Dirty Needle Stick in Dialysis

Summer, 1989

I have been working in outpatient hemodialysis on evening shift now for about six months, four days a week with every Wednesday and Sunday off. When I work every other Saturday, I also have Thursday off. Wednesdays are a welcome break in the middle of the week to run errands, schedule appointments, and teach afternoon Bible Club on for the neighborhood children, followed by prayer meeting in the evening at church. I’m also getting more sleep since I don’t have to get up at 5 a.m.

Sometimes it is a bit lonely since most of my friends work during the day when I’m available to see them. I’m learning more and more to be content with Christ and Him alone. Philippians 4:11-12 continues to bless and challenge me when I think of how Paul wrote this when he was in prison in Rome. “Not that I speak in respect of want; for I have learned, in whatever state I am, in this to be content. I know both how to be abased, and I know how to abound; everywhere and in all things I am instructed both to be full and to be hungry, both to abound and suffer need.”  I figure if the Apostle Paul had to learn contentment, I can learn to be content also during the lonely times and draw near to the Lord.

I thank the Lord for helping me pass and become certified in ACLS (Advanced Cardiac Life Support). This is a requirement for every dialysis nurse since we are in a separate building from the hospital and do dialysis in the ICU (intensive care unit). I learned how to intubate people when they stop breathing and  to order the correct drugs during a cardiac arrest. It was nerve wracking to run a mock code, but the Lord helped me remember all the correct steps!

I like working with the other nurses and technicians on the evening shift. There are three blocks composed of six patients in each block, so we can dialyze 18 patients at once. There is one RN and one tech assigned to each group. When we start at 2 p.m., we complete the dialysis for patients who were started around 11 a.m. After they are off the machine, we set up each machine for the evening patient with his individual dialyzer, which we can reuse a number of times. We use new tubing each session. Some dialysis units reuse their tubing also, but we don’t. We also give a new life changing medicine called Epogen  at the end of each dialysis session. It helps the patient produce their own red blood cells so they don’t become anemic and need fewer blood transfusions. The patients are starting to feel so much better on this new medication!

Some of the technicians are men who are also firemen/Emergency Medical Technicians (EMT) and work part-time in dialysis on their day off from the fire department. They are a fun bunch of guys who really keep cool in emergencies and are excellent at sticking the needles in the patient’s arm fistula or graft. I’m getting much better, but if I don’t get the needle in first stick, I ask one of the EMT’s to do the second stick. They love telling us stories from their fire runs and how they handle each situation. There is a real sense of team work on this unit which is refreshing!

Inserting dialysis needles is an acquired skill!

Inserting dialysis needles is an acquired skill!

I have enjoyed getting to know the patients on evening shift also. Many of them are young and in school or work during the day. Some are waiting for a kidney transplant. I’ve had several opportunities to share the gospel with them, and pray for each of them to receive Christ. They are all very aware that they will die without dialysis three times a week. If they cheat on their fluid restriction or eat too many high potassium foods, they have a rough dialysis session because we have to take off more fluid.

This past week, I was chatting with Jim, one of my older patients, as I took him off the machine. After I took his needle out of his arm, I quickly pressed a wad of gauze on the needle site as Jim placed his finger on top of mine to apply pressure for 5 minutes. As I put the dirty needle in the red bucket for medical waste, somehow the needle  pricked my finger on my other hand through my glove. I pulled the needle out of my finger, put it in the bucket, took off my gloves, and pressed gauze firmly on my finger. I quickly walked to the sink,  vigorously washed my hands with warm soapy water,  and applied a band-aid to my finger. As I scrubbed my hands, I prayed, Dear Lord, Please don’t let me get HIV or hepatitis from this needle stick.

A deadly blood disease was discovered in 1981 among gay men and IV drug users called Human Immunodeficiency Virus (HIV). Some health care workers have also contracted HIV from contact with blood or fluid from HIV infected patients. Some patients have gotten HIV from contaminated blood transfusions and later died from the disease because there is little treatment for it yet.

After washing my hands, I went to my head nurse to report the needle stick. She said we had to go talk with Jim to get his sexual history and obtain permission to draw his blood to check for HIV. Thankfully, he was hepatitis negative at his semiannual blood draw. I was glad that Jim had told me previously that he had been married to his wife for over 50 years and was a farmer before he retired. I nervously approached him and quietly explained the situation. He told me his wife was his only sexual partner, and he signed the release to be checked for HIV. I was so thankful to hear that he was faithful to his wife! I drew his blood and sent the tube off to the lab.

A couple days later, Linda, my nurse manager called me at home. “Pam, we just got Jim’s lab test back and it was negative for HIV! I just informed Jim also.” “Thank you, Linda, for letting me know here at home before I came to work.” I hung up and got down on my knees before the Lord. Dear Lord, Thank You for protecting me from this deadly disease. Thank You that my times are in Your hands. Use me for Your glory and honor.

“When I am afraid, I will trust in Thee. In God I will praise His word, in God I have put my trust; I will not fear what flesh can do unto me.” Psalm 56:3-4

Reflection

Similar to the pink face shield I wore in dialysis

Similar to the pink face shield I wore in dialysis

When I first started my nursing career in 1977, I didn’t even wear gloves to start IVs in patients! In dialysis, I remember they gave me a pink plastic face shield and latex gloves to wear whenever I put needles in or took them out to protect my face and skin from blood. I finally became proficient at feeling the vein through the gloves and applying the tape afterwards.  I later developed a latex allergy from the many years of wearing latex gloves. Now, I only wear nitrile gloves and require a latex free operating room whenever I need surgery.

Ryan White, who fought courageously to educate the public about HIV which he contracted from a contaminated blood transfusion

Ryan White fought courageously to educate the public about HIV which he contracted from a contaminated blood transfusion.

For those of you who are younger, I encourage you to read about Ryan White (1972-1990) who had hemophilia, a bleeding disorder requiring frequent blood transfusions. At age 13, he contracted HIV from a contaminated blood transfusion. He was cruelly ostracized from his school because students and parents were so fearful of catching HIV from him. In those days, a person usually only lived 3 to 6 months with HIV. Here is the link to Ryan’s story: http://hab.hrsa.gov/abouthab/ryanwhite.html

 

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