Pregnant and on Surgery rotation, can you opt out of HIV patients?

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hyupark

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I'm pregnant and am currently doing surgery rotation. Is it possible to opt out of HIV patients?

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Can you explain your reasoning why the pregnancy affects whether or not you take on HIV patients, whereas before it was not a big deal?
 
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Frankly, you should be more worried about Hep C than HIV; the transmission risk is 10 times higher. And as noted above, if you were taking necessary precautions before you were pregnant, that shouldnt be any different now.
 
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Try this:

"Umm...yeah...I'm totally preggos. Is there anyway I could scrub in on that HCV liver transplant and not that other case, 'cause I'm totes afraid of getting SUPER AIDS? K? Thanks. Bye."
 
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I'm pregnant and am currently doing surgery rotation. Is it possible to opt out of HIV patients?

I don't think that request would be well received by residents and attendings (especially if they're evaluating you).

After a med student had a surgical accidental stick scare from a HCV/HIV patient, our hospital made a policy that students are not allowed to scrub into HCV/HIV infected patients. Is it enforced, observed, or even known by the attending surgeons? No.

I completely understand your concern, but do know that these accidental sticks are rare occurrences. Just be aware of the surgical field and don't make any sudden movements (e.g., I'm gonna grab that retractor at the speed of light and with the strength of hercules to impress my attending, I'm gonna suture this laparotomy incision in under 30 seconds). Also, if you have a choice of procedures, just choose the patients without HCV/HIV.
 
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Actually I know a lot of attendings who will tell the students to sit this one out when it is a known high risk patient...
I can see that. With those patients students are more of a potential liability than anything else.

Also at my school, students have to do a lot of venipunctures and things of that sort while on the inpatient unites; but we're not allowed to be asked if the patients have HepC or HIV; this is kind of a similar situation.
 
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I remember having one real old school surgery attending, rather intimidating, the type to pimp you to extremes, throw you out of the OR, etc. balanced by having high expectations for you to participate in the surgery (make incisions, bovie, close skin, tie less crucial knots, etc.)

I walked into to the OR for a case w/ patient with either HepC or HIV and he was just like, "Stand back there and look good, your education isn't worth risking my health, the scrub tech and most importantly your own future. You have years to learn medicine, no reason to get in a hurry right now, it can wait for the next patient."

I actually really respected him for that, I had always been the type to think "I need to be able to take care of all patients", but he was completely right in retrospect.
 
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There is definitely a professional way to do this. Try bringing it up at the beginning of a rotation, or at the start of working with a particular resident/attending. And maybe frame it more like "I am currently pregnant and therefore, as you can understand, I am more concerned than usual about my exposures to certain diseases that might affect my child". Then you can mention HIV, HCV, even the other viruses like measles and rubella.
 
yes, this is an appropriate thing to discuss with your attending, or resident. They will not want to risk your future child in high risk type situations. Especially since if you got a needle stick, there are some post-exposure medications you cannot take. I agree the hepC is the more concerning, however, if you explain it to whoever is assigning cases they'll just try to avoid putting you in high risk type situations. Honestly ,the nurses though were far more protective of the students as a whole than the attendings, ex high viral load aids patient having an EGD, attending and resident didn't have on protective gear, nurse insisted on putting it on me. (She explained later that she was really afraid he'd cough blood into my face). I appreciated her for that. If that story doesn't make sense, it was a long time ago, and I may not be remembering the exact procedure.
 
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