The discussion of the long term effects of repeated concussions on football players seemed to peak with the Super Bowl. Prevention, signs and symptoms, progressive effects, and league responsibility became common topics heard in the media, the work place, and home. A question asked by some, stated as fact by many, involved career choice. For athletes who love the game, enjoy the adrenaline rush of competition, and have the talent to earn salaries beyond the imaginations of most, would they do anything else?
This quandary transcends high profile, top-dollar sports.
In 1971, my nursing professor, Rose Sandling, told a story about working in the Emergency Room. A window washer fell through a window. He rolled into the ER on a gurney. Without hesitation, Rose scooped both arms under the man to log roll him and examine his back for injury. Glass riddled his back and sliced her hands. This was years before gloves became an essential part of physical examination. Lab tests revealed the man had syphilis. Rose received appropriate treatment and continued her career. I never gave her tale a second thought.
The first time I stuck myself with a needle I knew it was “clean.” Still a novice on a busy day, I jammed an 18 gauge needle through my thumb and thumbnail as I hurried to draw from a vial of sterile saline admixture. It happened so suddenly I felt no pain, grimaced at the thought of pulling it out rather than the feeling. The experience taught me when I could afford to hurry and when I had to take careful, methodical steps.
By the late 70’s, the first cases of what became known as AIDs, appeared. No one knew anything about the disease except that once symptoms appeared, death followed shortly thereafter. Wearing personal protection at the bedside never occurred to anyone until many health care providers, me included, went home with traces of blood and body fluids invisibly stuck in cuticles, knuckles, and skin tears. I never thought about the risk of exposure to what was then unknown.
Jump forward fifteen years. I pushed a syringe into a sharps container so the next person to use the container wouldn’t come in contact. I pulled back a bleeding finger and an18 gauge needle. Hospital protocol during that period did not mandate testing of the employee, and the source of the needle contamination was unknown.
“Should I have myself tested?” I asked a friend who happened to be an infectious disease doctor.
“It depends on what you want to know.”
I grew up in the generation of free love, women’s liberation, female empowerment, and modern technology. I wasn’t promiscuous, but I allowed myself freedom of thought and action. I had been artificially inseminated before donor screening and regulations were instituted. And I had been a nurse before the age of gloves. Indeed. What did I want to know?
I obsessed about my decision. A limit existed between time of exposure and testing. What if I tested positive? What then? HIV. Hepatitis. Either meant a drastic change in my life and that of my son’s. Might this be one of those times when ignorance would be bliss?
I tested negative for all communicable diseases on the screening panel.
Last week I removed a line from the brachial artery of a man who had been anti-coagulated. His line leaked a serous pink fluid and a bruise blossomed around the insertion site up and down his arm. The line had to be removed. I lost count of how many times I had done this procedure. Cut the sutures. Apply pressure with 4 x 4s of gauze. Pull the line. Hold pressure. Hold more pressure. I pulled the 4 x 4s back to assess the site. It appeared stable. For five seconds. Then a fountain of pulsating blood sprayed my face. I felt the reflex blinking of my left eye to wash away foreign matter. I didn’t stop holding pressure on the arm, but flagged down a nurse walking by my room and asked for help. When he walked into the room, his eyes widened just a trace, just enough to share the shock he felt. I applied more gauze while he put on gloves. He took over holding pressure.
I hurried to the bathroom after grabbing a plastic “bullet” of sterile saline used by the respiratory therapists. Thoughts of my sight came first. I flushed my left eye until it felt clean. Then I looked in the mirror. Blood freckled my face. My bangs clumped from the wetness. For some reason, the spots on the bridge of my nose bothered me more than those on my cheeks and forehead. I scrubbed them first. My usually blonde hair remained pink-tinged despite a liberal splashing of water.
This time I didn’t hesitate to get tested. Chronic illness had landed the patient in our ICU three times in the past six months for congestive heart failure and gastric ulcers. I knew his cardiac history, his transfusion history, his social history, and felt confident about his test results. But. While I waited for official confirmation, doubt drilled its way into my head and the “What ifs…” infected my consciousness.
Such is the nature of my career. As a nurse, I bought a house by myself, raised a child, enjoyed some travel, and went back to school. The dangers inherent in my profession have changed. Some are more deadly. It doesn’t matter. I have no regrets. I am a nurse. I would do it all again.
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