KHOPOTSO: Dr Candice Bodkin, a former lecturer in the Department of Nursing Education at Wits University, is one of the two authors of the book. The inspiration came from her own experience as a nurse at Johannesburg General Hospital.

Dr CANDICE BODKIN: I worked in ante-natal clinic and I found that about 30-odd percent of my patients were HIV-positive. And I had a lot of difficulties as a nurse to manage my patients. There were no guidelines. Some were on antiretrovirals, some weren’€™t, some had TB. I found that they had opportunistic infections and it was difficult to manage.          

KHOPOTSO: Bodkin says the book was necessary because nurses are often the first people HIV-positive people have contact with when accessing healthcare.

Dr CANDICE BODKIN: A nurse needs to be able to identify: is this person HIV-positive or not; does this person have any opportunistic infection or not; does this patient need HIV counselling. So s/he needs to make those kinds of decisions very early with the patient and then decide when to refer’€¦ And that’€™s what we’€™ve tried to help with the book. It’€™s a small book. It’€™s hopefully very easy to read. It’€™s in a vinyl cover; it can stay in your pocket. So, when you’€™re sitting in front of a patient in the primary healthcare setting, and you’€™re not sure what to do, take the book out and have a look. Certainly, nurses carry a huge burden on the early identification. Not only the early identification – but the follow-up management of the patient.        

KHOPOTSO: Recognising the fact that many nurses know little about HIV and AIDS, the book begins with a dummy guide of what HIV is and how can a person contract the infection, then delves into the clinical aspects of managing patients.

Dr CANDICE BODKIN: They know the basic fundamentals, but when it comes to the more in-depth clinical management they are struggling. They don’€™t know their drugs, they don’€™t know all the drug interactions, how to manage the patients on a particular drug, particular issues related to confidentially, disclosure, all the different conditions that HIV patients present with. It creates a lot of difficulty. And when they don’€™t have knowledge it creates stress and anxiety in the workplace and lack of job satisfaction’€¦ The knowledge is really inadequate.        

KHOPOTSO: She explains what is at the heart of this lack of knowledge.

Dr CANDICE BODKIN: HIV has been incorporated into the curriculum, but only recently. And certainly, all the universities and colleges are trying to train HIV. However, we’€™re faced with a problem that many nurses were trained before the introduction of antiretroviral therapy. They don’€™t know how to manage patients on antiretroviral therapy’€¦ So, the book not only helps nurses that were trained prior to the introduction of antiretroviral therapy, but also helps in the training of current nurses who are currently being trained in nursing colleges and universities.    

KHOPOTSO: The book points out that health facilities are potential risk areas as patients whose immune systems are weakened by HIV are most likely to pick up diseases from hospitals. The authors outline what measures nurses should take to protect their patients with HIV from illness that can be avoided. It also seeks to address any prejudicial attitudes from nurses towards treating patients with HIV        

Dr CANDICE BODKIN: Some nurses are resistant. But other nurses are trained from the beginning to accept their patients and not to judge their patients’€¦ If there was resistance it would be more from the workload, the lack of knowledge, the fear related to HIV more than anything else. Certainly, when we have foreigners coming into South Africa, they are far more fearful’€¦ of HIV than what our local nurses are. Probably because we may be a bit more desensitised, we see a lot of it, we’€™ve all had a needle-stick injury, we’€™ve all done it before. So, we’€™re not as fearful as what a foreigner would be, for instance.

KHOPOTSO: The ‘€œPocket Guide for HIV and AIDS Nursing Care’€ is published by Juta Publishers and will be available in academic bookstores before the end of November.