HIV nursing in Poland
At the start of the HIV epidemic in the 1980s, Poland was experiencing severe economic and political crises, with martial law, food rationing, very poor supply of goods to shops, and a shortage of even the simplest cleaning items. Surprisingly, during those economically difficult years, as one HIV nurse recalls, medical staff caring for HIV patients always received the best possible equipment, and as much as was needed (much to the envy of colleagues from other specialties). The quality of gloves, bedclothes, and medical utensils designated for HIV patients was always the best. Paradoxically, due to current financial difficulties in the Polish healthcare system, this is no longer the case. Nurses now receive poor-quality equipment in comparison, and do not always feel completely protected while working.
The introduction of antiretroviral therapy (ART) has undoubtedly created a huge change for both patients living with HIV and medical staff. At present, treatment is completely free for any patient who fulfils medical and legal criteria. Post-exposure prophylaxis is also available, considerably reducing anxiety and increasing job security for doctors and nurses. So far, there has not been a single case of HIV in Poland caused by exposure in a healthcare setting.
Antiretroviral therapy gives patients better quality of life, and greater life expectancy. Patients begin to feel more secure about life, and visit the hospital more often for diagnosis or treatment. Over time, the relationship between nurses and patients develops and flourishes. As nurses observe patients’ health improvements, it makes their work easier from the psychological point of view. In the early days of the epidemic, the emotional load for nurses was much heavier when patients were passing away one by one. Nurses note now that their work brings them much more satisfaction.
The success of ART brings with it the need for long-term psychological support for the infected and their families. While the perception of HIV by healthcare professionals has changed greatly over the years–from fear to acceptance, or even viewing HIV as less contagious than, for example, hepatitis C–many myths, false beliefs and prejudices continue to flourish in general society. HIV-positive diagnoses still come as a shock for individuals and their families, and thus, there is a great need for reliable and level-headed HIV and AIDS education that is presented in a friendly environment, and in a caring way. In hospitals, this extra duty usually falls to already overstretched nurses and many do not feel sufficiently prepared to perform this task, as very little training is available. Recently, as part of its activities, the National AIDS Centre conducted 13 elementary-level workshops for 448 medical staff including nurses and midwives. Unfortunately, this was not sufficient to train all those who wished to take part. Updated guidelines for treating patients are also required.
In summary, Polish nurses who take care of HIV patients are very committed to their work and to helping their patients. However, they need more professional support, particularly in those aspects of the epidemic that are uniquely Polish.