What My Needle Stick Injury Taught Me

    What My Needle Stick Injury Taught Me

By Uzma Marium, MD 

When it comes to occupational hazards, needle stick injury can be quite a taboo- only to be discussed in hushed voices within the doctors’ lounge or nursing stations, and only with your closest peers. But if you ask my opinion, I think it’s time that we normalize needle stick injury because not talking about it can only make it more hazardous than it already is, especially when many don’t even report it!

I was almost about to do the same thing but thankfully, I came back to my senses pretty quickly and just happened to be surrounded by the most supportive nurses and residents at the time of occurrence. A little bit of flashback- I was posted in the Oncology ward for a month during my internship year and boy, was it a hectic on-call night! To make the scenario more vivid I’m going to highlight the key points that I learned that night after what felt like the kiss of death.

1. Quick snacks can actually prevent accidents… 

One thing I learned the hard way is that no matter how hectic a call is, you must not allow yourself to starve. After all, call calories don’t count. But there I was at around 10 pm, having skipped through lunch and dinner and only surviving on caffeine, which I believe resulted in my shaky hands. The patient- a sweet, elderly gentleman with gastric adenocarcinoma- had just finished his session of chemotherapy in the Day Care Unit and was good to go home after I remove the porta Cath needle. I greeted the patient and confirmed his identity. Then, after double gloving myself, I started the removal of the porta Cath needle under aseptic conditions. Now, those who are familiar with porta Cath needle would know that removing the needle is quite a fine technique as some porta Cath require you to pull the needle out of the chamber with a bit of a force while your other hand needs to be absolutely steady. Well, mine wasn’t so steady (thanks to all the caffeine) and as the needle came off, I felt a sharp prick on my index finger that was stabilizing the porta Cath chamber.

2. Be calm, not sorry! 

Yes, at the end of the day, healthcare workers are also humans, and accidents can happen anywhere. But have I told you? When I suspected the prick I wanted to drop everything and haul. On the contrary, I had to keep my calm because I didn’t want the patient to think that was a lousy intern who couldn’t do a simple job without making a fuss. I finished dressing the porta Cath site and smiled at the patient who couldn’t stop thanking me. Then I turned around to inspect my left index finger (imagine dramatic background music). I could see a small hole through my gloves and my heart sank. I ran to the sink to remove my gloves. To my horror, there was a tiny reddish puncture where the needle has pricked me on my index finger (thankfully, no active bleeding as it could have indicated a deeper needle penetration). Yes, I finally cried.

3. It’s okay to confide…

Hiding the fear in my voice, I politely asked the nurse to give me the patient’s hospital number so that I can trace the patient’s previous serology in the system. My hand was trembling as I clicked on the serology report and for the first time I felt a little relieved to see that the patient was recently tested and was negative for Hepatitis B and C and HIV. So, should I report? That moment I realized that there’s really nothing wrong in brushing aside the fear of judgment and confiding with someone from the on-call team, preferably someone senior. And pricking yourself really does not equate to incompetence. You just have to swallow your ego and prioritize your own health and safety. So I informed my resident.

4. Report, report and please report!

To my utter relief, my resident was really supportive and told me how he had pricked himself once as a medical student. He said no medical student or healthcare worker is immune to needle prick injury and that the best thing to do is to follow the hospital protocol and report your injury. Instead of worrying yourself sick, let the Occupational Health service decide how serious your injury is and what is the most appropriate measures to be taken.  Off he sent me to the ER. I had to fill a form with the patient’s detail and my detail. Then the nurse drew my blood and said I could check my result within a few hours. Trust me, it made me feel so much better to share my worries with a bunch of people that night.

In conclusion, occupational exposure to blood-borne diseases can be a significant cause of anxiety among healthcare workers. However, accidents do happen, and panicking is a very understandable reaction. But hiding the incident can be dangerous because only when we report, the data is used to make important statistics and inferences. And reporting it can actually lessen your mental stress to a great extent. The good news is, the risk of seroconversion from a needle stick has been estimated to be very, very low, around 0.23%. So, the only advice is to be absolutely cautious while dealing with sharps (and please, eat and hydrate yourself during calls). If you ever do end up with an injury, remember you are not alone. Simply report it and follow your hospital protocol. You will be surprised to find all the help and support that you were too scared to reach out for.

My name is Uzma Marium. I’m an MD graduate from the National University of Science and Technology, College of Medicine, Sohar, Oman. Currently, I’m doing an internship at Sultan Qaboos University Hospital, Muscat, Oman. Follow my Instagram @uzmarium!

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