HIV-positive nurse urges safer needles

Tuesday, June 8, 1999 | 6:54 a.m.

It happened on Oct. 17, 1997 as she worked with the man at Northern Nevada Medical Center in Sparks.

Today, Black, 28, of Reno, takes 22 pills a day to keep her HIV infection from progressing to AIDS and to delay the effects of hepatitis C, an incurable liver disease.

The moment the needle broke through her skin, Black, a registered nurse and single mother of two, said her life was torn apart.

"This is now my story. I don't want other people to have to tell the same story," she said.

The only way to ensure that is for Congress to pass the Health Care Worker Needlestick Prevention Act of 1999, she said.

The act - which Sen. Harry Reid, D-Nev., introduced June 2 in the Senate and Marge Roukema, R-N.J., introduced earlier in the House - would require hospitals and health-care facilities to use safe needles and keep better track of injuries from needles and other sharp objects.

The federal legislation would be modeled after a California law passed last year that mandates hospitals use safe-needle technology. The California law takes effect this August.

Black said she doesn't know a nurse who hasn't had a needle stick at some point in his or her career.

The 1993 graduate of the Orvis School of Nursing at the University of Nevada, Reno, said she'd had two needle sticks before the one in October 1997. Those patients didn't test positive for AIDS or other blood-borne diseases, and Black, like many nurses, considered needle sticks just a risk of the job.

National statistics show needle sticks are common in the health professions. Each year about 800,000 hospital workers nationwide are injured from accidental needle sticks, according to the Occupational Safety and Health Administration.

Of those, about 16,000 needle sticks are contaminated with HIV, the virus that causes AIDS. The federal Centers for Disease Control and Prevention has documented 54 cases of HIV from needle sticks but says more are possible because health care workers' needle sticks are under-reported.

"A lot of health-care workers don't realize the significance of reporting that they've had a needle stick," said Cynthia Bunch of the Nevada Nurses Association.

Hospital nursing administrators in northern Nevada said a law isn't necessary to protect health-care workers from exposure to blood borne diseases, because needleless devices are being used in their facilities, and more are being evaluated for their usefulness.

Needleless intravenous devices were being used at Northern Nevada Medical Center when Black was pricked, said Jean Lyon, chief nurse executive.

"We had the needleless devices throughout the hospital at the time she stuck herself," she said.

Lyon said Black overrode the needleless IV in the patient's arm and used a regular needle to flush out tubing that was clogged with blood.

She also said Black, in violation of hospital policy, wasn't wearing gloves that could have acted as a barrier to the needle stick.

Black admits she wasn't wearing gloves but disputes they would have prevented her from being injured. She also disputes the IV system in place was needleless and said she didn't have time to switch it over to a needleless line.

"I was honest about the fact I was not wearing gloves when I got stuck," she said. "If I had foolishly overridden their system, I would have said that, too, and I did not."

Since Black's needle stick, the hospital has changed needleless systems. The new system doesn't allow a nurse the option of using a needle in an IV line, Lyon said.

"We thought we had a fail safe system in place at the time of this accident." Switching needleless IV systems cost the hospital $18,000, she said.

Black's injury was costly, she said. The drugs she takes for HIV are $4,000 a month; the medications to control hepatitis C are $2,000. Worker's compensation insurance pays her medical costs.

"That buys a lot of safe needles," she said.