Needle stick injury during rotations; hospital won't pay for doing my bloodwork

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Smiths11

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I wasn't sure where the right place was to ask this, and figured EM Residents/Attendings might know something about this.

I accidentally touched a patient's needlestick. It didn't penetrate my skin so I was debating whether or not to say something. He was discharged before I decided to report it. I was told I should register as a patient. The doctors, nurses, and staff assured me I was covered under the hospital's worker's compensation policy. I agreed to go to the ER where they did a rapid HIV and Hepatitis panel. I was also given the 1st dose of HAART.

Next day when I went to the employee health office, they told me I am not covered as a student. I talked to my school and they told me they can't do anything.

I have a $2,000 deductible so now I will be left footing a large bill, on top of which I have to pay big money for the rest of HAART.

Is there anything I can do about this or am I screwed? I also don't think HIV and Hep screening were useful so soon after needle exposure; is there any way I can fight this? Furthermore, they are billing me for a physical exam which they never performed. I feel so stressed out about this. Any advice would help. Thanks
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Why would they do a hiv and hep screening? Did they expect you to seroconvert less than 24 hours after a nonpenetrating event?
 
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Smiths11 said:
Exactly, there was no need to do it. It was the 1st year resident who ordered the tests for me, I guess he didn't know what he was doing..
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I think they do it so they get a baseline. Negative now then if you're positive later then well you know why. Go through your medical school, our school always said it would be covered and it would be done through them essentially regardless of what insurance we had.
 
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wonderbread12 said:
I think they do it so they get a baseline. Negative now then if you're positive later then well you know why. Go through your medical school, our school always said it would be covered and it would be done through them essentially regardless of what insurance we had.
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I tried that. My school said no - that I am responsible.
 
Smiths11 said:
I tried that. My school said no - that I am responsible.
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Very strange policy, I would take it up with people's bosses until you get a yes or get to the Dean...I would say that this is not the standard ....best of luck!
 
(1) Standard practice to draw baselines. Think before you call someone else stupid.
(2) Ask your school. Again. Ask multiple people. Go up the chain of command. If they won't budge, ask the hospital again. Ask them to write off the bill. Ask the chief of the ED to write off the bill. Be very pleasant and nice. Play the poor student card. They should NOT be discouraging the reporting of needle sticks by charging their students high fees. I'd save the complaint about up-charging for a physical exam for later, if you need something in reserve.
 
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Janders said:
(1) Standard practice to draw baselines. Think before you call someone else stupid.
(2) Ask your school. Again. Ask multiple people. Go up the chain of command. If they won't budge, ask the hospital again. Ask them to write off the bill. Ask the chief of the ED to write off the bill. Be very pleasant and nice. Play the poor student card. They should NOT be discouraging the reporting of needle sticks by charging their students high fees. I'd save the complaint about up-charging for a physical exam for later, if you need something in reserve.
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Ok, sorry you're right. I shouldn't have judged. I deleted my original comment.

In your opinion is the school or hospital more likely to be responsible? Which of the two should I focus on first?
 
I would have washed my hands and moved along. If you didn't break skin, and you don't have any open sores, I don't see a problem. If I went to employee health every time I got some patient fluid or blood on my skin they'd give me an office down there.
 
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The right approach would be to try to get the charges waived, then enlist the dean to try to get the charges waved, then put together a formal presentation for the student government about how horrible their insurance is and that they, and the dean need to address this huge liability that they allow to exist. Close with the fact that you and any other student will be out at least $2000 for a needle stick and that there is absolutely no way that that will do anything but make people not report potential exposures and puts all the students at risk.
 
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I had a hospital system charge me for the emergency room visit I had to do when I was attacked during my shift at that hospital by a psych patient wielding a shard of broken glass coated with her blood because I interrupted her suicidal gesture. They flunked their billing attempt with worker's comp and decided to go after me, going so far as to send me to collections for several months over it.

I learned something very important. Do you know what happens when you don't pay a medical bill like that? Very little. It might put a ding on your credit record and bill collectors will harass you until you exercise your legal rights to stop them from doing so. But all that will go away with time, and you can put a note on your credit report contesting it. Heck, so many people have unpaid medical debt on their reports that it doesn't really significantly impact credit decisions most of the time. It isn't worth their time or expense to sue you. They will harass you until you tell them to stop, and then they will eventually write it off. For a few years, it will show up on your credit report, and then it will fall off, like it never happened.

So, that is your worst case scenario. (Yes, you do need decent credit if you need to take Grad Plus loans for school, but there are very specific guidelines for how much debt you can default on before you need a cosigner, and from personal experience (see above), I can tell you that it is more than $2000.

I'm not saying that telling them to get bent should be your first action. But it is important to know what is the worst that can happen, so that you aren't needlessly stressing about worse, imagined outcomes. So, since there is no way they can extract payment from you, that provides them an incentive to work with you. Approach the hospital, not your school. Go up the chain, negotiate, ask them to forgive the debt, or a major portion of it. If you keep asking, and if it becomes clear to them that you aren't going to pay them $2k, they may get a lot more cooperative.

You were advised to go to the ED for treatment. It isn't as if you decided on your own to go there, on a lark. You were advised that your care would not be billed to you, by people who likely believed that, and you relied on that information, which was provided to you by the staff of that hospital. Based upon that, it isn't clear that you do owe this bill. It isn't wrong to ask for it to be written off.
 
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IlDestriero said:
I would have washed my hands and moved along. If you didn't break skin, and you don't have any open sores, I don't see a problem. If I went to employee health every time I got some patient fluid or blood on my skin they'd give me an office down there.
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You are right, that is what I would have done as well, knowing what I know now. But a student is learning about what is a significant exposure. If hospital staff advised them to go to the ED, and they acted upon that advice in good faith, then it really is on them to make it right. They presumably could have triaged better, or done a little more to ensure that their advice regarding the financial aspects of the event were accurate.
 
So this actual extends in the realm of personal injury and liability. If you got stuck maybe the school failed to provide you adequate training and has some liability. People have sued employers and similar for just getting needle stick injuries and won.

It's hard for me to believe that they will not pay for this. Playing nice is the best first plan. That will probably work. But if they don't pay, I'd seek an attorney, they will pay very quickly when they realize they could be out a lot more money for the injury (emotion distress, etc.).
 
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Psai said:
Why would they do a hiv and hep screening? Did they expect you to seroconvert less than 24 hours after a nonpenetrating event?
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You need to do an initial screen to prove you didn't have it in the first place, so that, should you come up positive later, they can't just say you had it all along.
 
Thanks everyone for replying.

I will try to talk to the hospital again and see what happens. I'll try to involve my school as some have suggested. It seems that the consensus is that I should talk to the hospital first.

Getting a lawyer is probably out of the question, since they likely charge $300/hour, defeating the purpose in the first place.

I'm so stressed out over this. It sucks that not only do I have to pay to be there, but I have to pay to get treated as well.

I'm glad that I can reach out to others on here for support.
 
Better question: why are you touching a patient's needle with bare hands? That's like old school mouth pipetting.
 
I wish this would have happened at our freestanding ER.

I would have simply not charged you.

This example, and many others, is why America is hosed with all these big conglomerate health care agencies taking over...

I love how people say Texas emergency healthcare is high because of FECs, it's not because of <insert conglomerate pricing controlled hospital here>.
 
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If it didn't break the skin, it really isn't a needlestick. Oh, and before you sign any 1099 contract to work as an independent contractor in an ED...remember that you aren't covered by workman's comp. If anything happens (from a needlestick to a patient stabbing you and putting you in the ICU) during a shift that requires you to seek medical care the hospital will bill you and the CMG that paid for your dinner will wash their hands of the matter.
 
I did have a glove on. I think there might have been a small break in my skin, though I am not sure. The reason being that I noticed a miniscule opening in my skin a few hours later, in a spot a few inches from where I got pricked, or at least where I thought I was pricked. If it was it, then it was very superficial from what I noticed. There was no bleeding, and didn't notice any blood on the glove.
 
Smiths11 said:
I did have a glove on. I think there might have been a small break in my skin, though I am not sure. The reason being that I noticed a miniscule opening in my skin a few hours later, in a spot a few inches from where I got pricked, or at least where I thought I was pricked. If it was it, then it was very superficial from what I noticed. There was no bleeding, and didn't notice any blood on the glove.
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My advice would be to forget about this forever.
 
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goodoldalky said:
My advice would be to forget about this forever.
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I would love to. But after seeing that tiny superficial cut - maybe about the size of a few grains of salt - I feel the need to take all the precaution I can.

I am hearing vastly different things from different people. Some say it has to go into the blood supply, therefore has to be a deep enough cut. Others say that even if it doesn't visibly break the skin you are at risk, no matter how little that risk is. This all tells me to just assume the worst and take all the measures I can.
 
Smiths11 said:
I would love to. But after seeing that tiny superficial cut - maybe about the size of a few grains of salt - I feel the need to take all the precaution I can.

I am hearing vastly different things from different people. Some say it has to go into the blood supply, therefore has to be a deep enough cut. Others say that even if it doesn't visibly break the skin you are at risk, no matter how little that risk is. This all tells me to just assume the worst and take all the measures I can.
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Sure, you might have infinitesimal risk. Live a little. I see people in the ED all the time wanting to go on antiretrovirals for stuff I would never take them for. I mean, people have unprotected sex with HIV+ folks for months (maybe years) without getting HIV. Hep C is a little easier to get but these things don't happen very easily, especially for little tiny solid needle scratches.
 
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Smiths11 said:
I would love to. But after seeing that tiny superficial cut - maybe about the size of a few grains of salt - I feel the need to take all the precaution I can.

I am hearing vastly different things from different people. Some say it has to go into the blood supply, therefore has to be a deep enough cut. Others say that even if it doesn't visibly break the skin you are at risk, no matter how little that risk is. This all tells me to just assume the worst and take all the measures I can.
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http://journals.cambridge.org/downl...13a.pdf&code=b02801874f6b02046798fcc5c0bfb3b2

Let's plug in your variables and see....

Unknown HIV status - high risk (being generous here)
fresh blood (again, you didn't say if the needle had blood on it but why not)
superficial transcutaneous without bleeding (again, being overly generous as it sounds like you had entirely intact skin)
Trace volume

Risk of seroconversion: 0.005%

Do what you want to do, but this sounds pretty neurotic.
 
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If this is relevant for dental heath practitioners, I should say that it is also relevant for medical health practitioners:

http://www.cdc.gov/oralhealth/infectioncontrol/faq/bloodborne_exposures.htm


Did you mention if an incident report or risk management report was completed by you?


Also, read through this:

https://www.osha.gov/dsg/hospitals/documents/1.2_Factbook_508.pdf

http://www.dol.gov/dol/topic/safety-health/

Statistics are fine, until you become one of them. Healthcare professionals need to know and maintain this principle: If they cannot effectively take care of themselves, they will be in no position to provide prolonged, effective care for others.

Each of us has to look out for ourselves. It's not at all being neurotic, b/c small cuts could be an issue, though rare, and depending upon length of exposure and the load of the patient. Take CARE OF YOU. You will be hard pressed to find others that will be looking out for you.

There are also OSHA and other standards in place for a reason. Also, get a copy of the hospital's policy on their protocol for dealing with such incidences. They are covering their butt by telling you to go to the ED, but they need to take some responsibility here. Do your research. Also file an incident report and see to it that it gets to Risk Mgt. Keep a copy of everything.

I also agree with this.
IlDestriero said:
The right approach would be to try to get the charges waived, then enlist the dean to try to get the charges waved, then put together a formal presentation for the student government about how horrible their insurance is and that they, and the dean need to address this huge liability that they allow to exist. Close with the fact that you and any other student will be out at least $2000 for a needle stick and that there is absolutely no way that that will do anything but make people not report potential exposures and puts all the students at risk.
Click to expand...
 
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jl lin said:
If this is relevant for dental heath practitioners, I should say that it is also relevant for medical health practitioners:

http://www.cdc.gov/oralhealth/infectioncontrol/faq/bloodborne_exposures.htm


Did you mention if an incident report or risk management report was completed by you?


Also, read through this:

https://www.osha.gov/dsg/hospitals/documents/1.2_Factbook_508.pdf

http://www.dol.gov/dol/topic/safety-health/

Statistics are fine, until you become one of them. Healthcare professionals need to know and maintain this principle: If they cannot effectively take care of themselves, they will be in no position to provide prolonged, effective care for others.

Each of us has to look out for ourselves. It's not at all being neurotic, b/c small cuts could be an issue, though rare, and depending upon length of exposure and the load of the patient. Take CARE OF YOU. You will be hard pressed to find others that will be looking out for you.

There are also OSHA and other standards in place for a reason. Also, get a copy of the hospital's policy on their protocol for dealing with such incidences. They are covering their butt by telling you to go to the ED, but they need to take some responsibility here. Do your research. Also file an incident report and see to it that it gets to Risk Mgt. Keep a copy of everything.

I also agree with this.
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I have a feeling that they didn't file or record anything. I was under the impression that I'd be filing a report. But in fact all that happened was I went to the ED and registered as a patient. I have no experience here but it was strange to me that I wasn't filing anything.
 
MSmentor018 said:
i wouldn't worry. unfortunately school and hospitals doesn't cover it. that's one of the reasons you have to have health insurance in med school
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Are you sure? I hear many people saying the opposite.
 
Apollyon said:
Yet another reason why the whole DO world seems like "the wild west" (I said the same about the DO match). How does this **** even happen?
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I was so close. One of my greatest regrets in life is not trying slightly harder, maybe doing a bit more research, a bit more shadowing, or a slightly higher score on my MCAT...

I pity the fools (the few of them) who purposely chose DO over MD because DO's are "holistic" and "natural" and "care about the whole patient" and "don't focus on only the symptoms"
 
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Smiths11 said:
I was so close. One of my greatest regrets in life is not trying slightly harder, maybe doing a bit more research, a bit more shadowing, or a slightly higher score on my MCAT...

I pity the fools (the few of them) who purposely chose DO over MD because DO's are "holistic" and "natural" and "care about the whole patient" and "don't focus on only the symptoms"
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20 years ago, I thought that it was 50/50. Then, in residency, the first DO we took told me that it was more like 90% that went DO because they didn't get MD. Don't know how how true that was/is, but I wouldn't doubt it.
 
I did a little bit of research after jl lin's post referencing OSHA. Here is a link to OSHA Occupational Health and Safety Standards, Bloodborne pathogens - Standard 1910.1030:

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051

If you scroll down to 1910.1030(f)(3)(ii):

1910.1030(f)(3)(ii)(A)

The source individual's blood shall be tested as soon as feasible and after consent is obtained in order to determine HBV and HIV infectivity. If consent is not obtained, the employer shall establish that legally required consent cannot be obtained. When the source individual's consent is not required by law, the source individual's blood, if available, shall be tested and the results documented.

1910.1030(f)(3)(ii)(B)

When the source individual is already known to be infected with HBV or HIV, testing for the source individual's known HBV or HIV status need not be repeated.

1910.1030(f)(3)(ii)(C)

Results of the source individual's testing shall be made available to the exposed employee, and the employee shall be informed of applicable laws and regulations concerning disclosure of the identity and infectious status of the source individual.
​
As far as I know, my hospital hasn't done this. Now I have a script for 10 days of prophylaxis, but shouldn't someone inform me of what's going on? I spoke to the ER attending and nurses who gave me the prophylaxis and drew my blood, and they had no idea what I was talking about. I know I should talk to employee health, which I will on Monday. But it's weird to me that this chain of events (contacting the patient, requesting a blood test) hasn't been initiated yet without me explicitly telling them to which I will on Monday. As soon as I complained of the injury, should not they have attempted to follow this above protocol? It is the law...

Thanks again to everyone commenting and supporting. It's really so much appreciated. I feel so alone and overwhelmed with this :(

Is it illegal for me to contact the patient on my own? What if I were to look up his information and straight up call him, requesting he comes in for blood work?
 
Our hospital has a very clear policy on exactly what to do and when, who to notify, where to go during work hours vs after hours, etc. and it's all about 5 clicks away on any hospital computer on the intranet. It's surprising and concerning that your hospital doesn't seem to have a protocol in place.
(Though as noted above, I think your chance of infection, if what you posted is accurate, is zero and I certainly wouldn't take a month of prophylactic meds. I don't know what they give now, but the old regimen was brutal.)
 
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IlDestriero said:
Our hospital has a very clear policy on exactly what to do and when, who to notify, where to go during work hours vs after hours, etc. and it's all about 5 clicks away on any hospital computer on the intranet. It's surprising and concerning that your hospital doesn't seem to have a protocol in place.
(Though as noted above, I think your chance of infection, if what you posted is accurate, is zero and I certainly wouldn't take a month of prophylactic meds. I don't know what they give now, but the old regimen was brutal.)
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Was exposed intern year. Known hiv+ patient. The combo they used was Truvada and Isentress(probably misspelled). No side effects other than fatigue. I knew another intern in a different speciality that was exposed and couldn't tolerate it, throwing up daily.
 
I remember as a med student the surgeon got me in the OR with a needle. Had to go to the ER, register as a patient, sit in the waiting room for 3 hours (professional courtesy need not apply to med students apparently), get labs drawn, and get a 700+$ bill at the end of the day. The surgeon ended up arguing it with the hospital and I think they ended up dropping it.
 
Smiths11 said:
Are you sure? I hear many people saying the opposite.
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they sure as hell didn't pay for mine. got tagged a ER visit (happened on a weekend). at first the bill was huge, then through argument with insurance company and the ER docs comped my encounter so I only had to pay the hospital facility and lab fee. then had to pay for follow up visits/lab. it's the price of working in healthcare.
 
Were you at your home institution? I went to a school with rotations at several sites and before we started rotations one of the things they told us over and over was not to go to the ED or employee health anywhere other than our home institution. They gave us all a phone number to put in our cell phones in case someone tried to argue with us. But they had had situations like this where people went through employee health or the ED of other hospitals and our school couldn't fix it and the students got huge bills. But student health (if open) or our own ED would take care of it the right way and the university would pay for everything, including testing the patient even if they were somewhere else.
 
mdpdgirl said:
Were you at your home institution? I went to a school with rotations at several sites and before we started rotations one of the things they told us over and over was not to go to the ED or employee health anywhere other than our home institution. They gave us all a phone number to put in our cell phones in case someone tried to argue with us. But they had had situations like this where people went through employee health or the ED of other hospitals and our school couldn't fix it and the students got huge bills. But student health (if open) or our own ED would take care of it the right way and the university would pay for everything, including testing the patient even if they were somewhere else.
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I went to lecom in fl. it's just a building. no true home sites or student health
 
mdpdgirl said:
Were you at your home institution? I went to a school with rotations at several sites and before we started rotations one of the things they told us over and over was not to go to the ED or employee health anywhere other than our home institution. They gave us all a phone number to put in our cell phones in case someone tried to argue with us. But they had had situations like this where people went through employee health or the ED of other hospitals and our school couldn't fix it and the students got huge bills. But student health (if open) or our own ED would take care of it the right way and the university would pay for everything, including testing the patient even if they were somewhere else.
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That's still a bit unacceptable. What if you are in NYC for a rotation and your home base is in Texas? How could they test a pt so far away? Also the PEP is time dependent as far as starting it.
 
Smiths11 said:
I have a feeling that they didn't file or record anything. I was under the impression that I'd be filing a report. But in fact all that happened was I went to the ED and registered as a patient. I have no experience here but it was strange to me that I wasn't filing anything.
Click to expand...


You are still an employee as a resident. Regardless, an incident report should have been completed. Go to HR and tell them you need to file an incident report, and then go from there. Frankly, someone was deficient in not telling you to do this. At the very least, as a nurse to procure the form for you and put in all the pertinent information, including the medical staff that saw you--w/ times and date, etc. You should also be able to speak with the Risk Mgt Director or at least someone that follows these and other such issues throughout the institution.
 
IlDestriero said:
Our hospital has a very clear policy on exactly what to do and when, who to notify, where to go during work hours vs after hours, etc. and it's all about 5 clicks away on any hospital computer on the intranet. It's surprising and concerning that your hospital doesn't seem to have a protocol in place.
(Though as noted above, I think your chance of infection, if what you posted is accurate, is zero and I certainly wouldn't take a month of prophylactic meds. I don't know what they give now, but the old regimen was brutal.)
Click to expand...


Sure but now OP would be remiss if they didn't keep an eye on it. The risk is close to zero, but no one can indeed say it is zero. Viruses are nasty things that can crop up as problems later. You are probably right, but there is still a chance, and being a particular kind of person, especially re: my own health, I'd keep an eye on it.

ITA re: policy, and I see to it that there was a record on file and a copy for me of the entire incident and what was done about it.
 
Smiths11 said:
I did a little bit of research after jl lin's post referencing OSHA. Here is a link to OSHA Occupational Health and Safety Standards, Bloodborne pathogens - Standard 1910.1030:

https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051

If you scroll down to 1910.1030(f)(3)(ii):

1910.1030(f)(3)(ii)(A)

The source individual's blood shall be tested as soon as feasible and after consent is obtained in order to determine HBV and HIV infectivity. If consent is not obtained, the employer shall establish that legally required consent cannot be obtained. When the source individual's consent is not required by law, the source individual's blood, if available, shall be tested and the results documented.

1910.1030(f)(3)(ii)(B)

When the source individual is already known to be infected with HBV or HIV, testing for the source individual's known HBV or HIV status need not be repeated.

1910.1030(f)(3)(ii)(C)

Results of the source individual's testing shall be made available to the exposed employee, and the employee shall be informed of applicable laws and regulations concerning disclosure of the identity and infectious status of the source individual.
​
As far as I know, my hospital hasn't done this. Now I have a script for 10 days of prophylaxis, but shouldn't someone inform me of what's going on? I spoke to the ER attending and nurses who gave me the prophylaxis and drew my blood, and they had no idea what I was talking about. I know I should talk to employee health, which I will on Monday. But it's weird to me that this chain of events (contacting the patient, requesting a blood test) hasn't been initiated yet without me explicitly telling them to which I will on Monday. As soon as I complained of the injury, should not they have attempted to follow this above protocol? It is the law...

Thanks again to everyone commenting and supporting. It's really so much appreciated. I feel so alone and overwhelmed with this :(

Is it illegal for me to contact the patient on my own? What if I were to look up his information and straight up call him, requesting he comes in for blood work?
Click to expand...

Don't know about that. Again, contact Risk Mgt, perhaps even the someone in ID, such as an ID nurse/doc that must follow infectious trends in the hospital. Perhaps they can help but your mind to rest.
At the very least RM and ID should be made aware of the following:

"? I spoke to the ER attending and nurses who gave me the prophylaxis and drew my blood, and they had no idea what I was talking about. "

There can be such massive communication and follow-through breakdown, and so this needs to be brought to the attention of the right people. If people don't have an understanding of the protocols/policies, or at least don't know where to look to refer to them, something is wrong.

This is why certain things require yearly, mandatory inservices and mandatory re-testing.


Best Wishes to you.
 
jl lin said:
You are still an employee as a resident. Regardless, an incident report should have been completed. Go to HR and tell them you need to file an incident report, and then go from there. Frankly, someone was deficient in not telling you to do this. At the very least, as a nurse to procure the form for you and put in all the pertinent information, including the medical staff that saw you--w/ times and date, etc. You should also be able to speak with the Risk Mgt Director or at least someone that follows these and other such issues throughout the institution.
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I'm a student though, not a resident.

I will try to talk to risk management, HR, and employee health services. And as someone else said above, if not, I will contact ID. Hopefully they all just don't send me in circles. It's beyond absurd that experienced nurses or doctors don't know what the hell they're doing, or don't at least guide me to do the right thing. If I had the money, I would hire a lawyer to sue them for this b.s.

Thanks everyone once again, I appreciate all of your comments and help.
 
IlDestriero said:
They treated you, sent labs and recommended the prophylaxis and follow up. Definitely lawsuit material.
Click to expand...

They are required by law to file an incidence report, get exact details from me about what happened and with what patient, and contact the patient and request him to come in for a HIV/HepB/HepC test, and allow me to know its results if the patient accepts. I know this because of all the research I have done since this happened. This is something that should be in their protocol and something they should have told me, not the other way around. And they should know what I am talking about when I bring this up to them, not send me around in circles. Had I not spent countless hours researching the regulation, I would have never known, and obviously neither would they. Instead I would be taking PEP unnecessarily for 28 days.

I'm already taking it for more days than I need (assuming the pt is negative and agrees to a test) since they still haven't acted yet and are instead clueless or sending me around in circles, leaving me to figure out what the hell needs to happen. More money/time/stress wasted on my part + risking the side effects for no reason.

Contrast this to what another posters here said about having the exact protocol available just a few clicks away, including who to talk to based on when the incidence happens, etc. This isn't a luxury, it's the law.
 
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Smiths11 said:
They are required by law to file an incidence report, get exact details from me about what happened and with what patient, and contact the patient and request him to come in for a HIV/HepB/HepC test, and allow me to know its results if the patient accepts. I know this because of all the research I have done since this happened. This is something that should be in their protocol and something they should have told me, not the other way around. And they should know what I am talking about when I bring this up to them, not send me around in circles. Had I not spent countless hours researching the regulation, I would have never known, and obviously neither would they. Instead I would be taking PEP unnecessarily for 28 days.

I'm already taking it for more days than I need (assuming the pt is negative and agrees to a test) since they still haven't acted yet and are instead clueless or sending me around in circles, leaving me to figure out what the hell needs to happen. More money/time/stress wasted on my part + risking the side effects for no reason.

Contrast this to what another posters here said about having the exact protocol available just a few clicks away, including who to talk to based on when the incidence happens, etc. This isn't a luxury, it's the law.
Click to expand...


I feel very badly that this has happened. All I can say is that in HC, one really has to look out for oneself. Yes, probability wise, you may well be absolutely fine. It doesn't change the possibility that you may become some statistic.

Do what you can to look out for you. I am always thrilled when I see regulations and people ignorant of them or just ignoring them. And yet we ask for honorable behavior and acting in good faith from students and doctors and others in HC, yet institutions aren't always willing to do the same. Seems like just about any place you look today there are double standards and rationalizations for lack of due diligence of the part of big entities, but then individuals are held to a standard that the big "boys" do not necessarily have to maintain.

Really, all you are asking is due diligence in following the protocol for you own wellbeing and that of other students and healthcare providers/workers.

But then you risk getting someone bothered by you, which could put you in a bad light w/ someone's evaluation or such, all b/c you desired due diligence.

You can shut your mouth, suck it up, and take your chances, OR you can stand up and say, "Wait a minute. Something is definitely wrong here."

Let me tell you the reality of that. Sadly, most would probably follow the former over the latter, especially when they look at the ASSUMED risks--which in this case are even more dubious, b/c you have to profile from the patient, and those that follow the former will suck it up and move on through their their rotations without a peep hoping for the best. Meanwhile, there is no accountability on the end of the institution, and the next person, next time, may indeed be exposed to someone with greater risk or have a greater risk exposure event.

The mentality of "Every man/woman for himself/herself" is not doing medicine or HC any major good.

It doesn't help with where they stand in terms of preserving their jobs/roles (midlevel expansion), and it doesn't do any good in terms of how they are treated when exposed to dangerous or potentially dangerous situations.

The idea that is perpetuated is to keep your head down, keep your lips wide--with the right people, and keep going. This is the climate/environment in a lot of medicine and healthcare.

Please tell me this. If individuals and a groups of professionals cannot stand up for themselves. how can these same individuals and groups of professionals advocate and stand up for their patients consistently enough?

If you can't take care of you, you are not going to be in a position to take care of others!

The problem is that HC is such big business now, that it thinks it can now turn a blind eye to such principles. Business and pleasing the right people comes first, and to hell with the individual.

Exercise you own set of principles here. You are not a fool for seeking due diligence with this incident. You may or may not pay a price for it--depending upon who gets annoyed and causes unwanted crap for someone else; but you are already in question anyway. Might as well try to see that the standards are maintained for you as well as others in the future.
 
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