Nurse Needlestick at Pediatrician -- WWYD

[Zukini]

Thank you all for your feedback. Nurse C called me this morning and provided more details regarding the incident (needle stick was after the actual vaccination before the needle was recapped, and it was Nurse B who was helping to hold DS legs who was stuck). Their clinical supervisor called me this afternoon and we agreed to the blood testing for DS at this time but not in their office, but at the local children's hospital satellite unit. She also agreed to my request for a formal letter for my files from the practice detailing the incident and the follow up. They will, of course, cover all lab costs incurred from the testing. But my concern is for his medical and insurance or insurability record in future, since everything is electronic these days, and who knows how it will be "connected" in future with testing my three year old for HIV and hepatitis.... at least I can file it away, and have something to fall back on if we are randomly questioned about it in future. She also said she would look into doing the testing under an alias, but wasn't sure how that would work just yet. They both assured me that DS is not at risk, and due to HIPAA etc will not be releasing the staff results to us. I'm okay with that.

Clinical Supervisor thanked us for being cooperative and understanding, and reiterated how much training they did with their staff, and that this would be reviewed for lessons learned. She also apologized for the inconvenience and stress caused.

So we still have to go in and do the draw, but I am hopeful the phlebotomy crew will be super skilled. She did mention restraints, but I think that might be a really bad idea with DS. He does really well with things like car seats etc now and I don't want restraints to become an issue for him... any office with crinkly paper aka a doctors office exam bed makes him cry upon entry as it is. Will discuss the gameplan for a successful draw with the hospital staff before we actually go in and take DH along for support. Thank you all.

[icunurse]

Ok, this is from a nurses standpoint - thank you. People have no idea how terrifying even the most "innocent" of needle sticks can be. I have been exposed to thousands and thousands of needles, blood products, bodily fluids, etc. 20+ years of nursing in the NICU and trauma ICU and I have been fortunate enough to have 1 needle stick. It was about as low risk as one could hope (probably not even blood exposure...needle from pushing an IV med -before the needless system- barely pricked my finger). But I remember every detail. I remember having to go to the ER to discuss my risks and determine if I needed to start meds that could potentially make me quite sick. I remember getting my blood drawn. I remember the family being quite kind about getting their Moms blood drawn (it was done by anonymous number, so it never made it to her chart). I remember the relief of finding out she was negative for everything and so was I. I remember going back 6 months later and being nervous to hear my follow-up testing (obviously the patient did not get any further testing). This happened probably 15 years ago and I remember it all. So thank you for caring for the nurse enough to take some of the stress off of her.

I can also assure you that I don't know any nurse that would reuse a contaminated needle. You could tell me that I have a lifesaving med in my hand and if I contaminated it in any way, I wouldn't be able to do it. You just get a new med, do a new draw, do things at a later date. It's not worth the risk of contamination. This is why nursing is consistently voted the most trusted profession.

Also, in regard to having HIV and hepatitis tests on your child's record....I don't think it will mean anything. Both of my children were adopted and had many tests done after birth in an abundance of caution and there has ever been an issue (the point is especially moot when results are negative).

Anyway, thanks again from a nurse.

[lalasmama]

Thank you all for your feedback. Nurse C called me this morning and provided more details regarding the incident (needle stick was after the actual vaccination before the needle was recapped, and it was Nurse B who was helping to hold DS legs who was stuck). Their clinical supervisor called me this afternoon and we agreed to the blood testing for DS at this time but not in their office, but at the local children's hospital satellite unit. She also agreed to my request for a formal letter for my files from the practice detailing the incident and the follow up. They will, of course, cover all lab costs incurred from the testing. But my concern is for his medical and insurance or insurability record in future, since everything is electronic these days, and who knows how it will be "connected" in future with testing my three year old for HIV and hepatitis.... at least I can file it away, and have something to fall back on if we are randomly questioned about it in future. She also said she would look into doing the testing under an alias, but wasn't sure how that would work just yet. They both assured me that DS is not at risk, and due to HIPAA etc will not be releasing the staff results to us. I'm okay with that.

Clinical Supervisor thanked us for being cooperative and understanding, and reiterated how much training they did with their staff, and that this would be reviewed for lessons learned. She also apologized for the inconvenience and stress caused.

So we still have to go in and do the draw, but I am hopeful the phlebotomy crew will be super skilled. She did mention restraints, but I think that might be a really bad idea with DS. He does really well with things like car seats etc now and I don't want restraints to become an issue for him... any office with crinkly paper aka a doctors office exam bed makes him cry upon entry as it is. Will discuss the gameplan for a successful draw with the hospital staff before we actually go in and take DH along for support. Thank you all.

They will probably discuss the papoose board. http://www.natus.com/index.cfm?page=products_1&crid=242 They also have an arm board http://www.medline.com/category/IV-A...ds/Z05-CA19_02 that they may use. Both are fairly common to use in a children's lab. The papoose board can be kind of scary, unless he's one that likes tight, squishy squeezes. The good news (good being relative, of course) is that it's pretty darn tough for a kid to wiggle on the papoose board, so that takes out the moving target out of the equation. And, these are the people that deal with the tiny, sick, and difficult veins; a 3 year old with autism isn't going to be anything "new" for them--it's their bread and butter.

Hope it goes well for you guys!

[HannaAddict]

I don't think anyone said the lawyer suggested retaliation.....at least I didn't mean to say that. He implied the nurse lied and that she was stuck first followed by OPs DS.

Why would she need the child to be tested if she was stuck prjor to needle sticking the child? I have no idea then what lala was saying nefarious that the lawyer said, but think the lawyer just meant both should be tested.

I doubt any nurse would give her test results out and not sure the relevance if she was stuck after.


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[JBaxter]

I'm pretty sure the nurse will also have a baseline blood draw done. It would show if she had active hepatitis or HIV neither of which would show up 24 hrs after a needle stick. Even working in the dental field I had titers drawn for HepB every few years.

[dogmom]

This was my take, too. I can see where a medical professional would be offended at the implication BUT it's also offensive to suggest a small child could have such an illness. This is how I read the "turnabout" comment.

One is implying a health care professional acting illegally and unethically and knowing stuck themselves and then a child with a dirty needle.

The other is taking offense because someone is ruling out the possibility that a child has a contagious disease. Which therefor implies that having said disease is offensive. There is a difference.

Other posters have managed to convey how health care professionals deal with needle sticks. I get that the average person doesn't know how this works and has baggage about hepatitis and HIV. Most health professionals I know got past that by the turn of the century. From my point of view as a nurse I have been assaulted (verbally and physically), ruined by body, worked horrible schedules, missed holidays with my family, had needles sticks, driven in to work when the average person was told to stay home during emergency situations, went to the hospital during terrorist actions, and generally thought that was part of my job to care for people. So if someone says "I don't want to put my child through two blood draws" I am sympathetic. But to have a knee jerk reaction that somehow the nurse is the one to be tested would piss off a lot of health care professionals given what we do for the public.

[Kindra178]

Sorry, I am just a bit confused. If your ds was stuck with a clean needle for his shot and then the nurse got stuck afterwards - is the ped practice suggesting your ds get blood work to make sure he doesn't have a blood transmitted disease? If that's the case, I would just go with it. Most good child phlebotomists can take a child's blood almost painlessly. It's the doctor's office's staff that makes it more traumatic. Phlebotomists at a children's hospital do it all day, every day.


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[MSWR0319]

If he is afraid of the pain, definitely ask for some numbing cream! It has to go on before you get there. My son has sensory issues and is terrified of the needle, the numbing cream has done wonders for him.