Celebrating International Nurse's Day
If you look up ‘kindness’ in the dictionary I wouldn’t be surprised if you found a picture of Dominick Varsalone. He is a special man who gave up the tools as a railroad man in the 1990’s to train as a nurse in the frontline against the AIDS epidemic in America. Dominick treated patients with respect and compassion and established the world’s first Positive Connection support group. His powerful story can be found in his 2016 book My journey as an AIDS nurse.
What can we learn from him to help us survive today’s challenges? I was fortunate enough to interview Dominick to uncover what it’s like to be a nurse during an epidemic. This interview offers us an insight into the power of nurses worldwide, the backbone of the healthcare industry.
What is your background?
I was born in 1956 in Jersey City, New Jersey in the USA. I am a second-generation Italian American. After high school, I went right to work as a freight train inspector and repairman for Penn Central Railroad. I then moved on to another company. I worked for 16 years o the railroads until I was fired from when my supervisor found out I was gay.
Turning that negative situation into a positive, I decided to go to nursing school. After graduating, I worked as an AIDS nurse at Broadway House for Continuing Care in Newark, a long-term AIDS facility. I then transferred to an AIDS clinic at Beth Israel Medical Center in Newark. I also worked at North Jersey Community Research Initiative (NJCRI) as a nurse researcher for AIDS clinical trials. For two years I was an independent consultant in the field of HIV/AIDS Prevention/Education and a skills lab instructor at the same school of nursing I attended. I worked a total of 20 years in nursing and I finished up my nursing career back at Broadway House for Continuing Care.
I retired from Nursing in 2013 and began to write my memoir My Journey as an AIDS Nurse.
In May 1986, I settled down with my partner for life, Robert Buhr and we now live happily in Cologne, Germany.
As a healthcare professional, how do you stay strong after witnessing patient declines every day?
There is no doubt that there have been many times in my life when I fell to the level of exhaustion, defeat, helplessness and/or despair. There was always someone there to lift me up and get me back on my feet again. I do not know many people who could witness death and dying every day and then get up on their own. Nurses also need to have a support system in place. For me, Positive Connection worked both ways. I lifted the members up and when I needed them, they were also there to lift me up. The biggest source of my strength and rejuvenation came from my husband Bob, who was always supportive, before, during and after nursing school.
I would prepare myself before each workday by telling myself that from the minute I walked through the door until the time I left, I needed to put on my happy face. This was important for the patients no matter how difficult it was to maintain. At home is where I usually let out my frustrations and cried many tears.
In the advent of Protease Inhibitors and when HIV/AIDS was becoming a chronic illness it became a little easier because patients, friends, and support group members were finally able to feel a sense of hope. It was at this time things also changed for me. The need for support groups was diminishing as patients and group members became more self-sufficient. I began to lecture on AIDS prevention and treatment at the school of nursing. I also developed a speakers-bureau for the group members to be able to tell their stories and pay the love forward to others.
This was helpful for the group members, for their audiences, for the student nurses and most especially for me as it brought our original idea for starting Positive Connection full circle.
From your experience, did you find that patients with a positive mindset were more resilient?
The really short answer to this question is absolutely! Before I became an AIDS Nurse, I could see the difference. At the beginning of the AIDS crisis, my newly made friends in the gay community were here one day and gone the next. They did not even have an opportunity to say good-bye in some cases. At the time I lacked the skills to effectively listen to the person’s needs and apply my tender loving care to the equation. However, I found the timing of the patients’ decisions was key to how much I could help with their care.
When most people became infected their mindset was pretty much the same, “How does one prepare to die?” The stigmas associated with HIV/AIDS then called GRID (Gay Related Immuno-Deficiency) were mostly insurmountable. Fighting for your life is hard enough, but the stigmas complicated the disease even further. Loss of health led to the loss of employment, which led to an inability to pay rent or mortgage which led to homelessness and having to rely on family or friends to have a place to sleep.
My friends were being shunned by their own parents, siblings and sometimes every person they ever held dear to them. So, keeping a positive mindset was virtually impossible and this was the case with most of the 150 or so friends I lost to AIDS in my lifetime.
When I graduated from Nursing School in 1994, I began to experience the AIDS crisis in a different way. Most of the patients I saw at Broadway House in Newark, NJ were not gay. Most of my patients were African American and Hispanic. Many were triple diagnosis patients: AIDS, Addiction, & Mental Illness. This made them more difficult to treat from a medical standpoint. From the standpoint of, stigmatization; however, they had to deal with even more negativity based on religion, race, and issues that they dealt with for many years prior to their AIDS Diagnosis. These patients became just as important to me in my life as those who were my friends.
As medications to treat AIDS became more readily available and patients were responding well to these new treatments (1995-2000), it became apparent to me that patients who maintained a positive mindset had greater survival rates. Those who were willing to change their former lifestyles and behaviors and were adherent with their medical care plans were more successful with their progress.
This became a personal goal for me. I started a support group called Positive Connection for anyone who needed a support team to help them cope. I learned very quickly that those who participated and developed a plan for their future are the same people I can call today and have a conversation with, “long-term survivors.”
I addressed this in my memoir with a man who was vastly different from me. He was tall and I am short. He was black and I am white. He was the patient I was the nurse. He was an IV drug user and I was not. He was bisexual and I am gay. He was brutally stigmatized all his life just for being himself. I shudder to say this, but I was “White Privileged” without even realizing it. It was at this time and because of wonderful friends like this brave man that I realized that a positive mindset is a key to optimal health. Somehow this man pulled through after coming remarkably close to death. I invited Robert to attend Positive Connection meetings and we became the best of friends. I learned as much from him as I learned in three years of nursing school. Most importantly I learned that just because we looked different, acted different and had a nurse/patient relationship we were actually, very similar. He was resilient with his treatment and I was persistent with my care for him and together we created a bond that truly made us brothers (Pgs. 149-152 “Tall Man on Campus” My Journey as an AIDS Nurse).
You nursed patients before there were AIDS treatments, how did you see suffering patients keep meaning in their life?
Before I was a nurse and before there were effective treatments for HIV/AIDS I mostly helped friends at home. When I became a nurse, I saw a lot of patients suffering and yet trying hard to keep some form of meaning in their life. As a nurse, it was most important to do an excellent initial assessment of the patient to elicit what type of support system they had at home. Did they have family, friends, and co-workers who we could try to incorporate into the plan of care? With that information I could creatively keep the patients’ goals at the forefront of their care.
What kind of things make sick people resilient?
The answer to this question is quite distinctive. As a nurse in AIDS care, I would usually ask each patient and their support system to describe to me how hard they are willing to work on beating the virus and working towards optimal health.
One story in my book relates to one patient who had jumped out of a third storey building to kill himself after being diagnosed with AIDS. He had two sisters. One of the sisters had very, different religious beliefs and she did not accept homosexuality. Even though she did love her brother, he did not feel that love. Upon his arrival from the hospital to our long-term care facility, he was placed in the unit where I worked as a charge nurse. Upon initial assessment he was able to indicate to me through non-verbal communication that he wanted to live. He saw that his sisters were going to be there for him. They were there day and night. He survived and attended Positive Connection support group meetings regularly. Soon after he married the man of his dreams.
After witnessing so much death first-hand, what are your thoughts on the meaning of life?
WOW! I love a challenge! Since I am not a philosopher, philanthropist, or even a high priest, I can only give you the answer that comes personally from my heart, mind, body, and soul as a regular human being. I think a more relevant question is “What is my purpose in life?”
I will try my best. My short answer is “Personal happiness shared with others.” After witnessing the deaths of many personal friends and countless numbers of patients there were times, I thought life no longer had any meaning. What always worked for me was keeping my personal happiness in check and trying my best to bring happiness to others in any small way that I could. One of my goals as a Nurse in AIDS care was to be the bearer of care with compassion through loving acts of kindness. This is something they do not teach in nursing school.
It might be sitting with a patient who is dying and holding their hand because they have no one to help them transition from this life. Or it might be sitting and crying with family members of someone who just died. I tried my best every day to bring happiness in my attitude at work. Happiness is born out of love for what I do. So then what is love? Well, love is absolutely nothing until you give it away. Giving love away is a kindness.
I am certain that every individual you ask to answer this question will have a different answer. Human beings were created to live a life that helps them work towards their own altruistic self. If you were to look up the definition of altruistic it will say something like this. “Altruism is the belief or practice of selflessness and concern for the well being of others before yourself.” Some of the synonyms are self-sacrifice, self-denial, compassion, kindness, goodwill, decency, public-spiritedness and generosity. Google has a list of the top twenty most altruistic people in the world. The list includes some people most everyone will know: Bill Gates, Mark Zuckerberg, Jeff Besos, Mike Bloomberg, Warren Buffett, and George Soros.
To me, this begs the question “Do you have to be wealthy to become your altruistic self?” My answer is emphatically NO! I think some of the wealthy people, are the least altruistic. Anyone rich or poor can consistently do small acts of kindness that come from the heart. This is where you will likely find altruism.
For me, the meaning of life is found in 4 “L’s”. First, we must Love ourselves. If we do not know what love is, we will never know how to give it away. Second, Listening is another key to the meaning of life. If you are not listening for clues from others you will not know what act of kindness is needed. I often find that simply listening and not speaking a word in return can often be the kindest gift you can give. Third is Laughing. My father taught me the special gift of humor and appropriate laughter. I have used this many times and it takes incredible insight to know exactly when to throw humor into a very tense or difficult situation. After all, laughter is the best medicine. The last of the four “L’s” is Learning. As the facilitator of my group, Positive Connection, I have often said I learn just as much as the group members. This now gives all of us the opportunity to teach each other. In Group we had a favorite saying “Each One, Teach One.” I feel that something learned but not shared is almost pointless.
I do not own any rights to the true 'meaning of life', but I can say is that this is what usually works for me. I also cannot tell you that I am this person all the time. That would be a lie. When I do feel hopelessness setting in, I know it is time to take pause, take a break and seek the mercy and compassion of others. You can be the kindest and most compassionate person, but if you cannot, or do not accept kindness and compassion from others you will suffer from burnout and wither away.
Our life no longer has meaning when we become depleted of love and compassion. When we are no longer able to listen, laugh, or learn. When we are physically, spiritually, emotionally, and socially run-down.
That’s a powerful answer, Dominick. So what are your tips for living a full life?
I will share eight of them.
1. Find what makes you happy
2. Find ways to show and give love and then give it freely
3. Be Kind to all living things without expecting anything in return
4. Laugh more and laugh loudly, it is contagious
5. Listen intently to the needs of others
6. Learn as much as you can about everything that matters and do not be afraid to ask questions
7. Seek out people who are different than you are and broaden your horizons, then teach others what you have learned
8. When you start to lose yourself or begin to think too much of yourself, take pause, take time to rejuvenate and go back to step one - find what makes you happy, then give it away again with love.
Finally, in the age of COVID-19, how can we better support nurses who are the backbone of our healthcare system?
During and after this global public health crisis, the general public can be most helpful in supporting nurses, doctors, other healthcare professionals and first responders by simply taking care of themselves. Stay home, stay safe and follow all the advised protocols so that nursing professionals can do their work safely and more efficiently. Remember, the more people who get infected, the more work and stress nurses will have to deal with.
In my 20 year career as an AIDS Nurse, I have to say that the biggest support to me were the cards, notes, and letters I received from patient’s family members and friends as well as the students I taught in Nursing School.
This year on Nurses Day (May 12th) it might be a nice gesture to send a note to a local nurse or to a nursing unit at a hospital nearby saying thanks for all you do. I have every card, note and letter I have ever received in a treasure chest. When I have to take pause or if I am feeling helpless or hopeless, I take them out and read them. And then it is back to step one.
Thank you kindly for your time and deeply considered answers. I wish you and Robert all the best for the future, you deserve it.
Σχόλια