Student Reporting of Needlestick Injuries

A survey of 702 surgical trainees in 17 programs from 2007 reported that 99% had a needlestick injury by the end of training. Yet, 51% of the injuries were not reported to an employee health service.  

“It was not until I went through the experience that I realised why some don’t report it. We cannot allow ourselves to establish a culture where a needlestick injury is a measure of incompetence or seen as an inconvenience of paperwork.”

Medical Student 

The author that writes the account below is an aspiring surgeon – a medical student on his general surgery rotation who has just encountered his first needlestick injury and is at a railroads of protocol. "Should I report it?" (even though the patient is an 89 year old woman with an unblemished medical history), "or should I ignore it?" given the assumption that it's 99% safe.

During suture, the medical student felt a pinch on his left index finger and, after unscrubbing, realised his skin had been punctured. As he paused for a moment to consider his next actions he heard the scrub nurse say, “You didn’t stick yourself, did you? I hope not because that’s a ton of paperwork for everyone.” I wonder what I would have done at that moment. As an impressionable trainee looking up to the medical professionals I was working with… would I have assumed that their nonchalance was justified or would I press harder to follow protocol?

Despite the apparent benign medical history of the patient, the tangible pressure assumed from his peers, and the student’s initial response of “I don’t think I was stuck, probably not” - the student chose to follow protocol and walked himself to the emergency department to get tested. This story would not have been written if the patient with a few innocuous medical conditions had delivered straight blood samples. This story was written because the patient tested above 99% positive as a carrier of HIV.

“What if I was known as the student that stuck himself” 

These were the words that took precedence of “what if I contract a life-threatening disease.” After a 4-week post-exposure prophylaxis medication, the student went back to general surgery and was able to reflect with renewed insight into the environment which saw him almost sacrifice life-saving treatment in place of peer-driven deniability.

“We only know what our patients’ decide to report to us, and we need to approach everyone with the same caution as we would the most contagious patient. I’ll never forget what an ER attending physician told me about being in a code. The most important pulse is your own. You must take care of yourself before you can take care of others.”

Medical Student

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