World AIDS Day (Dec. 1) is an opportunity to renew our commitment to creating a generation without this dreaded disease. This year’s theme – Focus, Partner, Achieve: An AIDS-Free Generation – is a perfect rallying cry for a fight that, unfortunately, is not yet over. Just this week, the US Centers for Disease Control and Prevention released a study which found that more than 1 million Americans have HIV, nearly 50,000 more become infected every year, and in 2011, fewer than 3 in 10 had the disease under control.
So a renewed commitment is essential – and some of us find the strength for that commitment in the inspiration of heroes. With HIV/AIDS there is no shortage of such heroes, from patients and families to researchers, clinicians, advocacy groups and policymakers.
Inevitably, though, I think of my nursing colleagues. In the early 1980s, when the disease first emerged as a virulent and mysterious killer and I saw my first patient with HIV/AIDS – when we didn’t know how to ease the suffering, and the stigma associated with this “gay disease” was more cruelly overt than it is today – nurses often took center stage.
No place was this more true than in San Francisco. In 1983, the San Francisco Department of Public Health and UCSF created the first outpatient clinic devoted to caring for people with AIDS and, led by Cliff Morrison – a nurse and clinical faculty member at UCSF School of Nursing – the first inpatient AIDS unit in the nation at San Francisco General Hospital.
Absent any known treatment or cures, Morrison and his colleagues focused on relieving the physical and emotional suffering of early AIDS patients. Symptom management – a major clinical responsibility for nurses in any setting and a major pursuit of nurse scientists – was crucial.
Morrison and his team also understood that easing suffering meant helping patients overcome the stigma of HIV/AIDS. Their early realization led to research by nurse scientists and others that has leant understanding to stigma’s role in all disease.
Community health nurses and researchers were among the first to understand that AIDS affected other communities, such as injection drug users and sex workers. Developing community health interventions was an important factor in stemming the epidemic.
As discoveries emerged, nurse educators at UCSF and other schools adapted our curricula, developing patient education techniques that helped individuals and communities reduce the risks of contracting HIV and helped patients adhere to treatment regimens. Over the years, nurse educators here have helped create a virtual army of HIV/AIDS-trained practitioners for the Bay Area and the world.
That’s important, because as HIV/AIDS has become more chronic illness than death sentence, nurses often are the clinical leads with patients. We work with physician colleagues to develop realistic treatment plans tailored to the context of our patients’ entire lives. We point patients to community resources and help them understand it is possible to live full and rewarding lives while managing the illness.
So, today, as the HIV/AIDS community renews its commitment to this fight, I feel enormous pride in my profession. We are only one among many groups whose heroic efforts inspire us today, but our work demonstrates the very best in nursing and health care – not just the compassion and kindness with which we are often associated, but our complex and essential role in many aspects and on many levels of patient care.
Still, there is much left to do. Let’s draw our strength for the continued fight from our heroes.