Taking care of an aids patient

[RNwithanxiety]

So tonight at work in the ICU my assignment is a hep c and aids pt. I am educated and know how it is transmitted etc but with my anxiety out of control I'm terrified the whole time. I'm dealing with his blood every hour and I'm so afraid I'm going to make a mistake and get exposed. My HA is making it hard to even be a nurse anymore... I'm so frustrated

[Slangevar]

You should know that there's a procedure in place for healthcare professionals who are accidentally exposed to HIV: http://www.jkscience.org/archive/volume91/jk10.pdf

The chances of it happening are SO slim (especially since you know these people have tainted blood), but if it did, you would immediately get drugs to kill the virus before it has time to take hold in your system. You'll be fine.

[RNwithanxiety]

I know all of that stuff, I promise I'm educated and I treat every pt the same. Nurses always say be more afraid of the ones that don't have their diagnosis. My anxiety just went full force when I got my assignment tonight. I'm trying to be rational

[Slangevar]

I hear you... I can imagine it would make anyone a bit skittish. Don't beat yourself up... all of my doctors are hypochondriacs. My gynecologist said, "You wanna know who are the worst hypos?  Doctors. Because we're always reading about these horrible new conditions!"  So you're in GREAT company.

As for tonight, you're stuck with the assignment, so I would do three things:

1) Remember that there's a safety net for you.
2) Try to put yourself in their shoes. It would be really sad to have something that caused people to be afraid of your bodily fluids.
3) Take a minute right now to imagine a best-case scenario for tonight. Maybe none of them seem sick and they turn out to be cool people. Maybe you learn something from one of them. Picture that and you're more likely to have that experience tonight.

Good luck!

[CrazyRNstudent]

I'm the same way, I had a hep C patient who freaked me out for weeks because I DIDN'T know she was hep c until after I had contact with her.

I know you know all the precautions, the statistics, the medications, etc. so I am not going to repeat them to you, what I am going to say though is repeat them to yourself and ask yourself have I done anything to put myself at risk...obviously the answer to that is NO because you know the precautions, you knew the diagnosis and you've been safe. Just take a few deep breaths and don't focus on their diagnosis, treat them in your mind like any other patient you've had.

HA can make health care a VERY difficult profession because it is easy for us to panic about things we logically know we should not be worried about but as someone else said, just keep in mind it isn't just you, it's doctors, other nurses, etc...we all do it!

[sweetblubrry]

I can completely relate to this because I am a CNA in a nursing home and one our patients is HiV+. This was a huge fear of mine many many years ago (probably 10-15) and so it was definitely a test. Like you, I know how it is transmitted. A drop of blood has very little viral content as far as HIV goes. Plus I would have to be bleeding too and that is not happening if I am wearing double gloves and protecting myself. I help her with basic things like brushing her teeth and taking her to the bathroom. I make sure to be very careful and I know that I am fine. I am sure she appreciates the help!

Unfortunately, my nursing home doesn't discuss patient conditions with the CNAs. I found out through another CNA who I'm not sure how they knew. I would have appreciated knowing just so I can be extra careful on her room because you never know what may be lying around!

[Slangevar]

So how'd it go, RNwithanxiety?

[RNwithanxiety]

I was anxious all night long but it went well. No accidents. Thank you so much for asking. My biggest issue with this was that my HA was directly interfering with how I do my job. Being afraid to take care of a patient like this makes me sound so judgemental and uneducated, which I am neither. While my anxiety was bad last night I was even thinking about how I wanted to leave nursing so I wouldn't have to deal with these "situations" anymore.

I'm working hard to fight a four month long span of severe anxiety. My episodes have started to last longer and come more frequently over the past couple of years. A lot of people with HA have AIDS/HIV fears even when they more than likely have not had any contact at all with the virus. I guess with knowing I had an AIDS pt I was afraid this would spark a new episode in the future of me thinking I have HIV and i wont have the peace of mind of knowing I probably havent been around the virus. I see me now, going over all of the events from last night in my head and my mind convincing myself I was exposed in some crazy way.

I just have to keep working to stay in control of my anxiety.

[Slangevar]

That's great news that there weren't any accidents!  Remember that - write it down if you have to, in case your HA brain flares up in the future.  You had no exposed contact to infected fluids, so you were definitely not infected.  (And I'm sure they appreciated the care you gave them.)

Hang in there... I can't imagine how challenging it would be to work in healthcare with HA, but it sounds like almost everyone there has it! 

[hypomom]

Hugs to you. I definantly understand as I was a CNA in a nursing home and then a hospital for a very long time. I started nursing school and quit and my ha was a major factor in my quitting