Practicum Journal Template

Access to human immunodeficiency virus (HIV) services is globally agreed upon and it has enabled the universal increase of antiretroviral therapy availability. However, for all people to benefit from these services, it is critical that one knows his or her HIV status. Another crucial component is with partner notification for HIV that counselors should do since it is an effective strategy for promoting early diagnosis, prevention of secondary transmission as well as prompting treatment of the sexual partners of the HIV patient (Kaplan, 2008).

• History of present illness

For my practices I encountered a 41 year old male who had been newly diagnosed with HIV +. Two weeks ago he started having a feeling of chronic fatigue, nausea, vomiting, fever, persistent diarrhea; night sweats, chills and has lesions and rashes on his genitals. He has been hiding these symptoms from his wife since he suspected to have the virus after a sexual encounter with a prostitute he met at the bar while drunk. He feared to have contracted HIV since he did not have protected sexual intercourse with her (Hamric, et al, 2014).

• Ethical dilemma

He informed me not to let his wife know about the diagnosis. I was faced with legal, ethical and also moral dilemma of respecting the autonomy and confidentiality of the patient and the need to protect the wife of the patient who is at risk of acquiring HIV infection. I had to consider various contextual factors and also combine a wide range o approaches while at the same time adopting the human rights perspective as provided for in HIV programmes. This helped me balance the interests of the patient’s partner (wife) and that of the patient which helped to enhances universal access to medical services of HIV (Huppert, 2015).

Education and Disclosure processes to the Maryland Board of nursing

Maryland Board of nursing provides a model based on Maryland law for Partner notification and HIV testing for the legislatures’ consideration. In Maryland when a HIV-positive patient does not want to notify his or her sexual partner or those they share needles with, the physician of the patients will be expected not to disclose the identity of the patient but they will have to inform the local health officer will inform the patient’s sexual partner. The statute requires physicians to act in good faith when making decision on whether to discourse the HIV status of their patients Maryland Board of Nursing. (2017)

References

Buppert, C. (2015). Resolving ethical dilemmas. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (479 - 487). Burlington, MA: Jones & Bartlett.

Hamric, A, Hanson, C, Tracy, M, & O’Grady, T (2014). Ethical decision making. In Advanced Practice Nursing: An Integrative Approach (5th ed.) (328 – 354). St. Louis, MO: Elsevier Saunders.

Kaplan, C. (2008). Ethical Dilemmas. Advance Healthcare Network.

Maryland Board of Nursing. (2017). Advanced Practice Registered Nursing: Nurse Practitioners.

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