The HIV-Positive Nurse—Implications for Clinical Practice

Abstract

The HIV Positive Nurses Committee has been an established committee within the Association of Nurses in AIDS Care (ANAC) for nearly the organization’s entire history, providing support to the HIV-infected nurse. However, the first formal support system was set up by the American Nurses Association (ANA) in December 1993. The ANA produced from its then–HIV Task Force a manual titled “Peer Support for the HIV-Positive Nurse: A Guide for the Development of Programs and Materials.” Many members of this task force were also active ANAC members, including Barbara Russell, Allen Harris, and Barbara Aranda-Naranjo. The “ANA Task Force and Peer Support Manual” eventually evolved into the auspices of ANAC and the establishment of the HIV Positive Nurses Committee. The initial purpose of the Committee was to support HIV-positive nurses who were ANAC members. However, as the HIV/AIDS epidemic evolved, so did the function and scope of the HIV Positive Nurses Committee. For several years, ANAC’s outreach program was confined to those HIV-positive nurses who joined the annual conference and held a meeting and support group. However, the focus shifted in October 1999 when a letter to the editor was published in the American Journal of Nursing (AJN) about the HIV Positive Nurses Committee and its mission of outreach and support. The AJN letter was titled, “Aiding Nurses With AIDS.” The response was overwhelming. The Committee heard from HIV-positive nurses from around the world asking for information and support. Naturally, because most nurses are not AIDS nurses, most of the requests came from non-ANAC members. The scope of practice from the nurses making the inquiries was as diverse as nursing itself. At that juncture, the Committee decided to broaden its mission and outreach to all nurses living with HIV/AIDS regardless of their practice settings. The major concern expressed by all the nurses was surrounding the issue of ability to practice in their state and if any restrictions applied. The Committee took on this challenge and surveyed all 62 Boards of Nursing (BONs) that govern profession and practical/vocational nursing in the United States and its territories The results of the survey were both revealing and disturbing. Many boards hold the position that all nurses are expected to adhere to “universal precautions” and any nurse not doing so (regardless of his or her HIV status) can be held accountable. Pretty standard stuff. Others require HIV-positive nurses to report their status if they do “invasive procedures”—this, of course, is open to interpretation. However, what nurse does not perform invasive procedures? Some states require an “expert review panel” to judge if the nurse is competent to practice if living with HIV disease. The BONs’ rules and regulations ranged from silence on the issue to rather draconian measures. Therefore, which state a nurse holds an active license in will shape the issue of mandatory reporting of HIV status. The rules and regulations vary greatly and the Committee would strongly recommend that nurses contact their local BON to investigate any updates, and so forth. All the boards can be located on the Web at http://www.ncsbn.org/files/boards.asp.