Needle stick and punished on grade

[Medstudentquest]

So here is my situation! I got stuck with a needle in a rotation. The people involved did not provide me with any nfo as to what to do, and I asked the nurses and they told me to go to the ER. I went to the ER but the consent form for HIV test at the hospital basically said that if I were to get anything, they were not responsible so I did not test myself at the hospital. Also, I was afraid I'd get totally destroyed on my evals if I reported the incident, so I initially did not report it. I ended up reporting the incident a few days later, and the people in the department were not thrilled about my decision to do so. I asked the patient to be tested, as the doctor who saw me in the ER said was my right, but basically patient was never tested, not even in her follow up visit, and in the end of the rotation, the director basically said that she would not be tested. I thought this was utterly unethical of him to do, as well as the fact that they sent me the bill for the ER.
Because I kept pushing the issue that they were responsible for the bill as well as for testing the patient, I got totally screwed on my final grade. I am highly unhappy with it, especially since I got great midrotation evals. I met with the overall director of the clerkship and she said basically that my only resource was to see my file at the hospital to review the evals. The problem is that again, because of the issue, there was alot of tension and nastiness from the side of the residents and that's why I got totally screwed on my final grade. I'm unhappy with this, because I worked my butt off in this rotation. Should I contact the dean? Any ideas?

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[fab4fan]

I sure would like to see that consent form.

Is it possible the people involved were upset because you delayed in reporting ? It's a bigger hassle for the parties involved if you don't report a work-related injury immediately. It can also mess up your ability to get coverage/compensation. Alway, always, report right away. You never know when a minor problem can become a career ending injury.

I can only speak as a worker bee that when it comes to this sort of injury, retaliation is a huge no-no, and can get a facility into hot water. I don't know how it works in the med-student world, but I would hope you guys would be afforded similar protections. I work in the ED, and we never harrass med students who come in with needle sticks. They happen; it's a part of life if you work with pts.

 

[Medstudentquest]

Main problem was that I requested patient to be tested, and I had to repeatedly ask the patient to be tested, yet they refused in the end. It would have been very simple for the patient to be tested since she was there several days and later came back to the hospital. Also the whole issue with the bill put further tension on the situation. I have no doubt that my final grade is punitive because of this and the fact that the director of the site sort of got the attending who didnt do anything during the incident into hot water because she did not follow procedure so she totally took it out on me as well. Again the whole not testing patient really bothers me because I have to continuously test myself for like the next year,w hich would have been solved if patient was tested.
Again it also bothers me that they screwed me on the grade. The director does not seem to want to do anything. Should I take action against the hospital?

 

[July2006]

Are you in the U.S.? If so, needlesticks are supposed to be strictly regulated! The hospital should have a written policy. You may be able to report the hospital to the US. Department of Labor’s Occupational Safety & Health Administration (OSHA) that regulates needlesticks in healthcare providers. http://www.osha.gov/SLTC/bloodbornepathogens/standards.html

The CDC’s National Institute for Occupational Safety and Health (NIOSH) also has a 24hour hotline for medical treatment for occupational exposures. 1-888-448-4911
More information at http://www.cdc.gov/niosh/topics/bbp/emrgnedl.html

(I’m in public health, not medicine, so I’m ignorant of the politics of reporting a violation.)

 

[fab4fan]

Main problem was that I requested patient to be tested, and I had to repeatedly ask the patient to be tested, yet they refused in the end. It would have been very simple for the patient to be tested since she was there several days and later came back to the hospital. Also the whole issue with the bill put further tension on the situation. I have no doubt that my final grade is punitive because of this and the fact that the director of the site sort of got the attending who didnt do anything during the incident into hot water because she did not follow procedure so she totally took it out on me as well. Again the whole not testing patient really bothers me because I have to continuously test myself for like the next year,w hich would have been solved if patient was tested.
Again it also bothers me that they screwed me on the grade. The director does not seem to want to do anything. Should I take action against the hospital?

There's your explanation right there...someone screwed up and didn't follow procedure, and now you are being punished for it.

The pt should have been asked. Not asking her was just incredibly ignorant. The pt of course has the right to refuse to be tested, but for your supervisors to refuse to ask? Good grief. Did they at least offer you prophylactic meds?

If this really played out as you described, it's an OSHA nightmare. I'm not saying I don't believe you, it's more like I just can't believe how stupid people can be sometimes.

Retaliation for needlesticks is a violation of federal law for healthcare workers. I'm not really qualified to say more than that; it sounds like you could use the advice of a good atty. Good luck to you, and I hope everything works out for you. It's hard enough to be a student...you certainly don't need this stress.

 

[Medstudentquest]

I know, especially because the patient was there repeatedly and could have been tested without a problem! Also, law in my state says that a patient even if they refused, you have a right to test them if their blood has come in contact with a health care worker. I am really upset that they screwed me over with my grade. Should I report them to OSHA or should I contact an atty then?

 

[RockShox]

Ok I want to say first that I am sorry for what you are going through and know that what I say next is meant in the most respectful way...

I have to admit your story is so backward I almost am having a hard time believing it. I will have to assume that you are in the US but it seems really unlikely as OSHA has tattooed the procedure for this situation into the brains of all hospitals, clinics, and workers.

Every person who works in a hospital and every medical student in the US gets mandatory info for what to do with needle sticks. I have worked in more hospitals that I can count and every one had a risk management rep on call just for these things. OSHA regulations state you are to go to your pre-designated place for treatment and workup. If that is your ER then so be it, you should not be billed. There you can receive the proper testing and meds.

As for patients, unless you are in California (which as an opt-out HIV testing policy) you must get permission to do an HIV test. Someone on your team should have at least asked and risk management would have had documentation that it was done. I mean for real! What hospital is going to want to cover $2000 for antivirals if they can just do a $50 blood test? However, if the patient says no then that is the answer. As for hepatitis (which is far easier to catch from a stick than HIV) there are no requirements for special permission to do the test (other than the usual consent for a blood draw).

Your conversation with the clerkship director is almost bordering on fiction. By definition the clerkship director is the one who approves all final grades and thus should be able to easily access your evals, review them, and institute whatever policies your school has in place for this. IF THAT FAILS GO TO THE DEAN OR WHOEVER DEALS WITH THIS STUFF.

If I had been your attending I would have given you a poor eval too, but NOT for the needlestick itself, but for not following proper procedure to begin with. I mean there is nothing worse than making a mistake, I know. But trying to cover up that mistake (especially for the lame excuse of protecting your own ass or someone else's) at the risk of your team, hospital, yourself, and your clerkship is almost inexcusable. It hints to immature decision making skills. It is hard to believe that any US medical student would be ignorant of these procedures. If you are willing to cover up what is gravely important to you personally, how can you be trusted to not do it again for much lesser things?

So my advice is to start owning yourself as an intelligent medical professional and start making wise, OBJECTIVE decisions about what to do next.

I really what you to know I am not trying to be harsh. It is SO hard to be straight forward without sounding like a jerk on the internet. I really am sending you good luck vibes.

Oh...and if you are sure you are being screwed by the clerkship and the dean blows you off don't go to OSHA or and atty...try every avenue within the school. If that fails then you could contact the LCME and file a complaint, but as someone else said this could kill your career.

 

[Tired Pigeon]

How bad were you screwed over on the rotation? Did you actually fail it or did you just not do as well as you expected to given your performance? Grading on these things is ridiculously subjective anyway, and if you're complaining about anything less than flat-out failing, you'll have an uphill battle proving you were retaliated against. Knowing you were screwed is one thing; proving you were screwed is an entirely different ballgame.

The thing to think about with regard to attorneys/OSHA is that you might win the battle but lose the war. Know that if you go this route, no matter how right you are and how entitled you are to do so, you will be branded as a huge troublemaker. This will bias the residents and attendings against you on future rotations (I'm assuming this isn't your last rotation). Word will get around and all of a sudden ALL your evaluations will be mediocre (not bad enough to prove "retaliation", just subjectively somewhere just above sh*tty). Chances of good LORs for residency apps will also mysteriously evaporate. The hostility/attitude you're dealing with now is NOTHING compared to what will ensue if your pursue legal recourse or bring in OSHA.

It isn't right that it's this way, and there are supposedly protections in place,
but understand the reality of the situation is that you may be better off letting this go (from the lawyer and OSHA standpoint). Don't let your sense of righteous indignation consume you to the point where you do lasting damage to your own career.

 

[Medstudentquest]

Ok I want to say first that I am sorry for what you are going through and know that what I say next is meant in the most respectful way...

I have to admit your story is so backward I almost am having a hard time believing it. I will have to assume that you are in the US but it seems really unlikely as OSHA has tattooed the procedure for this situation into the brains of all hospitals, clinics, and workers.

Every person who works in a hospital and every medical student in the US gets mandatory info for what to do with needle sticks. I have worked in more hospitals that I can count and every one had a risk management rep on call just for these things. OSHA regulations state you are to go to your pre-designated place for treatment and workup. If that is your ER then so be it, you should not be billed. There you can receive the proper testing and meds.

As for patients, unless you are in California (which as an opt-out HIV testing policy) you must get permission to do an HIV test. Someone on your team should have at least asked and risk management would have had documentation that it was done. I mean for real! What hospital is going to want to cover $2000 for antivirals if they can just do a $50 blood test? However, if the patient says no then that is the answer. As for hepatitis (which is far easier to catch from a stick than HIV) there are no requirements for special permission to do the test (other than the usual consent for a blood draw).

Your conversation with the clerkship director is almost bordering on fiction. By definition the clerkship director is the one who approves all final grades and thus should be able to easily access your evals, review them, and institute whatever policies your school has in place for this. IF THAT FAILS GO TO THE DEAN OR WHOEVER DEALS WITH THIS STUFF.

If I had been your attending I would have given you a poor eval too, but NOT for the needlestick itself, but for not following proper procedure to begin with. I mean there is nothing worse than making a mistake, I know. But trying to cover up that mistake (especially for the lame excuse of protecting your own ass or someone else’s) at the risk of your team, hospital, yourself, and your clerkship is almost inexcusable. It hints to immature decision making skills. It is hard to believe that any US medical student would be ignorant of these procedures. If you are willing to cover up what is gravely important to you personally, how can you be trusted to not do it again for much lesser things?

So my advice is to start owning yourself as and intelligent medical professional and start making wise, OBJECTIVE decisions about what to do next.

I really what you to know I am not trying to be harsh. It is SO hard to be straight forward without sounding like a jerk on the internet. I really am sending you good luck vibes.

Please don't comment on things you have no idea about. I didn't stick myself first of all, I made no mistakes for your info. Don't be ignorant and comment on things you have no idea about. A careless resident stuck me. It was during a call and I hadn't slept in 30hours. Don't assume things you have no idea about. I had no clue about the procedure since it was my first surgical rotation and I did go to the ER but no one on the team told me what the procedure was since they did not want me to report the incident for your info. The resident/attending who were involved were upset when they found out that I reported the incident. I was offered no prophylaxis whatsoever. I was told in the ER that I would not get billed but they DID BILL ME!!!!!!!!!!!!!!!!!!! because they said that they do not cover students. Your comments are absolutely ignorant. What are you talking about covering anything? I made no mistake whatsoever, the resident made the mistake and I was the victim of her poor surgical skills.

The patient was NOT asked to get testing period. My own clerkship director at my school called and she was told the same thing and since they can't find the patient now, she can't even test the patient now either even though she agreed the patient should have been tested.

You probably are not a medical student as any medical student knows how difficult it is to be in this situation. You also assume things without thinking or getting appropriate information. Unbelievable.

 

[Medstudentquest]

How bad were you screwed over on the rotation? Did you actually fail it or did you just not do as well as you expected to given your performance? Grading on these things is ridiculously subjective anyway, and if you're complaining about anything less than flat-out failing, you'll have an uphill battle proving you were retaliated against. Knowing you were screwed is one thing; proving you were screwed is an entirely different ballgame.

The thing to think about with regard to attorneys/OSHA is that you might win the battle but lose the war. Know that if you go this route, no matter how right you are and how entitled you are to do so, you will be branded as a huge troublemaker. This will bias the residents and attendings against you on future rotations (I'm assuming this isn't your last rotation). Word will get around and all of a sudden ALL your evaluations will be mediocre (not bad enough to prove "retaliation", just subjectively somewhere just above sh*tty). Chances of good LORs for residency apps will also mysteriously evaporate. The hostility/attitude you're dealing with now is NOTHING compared to what will ensue if your pursue legal recourse or bring in OSHA.

It isn't right that it's this way, and there are supposedly protections in place,
but understand the reality of the situation is that you may be better off letting this go (from the lawyer and OSHA standpoint). Don't let your sense of righteous indignation consume you to the point where you do lasting damage to your own career.

Well most people who have rotated through the site I rotated through have hated the site and residents. Most of my evals on other rotations have been great. The eval on the rotation that I'm doing currently has been great. I am conflicted as to what to do.

 

[Tired]

Please don't comment on things you have no idea about. I didn't stick myself first of all, I made no mistakes for your info. Don't be ignorant and comment on things you have no idea about. A careless resident stuck me. It was during a call and I hadn't slept in 30hours. Don't assume things you have no idea about. I had no clue about the procedure since it was my first surgical rotation and I did go to the ER but no one on the team told me what the procedure was since they did not want me to report the incident for your info. The resident/attending who were involved were upset when they found out that I reported the incident. I was offered no prophylaxis whatsoever. I was told in the ER that I would not get billed but they DID BILL ME!!!!!!!!!!!!!!!!!!! because they said that they do not cover students. Your comments are absolutely ignorant. What are you talking about covering anything? I made no mistake whatsoever, the resident made the mistake and I was the victim of her poor surgical skills.

The patient was NOT asked to get testing period. My own clerkship director at my school called and she was told the same thing and since they can't find the patient now, she can't even test the patient now either even though she agreed the patient should have been tested.

You probably are not a medical student as any medical student knows how difficult it is to be in this situation. You also assume things without thinking or getting appropriate information. Unbelievable.

Well, I am a med student (graduating in 2 weeks) and let me tell you the problems I'm having with your story.

1) You say you were stuck by a resident, but the resident didn't tell anyone else on the team? This is a little hard to believe.

2) You had a resident there when it happened, but the resident also didn't know what to do when you suffer a needlestick? Also hard to believe.

3) My school gives us a 2-hour talk on needlestick prevention and procedures prior to the start of 3rd year. My understanding was that this was an LCME requirement. You never got one of these?

4) We are explicitly told in the lecture mentioned above that all costs associated with a needlestick injury are our responsibility, as we are not employees of anyone. This caused a lot of consternation in our class, but they were very firm that this is common practice throughout the U.S., with the only exceptions being hospitals that (out of the goodness of their heart) take on that liability. This was news to you?

5) You were worried about your grade even though you made no mistakes and weren't even holding the needle? Again, that just sounds kind of fishy.

I'm also sorry this happened to you, but you made all the wrong decisions (reporting late, fighting the bill) and were obviously completely unprepared for the possibility that this could happen to you. Perhaps in residency you will take the time to figure out what to do before this happens.

 

[RockShox]

Medstudentquest. Like I said try not to get too excited I am not trying to be harsh so calm down. I hope that is not how you have been verbally dealing with this because it could be why you are getting no traction. Over excitement prevents solid reasoning.

Of course I am a medical student. I also have had the privledge of working with several national organizations including the LCME which accredits your school.

If there truly was a conspiracy by a team of residents, a staff physician, a ER doctor, and a clerkship director to not follow OSHA standards that even a hospital cafeteria worker is aware of would be the most amazing story I have heard in a long time. And it should immediately be reported to the LCME following the procedures outlined in Appendix D of the the LCME accrediting policies.

The LCME reviews every school in the US and checks to see that all students have taken an infectious disease training WITH exam AND signature of completion before they are exposed to patients. Any school that fails to do this risks serious consequence, no question. The risks are too high.

In addition I cannot imagine a clerkship director not addressing this issue with the chief resident, the residents involved, the attending, the dean, and Jesus Himself. At my institution any resident who would knowingly fail to direct a student to the ER after a stick for any reason would either be suspended or worse fired. We have fired residents for less.

I guess my point is it is hard to believe this is a real occurance and if it is the LCME should immediately be involved. Keep in mind that Appendix D states that the event must be proven legitimate and accurate so be sure you have the t's crossed if you go that route.

Honestly, I really am a nice person and very pleasant, I just am trying to be as straight as possible about my assessment given the limited space and the info you provided.

(And, don't assume that this type of thing is so rare that no one else has every been stuck by a resident or attending. Many of us have been there. Having done alot of traveling this level of bulls**t just doesn't happen at legitimate institutions in my opinion)

 

[Medstudentquest]

Well, I am a med student (graduating in 2 weeks) and let me tell you the problems I'm having with your story.

1) You say you were stuck by a resident, but the resident didn't tell anyone else on the team? This is a little hard to believe.

2) You had a resident there when it happened, but the resident also didn't know what to do when you suffer a needlestick? Also hard to believe.

3) My school gives us a 2-hour talk on needlestick prevention and procedures prior to the start of 3rd year. My understanding was that this was an LCME requirement. You never got one of these?

4) We are explicitly told in the lecture mentioned above that all costs associated with a needlestick injury are our responsibility, as we are not employees of anyone. This caused a lot of consternation in our class, but they were very firm that this is common practice throughout the U.S., with the only exceptions being hospitals that (out of the goodness of their heart) take on that liability. This was news to you?

5) You were worried about your grade even though you made no mistakes and weren't even holding the needle? Again, that just sounds kind of fishy.

I'm also sorry this happened to you, but you made all the wrong decisions (reporting late, fighting the bill) and were obviously completely unprepared for the possibility that this could happen to you. Perhaps in residency you will take the time to figure out what to do before this happens.

1-When did I say the resident didn't tell anyone on the team? Learn to read. The resident stuck me. The attending was there as well. Neither of them told me to go to the ER.
2-Neither the resident nor the attending told me to go to the ER. Again you must not be a med student. Many students are stuck and are told not to worry. One of my classmates was told not to be "such a baby" when stuck by a needle recently.
3-No.
4-I have no clue where you would go to school, but most hospitals cover when they stick students!!!! IT IS THEIR FAULT!! The student doesn't have to cover this. the ER told me this when I went to the ER that I would not be charged for anything. The overall clerkship director told me I should not have been charged. I have had other classmates gotten stuck and the hospital covered it. That's the way it is in most hospitals.
5-Again, don't be ignorant. I was observing a procedure, I was not holding anything. I was a mere observant with my hands on the patient. The resident was tired and clumsy. She stuck me. Period. As a student and the responsibility of my resident and attending would have been to tell me what to do. Period. Where is the discussion there? They did not want me to go to the ER because residents don't like it when the fact they have stuck someone is known. If you don't know this, I doubt you are a med student. I will absolutely not pay a bill that is not my responsibility especially when I asked first. They should have tested the patient.Period. Learn to think as a person before posting things when you have no clue about the experiences of others.

 

[watermen]

Well, I am a med student (graduating in 2 weeks) and let me tell you the problems I'm having with your story.

1) You say you were stuck by a resident, but the resident didn't tell anyone else on the team? This is a little hard to believe.

2) You had a resident there when it happened, but the resident also didn't know what to do when you suffer a needlestick? Also hard to believe.

3) My school gives us a 2-hour talk on needlestick prevention and procedures prior to the start of 3rd year. My understanding was that this was an LCME requirement. You never got one of these?

4) We are explicitly told in the lecture mentioned above that all costs associated with a needlestick injury are our responsibility, as we are not employees of anyone. This caused a lot of consternation in our class, but they were very firm that this is common practice throughout the U.S., with the only exceptions being hospitals that (out of the goodness of their heart) take on that liability. This was news to you?

5) You were worried about your grade even though you made no mistakes and weren't even holding the needle? Again, that just sounds kind of fishy.

I'm also sorry this happened to you, but you made all the wrong decisions (reporting late, fighting the bill) and were obviously completely unprepared for the possibility that this could happen to you. Perhaps in residency you will take the time to figure out what to do before this happens.

Hey man...let's be more supportive. It is terrible enough to get stick by needle, to get punished on evaluation is just pouring oil on the fire.

Well, I really feel sorry about your case, as a 3rd year medical student (I am assuming you are a 3rd year), I can feel your agony. Just let it go by...if you are really interested in that specialty, just do another rotation...forget about this incident and keep moving on...my advisor once told me, if I were to be troubled by my grade, I am not going to function well....so, let's forget about those grade or evaluation, as long as you know you are not harming anyone, your conscience is clear, you will be a good doctor regardless of what your evaluation say. I believe, what goes around comes around, one day when you become a resident, attending or program coordinator, remember to treat your medical student nice.

 

[Medstudentquest]

Medstudentquest. Like I said try not to get too excited I am not trying to be harsh so calm down. I hope that is not how you have been verbally dealing with this because it could be why you are getting no traction. Over excitement prevents solid reasoning.

Of course I am a medical student. I also have had the privledge of working with several national organizations including the LCME which accredits your school.

If there truly was a conspiracy by a team of residents, a staff physician, a ER doctor, and a clerkship director to not follow OSHA standards that even a hospital cafeteria worker is aware of would be the most amazing story I have heard in a long time. And it should immediately be reported to the LCME following the procedures outlined in Appendix D of the the LCME accrediting policies.

The LCME reviews every school in the US and checks to see that all students have taken an infectious disease training WITH exam AND signature of completion before they are exposed to patients. Any school that fails to do this looses their accreditation, no question. The risks are too high.

In addition I cannot imagine a clerkship director not addressing this issue with the chief resident, the residents involved, the attending, the dean, and Jesus Himself. At my institution any resident who would knowingly fail to direct a student to the ER after a stick for any reason would either be suspended or worse fired. We have fired residents for less.

I guess my point is it is hard to believe this is a real occurance and if it is the LCME should immediately be involved. Keep in mind that Appendix D states that the event must be proven legitimate and accurate so be sure you have the t's crossed if you go that route.

Honestly, I really am a nice person and very pleasant, I just am trying to be as straight as possible about my assessment given the limited space and the info you provided.

You are very rude. First of all, don't be condescending. It's not appropriate. There is no way you can be a medical student if you think with such a limited scope. Also dont be ridiculous. I never said there is a conspiracy. What I said is that neither the resident nor the attending directed me to the ER or told me what to do. This happens every day. You must not have done a surgical rotation. LOTS of people get stuck and are not told what to do or punished for doing so. Read other threads on this same forum and you'll see.

I do not know of any school that takes a class on needle stick incidents. That is an entirely made up story. Needle sticks are never dealt with deans. What are you talking about? Deans don't deal with that.

I highly doubt you are a medical student. Any true medical student knows and fears the repercusions that reporting these type of incidents can bring about. Please stop writing me. You have a very limited ability to think about things.

 

[RockShox]

Well, I am a med student (graduating in 2 weeks) and let me tell you the problems I'm having with your story.

1) You say you were stuck by a resident, but the resident didn't tell anyone else on the team? This is a little hard to believe.

2) You had a resident there when it happened, but the resident also didn't know what to do when you suffer a needlestick? Also hard to believe.

3) My school gives us a 2-hour talk on needlestick prevention and procedures prior to the start of 3rd year. My understanding was that this was an LCME requirement. You never got one of these?

4) We are explicitly told in the lecture mentioned above that all costs associated with a needlestick injury are our responsibility, as we are not employees of anyone. This caused a lot of consternation in our class, but they were very firm that this is common practice throughout the U.S., with the only exceptions being hospitals that (out of the goodness of their heart) take on that liability. This was news to you?

5) You were worried about your grade even though you made no mistakes and weren't even holding the needle? Again, that just sounds kind of fishy.

I'm also sorry this happened to you, but you made all the wrong decisions (reporting late, fighting the bill) and were obviously completely unprepared for the possibility that this could happen to you. Perhaps in residency you will take the time to figure out what to do before this happens.

👍 OMG, Tired. I hope you keep posting on this site after you graduate. Good luck.

 

[Medstudentquest]

Hey man...let's be more supportive. It is terrible enough to get stick by needle, to get punished on evaluation is just pouring oil on the fire.

Well, I really feel sorry about your case, as a 3rd year medical student (I am assuming you are a 3rd year), I can feel your agony. Just let it go by...if you are really interested in that specialty, just do another rotation...forget about this incident and keep moving on...my advisor once told me, if I were to be troubled by my grade, I am not going to function well....so, let's forget about those grade or evaluation, as long as you know you are not harming anyone, your conscience is clear, you will be a good doctor regardless of what your evaluation say. I believe, what goes around comes around, one day when you become a resident, attending or program coordinator, remember to treat your medical student nice.

I know this dude is very lame. Definitely not a med student. Well it hurts me because I have worked so hard on this rotation! A month and a half of waking up at 4:00am and sleeping 5 hours a night for nothing. Not ot mention I h ave to keep testing myself for the next year or so. It sucks. And they are just going to get away with it. 🙁

 

[RockShox]

Ok now I am completely convinced this is made up...

but i will feed you.

and just for the lawyer in me here is the actual policy in the Accreditation Guidelines book from the LCME

MS-30. Schools must have policies addressing student exposure to infectious and environmental hazards.

The policies should include 1) education of students about methods of prevention; 2) the procedures for care and treatment after exposure, including definition of financial responsibility; and 3) the effects of infectious and environmental disease or disability on student learning activities. All registered students (including visiting students) need to be informed of these policies before undertaking any educational activities that would place them at risk.

(Article III, Section 3, paragraph B, line MS-30, Accreditation Standards for US Medical Education, LCME, updated Feb 2007)

 

[Medstudentquest]

Ok now I am completely convinced this is made up...

but i will feed you.

and just for the lawyer in me here is the actual policy in the Accreditation Guidelines book from the LCME

MS-30. Schools must have policies addressing student exposure to infectious and environmental hazards.

The policies should include 1) education of students about methods of prevention; 2) the procedures for care and treatment after exposure, including definition of financial responsibility; and 3) the effects of infectious and environmental disease or disability on student learning activities. All registered students (including visiting students) need to be informed of these policies before undertaking any educational activities that would place them at risk.

(Article III, Section 3, paragraph B, line MS-30, Accreditation Standards for US Medical Education, LCME, updated Feb 2007)

Sure it is, I guess that's why I have ER records on the day of the incident, ER bills, an incident report. Go away.

 

[Tired]

Where is the discussion there?

It's clear to me now that there is no discussion. Either you are a liar, or you go to school somewhere in South America. Personally, I think this is a fake story posted by an attention *****.

For the benefit of students in this forum who may not have gotten to clinical rotations yet:

First, know your procedures in case of a needle stick. Usually you go to employee health during the day, or the ER at night. There is also a hotline number to call that is normally posted at every nursing station. You leave a contact number (use your pager) and they get back to you, usually very quickly. The hospital will normally get consent from the source patient (usually done by social work) to get HIV/Hep testing done. You will also be tested, and offered the option of HIV prophylaxis almost immediately. I recommend you take the drugs, although you will have to be on them for a while and they may make you sick. Don't play with your life.

Second, know the policy of your school/hospital as it relates to student needlesticks. My school does rotations at 7-8 different hospitals. At all but one, the cost of the ER visit and subsequent treatment is borne by the student. The reason for this is that you are not an employee, so they are not obligated to pay for your treatment (unlike, say, a janitor, nice huh?). Your health insurance, however, will pay for it. That's one more reason insurance is mandatory in med school.

Third, report the stick to everyone as soon as possible. And I mean everyone. Tell your immediate supervising intern and resident, the chief, the attending on the case, the clerkship director, and your Dean. If the attending is out, page him. Page the chief. Do not wait on this. I have never heard of "retaliation" for a needlestick. I have, however, heard of students being scolded for waiting. Despite this fake horror story posted here, most of your faculty wants to protect you and will not hold a stick against you. It happens all the time. [And for the record, if you stick yourself, and they make you do some kind of "safety training", that's not retaliation, that's trying to prevent future sticks; do not take it personally.]

RockShox, I miss anything here?

 

[Medstudentquest]

It's clear to me now that there is no discussion. Either you are a liar, or you go to school somewhere in South America. Personally, I think this is a fake story posted by an attention *****.

For the benefit of students in this forum who may not have gotten to clinical rotations yet:

First, know your procedures in case of a needle stick. Usually you go to employee health during the day, or the ER at night. There is also a hotline number to call that is normally posted at every nursing station. You leave a contact number (use your pager) and they get back to you, usually very quickly. The hospital will normally get consent from the source patient (usually done by social work) to get HIV/Hep testing done. You will also be tested, and offered the option of HIV prophylaxis almost immediately. I recommend you take the drugs, although you will have to be on them for a while and they may make you sick. Don't play with your life.

Second, know the policy of your school/hospital as it relates to student needlesticks. My school does rotations at 7-8 different hospitals. At all but one, the cost of the ER visit and subsequent treatment is borne by the student. The reason for this is that you are not an employee, so they are not obligated to pay for your treatment (unlike, say, a janitor, nice huh?). Your health insurance, however, will pay for it. That's one more reason insurance is mandatory in med school.

Third, report the stick to everyone as soon as possible. And I mean everyone. Tell your immediate supervising intern and resident, the chief, the attending on the case, the clerkship director, and your Dean. If the attending is out, page him. Page the chief. Do not wait on this. I have never heard of "retaliation" for a needlestick. I have, however, heard of students being scolded for waiting. Despite this fake horror story posted here, most of your faculty wants to protect you and will not hold a stick against you. It happens all the time. [And for the record, if you stick yourself, and they make you do some kind of "safety training", that's not retaliation, that's trying to prevent future sticks; do not take it personally.]

RockShox, I miss anything here?

I am neither. I know what happened to me and everyone else who was involved does too. I doubt you are a medical student. Do you have any idea how many med students dont actually report their needle sticks?tons. Do you know how many residents retaliate against med students for doing so? Tons. I have heard of many cases. Happens all the time. The attending and resident were both there. The site director even got the attending in hot water for her not taking care of the situation, one of the reasons she retaliated against me. Again I have never stuck myself. The only time I have gotten stuck it was by a resident. Don't assume things without knowing first. It's very lame. Lack of listening will also make your patients dislike you.

 

[RockShox]

Hey Tired,

No I can't see anything you missed. Except I guess you could add that the LCME also requires schools to provided access mental health therapy PRN.

To preclinical students, Tired is right, you should know that attendings get stuck all the time and so do residents. I have seen it many times. Be careful and not stupid of course but accidents happen. Learn to make good decisions now NOT then. And if you ever feel threatened follow the policy your school is required to have per LCME guidelines.


And good luck on your future residency Tired. Its amazing how refreshing a paycheck is even if it is small. Later!

 

[Tired]

I am neither. I know what happened to me and everyone else who was involved does too. I doubt you are a medical student. Do you have any idea how many med students dont actually report their needle sticks?tons. Do you know how many residents retaliate against med students for doing so? Tons. I have heard of many cases. Happens all the time. The attending and resident were both there. The site director even got the attending in hot water for her not taking care of the situation, one of the reasons she retaliated against me. Again I have never stuck myself. The only time I have gotten stuck it was by a resident. Don't assume things without knowing first. It's very lame. Lack of listening will also make your patients dislike you.

I don't believe your story. Simple as that. Nothing you have written makes any sense at all, and you are obviously only interested in taking shots at people who respond to you (including those who defend you, which is very strange).

The sad part is that, when those of us who actually know something about this try to provide factual information, you call us liars. Trolling is one thing, but telling blatant lies that could actually impact people's lives is quite another. LCME requires needlestick protocol training, RockShox even cited the relevent source, but you're going to get your kicks by spreading misinformation that it doesn't? This matters, and any (real) student who doesn't get this needs to go to their school and demand the training that is required.

As I have said, you are either a liar, a fool, or both. Hopefully with time you will either grow up, or learn to shut up. In the meantime, I have no more interest in you, and will not be responding to your assinine fairy tale posts any more. Hopefully others also recognize the fraud that you are.

 

[Tired]

Hey Tired,

No I can't see anything you missed. Except I guess you could add that the LCME also requires schools to provided access mental health therapy PRN.

To preclinical students, Tired is right, you should know that attendings get stuck all the time and so do residents. I have seen it many times. Be careful and not stupid of course but accidents happen. Learn to make good decisions now NOT then. And if you ever feel threatened follow the policy your school is required to have per LCME guidelines.


And good luck on your future residency Tired. Its amazing how refreshing a paycheck is even if it is small. Later!

Thanks for the info!

And for the record, military residencies have pretty sweet paychecks. Of course, I'll be back here in 6 years as a military attending complaining about how much more I could make as a civilian. 😀

 

[Medstudentquest]

I don't believe your story. Simple as that. Nothing you have written makes any sense at all, and you are obviously only interested in taking shots at people who respond to you (including those who defend you, which is very strange).

The sad part is that, when those of us who actually know something about this try to provide factual information, you call us liars. Trolling is one thing, but telling blatant lies that could actually impact people's lives is quite another. LCME requires needlestick protocol training, RockShox even cited the relevent source, but you're going to get your kicks by spreading misinformation that it doesn't? This matters, and any (real) student who doesn't get this needs to go to their school and demand the training that is required.

As I have said, you are either a liar, a fool, or both. Hopefully with time you will either grow up, or learn to shut up. In the meantime, I have no more interest in you, and will not be responding to your assinine fairy tale posts any more. Hopefully others also recognize the fraud that you are.

You have no right to insult me. I posted a situation that occurred to me and that was very scary and inappropriate on multiple levels. I am attacked for no reason. My story is the same as countless other students who get stuck. There is no reason for to insult/offend me. If you were never stuck you are lucky. I know what my school has and has not offered and I know what happened during my rotation. And no i didn't do the rotation at my school, I did it at an off site which provided me with no help during the incident. Furthermore, you were the one who insulted me and who talked in a condescending manner to me for no reason. I never attacked or mistreated anyone on this board, I simply respond in the manner that you talk to others. I already asked you to leave me alone. Thanks.

 

[philly4343]

ideally as medical students we should be protected by those who teach us.

the truth is that those who teach us are those who we have to watch out for. let me guess, this was on a medicine rotation.
Congrats you have been screwed.

I think you should get a lawyer and contact OSHA. They won't be able to touch you and get revenge because it would make them look like they were out for revenge.

I smell lawsuite.... you could be rich, quit and be on vacation for the rest of your life😎

 

[BlackSails]

When I was shadowing the administrative office I went through gave me packets on HIPPA, fire safety and workplace accidents, and I had to certify that I read and understood all three packets. I cant imagine med students not getting at least the same information.

 

[Medstudentquest]

ideally as medical students we should be protected by those who teach us.

the truth is that those who teach us are those who we have to watch out for. let me guess, this was on a medicine rotation.
Congrats you have been screwed.

I think you should get a lawyer and contact OSHA. They won't be able to touch you and get revenge because it would make them look like they were out for revenge.

I smell lawsuite.... you could be rich, quit and be on vacation for the rest of your life😎

Actually this was on Ob-gyne rotation. Medicine rotation was awsome. I have thought about the lawyer/OSHA thing though, but I wanted to solve this the professional and calm way initially. It's difficult to know what to do at thispoint.

 

[colbgw02]

Actually this was on Ob-gyne rotation.

Well, there's your first problem right there. OB/GYN sucks.

The fact that you've accused other people, who have demonstrated a lot of insight into these situations, of not being medical students at least half a dozen times is pretty darn suspicious.

And for the record, no, I'm not a medical student.

I, too, think this a fabrication, or at least not the whole story. It has been a thoroughly entertaining thread. Please, do continue.

 

[Dunce]

I can't believe I just waded through all of this

 

[Tired]

I can't believe I just waded through all of this

At least you didn't get suckered into believing it at first. I just feel like an idiot now.

 

[pinkfrosting]

I can't believe I just waded through all of this

same here...I must really have nothing else to do

 

[Medstudentquest]

Well, there's your first problem right there. OB/GYN sucks.

The fact that you've accused other people, who have demonstrated a lot of insight into these situations, of not being medical students at least half a dozen times is pretty darn suspicious.

And for the record, no, I'm not a medical student.

I, too, think this a fabrication, or at least not the whole story. It has been a thoroughly entertaining thread. Please, do continue.

Well there is nothing I can do, Ob is a required rotation. Whether it sucks or not is not the issue. Why are you insulting me? I haven't done anything to you. i simply came to try to get some advice as to what to do in an unfair situation, and all I get is mean and harsh treatment. Nothing is a fabrication. It's been a nightmare. How much I wish it wasn't true, you have no idea!

 

[Medstudentquest]

At least you didn't get suckered into believing it at first. I just feel like an idiot now.

🙁 A little support and kindness would have been appreciated. 🙁 Do you want me to post ER bills and incident report? Come on people. You all know what it's like to be a student. It'd be nice to get a little support on something unfair here.

 

[bjackrian]

This thread has entertained me after 12 straight hours of studying for a path shelf. Thank you.

Now I probably ought to do things more productive than read SDN. Like sleep. 👍

 

[Medstudentquest]

This thread has entertained me after 12 straight hours of studying for a path shelf. Thank you.

Now I probably ought to do things more productive than read SDN. Like sleep. 👍

Good luck on your shelf.

 

[colbgw02]

Well there is nothing I can do, Ob is a required rotation. Whether it sucks or not is not the issue. Why are you insulting me? I haven't done anything to you. i simply came to try to get some advice as to what to do in an unfair situation, and all I get is mean and harsh treatment. Nothing is a fabrication. It's been a nightmare. How much I wish it wasn't true, you have no idea!

Here's some support and advice: the only people that care about what you got on your OB/GYN clerkship are OB/GYNs. Everyone else realizes that it means nothing with regards to your overall clinical acumen. I've lost count of the number of people who had to deal with mean-spirited, unhappy, and spiteful residents and attendings on OB/GYN. Consider this a rite of passage. Also consider taking some time to educate yourself about your situation the next time something happens to you. Your residents and staff my have screwed you, but take responsiblity for your errors of both commission and omission as well.

I never insulted you. To synopsize, I said that your accusations are suspicious, that I think your story is at best incomplete, and that I find this thread entertaining

 

[Medstudentquest]

Here's some support and advice: the only people that care about what you got on your OB/GYN clerkship are OB/GYNs. Everyone else realizes that it means nothing with regards to your overall clinical acumen. I've lost count of the number of people who had to deal with mean-spirited, unhappy, and spiteful residents and attendings on OB/GYN. Consider this a rite of passage. Also consider taking some time to educate yourself about your situation the next time something happens to you. Your residents and staff my have screwed you, but take responsiblity for your errors of both commission and omission as well.

I never insulted you. To synopsize, I said that your accusations are suspicious, that I think your story is at best incomplete, and that I find this thread entertaining

Well this is not only unfair and inappropriate on their part, but it screws my overall great clinical performance thus far of Advanced and Outstanding on my transcript! When I interview for residencies they'll ask why I got what I got on this clerkship. It sucks! I worked so freaking hard. I could have just sat there staring at the wall and picking my nose and gotten the same grade.

 

[colbgw02]

When I interview for residencies they'll ask why I got what I got on this clerkship.

No, actually, they won't - unless you decide to go into OB/GYN. Medicine is replete with people who have an outlier in their transcript. And in my experience, that outlier is very frequently OB/GYN. On my OB/GYN clerkship, my grade suffered because I got in the face of a resident because she made me retrace her steps all across the hospital from the previous 90 minutes to find her handbag so that she could get her pump for her breast milk.

What is your chief concern here? If you're worried about getting sick or having to take prophylaxis, then fine. That's a legitimate issue. It's not something you can do much about, but I understand your anxiety. If you're pissed about having to pay the ER bill, then there are documents available somewhere that outline exactly what the hospital, your insurance, and you are responsible for covering.

If you're just pissed that some jerk residents and attendings screwed you over, then try to have some perspective here. You're not the first and you certainly will not be the last to have this happen to you. Unless you go into OB/GYN, the overwhelming likelihood is that this grade will mean precisely squadoosh in a year.

 

[Dr JPH]

So here is my situation! I got stuck with a needle in a rotation. The people involved did not provide me with any nfo as to what to do, and I asked the nurses and they told me to go to the ER. I went to the ER but the consent form for HIV test at the hospital basically said that if I were to get anything, they were not responsible so I did not test myself at the hospital. Also, I was afraid I'd get totally destroyed on my evals if I reported the incident, so I initially did not report it. I ended up reporting the incident a few days later, and the people in the department were not thrilled about my decision to do so. I asked the patient to be tested, as the doctor who saw me in the ER said was my right, but basically patient was never tested, not even in her follow up visit, and in the end of the rotation, the director basically said that she would not be tested. I thought this was utterly unethical of him to do, as well as the fact that they sent me the bill for the ER.
Because I kept pushing the issue that they were responsible for the bill as well as for testing the patient, I got totally screwed on my final grade. I am highly unhappy with it, especially since I got great midrotation evals. I met with the overall director of the clerkship and she said basically that my only resource was to see my file at the hospital to review the evals. The problem is that again, because of the issue, there was alot of tension and nastiness from the side of the residents and that's why I got totally screwed on my final grade. I'm unhappy with this, because I worked my butt off in this rotation. Should I contact the dean? Any ideas?

Wait...you got stuck but a needle and you are worried about your clerkship grade?

Am I the only one who calls BS here?

 

[Tired]

Wait...you got stuck but a needle and you are worried about your clerkship grade?

Am I the only one who calls BS here?

Prepare to be told that you're obviously not a med student . . .

 

[Dr JPH]

Prepare to be told that you're obviously not a med student . . .

Really?

Well...in 30 days I wont be! (you either...congrats BTW 🙂 )

 

[Smurfette]

What school/hospital is this?

Several thoughts come to mind after wading through this entire thread (since I bothered to read everything, I feel compelled to say something...)

1. Many of my med school classmates got a needlestick or several. Sometimes they didn't report or do anything about it...but everyone who didn't CHOSE not to. Most of the time, if that was the case, the "victim" never fessed up to the resident or attending about it. I NEVER heard of a classmate who didn't report it b/c they were told not to.
2. My medical school also did not pay for needlestick injury work-up/prophylaxis. In fact, we weren't employees and were not allowed to go to employee health at all. It was student health, which required a bus-ride from the hospital to get to....if we weren't at a more distant affiliated hospital.
3. At the time of the needlestick, was the resident aware that s/he stuck the OP? Did they change to a clean needle and have the OP change gloves?
4. What procedure would a student be involved in and not know what the procedure was? Not knowing what procedure is being done on a patient is a cardinal sin...and makes the student look really bad in front of the attending.
5. Med school clerkship grades are often subjective. I got screwed on some rotations too. You know what? I still matched. You know what else? No one ever asked me to explain it.

Disclaimer: before the accusations start, I am a "retired" med student who DOES know how things work. I'm a surgery resident, so needlesticks are something I know the protocols about.

 

[Dr JPH]

What school/hospital is this?

Its made up.

Its inconsistent, doesnt follow reason, doesnt fit a needle stick incident.

Unfortunately needle sticks are a serious issue and this person is turning it in to a story. Why? Only they know, but its awful that someone would trivialize such an incident that happens (or has happened) to many of us.

 

[Medstudentquest]

Wait...you got stuck but a needle and you are worried about your clerkship grade?

Am I the only one who calls BS here?

You must not have read what I posted. I have been going back and forth with these people for months because they did not test the patient, paid for my bill or cared at all what happened to me. Because I care for my health and wanted to make sure the patient was negative, and they were upset I did not drop the issue, they screwed my grade over. Both problems are infuriating. What's not to understand?

 

[Medstudentquest]

What school/hospital is this?

Several thoughts come to mind after wading through this entire thread (since I bothered to read everything, I feel compelled to say something...)

1. Many of my med school classmates got a needlestick or several. Sometimes they didn't report or do anything about it...but everyone who didn't CHOSE not to. Most of the time, if that was the case, the "victim" never fessed up to the resident or attending about it. I NEVER heard of a classmate who didn't report it b/c they were told not to.
2. My medical school also did not pay for needlestick injury work-up/prophylaxis. In fact, we weren't employees and were not allowed to go to employee health at all. It was student health, which required a bus-ride from the hospital to get to....if we weren't at a more distant affiliated hospital.
3. At the time of the needlestick, was the resident aware that s/he stuck the OP? Did they change to a clean needle and have the OP change gloves?
4. What procedure would a student be involved in and not know what the procedure was? Not knowing what procedure is being done on a patient is a cardinal sin...and makes the student look really bad in front of the attending.
5. Med school clerkship grades are often subjective. I got screwed on some rotations too. You know what? I still matched. You know what else? No one ever asked me to explain it.

Disclaimer: before the accusations start, I am a "retired" med student who DOES know how things work. I'm a surgery resident, so needlesticks are something I know the protocols about.

Like I said, in my own experience and the experience of several of my classmates, they are highly encouraged not to report it. Again, as I stated clearly, the resident stuck me. I was not doing a procedure or holding the needle or anything. The ER itself and my overall clerkship director stated that they should cover what was done. Again, I was merely an observant with my hands on the patient and she stuck me after a long night on call.

 

[SoCuteMD]

Actually this was on Ob-gyne rotation. Medicine rotation was awsome. I have thought about the lawyer/OSHA thing though, but I wanted to solve this the professional and calm way initially. It's difficult to know what to do at thispoint.

Perhaps you should try to institute "professional and calm" in most of your interactions.

I experienced an exposure scare (no stick, thank goodness, but the pt was confirmed HIV positive) at a major teaching hospital as an employee. The docs, administration, and my coworkers could not have been more supportive. I've seen the people in the Emergency Department at my current teaching hospital be equally supportive. I hope that most hospitals are this way.

 

[RockShox]

When I interview for residencies they'll ask why I got what I got on this clerkship.

Just say all the things that you have told us. I am sure that this will go along way to clearing up the matter. 🙄 And be sure to tell them they must not be doctors. That should synch the deal.

 

[Medstudentquest]

Just say all the things that you have told us. I am sure that this will go along way to clearing up the matter. 🙄 And be sure to tell them they must not be doctors. That should synch the deal.

Why are you being mean and sarcastic with me? I have done nothing to you.

 

[16846]

So here is my situation! I got stuck with a needle in a rotation. The people involved did not provide me with any nfo as to what to do, and I asked the nurses and they told me to go to the ER. I went to the ER but the consent form for HIV test at the hospital basically said that if I were to get anything, they were not responsible so I did not test myself at the hospital. Also, I was afraid I'd get totally destroyed on my evals if I reported the incident, so I initially did not report it. I ended up reporting the incident a few days later, and the people in the department were not thrilled about my decision to do so. I asked the patient to be tested, as the doctor who saw me in the ER said was my right, but basically patient was never tested, not even in her follow up visit, and in the end of the rotation, the director basically said that she would not be tested. I thought this was utterly unethical of him to do, as well as the fact that they sent me the bill for the ER.
Because I kept pushing the issue that they were responsible for the bill as well as for testing the patient, I got totally screwed on my final grade. I am highly unhappy with it, especially since I got great midrotation evals. I met with the overall director of the clerkship and she said basically that my only resource was to see my file at the hospital to review the evals. The problem is that again, because of the issue, there was alot of tension and nastiness from the side of the residents and that's why I got totally screwed on my final grade. I'm unhappy with this, because I worked my butt off in this rotation. Should I contact the dean? Any ideas?

I had something very similar happen to me, and I received pretty much the same treatment from the hospital admin.

The peds attending did a draw on a patient and decided to talk to the parents while holding the needle in her hand. The child kicked her hand the the needle went straight into mine. I reported it right away but got a very chilly response from the admin. on duty (it was a night shift). They told me not to worry about it, not to ask the patient to get tested, and to not push the issue. I told them they were crazy if they thought I wasn't going to have this properly documented, I was certainly going to ask the patient to get tested, and I expected them to cover my testing as well since it was the attendings irresponsible behavior that led to the injury.

When the realized that I was deadly serious, they started the report and ordered a 2nd draw (with parental consent) on the child, but slow tracked it from there on out. I had to wait more than 8 hrs for them to finish the paperwork and draw the blood while the paperwork clearly said that a draw and decision on AVPT should be made within the "golden hour" after a needle stick injury.

The rest of that shift and the next few days I got nothing but icy glances and daggers stared at me from the admin and attendings, they looked at me like I was some kind of traitor. Fortunately this was an un-graded preceptorship that I was doing during some downtime between my graded rotations, but they still placed a letter in my hospital file (that I wasn't allowed to see) about me being a "troublemaker" and to "watch out". The only reason I ever found about it was that one of the nurses I was friends with looked into it for me as she knew about the existence of these "hospital files" from previous incidences where they have done something like this.

In the end, you have to look out for yourself, push the issue with the hospital admin. (go as high as you can go, someone up there somewhere has to be a decent person), make them do what they are supposed to do in these situations, and be prepared for some kind of backlash even if you did nothing wrong. My best suggestion would be to push the issue with the academic side of the school/hospital. Go to the Dean/Academic Provost/Etc... I am sure they are more concerned with the academic malfeasance of the hospital than the people directly involved with the hospital. If that fails, unless you are prepared to turn this into a legal issue, you probably aren't going to get very far.