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The nightmare that won’t go away Living with AIDS - the challenge of the 90s recently as a decade ago, it was y believed that infectious dis ease was no longer much of a threat the developed world .... That s^ttered in the early by the advent of AIDS. Scientific American October 1988, Vol. 259, No.4 aids, the dreaded collection of ill nesses caused by the human immunode- ciency virus (HIV), may well be the "lost fiendish affliction of the 20tii cen tury. ft is estimated that over 90,000 people iqq^ the United States. By an estimated 300,000 people will pe diagnosed with AIDS. And in both ^tances, 99.9 percent will die, projects Suzy Fletcher. Fletcher, professor and chairperson of ® ^duate program in the School of . Indiana State University, vis- * ^ discuss the re- Ponsibilities and challenges that AIDS presents to today’s society. Acquired Immune Deficiency Syn- ome, as it is formally known, damages j ® ^y’s ability to fight off disease and Caves it open to attack from unusual ypes of cancer and ordinarily innocuous ^ections. It is a serious malfunction of ® body’s immune system. HiV is known to be transmitted by . ,®^ted semen and blood. This includes ^fiction of infected blood or blood pro- '^cts througji the sharing of unsterilized hypodermic needles, or the transfusing of contaminated blood and blood products to hemophiliacs and other blood recipi ents. Perinatal transmission (infected motiier to fetus), or transmission firom mother to nursing baby also occurs. It is not clear whether AIDS can be transmit ted throu^ bodily excretions such as excrement and urine. Fletcher pointed out that it is impor tant to realize that HIV infection does not always cause AIDS. The consequences of infection can be mild, severe, or some where in between, with AIDS being the most severe manifestation. The major ity of people infected with HIV do not develop symptoms or come down with AIDS. These people remain asymptom atic. Others have developed the milder, not usually fatal illness called AIDS-Re lated Complex (ARC). Battling Ignorance Education is essential to understand ing and preventing AIDS, Fletcher said. "Do not practice risky behavior," she urged. S^e sex, including the use of condoms and spermicides, and absti nence firom drugs and alcohol in poten tially intimate situations is crucial. "Drinking too much alcohol can cause you to have sex with people you ordinarily wouldn’t even talk to!" she said. Education is also crucial to dispelling the myths about the transmission of AIDS. For instance, HIV, the virus caus ing AIDS, is much more fi^gile than cold or flu viruses. Heat, soap and water, household bleach solutions, and the chlo- Suzy Fletcher, RN, DNS, professor and chairperson of the graduate program in the School of Nursing at Indiana State University. rine used in swimming pools kill the HIV virus, according to “The Essential AIDS Fact Book” by Paul Harding Douglas and Laura Pinsky. Fear and ignorance about AIDS distort the facts and impede the development of appropriate and effective control mea sures. The United States Public Health Service states, "AIDS is a blood-borne or sexually transmitted disease that is not spread by casual contact." The Institute of Medicine, National Academy of Sci ences states that AIDS cannot be trans mitted through casual contact such as Speaker supports better nursing resources rses take care of patients, tient Va bedside of the pa- all nf tk ® T^hey coordinate ers rt » the health care work- assft° u Patient. They constantly P'^OQi’ess of the patient and and m t ‘Jse good judgment Datio *. ^®cislons in regard to the Pahenfs welfare. cat^Qh ^ *^3ve a strong advo- tornf r Maguire, direc- cai I if * services at the Medi cal South Carolina Medi- 'ted UNriiS Maguire vis- svmrx« • '■ecently to present a X th^t!f* * about my job is care ofopportunity to take f^ent provide an environ- Drofoeo- them to practice as ^ssionals, she said. ^•ay challenge we face to- What people’s perception of derstai^ Many people don’t fully un- nursAe I? heavy responsibility ^have for patient care." ™ing to Maguire, much of what nurses do is not physician driven. That is, there are many things that are initi ated by nurses that are not directed by physician’s orders. "Nurses need to be very intelligent and thoughtful," she said. Improvements in nurses’ working conditions are of primary importance to the profession. Maguire believes nurses need to be freed from trans porting patients, housekeeping, filling water pitchers, and making beds to do the things they were trained for. RNs have a lot of knowledge about the tcrtal patient and assessing patient needs, said Maguire. This knowledge needs to be put to good use. An increased demand in the supply of nurses has resulted in a nursing shortage, according to a 1987 report compiled by Ihe U.S. Secrela^ of Health and Human Sen/ices C^is R. Bowen, M.D. The report reveals that the shortage of RNs is contributing to the deterioration of RNs’ work environ ment. As a result, this may be having a negative impact on the quality of pa tient care and access to health ser vices. The report recommends that the nurses’ time and energy should go toward the direct care of patients. Health care organizations need to pro vide adequate staffing levels for clini cal and non-clinical support services. Labor-saving technologies, such as automated information systems, need to be implemented also. And innova tive staffing patterns need to be intro duced that recognize and appropriate ly use the different levels of education, competence, and experience among all nursing personnel. Salary compensation is another area of concern to nurses, according to Maguire. "Nurses need to be com pensated throughout their careers," she said. "At the most, a nurse can increase her salary during her career by 30 percent. Compare that to CPAs who have the potential to increase their salaries by 150 percent." A variety of career opportunities ex ist for nurses, said Maguire. They can work in hospitals, provide in-home care, work in hospices taking care of the terminally ill, or in case manage ment, following a patient’s progress tm sharing an office with someone, or shak ing hands with an AIDS patient. Further more, the virus does not "live" on drink ing fountains, toilet seats, or other inani mate objects. Additionally, there is no evidence that exchange of saliva transmits the virus, even in prolonged deep kissing. No cases of AIDS transmitted by kissing alone have been reported, according to Doug las and Pinsky. Challenges The issue of health care is an enor mous one in coping with the AIDS pan demic, Fletcher said. The costs of pro viding medical treatment and resources are prohibitive. "From the point of diag nosis to the point of death, care for the average AIDS patient comes to $50,000," said Leo Teachout, executive director of GROW/AIDS Resource Pro ject in Wilmington. "People need to real ize that the taxpayers end up paying for most of that." And limited resources such as doctors, clinics, insurance, transportation to medical care facilities, counselors, and support groups compound the problem. As difficult as it is to believe, Fletcher thinks there may be some good that results from the battie with AIDS. We’re developing good community models of caring that will help other "victims," she said, such as the poor, the disabled, the homeless, the unemployed, the sub stance abusers, and the mentally ill. Allison Relos Maureen Maguire, RN, MSN, director of patient care services at the Medical University of South Carolina Medical Center in Charleston. prior to admission through post dis charge. They can chose a speciality such as geriatric nursing or pediatric nursing or may even opt to become nursing entrepreneurs, owning their own businesses. Maguire highly recommends a ca reer as a nurse. 'This is a very exciting and valuable time to be in nursing," she said. "It is an extremely worthwhile profession... you never stop teaming. In nursing, you always have the ability to grow as a human being." Allison Relos
UNCW Today (University of North Carolina Wilmington Alumni Newsletter)
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June 1, 1989, edition 1
9
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