RECOGNITION OF HIV/AIDS NURSING AS A SPECIALTY

Background

To provide the expertise required in HIV/AIDS care, nurses need more than the general knowledge and skills acquired in basic nursing education programs. Knowledge about HIV/AIDS prevention and care is complex, dynamic and rapidly expanding.

HIV/AIDS Nursing involves the care and treatment of a very diverse population of men, women, and children who have unique and multifaceted needs. Occurring across various practice settings, it includes the care of persons who are vulnerable to HIV, those living in any of the stages of the HIV continuum including diagnosis, the asymptomatic, symptomatic and end-of-life phases, and the care of their families of origin and choice. In addition to requiring expert knowledge of the complex and continually emerging diagnostic and treatment modalities, nurses working in HIV/AIDS care must also be cognizant of other co-existing factors, such as, substance use, pregnancy, psychiatric illness, stigma, and other acquired infections like Hepatitis B and C, and tuberculosis.

HIV/AIDS Nursing has a unique knowledge and practice base that is rich in its breadth and depth. It includes the physical, psychosocial, cognitive, emotional, and spiritual aspects of nursing care, as it relates to disease prevention, health promotion, harm reduction and palliative care. HIV/AIDS nurses work in collaborative practice environments and therefore, share knowledge with other health disciplines, with community-based service organizations and with a well-informed patient population. Shared knowledge can include information about HIV's epidemiology, pathophysiology, medication and holistic therapies, nutritional care, ethical/legal issues, and care for the caregiver.

This specialized knowledge can be acquired through a variety of educational experiences including:

• formal study and course-work beyond the post-basic level, (eg. Clinical Nurse Specialist and
  Nurse Practitioner preparation)
• persistent self-directed learning and ongoing review of the literature
• workshops and conferences,
• staff development programs and
• learning through the clinical practice of caring for those vulnerable to and living with HIV/AIDS

Specialized skill is obtained through the experience of working with this challenging population. Repetitive exposure to the clinical practice of HIV/AIDS Nursing provides the opportunity for observation of recurrent themes or patterns in the human response to HIV/AIDS. This yields comfort, efficiency, precision and sensitivity in assessing, planning, implementing and evaluating HIV/AIDS nursing care.

It is generally accepted that nurses with specialized knowledge and skill are more efficient and provide safer, more competent and compassionate care.

Position

It is the position of the Canadian Association of Nurses in AIDS Care that:

• individuals who are vulnerable to, or living with HIV/AIDS, experience unique and complex
  problems. To provide optimal prevention, health promotion and care for this population, nurses
  require specialized knowledge and skills.
• nurses working in HIV/AIDS care must be committed to ongoing professional development to
  obtain and maintain their clinical expertise.
• to optimize client outcomes, workplaces serving this population should make every effort to
  recruit and retain nurses who have acquired specialized knowledge and skill in HIV/AIDS care.
• pursuing designation of HIV/AIDS Nursing as a specialty, through the Canadian Nurses
  Associations' standards development and certification process, is one way of formally
  recognizing the expertise of nurses working in HIV/AIDS care.

References

Association of Nurses in AIDS Care (ANAC) (1997). Position Statement: The Nursing Specialty of HIV/AIDS Care. Reston, Virginia: Author.

Calkin, J.D. (1992) Specialization Issues. In AJ Baumgart &J. Larsen (Eds.), Canadian Nursing Faces the Future (2nd ed), 312-342. Toronto: C.V. Mosby Co.

Canadian Nurses Association (1996). HIV/AIDS curriculum in undergraduate nursing education programs: Report of a survey. Ottawa: C.N.A.

Canadian Nurses Association (Jan.1997). Out in front-Advanced nursing practice. Nursing now: Issues and trends in Canadian nursing. No. 2 {online}. Available: http://www.can-nurses.ca/pages/issuestrends/nrgnow/out_in_front.htm

Kidd, C., Whiteley, M, and Scherer, K. (1987). Development of Canadian Critical Care Nursing Standards. Canadian Critical Care Nursing Journal. Sept/Oct 1987, 8-12.

Sharp, Victoria. (1996). Commentary: The Need for Specialization in AIDS Clinical Care. AIDS Patient Care, 10, (6), 332-333.

Approved CANAC Board of Directors: November 25, 2000.