Ok… just trying to say that I have actual firsthand knowledge of talking to people in this exact scenario, which the OP doesn’t. No need to be rude.
Do you think the fact that you weren’t able to express your intention unambiguously should give you some pause before you berate your poor benighted paitents for making decisions that you wouldn’t make if you were them?
I don’t see how anonymization is possible in the situation in the OP. The nurse/needle stick recipient knows who’s needle she stuck herself with, and could have the knowledge to determine any diseases the patient has based on the advice of the occupational health consultant.
I can see someone in the US not wanting to have their blood taken out of fear the results will be reflected in their insurance. irishgirl and I are both from countries where you do not need to be afraid of going bankrupt over your health, so we are probably thinking a lot differently.
Not only that, when I took my son in for immunizations, the needles had this gizmo (not the original “cap”) attached that you used in some manner to bend the needle. the medical person (nurse?) was too quick for me to actually see it in action. I guess its to deter drug addicts from somehow aquiring and using these needles? Im positive thats what she said when I asked about it since it was new to me, hopefully im not remembering that wrong…
Oh Skald, you make me chuckle.
It’s not far-fetched to drum up a small-town scenario where the nurse knows the patient personally and everyone is on a first-name basis with everyone else. If it turns out the patient is HIV+ upon testing (but didn’t know it beforehand), and the nurse is told after bloodwork that she’s been exposed to HIV, any idiot would be able to connect the dots.
BTW, office managers have access to ALL of this information–who do you think calls in the claims? So, frequently, do various secretaries and the injured worker herself. And multiple people at the insurance company (bill scanners, bill processors, claim processors, claim techs, drug review, case management, claim adjusters, their supervisors, etcetcetc).
But as I have stated *multiple *times now, regardless of the reasoning for the patient’s refusal, it’s **not applicable **to the original post. Can we please (and thank you) stay on topic?
Oh, totally. You could take as much hair, saliva, urine, etc. that you needed, have access to my medical records, and anything else you needed as long as you didn’t stick me with a needle. I’m getting better about my phobia slowly over time (my doctor actually gave me a high-five today because I’m showing so much improvement) but in a situation where it wasn’t medically necessary I would refuse a blood draw. I don’t want other people to be worried about their health though so I would gladly do everything else possible to help ease their fears.
Virginia actually has a deemed consent law in which the person is required to submit to testing. This thread made me think about what would happen if the person refused to provide a sample and apparently you can force them to provide one.
if the person whose blood specimen issought for testing refuses to provide such specimen, any person potentiallyexposed to the human immunodeficiency virus or hepatitis B or C viruses, orthe employer of such person, may petition the general district court of thecounty or city in which the person whose specimen is sought resides orresided, or, in the case of a nonresident, the county or city where thehealth care provider, law-enforcement agency or school board has itsprincipal office, for an order requiring the person to provide a bloodspecimen or to submit to testing and to disclose the test results inaccordance with this section. At any hearing before the court, the personwhose specimen is sought or his counsel may appear. The court shall beadvised by the Commissioner or his designee prior to entering any testingorder. If a testing order is issued, both the petitioner and the person fromwhom the blood specimen is sought shall receive counseling and opportunityfor face-to-face disclosure of any test results by a licensed practitioner ortrained counselor.
FWIW, in my practice before I see a patient they sign the following statement (along with authorization for treatment, insurance authorization, etc)
DEEMED CONSENT: I understand that in the course of my treatment, staff and employees of [Psychobunny] may come into contact with my blood or bodily fluids. Virginia law authorizes health care providers to test for HIV, Hepatitis B and Hepatitis C if such an exposure occurs. I understand and agree that in the event of an exposure, I will be notified and given the opportunity to ask questions and consent to have this testing done. I understand that results will be released to the exposed party.
I explain that the law allows me to test them but if they refuse to sign we will not see them as patients since my staff’s health comes first.
+1.
I don’t get the privacy concerns here. Yes, the nurse now knows what you have. Just like my doctor and nurses all know what I have. So what? None of them can tell anyone due to HIPAA. The actual reason to be concerned about privacy–that someone who knows your information might do something nefarious with it–is not present.
The disclaimer by psychobunny and the Virginia law is exactly what I would expect. As long as no one can disclose or otherwise use your information, the only reason to want privacy is emotional, and the real harm put forth by such a patient trumps the fact that you’re upset that someone knows something about you (that, again, they can’t tell anyone else).
Absolute privacy is not a goal in and of itself. It’s all about minimizing harm, not codifying paranoia.
I understood her perfectly. I think your distaste for doctors colored your perceptions.
I asked one of the epidemiologists here at work this question.
In Massachusetts, the patient always has a right to refuse. If there had already been a blood draw, we are allowed to attach a test for Hepatitis B or C, but not for HIV.
Personally I agree that it would be terrible for a patient to refuse a test after someone else had an occupational exposure, and I’m including needle phobic patients in that. JMHO. Our epidemiologist said that it does not happen frequently here that patients refuse and, given our client population (skewed heavily towards people who struggle with addiction, homelessness, poverty and some other serious life issues), that’s reassuring to me.