disinfectant wipes at this NHS-Surgery!
I never went back there again.

The last time I had a blood-test taken in a NHS-hospital, I saw them wearing gloves, but I did NOT see them changing gloves after they served the patient before me and I did not see them changing gloves after taking a blood test from me. I never went back there again either.
What is the point of them using gloves if they don’t change them after every patient?

I decided there and then, that using a NHS-GP’s Surgery or NHS-hospitals for my blood tests was far too risky and I have used a private blood-test Centre ever since. There I see them washing their hands, I see them putting a disinfectant gel on their hands, they disinfect my skin, and I see them unwrapping and using a new needle when they take my blood test. Everything is very clean and hygienic, as it should be. It costs me money, but there again I wish to life & saving up money to pay for my blood tests seems the only way. I know I cannot go on like this, but what else can I do?
I have put these incidents into my overall-complaint, but the NHS-Ombudsman and NHS-Health Commission did not take my complaint seriously, in fact, they did not think I had anything to complain about.
 
The very last time I went to a NHS-GP Surgery, the NHS-GP was on the first floor, he knew that I have problems climbing stairs since the stroke. With the help of my husband I made it to the first floor but had to wait and whilst looking around I saw lots of football-regalia in frames on the wall and someone must have been really sick over these frames and it had NOT been cleaned at all. It shook me very much because this was a Surgery! I could not plug up the courage to sit down in that dirt.
When I finally saw the NHS-GP, he did not assist or help me medically for what I came for and he talked to his computer whilst I was there without bothering about me.

This incidence happened almost 6 years ago and I have not been able to plug up the courage to go to any NHS-GP again ever since.

Because of our illness we are extremely vulnerable and our body is rather fragile. Because of our vulnerability we do NEED hygienic Hospitals/Surgeries and staff/doctors who feel a responsibility towards fragile patients.
 
I wish you good luck to stand your ground. Kind regards from Kristina.

[Des]

I have a diffirent opion on this one.......

We (the ckd patients) do not want to be discriminated against... so I think it is unfair to discriminate agains the HIV+ people.

"Icky" is a terrible word to use to describe some other human being.

If you feel unsafe at all during your treatment... speak up otherwise let it be. They are people too.

Maybe you can have a good "read-up" on HIV and you will see that there are only a few ways the disease can transmit.
- Sex
- Blood transfusion
- other bodily fluids

If you in any way feel that you are exposed to the virus as per the above then request someone else to attend to you or move to another centre. Or ensure that gloves are worn and that all the correct procedures are followed.... you will be safe. 

[paris]

I am with Des.  I am around people living with HIV almost daily.  Not drug users; lawyers, business men and women, store owners and a politician.   It is not an airbourne virus, so if everyone in the clinic is using gloves during sticks there is no problem.  HIV sounds very scary, but it really is hard to get unless you are in an active realtionship with someone who has HIV. Des gave good advice---read some articles with facts regarding HIV and maybe you will feel more comfortable.    They didn't ask for this disease anymore than we asked for ours.     

[Rerun]

Then why when I travel .... I have to have a recent HIV test and Hep C test?  If it is no big deal?

We are at a dialysis clinic where blood could possibly be everywhere.  A nurse forgot to clamp something yesterday and a by stander was squirted all over.  HUGE DEAL if the patient had HIV!

I've seen the top pop off one of the dialyzers and blood was all over.....  I have not gone through all this to die of HIV!

HIV and HEP C should be in a room by themselves. 

Hey Kickstart there is how you get your private room.... Tell them you are Hep C positive!

[dwcrawford]

You discovered it from a public website?  Interesting in itself.

Yet patients are screen before going in as are the nurses and techs.  I've read terror stories here but I'm sure they are few and far between.  I did get squirted with a tube of  blood last week, but it was my  blood.  And they started cleaning up, disinfecting immediately.  Don't ask my chat friends about it!  Rosie didn't mean to do it.  (at least not the squirting).

Maybe if people's names were posted on a public website with having Hiv, we could send them to a lepers colony?  Oh no, too late.  The Reagans are gone!

[Des]

Then why when I travel .... I have to have a recent HIV test and Hep C test?  If it is no big deal?

We are at a dialysis clinic where blood could possibly be everywhere.  A nurse forgot to clamp something yesterday and a by stander was squirted all over.  HUGE DEAL if the patient had HIV!

I've seen the top pop off one of the dialyzers and blood was all over.....  I have not gone through all this to die of HIV!

HIV and HEP C should be in a room by themselves. 

I think this was about a charge nurse with HIV. I really think that they (the medical staff) makes the necessary precautions for anyone with contatious diseases.  We have to somehow trust them to a certain extent otherwise we will go mad with worry.
No one refered to it as "no bid deal". I agree it is a big deal if they do not follow the correct procedures in ensuring our protection. I will make a big fuss if they do not wear gloves for instance.  I do think that in most cases where there is a isolation room available, they do make use of it for such cases.

Where is nursewrechit when you need her? I wonder what her take would be on this.

[cariad]

I totally agree with you, Des. I can understand the concern, but the odds of transmission are extremely small even in the event of an accident. I have known a medical person who got pricked with a contaminated needle. She had to undergo a horrible medication regimen just to be safe, but as far as I know never contracted anything. And yes, well said, they are people, too.

Des, I actually needed stitches when I was in a Northern Province village in South Africa four years ago, and the doctor reused the needles. I watched as he washed them in alcohol. This was quite the anthropological experience, actually. There were signs pasted up everywhere saying in several languages "Please do not ask your doctor for a loan!" There was also a "menu" with prices posted for each procedure hanging on the wall in the exam room. (We actually desperately need this in the US - Americans know what I am talking about.) Oh, and I thought I was going to be stuck there all day, because when I walked in, the front room was mobbed with people all sitting on benches staring at a tv that was broadcasting something in another language. I was called within minutes. We decided that they must have been watching a wedding?  Not sure to this day, but no one seemed bothered that I was seen by the doctor first.

Anyhow, when I say "reused needles" and South Africa people gasp and assume I have a death wish or something. I have been tested many times since then as a matter of procedure - negative, of course.

zazenboy, if you don't mind my asking, how do you know the info you received on this website is accurate? Perhaps someone is trying to spread ugly rumors.

[bigshot99]

1. You live in SAN FRANCISCO!!!!  Move!

2.  Where do you think they hire people with needle sticking experience?? 

3.  How much do you think these itsdio get paid??

4.  I hate to tell you but these technicians have no medical experience when hired.

5.  Best of Luck.......         

thats not always true,I'm a patient care technician,,not a technician.i have medical experience. and as far as HIV goes any patient can have it thats sitting in the chair next to you.they are not required to disclose that information to the dialysis center.my self i think that they should be required ,and tested before they can be a patient at a dialysis center.we are not  idiots .as you spell it  itsdio.





EDITED: Fixed smiley tag error- kitkatz,Moderator

[qwerty]

Des has said it well. As staff we are not informed of HIV status of pts we work with either due to the HIPPA regulations. If tested for HIV then the pt has to asked specifically with an appropriate consent form to do so. The only thing we routinely test for is Hep B, Hep C and TB. HIV dies on exposure to air very quickly and where as Hep B lives on and on even after it's dried. This is why all staff should utilize universal precautions as it's not just to protect us its also to protect you as a pt. Administration is not permitted to divulge to general staff if a patient is HIV positive. Therefore we work with pts constantly not knowing if they are or they arent. Hep B pts have to be in isolation where as HIV doesnt have to be. Hep B patients machines are cleaned interiorly prior to another pt going on with bleach if a cobe or heat disinfect if a fresinieus. We as staff are just as suseptible to blood exposure as patients. We get finger sticks, and splattered also. We also are required to be tested yearly by the units too just like patients. This person has the right to her privacy just as pts do. You would have to have exposure to her blood for any period of time. Not her breathing on you, not if she hugs you, not if she cannulates you or gives your meds. In fact your probably more safe from that staff member then you may be from the pt sitting next to you. If you found this on a web site I would hope you would have the compassion to keep this to yourself and respect her privacy as she is expected to protect yours.