Exactly one year ago I had an injury on duty. It changed the course of my final year of med school and my general approach to medicine. It put me through four weeks of awful medicine and several terrifying blood tests. I won’t forget it, and I wish it hadn’t happened, but today I want to share three snippets where I was involved, but did not suffer the injury myself.
1. The Paramedic
It was a busy morning in medical emergencies and I was on call. I was a third year trying very hard to do a thorough neurological examination when I noticed a paramedic in a flat spin. I don’t really remember what made me notice her, but when I did she looked lost and upset, and nobody else had noticed. (It was a REALLY busy, cold and rainy morning.)
She had wanted to wash her hands after handing over their last patient, but hadn’t noticed that the basin was full of blood. When she opened the tap it spluttered, and splashed a lot of the blood into her face.
I don’t remember if I realised how terrifying it must have been for her, but I ended up taking her to Occupational Health because everybody else was occupied, and I was really grateful that I had read through the protocols and knew what to do.
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2. The Paranoid Student
We were on Gynae Clinic in fifth year when one of our patients with longstanding PV-bleeding collapsed. We started resuscitating her and one of our teammates did a ward HB. After the patient was stabilised, said colleague became very concerned that she had pricked herself, even though she had used a single-use retractable lancet. She was worried that she had scraped herself with a sharp plastic edge, even though no break in the skin was visible.
I admit that I thought she was being overly paranoid. I had never had an IOD (whereas she had one earlier that year) so I did not really understand that kind of panic. (Now, I do. Oh, do I ever.) Of course I didn’t SAY anything of the sort to her, and she got consent from the patient for an HIV-test. (The patient tested negative and so the student elected not to take prophylaxis.)
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3. The Unknowing Student
During my last rotation of med school (also Gynae!) I saw one of the younger students prick herself. She did not realise that the needle was already contaminated and I had to point it out to her. I felt awful for having to be the harbinger of bad news.
What really got me was how mean the professional nurse in charge of the clinic was when we reported the incident. She essentially tried to blame the student, which was incredibly inappropriate as the student was already very upset.
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My sincerest hope for all healthcare workers is that they WON’T have IODs and that they WON’T ever have to take prophylaxis. But I think realistically, we must realise that if we do not ever suffer an IOD, we may well be present when someone else does.
Please be sure that wherever you work, you know what to do when someone has an IOD – from the simple things like rinsing out an eye to things like the forms that need to be completed and the medication that must be taken. When people are suffering the shock of an IOD, they often go blank and forget what to do next. You can be the calm in the storm.
Most importantly, please be nice if you are present when someone has an IOD. Even if you saw that they did something stupid to cause it, don’t say it to them right then, because they truly do NOT need to hear that.