A ROHO Project: The AIDS Epidemic in San Francisco
The Response of the Nursing Profession, 1981–1984
The ten oral histories in the AIDS nurses series, the second segment of the Regional Oral History Office program on the history of the medical and nursing response to AIDS, have been completed. They record the contributions of these AIDS nursing pioneers in the earliest years of the epidemic when little was known about the new and lethal disease, fear was widespread, and patients were in desperate need of physical care and understanding. The nurses describe their myriad activities, among them, founding the AIDS outpatient clinic and inpatient ward at San Francisco General Hospital [SFGH]; devising infection control procedures to protect patients and staff; presenting AIDS education programs for hospital and outside communities; and taking care of the physical, psychological, and social needs of a largely gay and hence doubly stigmatized patient population. The oral history volumes were presented in May at a reception in UC San Francisco's Alumni House, sponsored by its School of Nursing and the UCSF AIDS Research Institute. The nurses receiving their oral histories spoke movingly of their experiences to a rapt audience of nursing school faculty and students.
Project Origin
The idea for an oral history series on the medical impact of the San Francisco AIDS epidemic originated with Evelyne and David Lennette, virologists who have been following the history of the disease since its first recognition in 1981. In 1991 they began generously to provide support for interviews with physicians at UCSF and SFGH who were prominent in AIDS medicine in its earliest phase, 1981-1984. That series with twelve physicians, two dentists, and one epidemiologist —the AIDS university physicians series —is now complete and available for research at the Bancroft and UCSF libraries. A third series with AIDS physicians in private practice is nearing completion. The oral histories with AIDS university physicians is online at: http:// www.lib.berkeley.edu/BANC/ROHO/ ohonline.
The physicians' accounts made evident the critical role of nurses in AIDS history. In 1994 we applied for and received a two-year award of $60,000 from the University of California Universitywide AIDS Research Program. Jointly sponsored by the Regional Oral History Office of The Bancroft Library, and the Division of the History of Health Sciences, UCSF, these oral histories significantly expand oral documentation of the AIDS epidemic, and are complemented by documents in the AIDS History Project at UCSF LIbrary.
Emerging Themes
Compared to the oral histories with physicians in phase 1, the oral histories with nurses portray a day-to-day, handson, in-the-trenches engagement with the people most affected by the epidemic— the people with AIDS.
As long as the patient is hospitalized, a nurse or nurses are caring for the patient in an immediate, personal, and ongoing fashion. Because nursing contact with patients tends to be more sustained and personal than is physicians', it is often more of a struggle to sustain a proper balance between personal involvement and professional detachment. Some of the nurses in these volumes speak of "burnout" and of the measures they take to lessen or escape it. Diane Jones, a member of the first nursing contingent on the AIDS ward at SFGH, described reasons for her longterm commitment:
"All along, the thing that's drawn me the most is the political dimensions of the epidemic and the personal dimensions, all of the questions that it raises about life and death and sexuality and discrimination and drugs and addiction and family dynamics and pain and despair and hope and courage . . . "
The role of the gay community in AIDS activities is another persistent theme. The fact that six of the ten interviewees in this series are gay or lesbian is not coincidental. In most cases, their sexual orientation was a basis for their original engagement in the epidemic, which to this day in San Francisco affects gay men in larger numbers than any other single demographic group. AIDS in the years covered by this project was widely perceived as a "gay" disease. The nurses in this series had the same perception and in many cases chose AIDS care as a way of assisting members of "the community," meaning the articulate and organized gay and lesbian community.
Yet another important theme is the impact of the epidemic on the stature of nursing. The interviews show nurses taking on more responsibilities, devising innovative services for holistic AIDS care, and assuming a stronger "voice" in the medical hierarchy. For example, it was nurses who organized and ran (of course with physician oversight), and continue to run the inpatient AIDS unit, Ward 5B (now 5A), at San Francisco General Hospital.
Gary Carr, nurse practitioner in the AIDS Clinic at SFGH, spoke of the professional and personal empowerment that AIDS work sometimes conferred:
"[Paul Volberding, AIDS physician at SFGH] was giving me the authority, the judgment, the recognition to tell people [that they had AIDS]. For a nurse practioner in those days, that was still a big deal."
Nurses also played a major role in structuring comprehensive patient management and community support systems which are a critical part of the multidisciplinary model of AIDS care for which San Francisco was known in the early epidemic.
—Sally Smith Hughes, Ph.D.
Research Historian and Project Director
Regional Oral History Office
Volume 117
Fall 2000
Table of Contents
Acquiring the Nine-Millionth Book
From the Director: Bancroft 1900, Bancroft 2000
Cal Day and the Friends Annual Meeting
Thanks For the Memories: Photograph Albums and Historical Images
Who Was "G.G., Chief of Ordnance"?
A Peek at the New Edition of Huckleberry Finn
A ROHO Project: The AIDS Epidemic in San Francisco
Nuts and Bolts: Creating a Bancroft Exhibition
Kudos for the Mark Twain Exhibit Catalogue
Jim Holliday Receives Hubert Howe Bancroft Award
GIFTS TO THE BANCROFT LIBRARY July 1, 1999 through June 30, 2000
