My nursing career started 30 years ago. Like most young graduates, I had big hopes, dreams, and ambitions for my future. Over time, I found myself working in different settings, including home health, geriatrics, and inpatient hospital nursing. Ultimately, I came to realize that many nurses are drawn to the work in certain areas because of the experiences we have had, places we have been, and people we have met.
One of those notable people in my life was Steve, a dear friend from 7th grade. Smart, funny, and free-spirited, Steve lit up every room he entered. He enjoyed singing and performing. He was 2 years older than me but we were very close and spent a lot of time together. After graduating high school, he joined the US Navy and was stationed in San Diego. Steve and I stayed in touch and talked several times a month, especially on the weekends when he was off base. We chatted about everything-he liked to know what the "old gang" was up to and always asked about my mother.
In one of our phone conversations in 1988, he told me that he was gay. We grew up in a small town where there were always rumors about him being gay, but he never confirmed it until then. He told me that he did not like the Navy and wanted to get out before his 2-year service time was up. As such, he told his superiors that he was gay and they upped his time and discharged him 6 months early. This was before the military's "Don't ask, Don't tell" policy.1 He then moved to Washington, D.C., with his partner who he met in the Navy.
In the Spring of 1991, I received another call from Steve, and he told me he had AIDS. I was shocked and very distressed. He said he was moving back to our hometown-which was hard for him. His father would not let him back in the house so he wound up staying with his older brother. I was in nursing school at that time, and my schedule was packed, but I always made time for him.
One day, I got a disturbing call from Steve's brother informing me that Steve was not doing very well. I went right over and found my friend with hemiplegia, laying on a mattress on the floor in his own feces. I arranged to get him to the hospital, the first of his many hospital admissions over the next nine months. He was diagnosed with toxoplasmosis, the most common central nervous system infection in patients with AIDS who are not receiving appropriate prophylaxis.2
I watched my once very active vibrant friend wither away. I spent a lot of time with him after class and on the weekends. I was especially interested in watching how the nursing staff cared for him. One afternoon, I overheard two nurses talking outside of his room. One nurse said, "He has AIDS... You know how he got that..." then snickered. I appeared in front of them and they immediately stopped talking and left.
Another time, I was sitting on his bed and playing UNO with him when a nurse-wearing a gown, gloves, face shield, and safety glasses-came in to ask him how he was feeling and if he needed anything. We were both shocked and a little scared. Steve asked her if there was some nuclear fallout we needed to know about. She did not laugh, took away his food tray, and threw the plastic utensils and paper plates in the trash can in the room.
Steve died in the summer of 1993. In high school, he was popular and had a lot of friends, but I was the only friend at his funeral. His family was there, but I felt the disconnect his family had with him during the brief service. I remember feeling a real sense of loneliness at his funeral.
After that experience, especially after losing a friend to AIDS and watching the way he was treated by people, particularly healthcare professionals, I felt a strong desire to work with patients with AIDS. I found a volunteer opportunity with the AIDS Community Alliance, where I worked as a "buddy" with a person with HIV.
I then became an HIV/AIDS educator at two drug and alcohol recovery houses for high-risk groups. I was surprised to find how little people knew about the subject. I later worked at a hospital clinic that specialized in HIV/AIDS care, where I managed this patient population on a daily basis. I spent a lot of time getting to know patients-their families, partners, kids, hobbies, hopes, and dreams. Patients shared stories of how difficult it was to disclose their HIV status to their loved ones-though many never disclosed their disease-as well as stories of HIV-related stigma, which still exists today. I have seen colleagues treat patients disrespectfully-even to the point of refusing to provide treatment for a patient with HIV. However, for the most part, I am fortunate to work with HIV specialists who are nonjudgmental, understanding, and compassionate, and to have witnessed our clinic grow and provide care for more at-risk groups.
Looking back to how my friend Steve was treated by the public, his family, and the medical community because of this condition, I am continuously inspired to make sure that patients with HIV/AIDS will always be treated with high-quality care, respect, and dignity.
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