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This happened a few weeks ago, but it still weighs heavily on my mind. I am mostly here to vent, but I would value any nonjudgmental FDS-minded advice, too.
My patient was in his early 50's, and contracted HIV years ago from an extramarital affair during one of his business trips to Thailand, according to his medical chart. He did not get tested for many years, at which point he was already suffering from multiple opportunistic infections, also known as "full blown AIDS." So it was too late for most modern HIV treatments. By the time he came to us, he was completely ventilator dependent and wasting away at just 104 lbs. He spent his last days in bed staring at the wall, refusing to communicate with his nurses.
He has three adult children, all of whom are sworn to secrecy regarding the nature of his illness. He has a wife, and she is completely in the dark about the real cause of his sickness. His eldest daughter, who is also his Medical Power of Attorney, has forbidden us, his medical team, from informing his wife of his HIV status.
I have already looked up the laws in my state regarding HIPAA, patient privacy, and HIV infection. According to the law, the patient has a legal right to keep his HIV status a secret from everyone, including his spouse. If anyone tells his wife without his permission, it would cost them their license.
So.....an innocent woman was exposed to HIV by her worthless, cheating-ass husband, and all three of her awful kids would rather watch BOTH of their parents die of AIDS in order to protect the reputation of their worthless cheat of a father. (If you haven't guessed yet, he contracted the virus from having sex with other men, so the kids are desperately trying to cover up both his cheating and his sexual orientation.)
I have no doubt that the whole family was raised in a patriarchal culture, where they learned to value their father's reputation more than their own mother's life. If they would just tell their mom, she could go get tested for HIV, start treatment immediately, and live a long, happy life without her cheating husband. But no. Gotta circle the wagons to protect the liar at all costs. I hate this world.
I have their address in his medical chart. I could send her a brief anonymous letter, mail it from a different zip code. It doesn't have to contain patient information, it could just say "Dear Mrs. X, You have been exposed to HIV. Please go get tested. If you have any questions, ask your kids."
I just can't stand that an innocent woman is victimized by yet another disgusting cheating scrote, and betrayed by her own children. I don't want to watch anyone else die of AIDS.
Thanks for reading. I know I'd be seriously fucked if I violated patient privacy. I just needed to vent.
I was thinking of making a post about all the scrotes my nurse friend has come across.
1. elderly man comes in. He can’t be discharged because he has no where to go, stuck in Med Surge. Come to find out, his wife kicked him out, has a restraining order against him. He has OF girl that has convinced him that if he gives her all the remaining money he has, she’ll take of him as he ages and he’ll be a sugar baby. His brain is on loop, just repeating the words, “sugar baby,” at odd intervals…even when brief moments of sanity kick in, he’ll tell anyone his ‘amazing’ story of his sugar momma.
Seriously, you guys, this pile of disgusting flesh thinks that a young woman is going to take care of his ass. This is patriarchy. A male believes so much in his own inherent value that he buys into the lie that he’s entitled to a young woman to take of him into the grave.
He spent all the money he and his wife saved for decades on the OF girl, so that she would take care of him and touch his decrepit pp!
2. The elderly man whose elderly wife had locked in syndrome after a stroke and heart attack. He can’t feed himself, let alone her, so she is literally wasting away in his care ON TOP of the giant, festering bed sores she has due to his lack of care for turning her body…Adult protective services as assessed the situation and won’t act because he “”loves”” her and can’t imagine his life with her. She is literally paralyzed, aware of her body rotting around her but her heart just.won’t.stop.beating. She feels pain, you can see it in her eyes. Tears roll out of them. He has put in for full medical intervention to prevent death, including poop tube, catheters, feeding tube which is infected because he doesn’t take care of it….the whole 9 yards.
Men get away with so much abuse as long as he can claim “”love”” to strangers.
———
It’s hilarious when men make fun of women leaving saying that we’ll die alone. *Most* women, even ones who ate aaaalllll the shit they were served for decades still die alone or deeply physically abused because men are truly horrible and sub-human monsters.
Do it.
Take all precautions to make sure you can't lose your job. Make someone else who can't be prosecuted to send the letter. Whatever, but this is too unfair. I can't stand it. Fuck the siblings, they can rot in hell. This was really hard for me to read. I can't imagine how hard it is for you.
Well If the wife gets aids from him then you'll regret not telling her. If I knew where the wife lives I would write an anonymous letting saying he cheated on her several times, cheating is not a medical condition so you can't lose your job by telling her that.
WTF? Isn't there some clause saying confidentiality can be breached if there is risk of harm to another person, the person themselves, or a child? She could be undiagnosed and untreated?!
I am not sure if you have done this yet. But don't write it as a nurse would! Write it as a man her husband had sex with that either gave him the AIDS or knows about the AIDS. Like a mournful ex-lover. They can't prove which men he has slept with or where. Type it or get a man to write it. Don't get in trouble.
Yikes, this is a nasty dilemma. I feel for you.
If you do decide to tell the wife, just make sure you cover all your tracks, and be meticulous about it, including deleting this post and any other digital advice you've sought. Digital footprints can come back to haunt us.
Could you just maybe have someone send her a pamphlet from a health clinic about the importance of getting tested for HIV? That's not disclosing anything? What an awful situation and the children are absolutely horrible. I have no words. Men do this all the time to their wives. I'm not surprised but how could someone do this to their mother. Sad you a complete stranger care more about her than her children.
Wow. The lengths people will go to to protect shitty men… What a story, and a big huge ethical dilemma. I agree that the wife has a right to know, but you also have a right to keep your job, because there's no use in saving one person when you're barred from saving anyone else ever again. I have hope that she will find out anyway, I bet she won't be content with the BS explanations her kids gave her. A woman's intuition often wins out in dangerous situations like this. Of course, there's no guarantee, but it seems your hands are tied.
I'm a therapist in training, and I think we would be allowed to tell her under the ethical principle of duty to warn (depending on the state because some states don't have duty to warn) if they were still having sex or planning to have sex as this would be a current or future action exposing her to risk of death through HIV/AIDS that we could prevent by telling her. I don't think we could break confidentiality based on her past exposure either though unfortunately.
Omg!! This is heartbreaking! Wow, the kids are awful as well. Ladies, please take care of yourself! Even if you are in committed relationships get checked regularly! We have a responsibility to take care and protect ourselves. No1 will do it for you, not even them kids 🤢🤮😭
Isn’t it also illegal to transmit an std knowingly as well ? He should be jailed
Don’t do anything. You run the risk of job termination and loss of licensure which can affect future job prospects. All HIV positive tests are reported to the state department of public health. It’s their responsibility to inform potential exposures. The kids will obviously know it was a health care worker who sent an anonymous letter and you likely would be found out.
I vote for do it. Whatever the law is, this is abolutely the morally corret thing to do. This is a life at risk due to unfair technicalities. Because in some places it is a crime to knowingly expose others to HIV. Why isn't it a crime in this case? There are probably a whole lot of people with access to his records no? How likely do you think it would be to trace it back to you? If anything happens with your license I would fight it in court, you have the potential to change things for so many people.. It's not my place to tell you to do that since it's your life and your risk. But sometimes we are 'chosen' as the catalysts for something so much bigger than ourselves and you are 100% in the right.
Holy shit. It sounds like the kids have been brainwashed to accommodate him instead of her. I'm sorry this is weighing heavily on you, I'd be furious too.
What does the wife think her husband is doing in the hospital? does she know he is dying? what does she think is going on?
Is it/could it be ethical/legal/common practice/legitimate to tell the whole family that they might need to get tested for somethings? I mean they may have shared a bathroom with this man so isnt it 'possible' (being creative) that it could have been trnsmitted? Can you frame it in this, or similar, way without making any disclosures that jeapordise your job/profession? At least then she will get tested and be able to look after her health if god forbid he transmitted it to her. Obviously it doesn't deal with the issue of infidelity, but at least it prioritises her health and safety...