AIDS during the 80s

[Irish_Mist]

We are studying lymphatics and immunity in my anatomy and physiology 2. For extra credit, we watched a movie called "And the Band Played On". It was about the AIDS epidemic and the doctors from the CDC as well as the French scientists and doctors trying to figure out what was killing gay men, hemophiliacs, and others.

I learned about things like bath houses, the retrovirus topic, patient zero. Forgive me for sounding a bit "sheltered". I just never knew about the bath house topic but then again, I was born in 1988. :)

My mom was a restaurant manager at the time and even lost some of her employees/dear friends to AIDS. It truly was saddening to read about how these people lost their lives and how initially no one knew why. Anyhow, I'm sure many of you were nurses in the 80's when AIDS was such a mysterious crisis. If you were a nurse in the 80's, please chime in. Being in the medical field, what was it like? Were you afraid of getting this mystery disease? I read that there were some healthcare workers who refused to care for anyone with "gay cancer". Watching this movie got me thinking. It was fascinating to research AIDS from a cultural and scientific perspective. Things definitely have shifted in a different direction.

[enuf_already]

I was in nursing school in the late 70s when we were taught that you did not wear gloves, even to change a colostomy bag, because it might convey to the patient that you thought this was "dirty."

The AIDS epidemic, as others have mentioned, changed everything. It was a death sentence to what was usually a young person in the prime of his or her life. AIDS did not care about the color of your skin, your age, your religion, your social status, or your sexual preference. There was no cure and until we really figured out what this killer was, there was no drug cocktail to slow it down. Fear bred ignorance and intolerance.

I cared for a fair number of full blown AIDS patients and probably many more that were HIV+ or died secretly taking AIDS to the grave with them. Their backgrounds were varied. Several were gay men. One in particular had lost his partner to this same killer and he knew his fate as he had cared for his partner at home until he died. Another man had contracted the virus from prostitutes while in the service overseas. Several cases were traced to suspected IV drug abuse and needle sharing. I witnessed several colleagues shed tears and live life in fear after sustaining a needle stick from a patient with HIV.

AIDS affected universal precautions, screening for blood donation (and guidelines for transfusions) and HIV screening before certain medical procedures. We now have education about the risks of unprotected sex, needle sharing risks for IV drug abusers, and new safety equipment to reduce needle sticks.

It has taken a long time to come this far and I believe we have learned a lot, but given similar circumstances today, would we react differently?

Hopefully we will never have to endure another killer, such as AIDS, to find out.

[Jory, MSN, APRN, CNM]

I still remember the first time I heard of AIDS and I also remember a member of the CDC getting on national television and saying that women could not contract HIV, but only be carriers. Now we know that is not true.

Needlesticks were considered to be a hazard of nursing and then many nurses were fearful...thinking about how many times they had been stuck or cut over the years and in direct contact with blood...infection control was washing your hands. Gloves were always available, but a "tough" nurse, rarely used them.

It is laughable that anyone of any intellect could ever think that it was a "gay" disease. A virus doesn't know your gender or who your sexual preferences are. I remember the blood banks fighting tooth and nail because they didn't think it was necessary to test the entire blood supply for Hep C...before a test for HIV came out, because a HIV and Hep C tended to be paired together and it was the closest thing to a test we had.

I think the turning point was when Princess Diana visited an orphanage and picked up a baby that was infected with AIDS. Her minders asked her not to pick the child up, but she did it anyway...strongly feeling she was in no danger. She was correct.

When people saw that and it made the national news and more evidence came out on how hard HIV was to contract, some of the stigma was lifted. Many people still associated AIDS with homosexuality, but the truth is, everyone can be put at risk.

[Ruby Vee, BSN]

I was a nurse in 1983, when we saw our first AIDS patient in the MICU. No where in his chart did it specify how he contracted the disease, nor was there any documentation of his sexual orientation. Nevertheless, several "born again" nurses refused to care for the man because they "knew he was gay and therefore immoral." This gentleman was a very nice man, and I was ashamed at the way some of my colleagues treated him.

The SECOND AIDS patient I encountered was not so nice. He was constantly spitting at people, declaring that he was trying to infect as many caregivers as possible. At one point he chewed through his arterial line and sprayed blood at anyone who approached him. No ONE wanted to take care of him, no one. And who could blame them? We actually kept track of who had been "Stuck with him" most recently, and rotated his care. He would complain that he never had the same nurse two days in a row and he was sure that people were discriminating against him because of his disease. While our staff was obviously not above such a thing, that clearly wasn't the case. We were avoiding him because he was nasty and mean.

My best friend, who was the best IV stick I've ever met, before or since, stuck herself with a dirty needle from an AIDs patient, before there was any sort of protocol for prophylaxis. (Due, no doubt, to the antics of the above patient. It was his needle.) She was sure she was going to die and no one could reassure her because we really didn't KNOW.

[annie.rn]

I was only born in the 80s, so I basically have no personal knowledge of the AIDS epidemic. However, sadly, there are still nurses out there who don't understand universal precautions, and I'm talking nurses who went to school after they were created. A nurse who used to work with me was assigned to a surgery; the patient happened to be HIV+. So how does she get ready to go out and interview him? She puts on a space suit that we use for total joint surgeries (and this was most definitely not a total joint-they are done elsewhere), knee high waterproof shoe/leg covers, and several layers of gloves. I cannot even imagine how that patient felt when she arrived in his room. What's even sadder is that she was never called on it by management- no write up, no further education.

That is so awful. I can't even imagine how that patient must have felt.

This has been a wonderful discussion and I have found myself feeling very emotional while reading all the responses .

I started nursing school in 1990. I worked as a CNA in a nursing home during this time. Like other posters have said, there was no such thing as PPE except for the one box of gloves locked up in the nurse's med. room which were not given to ANYBODY. There were no disposable wipes...we used washcloths and soap and water. And we had to rinse out the soiled sheets in "the hopper"... a giant laundry sink w/ a high power sprayer. Needless to say, there was frequently spray back. The older nurses and CNAs did not seem to worry in the least about HIV or Hepatitis or any germs for that matter.

The following summer I worked at the VA where we did see an occasional HIV positive patient. There was an air of fear surrounding caring for them but I don't remember anyone going overboard with the PPE. Now that I think about it, that was probably the least judgmental workplace I've ever been in. I do remember one HIV positive pt. that was a spitter and a biter. He would threaten to bite for the sole purpose of "giving you HIV". The CNA's I worked with were so great. They wouldn't let me care for him because in their words, "You're young and have your whole life ahead of you. I'm old. I'll take care of him." Of course I would have taken care of him if not for being banned from doing so.

A few years later while in the military I won't forget having an HIV positive patient and one of the nurses being so ignorant and making many inappropriate comments in an open bay ICU where the patient could hear. When this nurse would care for said pt., he would triple glove, gown and mask....no matter the task. I pulled him aside after that stunt and had a little chat about pt. sensitivity.

That makes me remember something interesting. In the military at the time, (maybe it's still the same) we were required to be tested for HIV every year. This was before "don't ask don't tell" so if someone came up positive there was a huge stigma attached since being HIV and homosexuality went hand in hand in most people's minds. The service member had to disclose sexual partners so that their partners could be tested. If they had same sex partners, they were discharged. There were ways around this (lying, anonymously disclosing partners) but rarely would a homosexual and HIV positive person be allowed to remain in the military. Those that were not forcibly discharged were followed closely. They were sent once a year for a check up at large military medical center and were limited on where they could be assigned and they were non-deployable. They got the latest medications and rarely did we see them on the inpatient side of things.

I can remember the huge fear after an exposure. My mother was stuck by a needle of an HIV positive patient when I was in middle school (mid-80's) and we were all terrified she would get HIV and develop AIDS and die. As others have said, HIV was considered unsurvivable in the long term in that era.

I have a disease that has a stigma attached and I know how it feels going to the doctor and wondering what they are thinking of me. I tend to go overboard w/ friendliness and "acting normal" for fear of judgement. It literally makes me cry when I think about being in the shoes of those HIV positive people (especially homosexuals b/c of the stigma of homosexuality even WITHOUT being HIV positive) in the earlier days of HIV. Especially partners not being allowed in to visit w/ their loved one.

I can remember when being told in report that a patient was HIV positive that it was a HUGE thing. Now, it's mentioned as one small piece of the pt.'s hx. Unless, of course, that is why they are in the hospital.

To the OP, thank you for the incredible, thought provoking post. I have enjoyed reading the responses greatly. Especially from the nurses working in the 1980's. To those nurses, thank you for caring for those pt.s w/ respect and for playing a small part in maintaining their dignity.

[uRNmyway, ASN, RN]

Sadly, the hysteria isn't over. I recently had a talk with a co-worker who was upset when the HIV + status of a patient wasn't disclosed to him. My response?

'I didn't tell you because it doesn't matter. You're supposed to use standard precautions for everyone, regardless of their HIV status.'

He looked at me like I had grown a second head.

I then followed up with 'For all you know, and for all THEY know, half the patients on this floor could be HIV +. So just be safe with all of them.'

On the other hand, my nursing instructors were lovely ladies who started their nursing careers before standard precautions. We were to wear the appropriate PPE for contact with body fluids, but other than that, they insisted it was demeaning to the patient to wear gloves for any and all contact. And I completely agree with them. I'm one of the few who does this, and always get weird looks. Oh well.

[Ruby Vee, BSN]

Some time in the late 80s, Wisconsin was considering legislation that would make it compulsory for health care workers to disclose their HIV status to patients. At the same time, the patient's HIV status was protected information, and unless it was necessary to their treatment, we weren't allowed to know if they were HIV positive or not. Given that, unless the health care worker is actually TRYING to infect patients (this was about the same time as that dentist in Florida deliberately infected something like 27 patients), a health care worker is FAR more likely to contract HIV from a patient than the other way around, I thought the legislation was nuts. My father and most of my relatives insisted that patients had a right to know the HIV status of their health care workers. It made for some tense holiday meals!

[Irish_Mist, BSN, RN]

Some time in the late 80s, Wisconsin was considering legislation that would make it compulsory for health care workers to disclose their HIV status to patients. At the same time, the patient's HIV status was protected information, and unless it was necessary to their treatment, we weren't allowed to know if they were HIV positive or not. Given that, unless the health care worker is actually TRYING to infect patients (this was about the same time as that dentist in Florida deliberately infected something like 27 patients), a health care worker is FAR more likely to contract HIV from a patient than the other way around, I thought the legislation was nuts. My father and most of my relatives insisted that patients had a right to know the HIV status of their health care workers. It made for some tense holiday meals!

I nearly passed out when I read this. After I re-read it, I regained my senses. If this were to happen today, this potential legislation would be challenged in federal court. People have the right to their privacy and that includes health care workers. People like that dentist are a definite minority in purposely infecting other people. Or so I would like to think....

On another note, it shocks me that people to this day are convinced that causal contact and sharing a bathroom can cause AIDS.

[yajaira21]

I was a nurse in 1983, when we saw our first AIDS patient in the MICU. No where in his chart did it specify how he contracted the disease, nor was there any documentation of his sexual orientation. Nevertheless, several "born again" nurses refused to care for the man because they "knew he was gay and therefore immoral." This gentleman was a very nice man, and I was ashamed at the way some of my colleagues treated him.

The SECOND AIDS patient I encountered was not so nice. He was constantly spitting at people, declaring that he was trying to infect as many caregivers as possible. At one point he chewed through his arterial line and sprayed blood at anyone who approached him. No ONE wanted to take care of him, no one. And who could blame them? We actually kept track of who had been "Stuck with him" most recently, and rotated his care. He would complain that he never had the same nurse two days in a row and he was sure that people were discriminating against him because of his disease. While our staff was obviously not above such a thing, that clearly wasn't the case. We were avoiding him because he was nasty and mean.

My best friend, who was the best IV stick I've ever met, before or since, stuck herself with a dirty needle from an AIDs patient, before there was any sort of protocol for prophylaxis. (Due, no doubt, to the antics of the above patient. It was his needle.) She was sure she was going to die and no one could reassure her because we really didn't KNOW.

So what happened? Did she get it?

[Ruby Vee, BSN]

So what happened? Did she get it?

No, she didn't get it. But now, thirty years later, she's being worked up for liver failure. Not sure what that's all about.

[lmrn13]

No, she didn't get it. But now, thirty years later, she's being worked up for liver failure. Not sure what that's all about.

Maybe Hep C??

[Ruby Vee, BSN]

Maybe Hep C??

Could be. I hope they figure it out soon!

[BluegrassRN]

We had a nurse the other day who seemed out of sorts that her admit had HIV. Everyone was a little incredulous that it was an issue for her, and there were several comments such as "This isn't the 80s, you don't need to be ignorant about taking care of an HIV pt," and "well, don't have unprotected sex with him and you'll be fine." Nice to see that even in small town Midwest, that attitude and level of ignorance isn't acceptable.