A SHARP SHOCK LEADS TO NEW LIFE’S PURPOSE
Nurse turned advocate after HIV jab
Curry College commencement speaker Karen Daley has been living with HIV for nearly as long as many of today’s graduates have been alive.
But the former Brigham and Women’s Hospital emergency nurse still has a crystal-clear memory of the fluke needle prick that changed her life forever.
“My first inclination was not to report it, not to be seen,” said Daley, now 64 and a Curry alum. “I thought it was likely a low-risk stick, so I didn’t want to come in during my days off for testing. I would have never guessed it would be more.”
It was late afternoon in July 1998, and the emergency room was frenetic with its standard midsummer crowd. Daley had just drawn blood from a patient, and with one swift motion she reached back to toss the instrument into a box already overflowing with needles. One pierced her finger. It was a deep jab, she could tell. She calmly watched the blood rush to the surface of her glove.
After all, it wasn’t her first needle injury. Daley, who was serving as president of the Massachusetts Nurses Association, had been working in the Brigham for 26 years. This was before needle covers in hospital settings were commonplace, and even before Massachusetts became the only state to require that these injuries be reported to the Department of Public Health — two efforts that Daley spearheaded when she reinvented herself from nurse to advocate.
“What I learned later was that it was a pretty preventable injury,” Daley said. “The box was overfilled, and we didn’t have a safety device.”
Five months after her injury, after she had suffered flu-like symptoms and lost 12 pounds, Daley found herself receiving test results she never thought she would have to hear.
‘They’re not negative,” the nurse practitioner said.
Daley had been tested for hepatitis C and HIV. Her labs would have to be redrawn. She had opted not to take the post-exposure prophylaxis that could have prevented infection. It didn’t make sense to endure the brutal side effects for what would likely amount to a minor fingertip wound.
But the initial results — “not negative” — gave way to a more devastating and definitive outcome.
When she walked into the office one day between Christmas and New Year’s Eve 1998, the infectious disease specialist, medical director and social worker greeted her.
“I can tell you I walked out of there unable to take in what they were saying to me,” Daley recalled earlier this week.
She shuffled to the elevator in a daze. As she waited for it to open, she had one clear thought: “I’m never going to work in the emergency room again.”
Daley could not bear the thought of entering the ER again, reliving her injury, routinely drawing blood after that single act had led to the onset of a still deadly illness. People were dying from HIV and AIDS, and even more people were dying from co-infections.
Daley knew she was at greater risk given her double diagnosis of HIV and hepatitis C.
“When I was first diagnosed, one of my nightmare fantasies was that I would fall, hit my head, start bleeding and not be able to warn someone,” she said.
So Daley shifted her focus. After she told close friends and family — she is one of seven siblings — Daley began researching needlestick injuries. She learned that, at the time, there were close to 600,000 each year in hospitals alone. Only about 15 percent of hospitals were making safer devices, like needle caps, available for workers.
Daley began grueling treatments as she launched her lobbying efforts. Her hair thinning and skin a pale gray, she helped pass the mandatory reporting legislation in Massachusetts in 1999. The Bay State sees about
3,000 needle injuries each year.
A year later, Daley testified before Congress in favor of a bill that would take needle safety measures from recommended to mandatory at health care facilities across the country. She was invited to the Oval Office to watch then-President Bill Clinton sign the “Needlestick Safety Prevention Act” into law on Nov. 6, 2000.
Daley’s mark in the HIV/ AIDS community has gone beyond policy.
“I think it is enormously courageous for someone like Karen and other people in the public eye who are HIV-infected to come out and reveal their status,” said Dr. Daniel Kuritzkes, principal investigator of the AIDS Clinical Trials Group Network and Chief of Infectious Diseases at the Brigham.
“It shows you can be a perfectly healthy person living with HIV infection and having an otherwise normal and productive life,” Kuritzkes said.
Ruth Ennis, Daley’s younger sister, was one of the first people Daley told after her diagnosis. Ennis said her sister never complained about giving up her passion.
“It was an amazing thing to see,” said Ennis, 56, of Charleston, S.C. “To this day she misses nursing. But she found another calling, which isn’t easy to do.”
It is that skill — the ability to make the best out of unexpected events — that Daley will seek to impart to Curry graduates today as the last lesson of their undergraduate careers.
“When life takes unpredictable turns, when things happen that don’t make sense and aren’t in your plans, it’s not about life being unfair,” Daley said. “It’s how you find meaning and purpose in spite of that. Through it.”