Celebrating International Nurses Day.

STIGMA AND discrimination are HIV/ AIDS' best friends, says HIV nurse specialist at Capital and Coast District Health Board Suzanne Miller. "While people continue to think only those in marginalised and criminalised sectors of society risk catching the disease, rates in New Zealand among all sectors of society will continue to increase."

Miller was guest speaker at a celebration of International Nurses Day (IND) at NZNO's head office in Wellington last month (May 12), where she addressed the International Council of Nurses' theme for 2003 of "Nurses fighting AIDS stigma". The event also marked the official opening of NZNO's new premises in Willbank Court.

Miller said the disease had reached pandemic proportions, with around 1300 HIV-positive men, women and children in New Zealand and 40 million living with HIV/ AIDS worldwide. As numbers continued to grow, everyone was at risk of contracting the disease.

"HIV/AIDS doesn't discriminate on the grounds of age, gender, economic and social status or sexual preference. In the last few years, society has become more complacent about the disease and as a result, numbers are increasing. If we are going to put an end to stigma and discrimination, then we must speak about it openly and honestly so we will all know how to protect ourselves."

Miller used two life sized, wire-mesh torsos--one male, one female--to illustrate how the disease is transmitted and how it doesn't discriminate. The headless torsos represented the fact there was no one face of a person who has HIV, while the mesh represented the transparency of the risk to everyone. "Globally, heterosexual transmission accounts for the majority of new HIV/AIDS cases, so clearly viewing HIV as a disease of homosexual men, prostitutes or intravenous drug users is a deadly misconception."

Miller stressed the importance of education and the use of condoms as the most important tools in the fight against the disease. It paid to know your enemy and how to protect yourself, she said. "Sexual behaviour is the single most important factor influencing the spread of HIV. The presence of a sexually transmitted disease increases the risk of acquiring or transmitting the virus tenfold. Education can prevent people becoming infected with the virus, as well as teaching others how to care for and love those who are infected. While our attitudes in developed countries have improved, the stigma is still there and to some extent has shifted to other marginalised groups, such as refugees, women and displaced people."

Also attending the Wellington gathering were Minister of Health Annette King, MP and Health Select Committee chair Steve Chadwick, Ministry of Health chief nursing adviser Frances Hughes, Nursing Council chief executive Marion Clark, NZNO president Jane O'Malley, and other board of directors' and Te Runanga members. King congratulated nurses for playing such a vital role in the fight against HIV/AIDS. She said New Zealand had done "incredibly well" at keeping the incidence low compared to other countries. She also drew comparisons between nurses' public health role in helping prevent HIV/AIDS and controlling the severe acute respiratory syndrome epidemic (SARS). "It is inevitable New Zealand will end up with a number of cases, but we need to keep SARS in proportion. Nurses are at the forefront of managing our response."

An event at the New Zealand AIDS Foundation Awhina Centre in Wellington honoured the contribution of practice nurses to the health and welfare of people living with HIV. The evening began with stories from two people who had the virus and included an update on HIV treatments and dietary advice.

Fifty nurses, including students, gathered for a celebration breakfast in Nelson to mark IND. Organised by the College of Nurses Aotearoa, the guest speaker was MidCentral Health's nurse practitioner (NP) Jenny Phillips. A wound care specialist in the primary health sector, Phillips also ran a wound care seminar in Nelson the weekend before IND.

Speaking on the pathway to expertise, she said that when she trained, the profession's key words were nurture, comfort and obedience. wire-mesh torsos. "Nurses did as we were told. The key words now are empathy, health and accountability for and with our patients and clients."

Outlining her own journey to a Master's degree, Phillips said expert knowledge could be gained by self study and commitment "but it can be difficult to develop the critiquing skills needed to be able to look at the research, look at the evidence".

The introduction of NPs had caused de bate in every country where they had been introduced, she said. "New Zealand has set higher standards than many countries but what's wrong with setting high standards? Talk of tall poppies and elitism should have no place in our profession. Nursing now has a clinical pathway for those who wish to expand their knowledge and remain in clinical settings, for those who have expert skills and expert knowledge."

Phillips believes many nurses are "80 percent on the way" to becoming NPs. She advised nurses to "save everything" for their portfolio and to be prepared for the three-hour interview which was part of the NP application.

Phillips is now working towards gaining prescribing rights. This will include completion of the necessary papers and 250 hours of supervised practice.

The day was marked in Auckland by a number of social events while in Christchurch the NZNO regional council invited nurses to a special screening of the Australian movie Crackerjack.

At Timaru Hospital, medical ward enrolled nurse Lynn Arras was named Nurse of the Year on May 12. Arras said she was "blown away" by the award, which she had never expected. Her colleagues selected Arras for the honour this year for the way she dealt with patients, gained their trust and was able in help them participate in their treatment. Arras said receiving the award had given her the "oomph" to continue nursing.