SHARPS SAFETY: Continuing the battle

SHARPS SAFETY: Understanding the federal needlestick prevention law, Part I

By Lisa Black, RN, BSN

I'm honored to continue the Sharps Safety column in the footsteps of Lynda Arnold, one of my heroes. Healthcare workers owe a huge debt of gratitude to Lynda for her remarkable contributions to the field of healthcare worker safety.

To readers who have followed this column over the 13 months since its inception, I look forward to continuing to bring you valuable sharps injury prevention information. If you're new to this column, I welcome you, and hope you'll find the information presented here to be timely and informative.

"I'm going to be a nurse..."
First, I'd like to share a little bit of my background with you. Some children declare, "When I grow up, I'm going to be a doctor…. lawyer… fireman." My declaration was always, "I'm going to be a nurse when I grow up." Despite many suggestions to pursue a more glamorous (not to mention lucrative) profession, I was exhilarated to have fulfilled my childhood dream of becoming a registered nurse upon graduation in 1993 from the Orvis School of Nursing in Reno, NV.

Armed with a license to practice nursing and more questions than answers, I embarked on a remarkable journey into the world of nursing. While my bedside career hasn't been as lengthy as that of many of my nursing colleagues, it has, nonetheless, been filled with remarkable moments: some sweet, some bittersweet, and some just plain terrifying.

One of those terrifying moments molded my nursing career away from the bedside and into the field of healthcare worker advocacy. On October 17, 1997 I faced a moment all nurses fear. I was caring for a gentleman in the terminal stages of AIDS and watched, horrified, as a needle filled with my patient's blood pierced my left hand.

I immediately began a regimen of HIV prophylaxis. And I was assured that I wouldn't be one of the 3 in 1,000 healthcare workers who becomes HIV positive following an occupational blood exposure.

Nevertheless, in July 1998, following fever, lymphadenopathy, and severely abnormal blood counts, I was diagnosed as having been infected with both HIV and hepatitis C from my needlestick injury nine months prior. I can't overstate the horror of such a diagnosis.

Several nights after my needlestick injury, I watched the gentleman to whom I'd been exposed succumb to what has been termed the "dread disease of the late 20th century." I now live with the reality that a similar, premature end likely awaits me as well.

A face to the figures
In trying to comprehend my predicament and what it meant for my daughters, then aged three and seven, I began to search for information about occupational blood exposures. During my informational quest, I learned that my injury was 100% preventable. I also learned that the Food and Drug Administration had issued an needlestick prevention alert five years prior to my injury, and, like the facility at which I was employed, a full third of medical facilities in this country had failed to heed this recommendation to eliminate using needles to access intravenous lines after initial insertion.

Realizing that bitterness and anger wouldn't give me back my life as it was before the HIV and hepatitis C viruses were a part of it, I committed myself to putting a human face to the needlestick injury statistics. While, statistically, the risk of being infected with a bloodborne pathogen from an occupational exposure is remote, when the unthinkable happens to you, the percentages and numbers no longer matter.

With the passage of federal needlestick prevention legislation in October 2000, we are huge strides closer to a day when stories such as mine will no longer be told. To whatever extent we can continue to further educate and minimize the risks to healthcare workers, we must strive toward that end.

Joining the journey
As a result of my injury and illnesses, my life has been molded and reshaped in a direction far different than any I'd ever imagined. While my story is one of tragedy, fear, and misfortune, it is also a story of hope and triumph. My experiences have provided an impetus for quite a remarkable journey into healthcare advocacy. I now work to fulfill another dream…to see a day when nurses no longer face this threat, and stories such as mine are no longer told.

I invite you to share in my dream and join me in this journey.

Send questions or comments to Lisa at lisa.rn@att.net.

Coming next: The federal needlestick prevention law: What does it mean for you?