Nursing During The HIV/AIDS Crisis

heron, ASN, RN · Jan 8, 2017

What was the query?

DoGoodThenGo · Jan 8, 2017

Sorry, left that out; have a tendency to go on....

Poster wanted to know what things were like during the HIV/AIDs crisis. Cannot recall exactly which thread and or what one posted. Recall only query was wanting to know how "things were back then".

Have nasty URTI atm so the mind is a bit groggy, but will try to find the post.

Jules A, MSN · Jan 8, 2017

This was a bit before my time but my elders described having an influx of young acutely psychotic patients with no clear psych diagnosis or history which later was found to be a HIV psychosis process. So very sad but thankfully things have changed, I only pray this is the course for other diseases that continue to rob us of our family and friends.

heron, ASN, RN · Jan 8, 2017

I was up to my ears in it from 1984 until 1998, first as a nurse in a university health service then as a charge nurse on a dedicated AIDS unit from 1987 thru 1998.

The best work I've ever done, with some of the most skilled colleagues I've ever had. My old unit has two panels in the AIDS quilt.

**LibraSunCNM, BSN, MSN, CNM** · Jan 8, 2017

I read the story about Ruth Coker Burks recently, what an amazing woman! Her stories of the countless parents who wanted nothing to do with their dying sons were so awful. I have so much respect for everyone who stepped up to the plate during the horrible AIDS crisis and cared for these men when no one else would.

I think I've mentioned it before but my aunt graduated from St. Vincent's school of nursing in the '60s and worked there for years. Her best friend from nursing school worked there her whole career. I myself got to do my psych rotation there right before it closed. It had its problems, but the closing of St. Vincent's still brings me to tears. It embodied true Christian values, caring for everyone regardless of background. I still don't understand why the church couldn't step in and help financially, but as an NYC institution it is sorely missed by many.

DoGoodThenGo · Jan 8, 2017

I read the story about Ruth Coker Burks recently, what an amazing woman! Her stories of the countless parents who wanted nothing to do with their dying sons were so awful. I have so much respect for everyone who stepped up to the plate during the horrible AIDS crisis and cared for these men when no one else would.
I think I've mentioned it before but my aunt graduated from St. Vincent's school of nursing in the '60s and worked there for years. Her best friend from nursing school worked there her whole career. I myself got to do my psych rotation there right before it closed. It had its problems, but the closing of St. Vincent's still brings me to tears. It embodied true Christian values, caring for everyone regardless of background. I still don't understand why the church couldn't step in and help financially, but as an NYC institution it is sorely missed by many.

At the time the New York Archdiocese (IIRC) claimed it didn't have the money to save Saint Vincent's. Cardinal Dolan got the money to restore or whatever for Saint Patrick's Cathederal, but that only cost around 200 million, Saint V's needed about one billion.

As to why Saint Vincent's closed people are still pointing fingers. Bottom line was the area/community outside was changing but the Sisters and hospital failed to realize this and make changes. The order clung to providing charity care even as it drove them into bankruptcy (again). Besides once they made that deal with the Rudin family fate of the hospital was sealed. Once St. V's declared bankruptcy again that family moved quickly to secure their stakes.

Greenwich and the West Village have changed as well. Neither are the working to middle class areas (with some higher income) that they were when the hospital was built and up until the 1990's or so. It is all *big* money down there now, with many of the gays like Lance Bass not even born or were very young when the AIDs crisis was going strong. Regardless of sexuality many of the new arrivals down there (and some of the long time residents like Susan Sarandon) felt Saint Vincent's was a dirty, old "paupers" hospital that they wouldn't set foot inside.

In any event some good did come out of the closing of Saint Vincent's. An AIDs memorial was recently unveiled/opened at the park across the street from former hospital.

How the gay community conquered AIDS and saved lives | Faith Matters | NJ.com

A Tribute to AIDS Victims - NY City Lens

‘Triangulating’ the past, present and future | The Villager Newspaper

The complicated relationship between NYC real estate and the AIDS crisis - Curbed NY

smf0903 · Jan 8, 2017

There is an interesting documentary on Amazon if you have access to it called "How to Survive a Plague" that discusses the interactions between the AIDS community, hospitals/facilities, the government and pharmaceutical companies, and grassroots groups such as ACT UP, all during the onset and peak of the AIDS crisis. It really was quite eye-opening and fascinating how some of the treatment protocols came about and how AIDS patients were treated (or not) by some facilities (the documentary centers mostly on the goings on in NY at the time).

Thanks for all of the links! I am always interested in reading more about this.

Edit: The "Faith Matters" link discusses the book/documentary. I guess I should have read the links first!! :)

AliNajaCat · Jan 8, 2017

https://allnurses.com/nurse-colleague-patient/aids-during-the-915983-page3.html

Here's a whole thread on this, with some very poignant stories.

I posted some of this on another thread last year.
I'm old enough that I worked ICU when the AIDS epidemic was just beginning, and I was in the San Francisco-Seattle axis where we had a lot of gay patients anyway. Remember, too, that the gay community was fabulously supportive of community in general, always turned out in large numbers for blood drives. A few years later I thought back to all the blood I had slopped around in from the Irwin Memorial Blood Bank in SF when I worked ICU-- think open heart surgery, GI bleeds, multitrauma...

We had a unit clerk who was a photographer and came home from a trip to NYC not feeling well, He never really got better, said his docs thought he had some sort of leukemia but they had no idea what it was. He died. I had many gay friends, and it seemed like every other one of them was sickening and dying and nobody knew why. Until we did.

Universal precautions came out. We knew how the disease was transmitted and how to avoid exposure. That was the easy part for me, but I couldn't understand why it was so hard to understand for so many others.

I must say that it was a time when I was not proud of a lot of my colleagues. I would take my patient assignment of some poor man with what was then a fatal pneumocystis pneumonia (thank god we have better treatment now) and soon a fearful face would peek around the door with the unspoken question: Would this nurse let me in to see my lover who is dying? So many wouldn't, would shoo them away saying, "Family only!" as if the patient would have any family members who would even acknowledge his existence; I never met one who did. It absolutely broke my heart. "Please come in," I would say. "I'm sure he'd be so happy to have you here. Would you like to help me bathe him?" "Can I?" "Of course you can, I'm sure he'd prefer you to me at this point!" The tenderness between these guys was indescribable. And we would all cry.

I had one experience, among so many, that was particularly heartbreaking. I was floated to a general surgery floor for a coupla summer days and for some reason we had a man with pulmonary failure on the "hot" side of the house, where the sun just baked the rooms all afternoon and no amount of air-conditioning would keep up with it. He wasn't my patient but I covered him when his nurse went to lunch, and his light went on. "Hey, Jen's at lunch. I'm GrnTea, what can I do for you?" He was lying in bed with the oxygen on, sweating and breathing with difficulty, and he said, "I'm just so hot. Can you help me?" So I got a basin of ice chips and alcohol (remember that? We did that before we had cooling blankets) and some washcloths and started to swab him down. And he started to cry. I stopped, startled, said, "What? What? Am I hurting you?" and he wept and wept and said (and this is where I start to cry now and every time I think of this story, thirty years later), "Nobody has touched me for three weeks." That poor man, in the hospital sick as a dog and knowing he was probably going to die very soon, and not one nurse had helped him bathe or eat or turn as he got weaker and weaker. It broke my heart.

The next day I went in and asked to care for him again. He had been found dead on the floor of his room, having taken off his oxygen to go to the bathroom, probably because he thought nobody would answer his light, and probably desaturated enough to pass out. And they didn't find him until change of shift because nobody looked in on him all night.

And this was at the hospital where universal precautions, now called standard precautions, began. Not everybody seemed to believe in them, though. I was engaged and learned not to tell my beloved about my day at work because he was so afraid I would be exposed and he would lose me. Later I was able to explain blood and body fluid precautions to him in a way he understood, but it was a tough sell.

I haven't seen the movie but I have the book by Randy Shilts, and was living in the Bay Area when he wrote it. He died. If you write a book about nursing in the AIDS epidemic years, I would like to read it.

heron, ASN, RN · Jan 9, 2017

https://allnurses.com/nurse-colleague-patient/aids-during-the-915983-page3.html
Here's a whole thread on this, with some very poignant stories.

Excellent thread - wish I hadn't missed it :shy:

Rocknurse, MSN, APRN, NP · Jan 9, 2017

There is an interesting documentary on Amazon if you have access to it called "How to Survive a Plague" that discusses the interactions between the AIDS community, hospitals/facilities, the government and pharmaceutical companies, and grassroots groups such as ACT UP, all during the onset and peak of the AIDS crisis. It really was quite eye-opening and fascinating how some of the treatment protocols came about and how AIDS patients were treated (or not) by some facilities (the documentary centers mostly on the goings on in NY at the time).
Thanks for all of the links! I am always interested in reading more about this.
Edit: The "Faith Matters" link discusses the book/documentary. I guess I should have read the links first!! :)

I saw that documentary recently and found it profoundly moving. I don't know how the gay community survived but obviously they took strength from banding together against enormous adversity and fear. I found it very inspiring and I think it should be mandatory viewing for anyone in healthcare. It's a good lesson in how not to project your own prejudice or let it interfere with your healthcare duties. Powerful stuff.

HouTx, BSN, MSN, EdD · Jan 9, 2017

Hindsight is always easier, isn't it. It's easy to condemn nurses & other clinicians who were frightened about dealing with HIV/AIDS "back in the day".... but remember, we were dealing with it before we even knew what caused it. We didn't know how it was transmitted. We had very real fears/concerns about exposing our family members to this ghastly (& 100% fatal at that time) disease. To put it in current terms - think EBOLA.

I recall patient care assignments only for 'volunteer' staff & having to wear 'spacesuit' protection. I recall providing support to family and SO's who couldn't find a funeral home willing to deal with the remains of their loved one. It was horrible and still brings tears to my eyes.

As our knowledge of the disease grew, we altered our practice accordingly. I honestly do not recall any overt discrimination based on any patient's sexual preference at that time... but I worked with many openly gay colleagues at a large academic medical center.