The Grand Finale

It has been such a good experience this semester to be a part of what the 1917 Clinic is doing to provide quality care to people living with HIV and AIDS.  As I am now at the end of this project, I find that I am more prepared for my career as a nurse and for the challenges that I will face in this field.  My ability to communicate with and care for people has been expanded and I have learned to see people first and foremost not as a diagnosis, but as individual people that I have the ability to influence.

            This last post will be short and sweet.  As I mentioned in my last post, approximately 50% of the women that I contacted actually came in and received their pap smears.  In one six week period, I called 68 women and 33 received their exams.  It has been difficult to determine exactly what this data means (if the phone calls have been helping or not) because this is the first time that Truus and others at the clinic have kept statistics about phone calls.  This said, the information that I have collected will be a baseline for future studies of the effect of phone calls on patient adherence to the recommended cervical cancer screenings.  What I can say is it’s possible that some of those 33 women that came in for pap smears might not have were it not for the phone calls.

            This semester in the 1917 Clinic has provided me with an opportunity that I am certain I could have received no other way.  I am forever grateful to the clinic, to Truus, and to the Honors in Nursing program at UAB for the chance to grow into a more prepared and compassionate nurse so that I may be a positive influence on the future of healthcare. 

The Light at the End of the Tunnel

            This semester so far has been by far one of the most unique learning experiences that I’ve ever had.  It’s not every semester that I get to spend more than just a day at a facility that provides one of a kind compassionate and comprehensive care to a certain populations of people.  Also, I feel that getting the chance to make a real difference in this clinic is another experience that does not come around very often.

            So what has been happening at the 1917 Clinic?

            I’ve continued to weekly identify and contact the women coming into the clinic in the next week who are not up to date on their GYN services.  It has been very interesting to hear the reactions of the women when I call them.  I’m not sure what I was expecting, but the majority of the women seem genuinely pleased that someone is calling them, informing them of a health need.  I have received positive response from the vast majority of women, and I have received negative responses in a very small number of the women.  This has been encouraging to me as I continue to make phone calls—it would be rough to continue if the people I spoke to were angry that I was calling!

            I’ve been gathering statistics for the majority of the semester, and it has been educational to begin analyzing them.  I’m finding that roughly 50% of the women that I call actually receive their GYN services.  One of the concerns at the beginning of the project was that perhaps by calling women and telling them they needed a pap smear, they may in fact be less likely to show to their appointment, perhaps out of nervousness of having a GYN exam.  From that data I have collected so far, I have actually found that only around ¼ of women that I talk to do not show up for appointments, which is not any higher that it was before the phone calls were made. 

            Over the remainder of the semester, the majority of my efforts will be spent in adding to my statistics weekly, as well as analyzing them to determine the implications.  Ultimately, I would like to answer one very important question.  Are these phone calls improving the adherence of women living with HIV to the recommended screening for cervical cancer?

            More on this in the coming weeks!

The Voice of the Women

I want to share two videos with you today, which both left me tearful for very different reasons. 

This first video is the testimony of an Arab woman, who describes the difficult circumstances surrounding her  disease.  

The second video is VERY different.  This story gives me tears because of the way that these women can and should be treated.

            What I would like for all of use to glean from both of these videos is that women living with HIV are people longing for a chance to live and love, just the same as the rest of the world.  For so long, there has been such a negative stigma surrounding HIV and AIDS (as we saw in the first video), and I would love to see that stigma disappear!  This isn't just a job or a duty for nurses or people who are involved in health care, but for everyone.  Sure, the stylists did the hair and makeup of many women and gave them the chance to feel physically beautiful, but I believe that the best gift they gave was to treat these women with the same respect and kindness as they would any other person.

            As I spend time at the 1917 Clinic every week, I am constantly learning more about the virus and the effect that is has on the human body.  But even more than that, I am weekly amazed at just how much the doctors and nurse practitioners really care about their patients.  I hope that through their example, interacting with the patients, and seeing some of these real life videos, I can become a person who treats this remarkable group of women like the living, breathing human beings that they are.  They have such powerful, encouraging stories, and I hope we can all learn to really listen.

Carpe Diem

            Today for my project I got to do something a little different—I branched out of making phone calls to patients and was able to shadow the Women’s Health Practitioner that I’m working with.  In doing this, I was able to see what she does every day, but more importantly, I was able to see that many of these women who are living with HIV and AIDS are some of the most beautiful and strong women I have ever seen.  Every day they have to think about their health and the way they live their life, and so many of them live a good and full life in the midst of their circumstances.  And that is a success all in itself!  The past cannot be changed and the virus can never be cured (at least, not in this day and age, but I have hope for the future of medicine!), but there is such a huge difference between a woman who is tolerating the fact that she is living with HIV and a woman who is still really LIVING with HIV.

            All of this just makes me appreciate more what I have learned in nursing school about helping my patients to maintain a healthy, positive quality of life.  I’ve seen many patients in the hospitals who have lost so much joy in life because of an illness or an injury that has taken its toll.  And while these people do have incredibly difficult circumstances, as any illness or other medical ailment is hard on life, it is encouraging and refreshing as a student to know that it is still possible for chronically ill people to live a full and good life.  Seeing several women today who are actively doing that—living well, laughing much, and loving their families—gives me, as a student and future nurse, a desire to encourage and be a positive influence in the lives of all my patients.  I want to talk with them and help them to think less about how much an illness may have crippled them and more about how life can still hold little joys and pleasures even in the most difficult circumstances.

            So I desperately need to say thank you to all of the strong, beautiful, powerful women who are pushing through the hard times and continuing to really live life in the presence of HIV and AIDS.  In the future, I hope to be an encouragement to you, but today, you were an enormous encouragement to me.

The Adventure is Underway

It’s been a little while since I updated this blog about my project, but things have been moving along so well!  I find that I am enjoying my time at the 1917 Clinic so much, and I am learning a great deal from sifting through doctor’s notes and patient’s charts.  When I first started nursing school, a bit of me was a little sad that I wouldn’t really get the chance to experience paper charts because of technology, but I don’t know what I was thinking!  I am so grateful for technology, as well as not having to always decipher the handwriting of doctors, nurses, and other health care professionals!

So, the project—first, I didn’t mention in my first post that this project was actually inherited!  It was started during this past summer by a girl named Lauren Lanehart who is a semester ahead of me in nursing school.  She first communicated with the clinic and got the service learning project set up, and so a lot of what I am doing is all a matter of following in her footsteps.

So what exactly have I been doing?  Every Friday when the schedule is printed for the next week, I come into the office and get a hold of it!  I sort through all of the patients using the clinic’s electronic records, and I determine which of the female patients need to have their GYN services performed.   The recommendations for all HIV women is to have two paps in the first year (6 months apart), and if both of those are normal, then move along to having paps performed annually. When I find women who need to be updated on their services, I call them and remind them of their appointment and offer to have our Women’s Health Practitioner see them while they are at the clinic for their convenience.  For many of these women, transportation can be an issue, and it is important for me to encourage them to get their paps while they are at the clinic. That is the very basics of what I’ve been doing!

At this point, the majority of the women I have been able to speak with have been incredibly wonderful!  The majority of them when I call seem genuinely grateful that there is someone who is interested in their health, and that has made me feel so good!  The most common question I’ve received from the ladies is from the ones who have had abnormal paps.  They always want to know, “Why do I have to get another one now?  I just had one six months ago!”  And this is such a good question from them.  It gives me a chance to educate them that it is important for HIV positive women to be screened more frequently when they have abnormal paps because it is so much more likely for them that an abnormality might progress to HPV which is the cause of cervical cancer in the majority of cases. 

All this said, so far, so good!  I can honestly say that I am loving the 1917 Clinic and the time that I spend there.  This project is helping to make me into a better nurse by teaching me important concepts about patient communication and also about developing caring relationships with patients—even though I only talk to them on the phone for probably under 5 minutes!  But I am growing to care for these women every week, and I am developing a passion for their cause that will never be erased.

The Adventure Begins

Greetings everyone:

            My name is Hannah Brancheau, and I am a third semester nursing student at UAB.  I’ve been delighted to find myself in the honors program at the school of nursing, which has provided a unique chance for me to learn while at the same time serving!  This Fall, I will be participating in a service learning project at the 1917 Clinic in Birmingham, AL.  Basically, I’ll be providing a service to them while also learning something myself.

            The 1917 Clinic serves a very unique group of people—people living with HIV and AIDS—and provides a great number of services for these people.  My passion is for women and children, and so while I am at the Clinic I will be working specifically with the women’s health providers.

            What, you may be asking, will I be doing with these providers?  Thank you for asking!  I’m going to be doing quality improvement that aims to increase the compliance rate of women to their pap test—basically, encouraging these women to stay up to date on all of their GYN services!

            Believe it or not, this is a major concern for women living with HIV and AIDS.  Any women living with HIV is 5 times more likely to develop cervical cancer than an HIV negative woman.  And when it comes to cervical cancer, early detection is key!  The earlier treatment can be initiated, the better, and the pap test is the primary mode of screening. 

            I’m looking forward over the next few months to updating this blog as a means to help you understand more about women living with HIV and AIDS, as well as to update you on the project that I am participating in.  I’m looking forward to the opportunities this semester will provide and I hope you enjoy the ride with me!