‘You’re Not God You’re Just a Person’: Revolutionising Roles, Hierarchies and Relationships on Australian HIV and AIDS Wards

Abstract

Historically hospitals have been hierarchical workplaces with a starkly gendered division of labour between doctors and nurses. However, on HIV and AIDS wards traditional roles and relationships were revolutionised. In many clinical settings the relationships between doctors, nurses and patients changed dramatically in the years between Australia’s first AIDS diagnosis in 1982 and the introduction of effective treatment in 1996. The distinct virological nature of HIV brought to light, and elevated, the crucial role of nurses in patient care. Nurses and their patients – often young, vocal and politically assertive gay men – formed close relationships that blurred the lines between their personal and professional lives. Doctors were no longer ‘God’ on the wards and, in many healthcare settings, patient care and the role of nurses were transformed.

The author would like to extend her thanks to the many nurses who agreed to be interviewed for this research and without whom this article would not have been possible.

No potential conflict of interest was reported by the author.

Notes

1 Yueming Li et al., ‘Demographic Pattern of AIDS in Australia, 1991 to 1993’, Australian and New Zealand Journal of Public Health 20, no. 4 (1996): 421–5; David Wilkinson and Greg Dore, ‘An Unbridgeable Gap? Comparing the HIV/AIDS Epidemics in Australia and Sub-Saharan Africa’, Australian and New Zealand Journal of Public Health 24, no. 3 (2000): 278–9; Paul Sendziuk, Learning to Trust: Australian Responses to AIDS (Sydney: UNSW Press, 2003), 10.

2 For example, HIV ravaged intravenous drug users in Scotland. It continues to devastate the Global South and African American communities in the United States. See: V. Morrison, ‘The Impact of HIV upon Injecting Drug Users: A Longitudinal Study’, AIDS Care 3, no. 2 (1991); Anna Satcher Johnson et al., ‘Epidemiology and Surveillance of HIV Infection and AIDS among Non-Hispanic Blacks in the United States’, in African Americans and HIV/AIDS: Understanding and Addressing the Epidemic, eds Donna Hubbard McCree, Kenneth Terrill Jones and Ann O’Leary (New York: Springer, 2010); Joseph Kagaayi and David Serwadda, ‘The History of the HIV/AIDS Epidemic in Africa’, Current HIV/AIDS Reports 4 (2016): 189–91; Mark Hunter, Love in the Time of AIDS: Inequality, Gender, and Rights in South Africa (Bloomington: Indiana University Press, 2010).

3 Author interview with Marie (Leeuwun, Western Australia, 13 April 2019). Please note, all interviews cited in this article were recorded between 2017 and 2019 by the author and remain in the author’s possession.

4 Nursing and Midwifery Board of Australia, Registrant Data (Nursing and Midwifery Board of Australia, 2019), 14–17.

5 Judith Bessant, ‘“Good Women and Good Nurses”: Conflicting Identities in the Victorian Nurses Strikes, 1985–86’, Labour History 63 (1992): 157.

6 Bob Bessant, ‘Milestones in Australian Nursing’, Collegian 6, no. 4 (1999).

7 Lynn McDonald, Florence Nightingale: The Nightingale School, The Collected Works of Florence Nightingale (Waterloo, Ont.: Wilfrid Laurier University Press, 2011), 850–1.

8 Ann Game and Rosemary Pringle, Gender at Work (Sydney: George Allen & Unwin, 1983), 94.

9 Australian Bureau of Statistics, Australian Social Trends, April 2013 (Australian Bureau of Statistics, 2013).

10 Paul Van Reyk, ‘Life during Wartime: Nursing on the Frontline at Ward 17 South at St Vincent’s Hospital’, HIV Australia 12, no. 1 (2014): 38.

11 Game and Pringle, 94, 106.

12 Ibid.

13 Sam Porter, ‘A Participant Observation Study of Power Relations between Nurses and Doctors in a General Hospital’, Journal of Advanced Nursing 16, no. 6 (1991): 728–35.

14 Game and Pringle, 107–8.

15 Arlie Russell Hochschild, The Managed Heart: Commercialization of Human Feeling, updated, with a new preface (Berkeley: University of California Press, 2012), 20.

16 Ibid., 134.

17 Author interview with Marilyn Beaumont (Melbourne, 29 October 2019).

18 Author interview with Sian Edwards (Melbourne, 29 August 2018).

19 Ibid.

20 Ibid.

21 Ibid.

22 Ibid.

23 Author interview with Marie.

24 Author interview with Sian.

25 Van Reyk, 38.

26 Author interview with Brad (Blue Mountains, NSW, 19 November 2018).

27 Ibid.

28 B.L. Brush and E.A. Capezuti, ‘Revisiting “A Nurse for All Settings”: The Nurse Practitioner Movement, 1965–1995’, Journal of the American Academy of Nurse Practitioners 8, no. 1 (1996): 5–6.

29 Author interview with Trevor (Sydney, NSW, 20 April 2017).

30 Diagnosis has been traditionally ‘the province of the medical profession’. See Game and Pringle, 98.

31 Ibid.

32 Ibid., 111.

33 Elizabeth Herdman, Susan Kippax and National Centre for HIV Social Research, Institutional Discrimination: Critical Ethnography of HIV/AIDS Related Discrimination in a Hospital Setting (Sydney: HIV AIDS & Society Publications, 1995), 43–4.

34 Graham Willett, Living Out Loud: A History of Gay and Lesbian Activism in Australia (Melbourne: Allen & Unwin, 2000), 213–17.

35 David Bradford, Tell Me I’m Okay: A Doctor’s Story (Melbourne: Monash University Publishing, 2018), 85.

36 Jennifer Power, Movement, Knowledge, Emotion: Gay Activism and HIV/AIDS in Australia (Canberra: ANU E Press, 2011), 140.

37 Willett, 170.

38 For further discussion of the relationship between the gay community and the medical profession in the early years of the crisis, see Shirleene Robinson and Emily Wilson, ‘Working Together? Medical Professionals, Gay Community Organisations and the Response to HIV/AIDS in Australia, 1983–1985’, Social History of Medicine 25, no. 3 (2012).

39 Frank Bowden, Gone Viral: The Germs That Share Our Lives (Sydney: NewSouth Publishing, 2011), 37.

40 Author interview with Marie.

41 Graham Lloyd, ‘Death of the Carer Who Became Victim’, newspaper clipping, Kathleen Duff’s personal collection.

42 Herdman et al., 15.

43 Power, 107.

44 Author interview with Marilyn.

45 Power, 108.

46 Dean Andrews, ‘Shepherd Denies “Summit” an Election Ploy’, Capital Q, May 1992.

47 Author interview with Mary (Victoria, 15 October 2018).

48 Author interview with Siobhan (Melbourne, 28 August 2018)

49 Lydia Bennett, ‘The Impact of HIV/AIDS on Healthcare Professionals: Psychosocial Aspects of Care’ (PhD thesis, Sydney University, 1992), 152.

50 Power, 91.

51 Ibid., 94.

52 Ilsa Colson, More Than Just the Money: 100 Years of the Victorian Nurses Union (Melbourne: Prowling Tiger Press, 2001), 49–52.

53 Glenda Strachan, ‘Not Just a Labour of Love: Industrial Action by Nurses in Australia’, Nursing Ethics 4 (1997): 298–301.

54 Mary Dickenson, An Unsentimental Union: The NSW Nurses’ Association, 1931–1992 (Sydney: Hale & Iremonger, 1993), 210–14.

55 Judith Bessant, 166.

56 For a more detailed account of nursing unionism’s response to HIV and AIDS in Australia, the dispute over testing and infection control and the 1991 motion carried at the AIDS Nursing Resource Group, see Geraldine Fela, ‘Blood Politics: Australian Nurses, HIV and the Battle for Rights on the Wards’, Labour History 115 (2018): 94–7.

57 Ibid., 101–3.

58 Vanessa Read, ‘Prejudice: Practice: Prediction: HIV/AIDS 1991 National Nurses Conference’, Australian Nurses Journal 20, no. 9 (May 1991): 26; Fela, 103.

59 Judith Bessant, 166.

60 Bennett, 143.

61 Arie Rotem et al., HIV/AIDS Related Discrimination Health Care Worker Project Component 1 (Canberra: Australian Government Publishing Service, 1993), 8.

62 Sue Wills, ‘Intellectual Poofter Bashers’, CAMP Ink 2, no. 11 (1972): 4–5; ‘What Is Gay Liberation?’, Gay Liberation, 12 November 1972, Papers of Terrence (Terry) Bell, Australian Lesbian and Gay Archives, Melbourne; Willett, 57.

63 Victoria Midwinter Pitt, Rampant: How a City Stopped a Plague (ABC [broadcaster], 2007), videorecording.

64 Power, 21.

65 Ibid., 46; Fiona Poulton, Lucy Bracey and Katherine Sheedy, Under the Red Ribbon: Thirty Years of the Victorian Aids Council (Melbourne: Victorian AIDS Council/Gay Men’s Health Centre, 2013), 4–6.

66 Power, 72–4.

67 Cheryl Ware, HIV Survivors in Sydney: Memories of the Epidemic (Cham: Palgrave Macmillan, 2019), 118–19.

68 AIDS Council of NSW, AIDS Council of NSW Annual Report 1990/1991, www.acon.org.au/wp-content/uploads/2015/04/ACON-Annual-Report-9091.pdf (accessed 19 June 2017); Power, 119–20.

69 Sendziuk, 73–4.

70 Dennis Altman, Power and Community (Hoboken: Taylor and Francis, 2013), 120.

71 Ware, 113.

72 Author interview with Trevor.

73 Author interview with Sian.

74 Ibid.

75 Ibid.

76 Ibid.

77 Author interview with Dean G (Adelaide, South Australia, 15 April 2019).

78 Ibid.

79 Alistair Thomson, ‘ANZAC Memories: Putting Popular Theory into Practice in Australia’, Oral History 18, no. 1 (1990): 26.

80 Author interview with Dean G.

81 Author interview with Brad.

82 Agnes Blackwood, ‘Quality Nursing Care’, The Lamp, August 1992, 4.

83 Author interview with Brad.

84 Ibid.

85 Author interview with Kathleen (Kingaroy, Queensland, 22 May 2019).

86 Author interview with Carmel (Launceston, 8 August 2019).

87 Ibid.

88 Ed Cohen and Julie Livingston, ‘AIDS’, Social Text 27, no. 3 [100] (2009): 40.

89 Author interview with Kathleen.