Clinic Rotation

DaFreak71 · Jan 19, 2007

I was inspired by your story because you recognized that despite your knowledge base, you still had fears about going to the HIV clinic. Instead of retreating into your comfort zone, you realized you needed to confront your fear head on and you did. Kudos to you!

Keep doing that....for the rest of your life.:blushkiss

Altra, BSN, RN · Jan 19, 2007

Kudos to you indeed ... :wink2:

Speaking in general terms, the indigent population often receives little primary care ... this clinic is a great place to learn, to get experience in the nuances of patient education, and to unfortunately see first-hand the consequences of out-of-control chronic conditions.

Josh L.Ac. · Jan 19, 2007

I had the privilege of working with HIV/AIDS patients during my master's degree in acupuncture. At first, I also was apprehensive about working with this patient population [we don't wear gloves when we perform acupuncture], so I traded shifts with other students. But finally I realized it would be a good experience and make me work through my bias - it wasn't against those with HIV, or GLBTG, but with low-income HIV patients that generally didn't take care of themselves while tax-payers foot the bill for their expensive drug protocols [another topic entirely].

It ended up being a great experience and I learned a great deal. In general, this patient population tends to really appreciate those that try to help them. My experience was with using acupuncture to help alleviate the side-effects of their meds, but in your case, it would be great to see if some of the nursing-care interventions can help do the same thing.

Congratulations on stepping out of your comfort zone.

jov · Jan 19, 2007

What were you feelings the first time you took care of a patient with HIV/AIDS?

My first patient with HIV/AIDS was a two year old. I was volunteering at a low-cost-almost-free community clinic outside of Nairobi. The mother's three year old had already died, and when we tested the rest of them, the mother and another child were also positive. We gave her info on the HIV clinic in Nairobi and encouraged her to have her husband tested. She came back the next day to tell us her husband told her he didn't have AIDS, that a positive test means she didn't have it either and he refused to get tested and refused to let her take the children to the government clinic. Our translator said the mother was lucky that her husband didn't beat her besides.

How did I feel? Grateful that my children and I live in the U.S.

Jules A, MSN · Jan 20, 2007

Good for you! I didn't really think much of it one way or the other. Sadly I had a very dear friend that I watched die from AIDS back in the early 80s when there weren't all the spiffy meds they have now.

Daytonite, BSN, RN · Jan 20, 2007

our first aids patient came to us when i was working on a stepdown unit. this was in the early 80s when aids was just beginning to be known and was primarily in the homosexual population. i was working is a quiet middle class suburban community hospital. the man was quite ill with, what i recall, histoplasmosis or taxoplasmosis in the gi track and sure didn't fit the profile of being a homosexual as he was married and had a very caring wife and daughter. we were giving him massive doses of iv bactrim which was new to us. we suspected something was very wrong, but no one was actually writing the words "hiv" or "aids" in his chart. this man ended up being placed on a clinical trial of a new investigative drug that did help him. at the time his family brought him food from home and the nursing staff was afraid to touch it and kept it isolated in it's own separate section of the refrigerator on the unit.

shortly after that, aids was out of the bag, ryan white and his family got burned out of their home, the nation was paranoid about aids and a lot of us were trying to put together what we had experienced with this patient. he wasn't a homosexual, at least not that we knew. and, no one had come out and said that he had aids, but it was clear from the infection and some of the other complicated infections that he also developed that he certainly had the disease. i used to wonder what the people back in the biblical times thought about being around people with leprosy. the sense of panic must have been the same.

i later was working, first as a staff nurse, and then as a unit manager in a large city hospital and teaching facility where aids patients and the indigent were pretty regular customers. it was a fascinating experience. i guess the worst is seeing young people, many in their early 20s, so very ill with infections that they can hardly move from their beds as they are literally dying because of the complications from aids. whatever they did to become infected with hiv, no one asks for the suffering when these infections come upon you. cancer patients whose immune systems have been wiped out by chemotherapy can go through the same agony and no one shuns them the way they do aids patients.

as for working with indigent people, i have to say that it certainly made me grateful for what i have. people are people. i've worked with indigent who were kind and those who were less than kind. our hospital had one social service worker for every single unit of the hospital because of the high volume of indigent patients we had. they have so many problems. nothing was more sad to me than seeing these people admitted and bringing with them a couple of large plastic bags--all their possessions in the world. and, i can't decide what junk of mine to keep and what to throw out! the security staff made very thorough rounds of the facility at night, especially during the winter months, because of the indigent they would find crouched behind doors of empty rooms just trying to be in a warm place for a night. the hospital had a clothing room with boxes of donated clothing sorted by size. any patient needing clothes upon discharge were given clothing from this room. the hospital auxiliary ladies made blankets, robes and slippers from donated fabrics. a supply of these was kept at every nurses station and given to any patient that asked for them or needed them.

i also want you to know that i have worked in two other hospitals where fabulously wealthy people were patients and had a few of them as my patients as well. if there is one lesson i have learned over my career and lifetime, it is that we are all people. take away the money and the circumstances and what you have left are human beings. some of us have had a good shake and some of us have not. i'm not going to debate the reasons or causes behind that, but just say this. . .i'm glad i'm alive and i feel that my career has given me the opportunity to give back to others whatever i have received. that's karmic, i think. and, i believe that i also received gifts from my indigent patients, as well as the candy and popcorn from other grateful patients, even though they may not be as easy to realize. gifts come in all shapes and sizes and are not necessarily measured in terms of dollar signs or the size of the box they come in. keep that in mind as you make your way through your career in nursing. you will find amazement around every corner and your mind will never age.

allnurses Guide · Jan 20, 2007

Back in the 80s when noone really knew anything, and we were all paranoid, I had a patient on reverse isolation in rm. 14, and an AIDS pt. in 13. Just when I'd gotten all dressed up, yellow gown, mask, gloves etc. for 14, 13's dinner tray showed up. I just grabbed it and went in so it wouldn't get cold during my extended time in 14. The AIDS pt, family and doctor all looked at me in shock, till I remembered I was all dressed up like I thought he'd spit on me or something! I yanked down the mask, and explained about the isolation and tray, but still felt like I'd insulted the poor guy. And no, I didn't dress up like that for 13's care later!