RESEARCH ARTICLE

 

The nurses'experience of possible HIV infection after injury and/or exposure on duty

 

 

L Roets^I; LE Ziady^II

^IPh.D; School of Nursing, Faculty of Health Sciences, University of the Free State
^IIM.Soc.Sc; School of Nursing, Faculty of Health Sciences, University of the Free State

Correspondence

 

 

---

ABSTRACT

The purpose of the research was to describe the experience of nurses in the studied hospital who had been exposed to possible HIV infection during injury or exposure on duty.
A qualitative phenomenological descriptive study was used to describe the emotions and non-verbal reactions of the twelve participants during two subsequent in-depth interviews. These were conducted post-exposure, and after counselling and prophylactic treatment took place. The nursing staffs from a selected private hospital were included in the study after exposure of blood and/or human body fluid. After completion of the study, it was found that the exposed staff's experience had two main categories. Firstly, they were grieving for the loss of the concept of being healthy and invincible, blessed with nursing skills and definite goals in life. The bereavement process included phases of denial, anger, anxiety and fear, with recurring thoughts regarding the adverse events, as well as acceptance which developed with time.
The bereavement process and shock of the exposure had wider consequences to the family, as well as an impact on the working environment. Most participants reported that they experienced genuine support and compassion from colleagues, at home and in the community.
The second category of experience was the physical side effects which participant's developments developed due to the prophylactic antiretroviral therapy. Some participants experienced severe difficulties due to the treatment, while other had fewer problems.
Some proposals to adjust and possibly improve the hospital's exposure surveillance system were developed from the research results, including that a 24-hour crisis management system be implemented for exposed staff members; that support groups be started for staff, colleagues and family members; that all staff receive orientation and support during unfamiliar procedures or placement in unknown departments; that all exposures-on-duty be investigated and studied so that pro-active or preventive measures may be devised; and that problems with staffing and working climate be resolved.
All the findings and proposals were subsequently addressed to the relevant members of the Hospital Management.
If healthcare services wish to retain nursing staff in future, more will need to be done to prevent all types of exposure-on-duty and, if they do occur, to anticipate, manage and shorten the subsequent period of the professional nurse or learner's bereavement.

Keywords: Nurse, experience, HIV, infection, injury, exposure

---

 

 

“Full text available only in PDF format”

 

 

References

AYAS, NT; BARGER, LK; CADE, BE; HASHIMOTO, DM; ROSNER, B; CRONIN, JW; SPEIZER, FE; CZEISLER, CA 2006. Extended work duration and the risk of self-reported percutaneous injury in interns. JAMA. Vol. 296 No. 9, September 6, 2006. http://www.iama.ama-assn.org/cgi/content/full/296/9/1055 [Accessed on 6 September 2006].         [ Links ]

BABBIE, E 2004. The practice of social research. 10^th edition. Belmont: Thomson Wadsworth.         [ Links ]

BALACHANDRAN, S 2002. Nurses and the occupational risk of blood-borne infections. Indian Journal of Medical Ethics. 10(4):OCT-DEC http://www.issuesinmedicalethics.org/104di088.html [Accessed on 14 October 2004].         [ Links ]

BANDOLIER EXTRA - EVIDENCE BASED HEALTH CARE. Needle stick injuries. July 2003. www.bandolier.com [Accessed on 20 September 2004].         [ Links ]

BLOEMFONTEIN MEDI-CLINIC HUMAN RESOURCES SECTION: injury on duty records / incident reports (per participant)        [ Links ]

BLOEMFONTEIN MEDI-CLINIC I MEDI-CLINIC GROUP, Infection Control Manual September 2003. TBI; MH-B4; IA5.         [ Links ]

BOWERS, R [s.         [ Links ]a.]. Coping with the 5 stages of grief and bereavement: What is grief? http://www.vork-united-kingdom.co.uk/funerals/gnef [Accessed on 19 June 2006].

BRAHM, E 2004. Trauma healing. http://www.bevondintractabilitv.org/essav/traumahealing/ [Accessed on 21 June 2006]).         [ Links ]

BRINK, H. 1996. Fundamentals of research methodology for health care professionals. Kenwyn: Juta en Co, Ltd.         [ Links ]

BURNS, N &GROVE, SK 2005. The practice of nursing research - conduct, critique and utilization. 5^th edition. St Louis: Elsevier Saunders Company.         [ Links ]

CALLAHAN, C; JAFFE, J; SEGAL, R & SEGAL, J 2005. Help guide mental help issues. Coping with loss: A guide to Grieving and Bereavement, http://www.helpguide.org/mental/griefloss.htm [Accessed on 19 June 2006]        [ Links ]

CHAGDUD TULKU 2006. Do-Gooding and Burnout. http://buddism.kalachakranet.org/compassion.html [Accessed on 10 November 2006].         [ Links ]

CROSS CREEK Family Counselling. Bereavement. https://www.crosscreekcounseling.com/bereavement.html [Accessed on 31 May 2006].         [ Links ]

DEPARTMENT OFHEALTH REPORT: National HIV Sero-Prevalence Survey in South Africa, 2005. http://www.healthlink.org.za/heaIthstats [Accessed on 6 July 2006].         [ Links ]

DE VOS, AS; STRYDOM, H; FOUCHE, CB & DELPORT, CSL 2007. Research at Grass Roots. Van Schaik Publishers. Pretoria.         [ Links ]

GOLDBLUM, P [s.         [ Links ]a.]. Is AIDS bereavement unique? http://www.whitecraneiournal.com/wc01071.htm [Accessed on 1 July 2006].

GORLE, HR 2002. Beware the Five Stages - Editorial TLC Group. http://www.bereavement.org/theories.htm.         [ Links ] [Accessed on 1 July 2004].

GORLE, HR [s.         [ Links ]a.]. Hospice net: knowledge of the grief process, http://www.hospicenet.org/html/knowledge.html. [Accessed on 1 July 2006].

GP-TRAINING.NET. 2006a. Bereavement, http://gp-training.net/training/consultation/bereave.htm [Accessed on 31 May 2006].         [ Links ]

GP-TRAINING.NET. 2006b. Coping. Patient advice leaflets: Understanding and coping with your feelings following a traumatic event, http://gp-training.net/pal/mhealth/trauma.html [Accessed on 21 June].         [ Links ]

HAIDUVEN, D & FERROL, S 2004. Sharps injuries in the home health care setting: risks for home health care workers. AAOHN J, 52(3): 102-8 2004. http://www4.infotrieve.com/newmed1ine/detail.asp?NameID=15068100 [Accessed on 21 December 2004].         [ Links ]

HAIKEN, M & HERSCHER, E 2004. Lifestyle, wellness, stress and chronic illness. http://healthresources.caremark.com/topic/stressill [Accessed on 23 August 2006].         [ Links ]

HASA Newsletter March/April 2003. HAS A: Northcliff, Johannesburg; pp. 12-15.         [ Links ]

HIVAN - CENTRE FOR HIV/AIDS NETWORKING: AIDS epidemic update 2003. UNAIDS Press Release 25 November http://www.hivan.org.za/arttemp.asp?id [Accessed on 6 October 2004].         [ Links ]

HOLMES, L 2003. About mental health. The psychological effects of trauma. http://mentalhealth.about.com/cs/traumaaptsd/a/trauma.htm [Accessed on 23 August 2006].         [ Links ]

INTERDENOMINATIONAL CHURCH OF THE HOLY LANDS 2005. Pastoral care for grief - one to one bereavement counselling - What are the different types of grief? http://www.interdenominational.net/pastoralcareforgrief.htm [Accessed on 1 June 2006].         [ Links ]

KELVENS, C 1997. Fear and anxiety. http://www.csun.edu/~vcpsvOOh.students/fear.htm [Accessed on 31 May 2006].         [ Links ]

KESSLER, D 2005. Frequently asked questions on grief and grieving, http://www.davidkessler.org/html/qagrief.html [Accessed 1 June 2006].         [ Links ]

LABUSCHAGNE, A 2003. Qualitative research - airy fairy or fundamental? The Qualitative Report, Volume 8, Number 1 March 2003. http://www.nova.edu.ssss/OR/OR8-l/labuschagne.html [Accessed 29 January 2004].         [ Links ]

LEAVER, J 2006. Grief forum, encyclopedia of mental disorders. Grief. http://www.minddisorders.com/Flu-Inv/Grief.html [Accessed 23 May 2006].         [ Links ]

LOUGHBOROUGH UNIVERSITY -COUNSELLINSG SERVICE 2005 Help for common problems.- bereavement and loss, http://www.lboro.ac.uk/service/counselling/pages/problems/bereavement.html [Accessed on 23 May 2006].         [ Links ]

MACNAIR, T 2005. Ask the doctor -bereavement. http://www.bbc.co.uk/health/ask_the_doctor/bereavement.shtml [Accessed on 23 May 2006].         [ Links ]

McNALLY, R 2004. Psychological debriefing does not prevent posttraumatic stress disorder. Psychiatric Times. April 2004, Vol. XXI, Issue 4. http://psvchiatrictimes.com/p040471.html [Accessed on 23 August 2006].         [ Links ]

McNICHOLL, I 2006. Adverse events of antiretroviral drugs. Hivinsite. http://hivinsite.ucsf.edu/lnSite?page=ar-05-01 [Accessed on 10 October 2006].         [ Links ]

MEDICINENET.COM. 2006. Definition of anger. http://www.medicinenct.com/script/main/art.asp?articlekev=33843 [Accessed on 31 May 2006].         [ Links ]

MEIENBERG, F; BUCHER, HC; SPONAGEL, L; ZINKERNAGEL, C; GYR, N & BATTEGAY, M 2002. Anxiety in health care workers after exposure to potentially HIV-contaminated blood or body fluids. SWISS MEDICAL WEEKLY 2002;132:321-324 http://www.smw.ch/pdf200x/2002/23/smw-09988.pdf [Accessed on 7 October 2004].         [ Links ]

MENTALHELP.NET. 2005. Grief and bereavement issues - Stage models. http://mentalhelp.net/poc/viewdoc.php?tvpe=docenid=8444 [Accessed on 23 May 2006].         [ Links ]

NISC DISCover Report - March 2003; Nursing literature review by Ms J. Prophet, SASOL Library, University of the Free State.         [ Links ]

O'NEILL, JF; SELWYN, PE & SCHIETINGER, H (eds.). 2003. A clinical guide to supportive and palliative care for HIV/AIDS. US Department of Health and Human Services, Health Resources and Service Administration, HIV/AIDS Bureau: Washington. http://hab.hrsa.gov/tools/palliative/chap20.html [Accessed on 29 September 2004].         [ Links ]

O'NEILL, JF & MCKINNEY, MM 2003 Care for the caregiver - A clinical guide to supportive and palliative care for HIV/ AIDS. pp. 329-347.         [ Links ]

OKUN, BF 1997. Effective helping -interviewing and counseling techniques. 5^th edition. Pacific Grove: Brooks / Cole Publishing Company.         [ Links ]

PECORINO, PA 2002. Anticipatory grief, death and bereavement: A continuum. http://www2.sunvsuffolk.edu/pecorip/SCCCWEB/ETEXTS/DeathandDvingTEXT/ [Accessed on 1 May 2006].         [ Links ]

POLIT, DF & BECK, CT 2004. Nursing research: principles and methods. 7^th edition. Philadelphia: Lippincott Williams and Wilkins.         [ Links ]

POPE, C; ZIEBLAND, S & MAYS, N 2000. Analyzing qualitative data. (Qualitative Research in Health Care Part 2). British Medical Journal. Jan. 8,         [ Links ] [Accessed on 29 January 2004].

PSYCHOSOCIAL IMPACT OF HIV/ AIDS. Module 2.         [ Links ] [s.a.]. http://userwww.sfsu.edu/~ali1212/Psvch.html [Accessed on 23 May 2006].

RADECKI, S; ABBOTT, A & ELOI, L 2000. Occupational human immunodeficiency virus exposure among residents and medical students. Archives of Internal Medicine. Vol 160 No 20, November 13; pp3107-3111.         [ Links ]

RYAN, G & WEISNER, T [s.         [ Links ]a.]. Analyzing words in brief descriptions: fathers and mothers describe their children, http://wwwanalvtictech.com/borgatti/ryanrext.htm [Accessed on 22 October 2004].

SPEZIALE, HJS & CARPENTER, DR 2003. Research in Nursing. J.B. Lippincott Company. Philadelphia.         [ Links ]

STOKER, R 2004. Anatomy of a needle stick injury. Business Briefing: Global Healthcare - Advanced Medical Technologies. http://www.bbriefings.com/pdf/950/ACF59B2.pdf [Accessed on 3 November 2004].         [ Links ]

TERRE BLANCHE, MT; DLRRHEIM. K & PAINTER, D 2007. Research in Practice, Applied methods for social sciences. University of Cape Town Press. Cape Town.         [ Links ]

TESCH, R 1990. Qualitative research: analysis types and software tools. Falmer Press: Hampshire        [ Links ]

WILBURN, SQ 2004. Needlestick and sharps injury prevention. Online Journal of Issues in Nursing. Vol. #9 No. #3, Manuscript 4. http:www.nursingworld.org.oiin/topic25/tpc254.htm [Accessed on 6 June 2006].         [ Links ]

WNUK, AM 2003. Occupational exposure to HIV infection in health care workers. HIV AIDS REVIEW 2003; 2(3/ 4): 140-143. www.msi.com.pl/pub/hiv/vol2/no3-4/5689.pdf [Accessed on 27 September 2004].         [ Links ]

 

 

Correspondence:
Dr L. Roets
School of Nursing
Faculty of Health Sciences
University of the Free State
BLOEMFONTEIN
Tel: (051)4013536; Fax:(051)4019140
E-mail: gnvklr.md@ufs.ac.za