I want to quit

[anon24]

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I recently was exposed to HIV via needle stick, currently taking post exposure prophylaxis. I haven't told my family or my friends, I don't think I can ever tell them. The person was HIV positive and probably has a high viral load. I can't work, I can't be normal, and I can't think. I don't think I can function while waiting to know whether I sero convert which is a long time. I don't want to practice medicine at this time. What would you do? I am a second year internal medicine resident. I think I should take a leave of absence.

 

[FiremedicMike]

Transmission rates from needle sticks are very low. You probably have an equal chance of being hit by a truck tomorrow.


That said, those meds suck, I've been there.

 

[colbgw02]

I think you should try your best not to think about it. Chances are everything will be fine, and you don't want to do anything drastic until you have a reason to.

 

[link2swim06]

At least it wasn't hep c. That I would be slightly worried about.

Your chance of HIV with PEP is almost a rounding error.

 

[Anduin]

0.3% from what I recall from my step 2 qbank.

 

[da8s0859q]

0.3% from what I recall from my step 2 qbank.

This.

OP, the odds are overwhelmingly in your favor.

I went through something very similar to what you're describing. You're not alone. I know it makes things hard. But in the end, statistically, you are going to be fine.

 

[BoardingDoc]

This.

OP, the odds are overwhelmingly in your favor.

I went through something very similar to what you're describing. You're not alone. I know it makes things hard. But in the end, statistically, you are going to be fine.

It's 0.3% without PEP.
Rule of 3s:
0.3% for HIV
3% for Hep C
30% hep B.

HIV PEP further decreases the risk by 80% --> new risk of 0.06%

 

[da8s0859q]

It's 0.3% without PEP.
Rule of 3s:
0.3% for HIV
3% for Hep C
30% hep B.

HIV PEP further decreases the risk by 80% --> new risk of 0.06%

Right. Went through this with hep C. Was actually looking up the PEP risk reduction which I didn't remember, thanks much.

 

[j4pac]

To answer you question...if you are a liability you should request a leave of absence.

 

[Mad Jack]

I've been there myself. The meds can absolutely destroy you physically and emotionally- they were a big factor in my engagement falling through. Just try to hang in there as best as you can. In two decades my hospital only had one seroconversion, and that was from a very messy accident from a patient with a very high viral load and without PEP.

Good luck. You'll very likely be fine. Just know that a looooot of us have been right where you're at and that we made it through and the horrible will pass.

 

[Doctor Bob]

I recently was exposed to HIV via needle stick, currently taking post exposure prophylaxis. I haven't told my family or my friends, I don't think I can ever tell them. The person was HIV positive and probably has a high viral load. I can't work, I can't be normal, and I can't think. I don't think I can function while waiting to know whether I sero convert which is a long time. I don't want to practice medicine at this time. What would you do? I am a second year internal medicine resident. I think I should take a leave of absence.

The cause for your mental distraction is immaterial. If you can't get past the distraction for whatever reason, then yes, you need a leave of absence.
If you have a bad outcome with a patient because of your distraction, the reason for your distraction will not be viewed as mitigating. If anything it may make things worse. You knew you couldn't function and continued to work anyways.

 

[Chicago2012]

I think, at the very least, you need to talk to someone. Hopefully, the comments on this thread will have helped.

 

[jl lin]

Definitely find a professional with whom you can discuss this. It's agonizing having to wait. Have had a number of messy codes and bloody patients and such over many years. Many of us have been through something like this. It's MUCH scarier when you know the person has a high load. Of course you know with such a case PEP is better than no PEP--even if the meds suck. If you can talk with the right person, you may be able to find the best course of action for you. For me, it was always keeping busy; but to be fair, for both patients, the risks seemed low to unknowable, given the situations. Yep. Your situation and that of others is scarier b/c you know the risk is greater. But even with that, the numbers are on your side. I'm sure that is little consolation for you right now.

What will you do though if you take a LOA? Will you suck up your day worrying about it? See, this is troubling too. Everyone is different. Go speak with a professional.

Positive thoughts for you anon24.

 

[Chicago2012]

 

[Smurfette]

I've been on PEP as well and it is miserable. Side effects can include depression, anxiety as well as the physical stuff like N/V/malaise. While you may be freaking out on your own, it is possible the meds are exacerbating it even more. Some thoughts:

1. Find someone else who's been through this to talk to in person. It may help you realize you are not alone, and give you a sounding board. Ask around at work, you'll probably be surprised by how many people have been through this.
2. See a mental health professional ASAP to help you work through this before things get worse.
3. Talk to your PD and let him/her know you are feeling overwhelmed as a result of all this. If you need to take an LOA, ask. Odds are, they will try to help you in whatever way they can. Do not let things get so bad that you get called to see the PD after others become concerned about you.

Best of luck.

 

[Dral]

As most others here, been there. It's so tough to get it out of your mind. Mine happened the day before vacation too, ugh.

Just take the meds and try to stay optimistic. My employee health nurse told me nobody at my hospital has ever seroconverted.

 

[anon24]

I had a few rough days initially but things have gotten better. I am no longer depressed or sad just a little nervous at times but nothing I can't handle. I appreciate all the support and positive feedback, you guys are all correct in stating my odds of seroconverting are very low. My institution has never had anyone seroconvert and I am having trouble finding any literature on people who failed PEP treatment.

thank you all

 

[thepretender67]

in what scenarios realistically do medicine residents get exposed to needle sticks? I thought this was mostly a concern for surgical residents.

Do medicine residents actually give vaccinations and draw blood that often? I thought this is something that nurses generally do.

 

[Dral]

You place lines. Central lines, art sticks, centesis, etc.

Central lines are actually higher risk because they are larger bore.