Experiences of first-year student nurses nursing HIV and AIDS patients in the Umgungundlovu District

Abstract

Abstract

The HIV pandemic continues to intensify in most countries, especially in Sub­ Saharan Africa, with 1.8 million new people becoming infected with the disease in 2011. Sub- Saharan Africa is the world's worst HIV and AIDS affected region. The intensity of the AIDS pandemic in South Africa creates additional challenges for health workers. Apart from the fact that they could be infected, they have to deal with an increasing number of people who suffer from a fatal disease for which no cure has been found. Nurses are expected to give all the necessary care to these patients. The HIV and AIDS epidemic in South Africa poses challenges for an overburdened health care system. There is limited knowledge about health care perceptions and emotional experiences of providing HIV and AIDS related care and support. It is against this backdrop that the researcher has chosen to explore the experiences of first-year student nurses, caring for HIV and AIDS patients.

Aim of the study The purpose of the study was to explore the lived experiences of first-year student nurses, nursing HIV and AIDS patients.

Methodology A descriptive phenomenological research design was used to explore the experiences of first-year student nurses, caring for HIV and AIDS patients. The research setting was two colleges of nursing in the uMgungundlovu District that offer the four-year nursing diploma programme. The type of purposeful sampling that was used was criterion sampling, which entailed studying cases which met pre-set criteria. In-depth interviews with the first-year student nurses, who had experienced nursing HIV and AIDS patients, were conducted. The data was analysed manually and put into categories and sub-categories as they emerged.

Results The findings revealed that the participants had positive and negative experiences when they provided nursing care to HIV positive patients. The positive experiences were that the participants did not fear meeting HIV positive patients and they were not traumatized. These participants nursed HIV positive patients like any other patient. The participants expressed their feelings as sad and bad. Participants who had negative experiences were shocked, scared and cried when they met HIV positive patients. Six participants reported that they did not know of any facilities available for debriefing and sharing of experiences. The remaining participants identified the group lecturer, group mates, the psychologist and registered nurse in the ward. There was a lesson in class that was dedicated to debriefing and the sharing of experiences.

The majority of the participants (n=10) stated that HIV and AIDS was transmitted through contact with infected body fluids and blood. The participants identified similar methods of transmission, which were unprotected sexual intercourse, needle-stick injuries, use of contaminated needles and mother- to- child transmission of HIV and AIDS. The participants were able to correctly identify the modes of transmission, except for one participant who was not sure if HIV and AIDS was transmitted through breast-feeding, due to a lack of knowledge of the modes of transmission.

Six participants identified voluntary counselling and testing (VCT) as a support service available for nurses exposed to HIV and AIDS. Three participants verbalised that they did not know of any services available to student nurses. Some participants were not sure if the services were available and accessible and had no idea if the services were available and accessible to the student nurses. There were various problems that were encountered by the participants with regards to accessing the services. These included a lack of privacy, fear of giving information to colleagues, early closure of the clinic and unavailability of the counsellor when needed.

Recommendations were made concerning the need for adequate preparation of student nurses in their early training, with regard to VCT, PMTCT, home- based care and support groups. The stigma for HIV and AIDS needs to be adequately addressed. Support for student nurses needs to be provided when dealing with death of HIV and AIDS patients, as a large majority voiced not being able to cope.

Conclusion Student nurses who shared their experiences nursing HIV and AIDS patients had positive and negative experiences when they provided nursing care to HIV positive patients. The participants needed the relevant support and counselling to be available when needed. Stigma still exists, even though HIV and AIDS has existed for at least thirty years.