In HIV Clinic Hiring, Weighing Lived Experience Alongside Advanced Degrees
Ensuring that an HIV clinic provides optimal care and services takes more than just hiring those with academic credentials. You could certainly pack your staff with people who were able to attend top schools with abundant resources. But just as important is making sure that members of the communities most affected by your work are part of your staff -- and are able to meet clients where they are.
But what does that look like in the context of hiring? Should managers get rid of education requirements, as in the case of some AIDS service organizations? That may not be realistic in some medical settings. So, how do clinics balance real-world and academic qualifications? TheBodyPro asked attendees at the 2019 Association of Nurses in AIDS Care conference (ANAC 2019) in Portland, Oregon, for their thoughts.
Transcripts have been lightly edited for clarity.
Natalie Leblanc, Ph.D., M.P.H., RN
Leblanc is an assistant professor at the University of Rochester School of Nursing in Rochester, New York.
I think there are two parts to consider. There is definitely merit in having someone who has lived experience be involved in the decision-making.
I think, however, having individuals who have rigorous training in how we analyze data, approaches to health care and clinical trials is essential to moving forward and ending the epidemic. It's important to have a combination. We now know that it's not necessarily working as an individual. We need to be working in teams to move forward. We need [to be] interdisciplinary, inter-professional, so everyone is coming to the table with their own expertise. And it's not a single person. It's using a team-based approach to address whatever the problem is.
Laura Remy, M.P.H., RN
Remy is a Ph.D. student at the University of Missouri in Columbia, Missouri.
I see those who are taking PrEP [pre-exposure prophylaxis] as the experts. I look at those who are on PrEP, who have overcome every barrier I've seen -- they've overcome racism, they've overcome being [part of] a sexual and gender minority group -- I see them as the ones that we really need to engage and empower. Not just people who look like [them], but [who] share in the goal: to end the epidemic.
I love using community health workers. They are the ones out there doing the work and they know the neighborhoods.
Helena Addison, M.S.N., RN
Addison is a Ph.D. student at the University of Pennsylvania in Philadelphia, Pennsylvania.
Lived experience is incredibly important. It should be weighed highly. There are so many things that happen in the world that aren't written about. And if they are written about, they aren't always read. A lot happens, and it's not all in a textbook.
Martez Smith, L.M.S.W.
Smith is a Ph.D. student at the University of Rochester in Rochester, New York.
I think lived experience should trump having a degree. I think, yes, a degree is a form of indoctrination. It teaches you jargon. An M.S.W. can teach you standards across the board, like writing a case note. But you learn a lot of that stuff in your field placement -- that's lived experience.
Some cities say you need a master's degree or equivalent experience, which is like three to five years. Clinics can adopt that framework or even place more emphasis on experience. Employing that person with a lived experience … gives that person on-the-job training! I think you can do no wrong with that.
Lucy Bradley-Springer, Ph.D., RN, ACRN, FAAN
Bradley-Springer is an associate professor emerita at the University of Colorado Denver and the editor-in-chief of the Journal of the Association of Nurses in AIDS Care.
I think they should give lived experience a lot of thought. The lived experience is extremely important. People who have lived that experience and want to work with others, that's a jewel. You need to find those people and recruit them. And once you find them, as the employer, you need to provide them [with] opportunities to go to school.
Shonta Smith
Smith is a nurse at the University of Maryland Institute of Human Virology's THRIVE Program in Baltimore, Maryland.
It needs to be a combination of both, but I would have to say that lived experiences matter most. The reason why I say that is because how I got into the care of being a nurse, and taking care of patients who are living with HIV -- or HIV is living within them -- is through lived experience. I saw people that were close, that I've developed a relationship with, that I've loved, and watched how the community treated them -- the stigma within the community. That fueled me to do what I do today.
I had my neighbor become HIV positive from her husband. I had some patients from my hospital -- one who I had for 36 nights in my assignment. Thirty-six nights. I still remember the room to this day. Having that experience, watching him and seeing him suffer the way he was suffering, fueled my passion and my drive and my motivation for why I do what I do today.