Impact of the Diagnosis of AIDS on Hospital Care of an Infant

Abstract

Detailed analysis of caretaker response to the first infant newly diagnosed with AIDS at a university hospital was done by review of nursing notes for three periods: before diagnosis of AIDS, after diagnosis, and after psychiatric consultation. Five consultation questions were posed, and the findings on investigation of these questions are discussed. It was found that the percentage of time that PRN medication was given dropped after diagnosis of AIDS but rose above the initial level after the consultation. The number of times per shift the nurse touched the baby (TLCs) was not found to be associated with use of PRN medication; rather it was explained by which nurse was caring for the child.

This study focuses on variations in nursing care of one infant to illustrate how variation in caretaker response can amplify the range of perturbations of the infant's behavioral response. It is speculated that caretakers of patients with AIDS may normally have feelings considered unacceptable in medical settings, including fear, blaming the patient, or a wish to avoid the patient. Such feelings are more difficult to tolerate in the care of children or infants and are superimposed upon the familiar stains associated with the care of chronically ill or dying pediatric patients.

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