MNA president uses personal story to push for needlestick legislation

by Susan Trossman, RN

As a long-standing advocate for nurses nationally and in her state, Massachusetts Nurses Association President Karen Daley, MPH, RN, is skilled at humanizing health care issues when speaking to the media, lawmakers and other registered nurses.

But on April 6, Daley walked into the Massachusetts State House to present testimony like no other. She wanted legislators, who were gathered to consider the merits of a proposed needlestick bill, to see firsthand that behind every injury, there is a real person.

So she gave them a close-up look into her own life now that she is HIV and Hepatitis C positive -- the result of being stuck by a contaminated needle while performing her job as an emergency room nurse. She spoke of her passion for nursing and of her sorrow over no longer providing direct patient care, which she has done for more than 25 years. She also described her symptoms and the paucity of information on Hepatitis C and treatment regimens for people who are co-infected.

"I can't describe for you how that one moment -- the moment when I reached my gloved hand over a needlebox to dispose of the needle I had used to draw blood -- has drastically changed my life," Daley said. "Since January of this year, I have had to come to terms with the fact that I am infected with not one, but two life-threatening diseases."

In concluding her testimony, she explained that her injury could have been prevented and urged members of the Joint Health Care Committee to support the proposed measure, which would force health care facilities to use sharps specifically engineered to prevent injuries and to demonstrate a significant reduction in needlestick injuries.

To date, Massachusetts is one of 19 states in which needlestick legislation is being considered. California, Maryland and Tennessee already have measures signed into law.

At a May 20 Washington, DC, press conference at which Daley spoke, Reps. Pete Stark (D-CA) and Marge Roukema (R-NJ) announced their introduction of federal legislation called "The Health Care Worker Needlestick and Sharps Injury Prevention Act." Stark and representatives from ANA, labor unions and manufacturers crafted the language of this comprehensive, new needlestick bill, which would require employers to adhere to a new, more stringent OSHA bloodborne pathogen standard that mandates the use of safer needle systems, such as syringes with retractable needles. At press time, Sen. Harry Reid (D-NV) was expected to introduce a companion bill in the Senate.

Since she went public, Daley has received considerable media attention. Her testimony was covered by the Associated Press and The Boston Globe, and she has appeared on the public television show, "Greater Boston."

Daley continues to speak out about the need for needlestick protections, because she wants to keep a spotlight on the issue until it is adequately addressed. At a recent meeting of state nurses association executive directors and presidents, she offered to testify before their state committees to help their legislation move forward.

"People have been calling me 'courageous' for going public, but it's a necessity for me at this point," Daley said. "I need to try to prevent what's happened to me from happening to someone else. I'm fortunate to be in a position in which I can have some impact."

Daley did have an impact on Massachusetts health care committee members. The day after she testified, the committee put its support behind the bill, allowing it to move forward in the legislative process. The Massachusetts Nurses Association helped draft the language used in House Bill 969, which was introduced by registered nurse and state Rep. Christine Canavan.

And in addition to generating media interest, there has been another positive outcome from her State House appearance. Daley said that the Massachusetts Department of Public Health is starting up the advisory committee proposed in the needlestick bill without waiting for legislative approval. The committee would determine which safer sharps systems should be utilized and work toward devising a plan that would ensure their use.

Even though Daley no longer works at her hospital job, she has barely slowed down. She already agreed to be part of the needlestick prevention advisory group and serve on another health department committee that is looking into the prevalence of Hepatitis C.

Further, she wants to develop an educational campaign targeting nurses on Hepatitis C, a disease that she once thought was innocuous, but now views as a "silent epidemic."

"I believe five years from now, we're going to see hundreds of thousands of health care workers diagnosed with Hepatitis C," Daley said. "There's a lot of complacency around the issue of bloodborne pathogens. When I got stuck, my first reaction was to pretend it didn't happen," Daley said. But she knew it was in her best interest to report the needlestick, and that's part of the message she wants to send to health care workers.

As for her colleagues' reaction, Daley said, "They have been tremendously supportive. People I work with understand my decision not to go back to the clinical environment. I don't know exactly where I'll go from here, but I have no doubt other doors will open for me."

Susan Trossman, RN, is the senior reporter for The American Nurse.

Health and safety resources

Brochures: Go to http://nursingworld.org/index.htm and click on the "Safety and Health" link or call (800) 274-4262

* HIV, Hepatitis B, Hepatitis C: Bloodborne Diseases (WP-2)

* Latex Allergy: Protect Yourself, Protect Your Patients (WP-7)

ANA position statements: Go to http://nursingworld.org/index.htm and click on the "Safety and Health" link or call (800) 274-4262

* "Availability of Equipment and Safety Procedures to Prevent Transmission of Bloodborne Diseases"

* "HIV-Infected Nurse, Ethical Obligations and Disclosures"

* "Personnel Policies and HIV in the Workplace"

* "Post-Exposure Programs in the Event of Occupational Exposure to HIV/HBV"

* "HIV Infection and Nursing Students"

* "Latex Allergy"

Other ANA resources

* ANA's congressional testimony on latex allergy -- available only online at http://nursingworld.org/gova/federal/legis/testimon/1999/latx0325.htm

* ANA health and safety column published bimonthly as of January 1999 in the American Journal of Nursing

* Independent study video Natural Rubber Latex Allergy: Recognition, Treatment, and Prevention, 2.4 contact hours offered through the American Nurses Credentialing Center Commission on Accreditation. Video produced by ANA in conjunction with the University of Vermont and costs $149 plus shipping and handling. Order from The University of Vermont, Latex Video, 30 South Park Drive, Colchester, VT, 05446-2501; (800) 639-3188 (phone).

Outside resources

* OSHA (Occupational Safety and Health Administration) website: http://www.osha.gov/

* NIOSH (National Institute of Occupational Safety and Health) website: www.cdc.gov/niosh/homepage.html