Students reach out to AIDS patients

Keith recently dreamed of a royal dinner where he was the guest of honor, seated at a table with 100 people. "Everyone who meant something to me was there -- I could tell them thank you. I love you. I'm sorry," Keith said. Soon a stage rose and 100 choir members broke into song, and "Everyone at the table got up and let go," Keith said. "Initially they had been depressed, but now they let go." It is this dream -- and reality -- of isolation for AIDS patients such as Keith that has inspired a University program designed to teach future nurses how to reach out and break through their fear of the fatal disease. Keith was one of a handful of AIDS patients treated last week by University Nursing students at Graduate Hospital as part of a senior case study that teaches the students how to care for HIV-positive patients. Students say the experience is both difficult and rewarding, and every little step is a great achievement. "Some days you work so hard and don't make much progress," Nursing senior Sheila Rossell said. "It's frustrating." Associate Nursing Professor Ellen Baer designed the program last year after her brother died of Acquired Immune Deficiency Syndrome. She realized from personal experience that nurses who were educated about the disease were more successful in dealing with the patients. "Medicine is somewhat stuck and nurses do for patients those things they can't do for themselves," Baer said. "What people with AIDS need is a nurse." But one of the major obstacles in the treatment of AIDS patients, Baer said, is that some health care providers are afraid of the disease due to popular myths and lack of education. She said many people are nervous they will contract the deadly virus and are influenced by a nationwide stigma against AIDS patients. Baer designed the class to teach nurses how to provide hands-on care for AIDS victims. The course, first implemented last year, was expanded this year to include both adult and pediatric patients. Baer said she feels there is a need to educate future nurses about the ways to treat AIDS patients, especially since the number of victims is growing dramatically. The program is designed to make the students think, and the students said their feelings often extend beyond the hospital and classroom walls. Nursing senior Rossell added that it is difficult not to take the Friday clinical section of the class home for the weekend. "I go to the hospital at eight in the morning and feel down for the rest of the afternoon," Rossell said. "It can be very difficult." Last Friday, for example, Rossell changed the dressing protecting Keith's plastic intra-venous port which connects to an I.V. feeding tube. Although the tasks that Rossell and others perform would not normally be complicated, some nurses' fear of AIDS patients, coupled with patients' frustration with their inability to help themselves, makes even bathing difficult. Rossell, however, comforted Keith and reassured him that he was in control. It is this type of exchange that the program tries to foster. Nursing senior Diane Bocchinfuso works with "pedes" at the Children's Hosptial of Philadelphia and said the dual classroom-clinical setting of the case study is "really good." "I love it," Bocchinfuso said. "We're in the class to learn the theory and then when we get to CHOP we actually get to do it." Nevertheless, some students say working with terminally-ill children wears down even the most upbeat students. But each added that working with children has special rewards. Class members meet twice weekly, once in the clinical setting at either CHOP or Graduate Hospital, and again in the classroom setting at the University -- which allows students ample time to discuss their individual cases of the past week. Health care theories and related topics are also discussed in the classroom. "I think the class is wonderful -- we learn all about AIDS in both adults and pediatrics," Nursing senior Sherri Werner said. "This is so important because it is making us familiar with HIV infection and AIDS." Keith also saluted the program saying that a major failure of the national effort to curb AIDS is insensitivity and lack of education. "Programs like this should have been started long ago," Keith said. "The Church should be ashamed. [Society] should be embarrassed by their shame. They all say love thy neighbor -- well that's bullshit." Keith, who said he is gay, added he hopes student nurses who have taken the class will better educate others about the necessity of using contraceptive devices such as condoms. "All I can say as advice is 'Cover it up'. This is not a disease for just faggots and drug users," Keith said. Keith added that he has been to other hospitals which, unlike Graduate, did not have a floor designated to help HIV-infected patients, and said nurses were fearful to treat him. Barbara Lineham, an AIDS/HIV clinical nursing specialist at Graduate said she thinks this program should be started at every nursing school in the country since nurses who understand the disease care for the patients better. But Baer said the nature of dealing with AIDS patients is often frustrating, since while you are treating them you know that the disease is fatal. "The people are very young -- 20 to 40 years old, and we're not used to accepting that these people are going to die," Baer added. "What is really upsetting is the inevitablility of death." Baer also said the disease is unique since it forces nurses to go back to the basics, citing patients' need to be bathed and have their bandages changed. "It's almost the old fashioned way of treating patients," Baer said. "Many of their problems are the ones that nurses used to always deal with." Keith said his family and a caring nurse have helped him come to terms with the disease and added that his dream inspired him to prepare and arrange his imminent "festive" funeral. "I was thinking of having balloons . . . and a Dixieland band, like they do in New Orleans," Keith said. "But I've decided to have show tunes and start with Ethel Merman belting out There's No Business Like Show Business."

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