Back in 1989, while I was working as a hospital RN and caring for an AIDS patient who had just undergone surgery, I was accidentally stuck by a needle that had been used during the surgery. What followed was an emotional, frightening, and exhausting time, made worse by a distinct lack of preparedness.

The hospital where I worked had given me no training and had not communicated any formalized protocol for these incidents. I received an HIV test on the spot, as well as a tetanus shot, but I was counseled that the needle stick "was not high risk," so I shouldn't worry too much about it. Needless to say, none of these actions gave me any feeling of security.

I was not offered AZT within the first hour of exposure, which, as I found out weeks later, was an aggressive protocol recommended by leaders in the field at that time. In fact, no one I spoke with at my facility even knew that this option existed.

Other questions remained unanswered during the ensuing six months - the time it took back then to ensure accurate HIV test results after exposure. Should I practice safe sex with my husband? Should I avoid getting pregnant? No good answers, no quality counseling. Crazy as it sounded, I began to wonder if my employers would take responsibility if I did end up HIV-positive as a result of this needle-stick. What would happen if we ended up in court? Would my employer's attorneys be investigating my background and my husband's background for any evidence that we had been involved in high-risk activities?

In the end, I was not HIV positive. But the experience was more traumatic than it needed to be because of the lack of foresight on behalf of my employer and myself. My facility should have had a better system in place. But it was my responsibility as well, I realize now, to demand that the protocols be there.

Things have changed significantly since 1989. OSHA now requires health care organizations to develop protocols for bloodborne exposure and review them annually (see OSHA Bloodborne Pathogens Standard Policy 29CFR1910.1030). Many states are also passing needlestick safety laws. But if you don't know exactly what to do in the event of a needlestick, you need to take steps to protect yourself and find out what your facility's bloodborne pathogen exposure protocols are. Your facility does bear the majority of the responsibility for informing you of the protocols and following up with actions in the event of exposure. But it is also your personal responsibility to make sure you are informed in advance.

Take steps to protect yourself. Because when the worst happens, it just might be too late to make informed decisions.

Josephine Raggett works in public health in the metropolitan Washington, DC area.