The experiences of professional nurses in caring for patients with HIV and AIDS at Ngwelezana Hospital, Empangeni, KwaZulu-Natal, South Africa.

Abstract

Human Immunodeficiency Virus (HIV) infection and Auto-Immune Deficiency Syndrome (AIDS) have spread globally during the past twenty-eight years and 67% of people living with HIV live in sub-Saharan Africa. HIV and AIDS are now the leading cause of death in this region. Worldwide, it is the fourth biggest killer. Nurses in health institutions in South Africa face challenges as result of increased number of very sick and terminally ill patients who are admitted to the hospital due to HIV and AIDS epidemics. Workloads have increased with no concomitant increase in number of staff to care for the patients. Aim: This study aims to identify dynamics of care of professional patients with HIV and AIDS by nurses and make recommendations that will deal with these problems. Methods: A qualitative study was conducted with the study population drawn from professional nurses who were involved in the care of patients with HIV and AIDS in the medical wards at Ngwelezana Hospital for at least five years. One focus group discussion was also conducted. The sample was selected purposively. Results: The study revealed many issues affecting the care nurses gave to patients with HIV and AIDS and the personal challenges (physical and emotional) they faced in the course of their work. Amongst these are contextual challenges which pertained mainly to health system issues- lack of institutional support and incentives, heavy workload with concomitant increase in number of patients attended to by nurses, training needs of nurses and multidisciplinary team work. Nurses had to deal with personal challenges such as helplessness, frustration, anger, death anxiety, physical and emotional stress. However, there were positive experiences such as empathy and self-actualisation in being able to care for terminally ill patients and seeing some of them get better with treatment. Recommendations: These include the need to address the training needs of nurses about management of HIV and AIDS, institutional support for nurses, critical incident debriefing and community awareness.