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Case history one

Murray is in the terminal phase of AIDS. He is aware that he only has weeks rather than months left to live. As you administer Murray’s bed sponge this morning he begins to weep. He shares his pain and distress at not being able to receive the blessings of his Church before he dies. Because he is a homosexual he has felt unacceptable. He cannot confess that his homosexuality is sinful because he does not believe that being gay is a sin. How will you help Murray?

Case history two

James is 47 years of age and has AIDS. He has been admitted into the local Hospice for social relief. On admission he looks very anxious and withdrawn. He communicates with staff as a matter of courtesy but does not identify or relate to any other patients on the unit. James uses one-word answers and does not disclose much about himself or the recent problems that he has been experiencing. James has been in a partnership with Keith for 20 years and Keith cannot comprehend the change in personality that James is displaying. Several months earlier they had a loving and open relationship. Keith wants to be there for James, but it is almost as if James doesn’t want him around anymore. Keith himself was diagnosed as HIV positive three months ago.

Case history three

You are a district nurse and have been visiting Stuart weekly for three weeks now following his admission to hospital for stabilization of a new medication regime. You have become aware that Stuart is totally unmotivated to attempt any sort of self-care without your prompting. You decide that you need to address this problem with Stuart. How would you approach this?

Case history four

Jenny has just learned that she is HIV positive. Her husband confessed to her years of infidelity with other men, which is why she had the test. She is devastated and comes to see you in your capacity as practice nurse at the local Health Centre. Jenny states, “Why has God let this happen to me?”

Case history five

Neil has been admitted to your ward because of an exacerbation of diarrhoea, the result of a side-effect of a new medication. He is confined to bed and totally dependant on the nursing staff for all basic care. During the administration of Neil’s morning care he blurts out angrily, “What is the point nurse? I can’t stand this anymore. If I were a dog someone would shoot me. Please give me something to put me out of my misery.”

Case history six

You are on night duty in the Hospice where Liam is a patient having been admitted in the terminal stages of AIDS. He has been restless and unsettled tonight and despite a cup of Milo, several changes of position he cannot go to sleep. He refuses night sedation. You decide to place some lavender oil on his pillow and as you gently rub his back he says, “Do you believe in God nurse?” How will you respond?

Case history seven

You are going over discharge planning with Maria when she starts to cry. The nurses on the ward have mentioned that Maria appears very reluctant to go home. You ask Maria how she feels about going home when she tells you about the hate mail she has been receiving through her letterbox recently. She thinks that her neighbours have become aware that she is HIV positive because when they see her, they cross the street and hurl obscenities at her. How will you help Maria?