May 6, 2013

While driving, I start going over my patients in my head. Blood sugar level and insulin at 08:30on 10th Avenue. It’s nice and warm outside. I would much rather be doing something else today.Nonetheless, I’m happy to be a nurse in home care and be able to take advantage of a little sun andits Vitamin D.

Mr. X’s blood sugar level is elevated, I have to give him insulin. Prepare it, inject it, then when gettingup to dispose of the dirty needle in the receptacle for this purpose, I suddenly lose my balance andstick myself with the needle! No, I’m bleeding! For crying out loud, I’ve stuck myself! OK, don’tpanic… I wash my hands and make the wound bleed, I think that is what they taught me. I smile atthe patient and tell him that I have accidentally stuck myself, that a procedure has to be followed andthat someone will be contacting him soon.

As soon as I am outside the house, I contact my chief of service to find out the exact procedure tofollow. Instead of telling me about the post-exposure protocol and the time period during whichI should be seen, he asks how many patients still have to be seen and tells me he has no one toreplace me. He urges me to finish visiting the five remaining patients and then return to the CLSC. Inthe mean time, he will prepare the documents for my post-exposure consultation.

In the end, it is four hours later that I am able to see those in charge of the post-exposureprogramme, after having taken a blood sample from the patient involved in this misadventure…

Even though a bit late, this post-exposure consultation made me realize what a close call this was. Infact, given that the chance of a viral transmission must always be suspected in these types of cases,I should have been seen in the two hours following the accidental exposure to be assessed and toreceive the treatment required as quickly as possible as its prophylactic effects diminish dramaticallywith every passing hour.

In addition, although I am a union representative, I did not act, despite the internal panic signals.

As a healthcare professional, I should have known the applicable protocol. If I had known it, I wouldhave insisted with my employer that I could not finish my day. I also should not have returned to thepatient’s home to take a blood sample and complete the forms for ethical and legal reasons. Andmy chief of service clearly did not fulfill his obligation to take the necessary measures to protect myhealth.

The only thing I did correctly was to go to the post-exposure consultation, because, according to thenurse in charge of applying this programme, many do not even go… Too much hassle!

I wanted to share this accident/incident with you that not only made me cry, but also reflect. I wasworried while I waited for the results and found out that my health, even my life, could be gravelycompromised by my work. The decisions taken by my chief of service and my own actions could havehad disastrous consequences for me and my family.

Don’t let such an incident happen to you and find out about the post-exposure protocol now. It canchange your life!

Do you know ?

You can also consult the FIQ publication, Play it Safe with Needles available on its website atthe following address:
http://www.fiqsante.qc.ca/publicfiles/documents/sst94_f.pdf

For more information, you can consult the Guide pour la prophylaxie postexposition (PPE) àdes liquides biologiques dans le contexte du travail published in October 2011 by the Ministryof Health and Social Services of Québec, accessible at the following web address :
http://publications.msss.gouv.qc.ca/acrobat/f/documentation/2011/11-333-02W.pdf

Every incident or accident, however minor, that happens at work must be declared to theemployer since consequences unknown at the time of the event can occur later and requiremaking a claim with the CSST.

Every healthcare professional has the duty, as a worker, to learn about the preventionprogramme that applies to her at work and the various protocols for protecting her healthand for ensuring her safety in her workplace.

The transmission of blood-borne viruses, such as HIV, Hepatitis C and Hepatitis B in acare setting are, for the most part, avoidable by applying universal precautions and theappropriate post-exposure prophylactic measures (PPE).

The first documented case of HIV transmission to a healthcare professional happened inAfrica in 1984 when a nurse stuck herself with a hypodermic needle used to draw a bloodsample from an arterial line.