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AIDS Nursing Care Summit was the sort of coming-together experience that we should promote
President’sMessage:THEHIV/AIDS NURSINGCARESUMMIT-A MODELFORTHEAAN
T
he HIV/AIDS Nursing Care Summit, hosted by the American Academy of Nursing last January, can serve as a model for what we, as nursing’s think tank, should be about in the future. In this AAN News section, William Holzemer summarizes the conference. I want to applaud his leadership efforts and those of the other members of the AAN’s Expert Panel on HIV/AIDS, as well as those of Director Jan Heinrich, in orchestrating this important event, but I also want to analyze the elements that bear repeating in other endeavors. Fellows have long wondered whether the Academy was fully realizing its promise. It has never been clear, however, just how we might go about achieving our preferred future, even in the kinds of conferences that we sponsor. I think that the HIV/AIDS Nursing Care Summit wove together a number of elements that might serve as defining characteristics of the sort of coming-together experiences that we should promote. First, the subject matter was vitally important, for HIV/ AIDS is pandemic. It touches all continents and exists on the interface between health care systems and social welfare systems. To address the needs of the affected person requires a knowledge of the behavioral and the biological sciences. Nursing’s metatheory is concerned with how the nurse can optimize health in the person embedded in a complex environment, and HIV/AIDS requires consideration of all the interrelationships among these four key concepts. The sessions made clear just how multifaceted the subject is by considering a range of topics from the global perspective and medical advances, to how co-morbidities (including poverty) shape care of people with HIV/ AIDS, to relevant legislation and possible resources, as well as the implications for health care reform. The nursing care summit was structured to be of concern to nurses with a range of functional responsibilities-clinicians, educators, ad.ministrators, policymakers. It acknowledged that care requires interdisciplinary collaboration; so speakers represented a range of relevant backgrounds, including consumers. In keeping with the Academy’s emphasis on scholarship, the registration packets contained NURS OUTLOOK 1994;42:135-40. Copyright o 1994 by Mosby-Year Book, 0029-6554/94/$3.00 + 0 35/l/55916 NURSING OUTLOOK
MAY/JUNE
Inc.
1994
Angela Barron McBride, PhD, RN, FAAN
copies of key documents on which the conference built (see references for a partial listing of such efforts at synthesis). In keeping with the Academy’s commitment to working with other organizations, the conference was cosponsored with HRSA agencies (AIDS Education and Training Center, Bureau of Primary Health Care, Division of Nursing and Division of HIV Services), NIH (National Institute for Nursing Research and Office of AIDS Research), other nursing organizations (American Nurses Association, As-
The HIV/AIDS Nursing Care Summit was the sort of coming-together experience that we should promote. sociation of Nurses in AIDS Care and Oncology Nursing Society), health-related companies (Burroughs Wellcome Co. and Stadtlanders Pharmacy), and the Agency for Health Care Policy and Research. To reach a still broader audience, the conference proceedings will be published as soon as possible. I would like to think that one of the defining characteristics of an Academy event is the extent to which the topic at hand is discussed in such a way that the central issues of the day can surface. They did at this conference. HIV/ AANNews
135
$b’
,* s,_ __-_
AIDS was discussed as a test for the adequacy of current moves to achieve health care reform. Many theoretical issues (e.g., understanding the disease trajectory, customizing nursing therapeutics), streams of research (e.g., caregiver burnout, symptom management), and policy matters (e.g., polypharmacy, ventilation to prevent the spread of TB) were applied to HIV/AIDS, but the discussions also underscored that these issues are matters that must be addressed even if one is not directly concerned with providing HIV/ AIDS care. There were several presenters who deserve to be recognized as models themselves. William Holzemer addressed whaa nurses have accomplished iri the last decade by listing a couple dozen pioneers, and thus made each nurse present feel a bit prouder as the roll call of accomplishments was read. Lorretta Sweet Jemmott elegantly demonstrated how existing models for behavior change (e.g., Theory of Reasoned Action, Social Cognition Theory) may be successfully used to frame new strategies targeting high-risk sexual behavior. Barbara Aranda-Naranjo reminded us that nurses can be either the barriers or the enhancers, and that they should not forget the patient’s perspective: “I am so much more than my T-cell counts.” KathleenCasey’s view of home care was energized by the fact that she surveyed clinical nurse specialists around the country for their opinions, then masterfully wove their comments into a series of challenges for the decade ahead. This summit was largely planned by the Academy’s Expert Panel on the Spectrum of HIV Infection and is thus a fine example of how our expert panels can serve the function of knowledge synthesis, dissemination, and utilization. That group is also taking responsibility for moving the
Building on the contributions of many pioneers in the first decade of HIV/AIDS, approximately 300 nurses involved in research, education, and practice gathered to discuss the state of the science and make recommenda
,_:, -_-
----
__._..-._-
-
-.__.
---.-.-
resulting recommendations for clinical practice, educatiann, research, administration, and policy forward, which means that the work of the conference can continue to build beyond the event itself. It is to be hoped that their work and that of other expert panels will take seriously a proud claim touched on over and over again at this summit, “We need to apply what we know.” There is so much that we as nurses know about delivering health care and maximizing quality of life, so we must rededicate ourselves to the task of putting that knowledge into practice-putting the system into our so-called health care system-. The HIV/ AIDS Nursing Care Summit was an important step in that direction. n
Agency for Health Care Policy and Research. Evaluationand management of early HIV infectlon(Clinie-al Practk Guideline No. 7) (AHCPR Publication No. 94-0572). Rockville, Maryland, AHCPR, 1994. Humphrey LC, ed. AIDS: An expanding tragedy. The final report of the National Commission on AIDS {abridged version). ‘Rcxkvilk; Maryland: CDC National AIDS Clearinghouse, 1993. National Center for Nursing Research. HIV infection; prevention and care. (NIH Publication No. 90-%+17).Bethesda, Mar&n& WCNR, 19%. National Institute of Mental Health. AIRS rese+rcb~ an NIGH blueprint for the second decade (NIH Publication No. 93~3563); Rockvllle, Maryland: NIMH, 1993. Phillips TP, Bloch D. eds. Nursing and the HIV epidemic: a national action agenda. Washington: US Department -of Health and Human Services, 1990. The Public Health Service. Strategic plan to combat HIV F AIDS in the United States. Washington: USDepartment of H&h 5nd HumanServices, 1993.
tions for a new and revised action care and nursing practice that is- reagenda to meet nursing care needs for sponsive to patient c-&e needs~ anticithe future. The specific objectives of pated during the seeor&: de-de of the the summit were (1) to examine the HEV/:A@S epidetici (41 te make recimpact of the first -decade of the HIV/ ommen&ions for acaderr&md conAIDS epidemic on patient care and tinuing education activities for nurses nursing in the Ifnited Statesi (2) to an caring for HIV/AIDS -patients &ring ticipate the impact of then second de- the d ci%.wdq and (S)q? e2Eaasine cade of the HIV/AIDS epidemic on pa- the ways in which know$edge’and ex tg fhe tient care and big practice; (3) to iwd in * our prioritize a ream agenda for patient HIV/A
T
he HIV/AIDS Nursing Care Summit, hosted by the American Academy of Nursing last January, can serve as a model for what we, as nursing’s think tank, should be about in the future. In this AAN News section, William Holzemer summarizes the conference. I want to applaud his leadership efforts and those of the other members of the AAN’s Expert Panel on HIV/AIDS, as well as those of Director Jan Heinrich, in orchestrating this important event, but I also want to analyze the elements that bear repeating in other endeavors. Fellows have long wondered whether the Academy was fully realizing its promise. It has never been clear, however, just how we might go about achieving our preferred future, even in the kinds of conferences that we sponsor. I think that the HIV/AIDS Nursing Care Summit wove together a number of elements that might serve as defining characteristics of the sort of coming-together experiences that we should promote. First, the subject matter was vitally important, for HIV/ AIDS is pandemic. It touches all continents and exists on the interface between health care systems and social welfare systems. To address the needs of the affected person requires a knowledge of the behavioral and the biological sciences. Nursing’s metatheory is concerned with how the nurse can optimize health in the person embedded in a complex environment, and HIV/AIDS requires consideration of all the interrelationships among these four key concepts. The sessions made clear just how multifaceted the subject is by considering a range of topics from the global perspective and medical advances, to how co-morbidities (including poverty) shape care of people with HIV/ AIDS, to relevant legislation and possible resources, as well as the implications for health care reform. The nursing care summit was structured to be of concern to nurses with a range of functional responsibilities-clinicians, educators, ad.ministrators, policymakers. It acknowledged that care requires interdisciplinary collaboration; so speakers represented a range of relevant backgrounds, including consumers. In keeping with the Academy’s emphasis on scholarship, the registration packets contained NURS OUTLOOK 1994;42:135-40. Copyright o 1994 by Mosby-Year Book, 0029-6554/94/$3.00 + 0 35/l/55916 NURSING OUTLOOK
MAY/JUNE
Inc.
1994
Angela Barron McBride, PhD, RN, FAAN
copies of key documents on which the conference built (see references for a partial listing of such efforts at synthesis). In keeping with the Academy’s commitment to working with other organizations, the conference was cosponsored with HRSA agencies (AIDS Education and Training Center, Bureau of Primary Health Care, Division of Nursing and Division of HIV Services), NIH (National Institute for Nursing Research and Office of AIDS Research), other nursing organizations (American Nurses Association, As-
The HIV/AIDS Nursing Care Summit was the sort of coming-together experience that we should promote. sociation of Nurses in AIDS Care and Oncology Nursing Society), health-related companies (Burroughs Wellcome Co. and Stadtlanders Pharmacy), and the Agency for Health Care Policy and Research. To reach a still broader audience, the conference proceedings will be published as soon as possible. I would like to think that one of the defining characteristics of an Academy event is the extent to which the topic at hand is discussed in such a way that the central issues of the day can surface. They did at this conference. HIV/ AANNews
135
$b’
,* s,_ __-_
AIDS was discussed as a test for the adequacy of current moves to achieve health care reform. Many theoretical issues (e.g., understanding the disease trajectory, customizing nursing therapeutics), streams of research (e.g., caregiver burnout, symptom management), and policy matters (e.g., polypharmacy, ventilation to prevent the spread of TB) were applied to HIV/AIDS, but the discussions also underscored that these issues are matters that must be addressed even if one is not directly concerned with providing HIV/ AIDS care. There were several presenters who deserve to be recognized as models themselves. William Holzemer addressed whaa nurses have accomplished iri the last decade by listing a couple dozen pioneers, and thus made each nurse present feel a bit prouder as the roll call of accomplishments was read. Lorretta Sweet Jemmott elegantly demonstrated how existing models for behavior change (e.g., Theory of Reasoned Action, Social Cognition Theory) may be successfully used to frame new strategies targeting high-risk sexual behavior. Barbara Aranda-Naranjo reminded us that nurses can be either the barriers or the enhancers, and that they should not forget the patient’s perspective: “I am so much more than my T-cell counts.” KathleenCasey’s view of home care was energized by the fact that she surveyed clinical nurse specialists around the country for their opinions, then masterfully wove their comments into a series of challenges for the decade ahead. This summit was largely planned by the Academy’s Expert Panel on the Spectrum of HIV Infection and is thus a fine example of how our expert panels can serve the function of knowledge synthesis, dissemination, and utilization. That group is also taking responsibility for moving the
Building on the contributions of many pioneers in the first decade of HIV/AIDS, approximately 300 nurses involved in research, education, and practice gathered to discuss the state of the science and make recommenda
,_:, -_-
----
__._..-._-
-
-.__.
---.-.-
resulting recommendations for clinical practice, educatiann, research, administration, and policy forward, which means that the work of the conference can continue to build beyond the event itself. It is to be hoped that their work and that of other expert panels will take seriously a proud claim touched on over and over again at this summit, “We need to apply what we know.” There is so much that we as nurses know about delivering health care and maximizing quality of life, so we must rededicate ourselves to the task of putting that knowledge into practice-putting the system into our so-called health care system-. The HIV/ AIDS Nursing Care Summit was an important step in that direction. n
Agency for Health Care Policy and Research. Evaluationand management of early HIV infectlon(Clinie-al Practk Guideline No. 7) (AHCPR Publication No. 94-0572). Rockville, Maryland, AHCPR, 1994. Humphrey LC, ed. AIDS: An expanding tragedy. The final report of the National Commission on AIDS {abridged version). ‘Rcxkvilk; Maryland: CDC National AIDS Clearinghouse, 1993. National Center for Nursing Research. HIV infection; prevention and care. (NIH Publication No. 90-%+17).Bethesda, Mar&n& WCNR, 19%. National Institute of Mental Health. AIRS rese+rcb~ an NIGH blueprint for the second decade (NIH Publication No. 93~3563); Rockvllle, Maryland: NIMH, 1993. Phillips TP, Bloch D. eds. Nursing and the HIV epidemic: a national action agenda. Washington: US Department -of Health and Human Services, 1990. The Public Health Service. Strategic plan to combat HIV F AIDS in the United States. Washington: USDepartment of H&h 5nd HumanServices, 1993.
tions for a new and revised action care and nursing practice that is- reagenda to meet nursing care needs for sponsive to patient c-&e needs~ anticithe future. The specific objectives of pated during the seeor&: de-de of the the summit were (1) to examine the HEV/:A@S epidetici (41 te make recimpact of the first -decade of the HIV/ ommen&ions for acaderr&md conAIDS epidemic on patient care and tinuing education activities for nurses nursing in the Ifnited Statesi (2) to an caring for HIV/AIDS -patients &ring ticipate the impact of then second de- the d ci%.wdq and (S)q? e2Eaasine cade of the HIV/AIDS epidemic on pa- the ways in which know$edge’and ex tg fhe tient care and big practice; (3) to iwd in * our prioritize a ream agenda for patient HIV/A