Die verpleegkundige se belewenis van moontlike MIV-infeksie na besering- en/of blootstelling-aan-diens

[摘要] English: The aim of the research was to describe the experience of nurses in the studied hospital who had been exposed to possible HIV infection during injury or exposure on duty.A qualitative phenomenological descriptive study was used to describe the emotions and non-verbal reactions of the twelve participants during two subsequent interviews. These were conducted post-exposure, and after counseling and prophylactic treatment took place. The staff from a selected private hospital were included in the study after exposure to blood and human body fluid. The exposures varied between stabbing with a used scalpel, needle prick injuries, contact between blood and broken skin, as well as two cases of exposure during unprotected cardiopulmonary resuscitation, which took place in the hospital's public parking area.The research results show that the study had achieved its goal. Data regarding the experience of staff that were exposed to possible HIV infection while on duty was collected, described and studied.After completion of the study, it was found that the exposed staff's experience had two main features. Firstly, they were grieving for the loss of the concept of being healthy and invincible, blessed with nursing skills and definite goals in life. The bereavement process included phases of denial, anger, anxiety and fear, with recurring thoughts regarding the adverse events, as well as acceptance which developed with time.The bereavement process and shock of the exposure had wider consequences to the family, as well as an impact on the working environment. Some staff members remained anxious and fearful on duty for some time, while others were still experiencing episodes of anxiety and fear at the end of the three months' surveillance period. According to the literature, these individuals may have been demonstrating the first symptoms of post- traumatic stress disorder, and they were therefore referred for further medical follow-up.Most participants reported that they experienced genuine support and compassion from colleagues, at home and in the community.The second category of experience was the physical side effects which participants developed due to the prophylactic antiretroviral therapy. Some participants experienced severe difficulties due to the treatment, while others had fewer problems. During the pre- treatment period, all the participants verbalized their fear and anxiety regarding use of the drugs. The opinion exists that anxiety might have coloured their experience of the side effects, though all the participants, excluding one, completed the prophylaxis with good effect.Some proposals to adjust and possibly improve the hospital's exposure surveillance system were developed from the research results, including that a 24-hour crisis management system be implemented for exposed staff members; that support groups be started for staff, colleagues and family members; that all staff receive orientation and support during unfamiliar procedures or placement in unknown departments; that all exposures-on-duty be investigated and studied so that pro-active or preventive measures may be devised; and that problems with staffing and working climate be resolved. All exposed staff must further receive empathetic and altruistic support, as well as positive, scientifically based information regarding the drugs that can or are to be used, including physical help with any possible side effects due to this medication.All the findings and proposals were subsequently addressed to the relevant members of the Hospital Management.If healthcare services wish to retain nursing staff in future, more will need to be done to prevent all types of exposure-on-duty; and, if they do occur, to anticipate, manage and shorten the subsequent period of the professional nurse or learner's bereavement.

[发布机构] University of the Free State