PEF nurses
take part in national survey (scroll down)
Act now to
prevent, treat injuries
Needlesticks — It takes more than a law to protect
you
By SHERRY HALBROOK
If you’re relying on the federal Needlestick Safety
and Prevention Act of 2002 requiring health care
facilities to use “safety” needles to protect
you from accidental needlesticks, think again.
PEF nurses are still getting stuck and they are still
going through the agonizing fear of exposure to fatal or
life-threatening infections and enduring the miserable
side effects of treatments aimed at preventing those
infections.
“This law requiring the use of safety needles is a
wonderful protection for nurses and other health care
professionals,” said PEF Health and Safety Director
Jonathan Rosen. “But not all safety needles are
created equal. And they don’t offer much protection
if employees are not trained in how to use them
properly.”
It happened to her
“I was totally panic stricken when I called
Jonathan,” says a psychiatric nurse 2 who had a
safety needle rammed halfway through her finger by a
patient earlier this year. She was just withdrawing the
needle from him when he struck her arm, which forced the
needle deep into her.
Although the patient denied that he did it intentionally,
he refused to be tested for HIV or hepatitis. So, the
nurse had to take every preventive measure in case he
might have infected her.
“Jonathan was very helpful to me. He did a lot of
networking for me and helped me finally find a doctor in
my area who specializes in HIV,” said the nurse, who
does not want her identity revealed because of the fear
her risk of HIV infection sparks in others.
“It’s amazing how people react to me when they
learn that I might have been exposed to HIV or
hepatitis,” the nurse said. “When I went in for
my blood test, I whispered the information to the nurse,
and (Would you believe it?) she put on a second pair of
gloves before she would draw my blood.
“I’ve done it to other patients, and now people
are doing it to me!” she said. “Before this
happened, I didn’t realize how much stigma is still
attached to HIV.”
That stigma also impeded her ability to find a competent
HIV specialist.
“Doctors who are qualified to specialize in this
don’t advertise it,” she said, “because
they’re afraid it will drive away other
patients.”
No easy options
The nurse, who began taking powerful preventive drugs
within two hours after her injury, found their side
effects very debilitating.
“Those drugs were horrible. They totally messed up
my white and red blood cell counts. I was afraid to take
them and I was afraid not to take them. I was violently
nauseated for seven days. I could not keep any food down
until they finally changed one of the drugs they were
giving me,” she said.
“Everybody has a different idea about treatment. The
psychiatric center followed the CDC (national Centers for
Disease Control) guidelines for preventive treatment, but
the doctors here aren’t experienced in prescribing
drugs for this. If a psychiatric patient is admitted who
has already been diagnosed as HIV positive, our doctors
just continue to prescribe the same medications the
patient was already receiving.”
The nurse said she spent endless hours phoning hospitals
trying to find a specialist “who would really
understand what these drugs do. I needed to know if my
blood counts were being affected by the drugs or
something else.”
At last, her PEF council leader and field representative
put her in touch with Rosen, who contacted a PEF member
at the state Health Department.
“He found two specialists in her county,” Rosen
said, “but only one of them would accept patients on
Workers Compensation.”
“It took me two weeks to get an appointment and, by
the time I got in to see the specialist, I had just
finished the course of preventive medications,” the
nurse said. “I brought in all of the results of my
blood work and he told me I had no hepatitis antibodies.
I had already received a series of three hepatitis
vaccinations, but he said I needed another booster. That
just messed up my white cell counts even more.”
Fear still with
her
The nurse said, “I went back to work the day after I
finished taking the preventive medications. I was only
receiving 66 percent of my pay, and I couldn’t
afford to stay out.”
Recently, she received the results of her six-month tests
which, again, showed no sign of infection.
“It’s a relief, but the fear is still there
— even though I know I will probably never test
positive. I can’t help being afraid,” she said.
It’s a worry her family shares.
“My sons have been very upset by this,” she
said.
“It makes me truly angry that the patient who stuck
me can refuse to be tested. He was released from our
facility in a couple of weeks, while I had to be out of
work and on that medication for 30 days.
“He’ll be back someday,” said the nurse,
who says she is “counting the days until I’m 55
and can retire. I’ve worked here 35 years, and I
just can’t do this much longer. We are getting some
very dangerous patients.”
Afraid to
complain
Meanwhile, Rosen said he is now helping a nurse at the
state Department of Correctional Services who recently
was stuck by a needle. This time it was not a safety
needle and it was contaminated with blood from an inmate
known to have hepatitis C — the most common cause of
liver failure and the need for liver transplants.
“I urged her to file a complaint about the
prison’s failure to provide safety needles with the
Public Employees Safety and Health (PESH) program at the
state Labor Department,” Rosen said. “So far,
she has been afraid of retaliation if she does that.
Since this incident, the facility has begun to provide
safety needles, but it still isn’t training staff in
how to use them.”
Protect
yourselves
What lessons can other nurses learn from these incidents?
“Don’t assume you are safe, and don’t wait
for someone to be stuck and possibly exposed,” said
the psychiatric nurse. “Get the joint health and
safety committee or PEF nurses’ committee at your
facility to compile the procedures and lists of doctors
and providers for your area, so they will be ready if
someone needs them.”
In fact, Rosen urged facilities to “enter into
formal agreements with
those providers.”
And he advised concerned nurses and managers to look at
the National Institute for Occupational Safety and Health
(NIOSH) website at www.cdc.gov/niosh/topics/bbp/safer.
It details the five key steps for preventing needlestick
injuries:
1. Form a sharps-injury prevention team;
2. Identify priorities;
3. Identify and screen safer medical devices;
4. Evaluate safer medical devices; and
5. Implement and monitor the use
of the new device.
PEF
nurses take part in national survey
In an attempt to minimize exposure to infectious diseases
for PEF nurses, the union’s Health and Safety
Department is collaborating with Columbia University on a
national research project.
“The goal of the project is to reduce nurses’
exposure to deadly and life-threatening diseases,”
said PEF Director of Health and Safety Jonathan Rosen.
“The project is designed to assess exposure to
bloodborne pathogens, needlesticks and related injuries
among non-hospital-based health care workers.”
This summer, surveys were mailed to 5,000 PEF nurses. The
data generated from the survey will help to identify the
current level of risk and the state of needlestick
prevention activities so that more effective intervention
strategies can be developed.
The National Institute of Occupational Safety and Health
of the Centers for Disease Control is funding the
project.
“This is the first time non-hospital health care
workers’ risk of needlesticks has been
evaluated,” Rosen said. “PEF-represented nurses
have responded enthusiastically to this survey and we
look forward to reporting the results in the near
future.” — Deborah A. Miles
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