Path: utzoo!attcan!utgpu!news-server.csri.toronto.edu!mailrus!uwm.edu!zaphod.mps.ohio-state.edu!sdd.hp.com!decwrl!elroy.jpl.nasa.gov!ucla-cs!Richard.DeWald@f70.n382.z1.fidonet.org From: Richard.DeWald@f70.n382.z1.fidonet.org (Richard DeWald) Newsgroups: sci.med.aids Subject: HIV Status Policy Message-ID: <38187@shemp.CS.UCLA.EDU> Date: 19 Aug 90 16:15:15 GMT Sender: news@CS.UCLA.EDU Organization: FidoNet node 1:382/70 - Humanitas, Austin TX Lines: 97 Approved: ddodell@stjhmc.fidonet.org (David Dodell) Note: Copyright 1990 by Daniel R. Greening. Permission granted for Note: non-commercial reproduction. Archive-number: 2391 I am a nursing student and a clerk in an emergency room. In a message of <13 Aug 90 23:20:06>, Annoyed As Hell (1:154/69) writes: AA>Recently, I helped a friend get admitted into a Milwaukee Hospita, who AA>is diagnosed with AIDS. That was very nice of you. AA>30 seconds after we sat down in the waiting room, the receptionist AA>called into patient admitting, and, in a regular voice audible AA>throughout the waiting room to any and all others present "Acquired AA>Immune Deficiency Syndrome-Peunomonia." Called into what? An overhead intercom or a private communication device? If it was an overhead intercom, this would be unacceptable, if it were a private line and it was just the loudness of the person's voice that bothered you, well, that's another issue (less serious than announcing a diagnosis over an intercom). AA>Additionally, his room has in big black and white letters "Bloo AA>& Secretion Precautions" for all to see, including visitors and other AA>patients on the entire floor! This is an interesting situation. Actually, all health care workers are asked to observe something called "universal precautions." In essence, what this boils down to is we treat every patient as if he or she has AIDS (or Hepatitis B). We take certain precautions against infection with everyone. However, in practice, every patient with a known HIV+ status is known to everyone there on staff (including the clerk). People are extra-special careful when drawing blood or doing anything that (in the worst possible scenario) could result in bodily fluids being splashed onto unprotected skin or membranes. Formally, "blood and bodily secretions precautions" has been eliminated as an isolation category because we are expected these days to take these precautions with ALL patients. Some hospitals still hang these signs on AIDS or Hepatitis B patients doors and/or charts as a reminder to be extra careful. AA>Isn't there some way Doctors, Nurses, and Medical Professionals AA>could refer to these patients and this diagnosis, without alarming AA>everyone else within earshot? Couldn't a code, or number, or even a AA>red piece of tape on the patients door be used to alert medical AA>personnal of precautionary conditions? I cannot tell you how many AA>times I have sat in the doctors office of a major physician here in AA>town (with numerous AIDS patients) while names, conditions, symptoms or AA>tests (Such as T-cell counts) are spoken of freely and openly. In the strictest theoretical sense, no one but the patient and his (or her) associated health professionals should know of a patient's diagnosis. In practice, we talk about our work while at work just like anyone else does. In a way, your concern for the lack of formality about an AIDS diagnosis may indicate that your health care workers are treating it like any other diagnosis (as they should). On the other hand, each of those health care workers is as familiar with the stigmata associated with the disease as anyone else. Prudence would suggest a bit more discretion would be kind, at this stage of the game, I am sympathetic to your concern. It probably isn't much solace to know that this wouldn't happen in MY emergency room. AA>WHAT EVER HAPPENED TO THE CONFIDENTIALITY THAT IS SUPPOSED TO BE AA>ASSURED FOR THESE PATIENTS BY LAW Nothing. It is not only a legal commitment, but a moral and ethical one as well. AA>Or is it that I am just one of the few people intelligent enough to AA>know what a Doctor or Nurse is talking about? That would be nice, but it is probably not the case. An emergency room (or a doctor's office) can be an interesting place to wait around. People hear things they shouldn't every day. However, hearing that so and so in the next bed has chest pain is something different from hearing that so and so has AIDS. Your concerns have some substance. AA>Is there any other way hospitals or clinics in other areas refer to AA>AIDS patients, without "disclosing" his/her condition (illegally, I AA>might add). If there is, can someone out there pass this along to the AA>health care "professionals" in Milwaukee, Wisconsin? No, and I really don't think they should. AIDS is an equal opportunity disease. HIV can and will infect anyone if given the opportunity. Your chest pain patient (in my emergency room) has as much of a chance of getting his diagnosis overheard as your vaginitis or your AIDS patient. The system isn't perfect. I do agree that AIDS patients deserve special attention owing to the severity of their condition, but we should treat them as we do all patients that are equally seriously ill--with dignity and care. Singling them out for special services beyond that invites prejudice. Richard DeWald, BSN Student Univ. of TX - Austin. -- Uucp: ...{gatech,ames,rutgers}!ncar!asuvax!stjhmc!382!70!Richard.DeWald Internet: Richard.DeWald@f70.n382.z1.fidonet.org