To expect to be told if a patient of mine is HIV positive

[NCISaddict]

If I have asked them if they have any medical conditions I should be aware of?
I am aware that it is very difficult to catch and that they may have encountered judgemental attitudes in the past, which is totally unacceptable but if your condition could put your HCP at some risk (even though it would be small) then surely you should inform them?

ISWYM Garlic

I work in the tattoo industry. On the consent form, it asks the client to state any transmissible or bloodborne illnesses they may knowingly have, including HIV. It also asks about any medications being taken or any other significant health/immune system issues.

Of course, whether the client tells the truth is one thing, but we do ask that they disclose that information on the consent form. Naturally, it's kept confidential. As a PP stated upthread, when it comes to aseptic practice and general hygiene, I handle every client I work on as if they were HIV+.

If you know you have a condition such as HIV, I think it's just courtesy to let the HCP/tattooist/piercer/dentist etc working on you know.

I'm sorry but YABU.

It's up to the patient what they disclose about their medical history and when.

In your role you should assume every patient has a blood- bourne virus and use appropriate PPE.

Having worked on on HIV ward in the 1980s I certainly wouldn't care about a bit of vomit and the patient themself probably knew you weren't at risk.

I'm actually very concerned that you're a paramedic and seem to know so very little about HIV. The risks are negligible as already explained on here ,and you should assume everyone is contagious!
I'd be more concerned about the people that don't know their status than the ones that do. The ones that do will be having regular blood tests and usually on medication which would result in a undetectable viral load. The nurses in your situation were probably told so they knew how to treat ,whether treatment would react with their medication etc...

Oh and I'd be more concerned about Hepatitis which a lot easier to contract.

Yes I would be mildly concerned about other more easily treatable diseases, I'm on anti virals at the moment due to exposure in the course of my job and I'm still not losing sleep about the risk, shit happens. The patient concerned in that event does not want to be tested and I fully accept that is their right.

I try and word my questions in a myriad of different ways (this wasn't a life threatening event) as the drugs I was giving can have interactions/ side effects etc and I need to know so I can give my patient the best possible care and not make any other conditions they suffer from any worse.

In other instances not telling me would not be surprising, I do get the embarrassment and worry, but in this particular case the difference between disclosure to me and to other HCP's was marked but I fully prepared to accept that IABU.

OP I think people are being a bit harsh here.

Yes, you should assume everyone is positive for BBVs.

Yes, you need to use universal precautions.

But patients have responsibilities as well as rights, morally and ethically they should make you aware. It's what decent human beings do. Though it's certainly not an obligation. Just be mindful that you aren't seeing people at their rational and sensible best.

Really as a paramedic you have to treat all patients as if they have HIV, and use proper precautions.

As an RN I find this wholly inappropriate to post this here. Universal precautions are available to you so risk negligable maybe speak to a manager rather than discuss on a public forum.

Well it'd be considerate if they do but some patients might find it hard to tell a complete stranger so YABU, a little as you can take the appropriate precautions in every case can't you?

This is an anonymous site and op has given absolutely no identifying details. There is nothing wrong with posting here.

I can assure you I have changed so many details it would be impossible to attach this to any individual patient.

Will you raise it with a manager OP? That really would be the best way to work through the issue that you have with this incident.

I think that, as others have said, we can all agree that in an ideal world the patient would tell you.

However that's not the reality of life as a paramedic and it seems that your training should prepare you for that, both practically and psychologically.

I think the issue here is less about the perceived risk to the paramedic and more about the feeling that the paramedic perceives that she is considered less of a health professional than the A&E staff, by virtue of not being informed as to the patient's HIV status.

Lots of people still think paramedics are just ambulance drivers.

I think it's likely that a patient may see their arrival at hospital as a prompt that they need to give out clinical information. Being in their own home is a completely different experience.

That is very clearly the issue Sidge. However the OP's feeling insulted is not really all that important in the grand scheme of life and death emergency medicine and the complex moral decisions that have to be made by people with HIV. (Nb I am not condoning people who physically abuse paramedics/police etc, although I do think they have to have a better ability to brush that off than a normal member of the public)

yanbu, but neither are they, they don't have to tell you that they have HIV, it would be good if they did so you had a full medical history, however at the same time you should be following the procedures that protects yourself from needed pricks etc...

The whole dont post here is unprofessional line is is crap!, if that's the case then no one at all should be allowed to post about work issues, as long as you dont give specific details or identifying details of the individual is concerned then their is no issue at all.

Sidge

Today 18:25 Sidge

I think the issue here is less about the perceived risk to the paramedic and more about the feeling that the paramedic perceives that she is considered less of a health professional than the A&E staff, by virtue of not being informed as to the patient's HIV status.

Lots of people still think paramedics are just ambulance drivers."

I think you are making HUGE assumptions about the patient's thought process. With no basis whatsoever.

It could be a simple as the patient being flustered at the time. Or not comfortable with the paramedic maybe?
It's really a huge leap for you to say what you said.

*not say what you said but ascribe those thoughts to the patient, I mean

You are probably more at risk from someone who doesn't know they are HIV positive than from someone who knows they are, but doesn't tell you.

Drugs for HIV are so good these days that many HIV positive people who are in treatment have an 'undetectable' viral load, meaning there is almost no chance of HIV being passed on.

eminado the point is that the OP ascribed those thoughts to the patient. Sidge is really just paraphrasing the OP. So you should be telling OP SIBU, as well as Sidge.

I do not feel insulted by the patient, I merely thought it was a little odd.
I do feel slightly bemused by your idea that we have a better ability to 'brush off' assaults than 'normal' people.