National Conference Calls for Better AIDS Training in Nursing Schools

A national conference that drew together a broad cross section of the nursing profession called this week for major changes in the way nurses approach AIDS, including development of a model AIDS curriculum for every nursing school in the nation.

“There is no real standard yet for what nurses need to know about AIDS infection,” said Kristine Gebbie, secretary of health for the state of Washington and chairwoman of the federally sponsored conference.

“We want to see faculty beefed up and the content laid out so that we can say every nurse in this country is prepared,” Gebbie said.

The 95 participants at Wednesday’s meeting represented key nursing organizations from across the country. They were asked by the U.S. Public Health Service to develop a national strategy for nurses to deal with the AIDS epidemic.

Their recommendations do not have the force of law. Nevertheless, workshop participants--including representatives of the American Nurses Assn., the major professional organization for registered nurses, and the National League for Nursing, which accredits nursing schools--are expected to wield considerable influence.

“This report will go out to the profession as a whole,” said Gebbie, a nurse who served on former President Ronald Reagan’s AIDS panel. “We want to mobilize the profession. We expect everyone to go back to their boards with it.”

She said it is essential that nursing schools establish a model curriculum for AIDS, such as those established for other diseases and conditions. “For example, there is a standard set of stuff about newborn babies that every school in the country teaches,” Gebbie said. “You can’t graduate from any nursing school without learning this material. But there is no similar standard for what nurses need to know about HIV (human immunodeficiency virus) infection.”

Large cities that are centers of the epidemic already have developed such curricula in many of their schools, she said. But, “if you enrolled in a school of nursing in the middle of the country, where (AIDS) cases are lower, you might never see an AIDS-infected patient while you were a student and you might not have a faculty member who had ever cared for a patient with AIDS or HIV infection.”

Workshop participants recommended that nurses be included in AIDS policy-making at all levels, from hospitals to city, state and federal governments.

“Nurses have been at the heart of the response to this epidemic,” Gebbie said. “This is a disease that demands intensive nursing response. Also, nurses are out in the community where prevention happens. They are often turned to with questions.”

The report also urges that nurses be trained to “take AIDS risk into consideration when evaluating their patients,” even those they treat for conditions unrelated to AIDS.

“That means every nurse has to learn and understand how to talk about sexual activity and not be afraid to explore issues of drug abuse and homosexuality,” Gebbie said.

“For many of us in nursing school, if we spent five minutes on human sexuality, it was like getting an extracurricular course. It just wasn’t talked about,” she said. “We need to teach nurses about that. We have to become accustomed to treating patients who live in non-traditional families.”

In that context, nurses also must know how and where to refer patients at risk for HIV for counseling, testing and other AIDS services, she said.

Finally, the group recommended that more comprehensive research be conducted into how to care for patients who suffer from the range of ailments associated with AIDS.

“Nurses know a lot about how to care for someone with weight loss, or someone with severe diarrhea, or someone who has a body image disturbance, but not a case where you have all systems failing at once,” Gebbie said.

At the meeting’s end, Dr. James O. Mason, assistant secretary for health, honored 10 nurses, including one from Los Angeles, for their work with AIDS patients.

Among those who received the Public Health Service award for “selfless dedication, compassionate service and outstanding leadership in providing nursing care” to people with AIDS was Erna Ferraro, a patient case manager with the Los Angeles County-USC Medical Center.