FEATURE: Behind the scenes at The Sussex Beacon’s Inpatient Unit

A day in the life of Anita Johnston, Team Leader at The Sussex Beacon’s Inpatient Unit.

ANITA Johnston is a vital staff member at the Inpatient Unit (IPU) at The Sussex Beacon, a Brighton based HIV charity. No day is the same in the charity’s 10 bed hospital, which offers support and care to people living with HIV. Here, Anita offers a rare insight into life at The Sussex Beacon’s Inpatient Unit, and talks about the challenges and changing needs of those living with the virus.

Everyday reality at the IPU
Prior to working as a HIV nurse, Anita studied a degree in International Relations and later worked for Brighton & Hove Council, before embarking on a career change. “What I really wanted to do was to help people, so going into nursing felt like a very obvious choice to me”, she says.

Whilst completing a three-year degree in Nursing at the University of Brighton, Anita had a placement at the Royal Sussex County Hospital’s HIV ward and later with the HIV Community Team. These experiences made Anita realise that she wanted to specialise in HIV care. After working at the Royal Sussex County Hospital in acute wards for 2 years, including the HIV ward, she began her career at The Sussex Beacon’s Inpatient Unit.

After three years of working as a nurse at the IPU, Anita was promoted to her current role as team leader early in 2018, where she oversees various clinical and managerial tasks.

A typical day on the ward starts with a detailed shift handover, where clients’ needs are identified and individual action plans developed for the duration of their stay. The medical team at the IPU provides different care and treatment options, and regularly supports people who switch or restart antiretroviral medicines, or take them for the first time. Whilst there is no cure for HIV at present, current treatment can keep the virus very effectively under control if the drugs are taken correctly. These work by keeping the level of HIV low in the blood, allowing the immune system to recover. Anita explains that a common priority in this process is “to enable clients to fit their medications into their daily lives beyond staying at the Beacon, as the timings when the tablets have to be taken are crucial”. Possible interactions with medications prescribed for other health reasons in addition to HIV drugs also need to be considered, and are often the reason why clients need continuous support.

New challenges and clients’ changing needs
The advancing quality of antiretroviral drug treatment means that the needs of HIV+ people are changing too. “Because of the improvements in HIV research, people on the latest HIV drugs now have near-normal life expectancy”, says Anita. As a result of an ageing HIV+ population, there is a growing need to combine HIV drugs with other medications for conditions that are generally associated with ageing. This process is not always straightforward, as HIV drugs can impact on other medications and need to be monitored carefully to ensure the effectiveness of treatment.

Another rising client need at the Inpatient Unit in recent years is around mental health. “We now have more patients looking to undergo drug and alcohol detoxes with us than ever before, especially since the closure of the Promenade Ward at Mill View Hospital in Hove, a former detox ward for people struggling with such addictions”, Anita explains.

Funding cuts to health and social services also continue to pose fundamental challenges for The Sussex Beacon and its service users. One of the biggest problems experienced by many clients is the issue of housing. “This is way beyond the Beacon’s ability to help, but it nonetheless limits the progress clients can make when they stay with us”, Anita says. “Many of our clients live in inappropriate or unstable housing situations, and some even face homelessness”, she adds. Lacking personal safety and a secure home are worrying concerns for mental health but can also have serious practical implications, such as limited or unreliable facilities to store medication.

Stigma of being HIV+ in 2018
Despite increasing awareness of HIV, Anita points out that a lack of education around the virus in the health care sector continues to exist today. “Many healthcare workers still do not fully understand how the virus can be passed on”, Anita explains. Such lack of knowledge can make it difficult for those living with HIV to engage with vital services. The Sussex Beacon’s role is therefore crucial as it offers “a safe place where people feel they are not judged for having a condition that still has a stigma attached”, Anita adds. The IPU’s medical team has become more skilled in recent years, and has recruited new staff members from acute backgrounds, including mental health. “We are lucky to have a strong and enthusiastic team, where everyone connects to the patients and their work”, Anita adds.

The team is eager to specialise in additional areas and will continue to increase their skill set so that they can meet the changing needs of their clients. Whilst working in nursing can without a doubt feel challenging at times, Anita’s dedication to her work remains as high as ever. “Seeing clients who were feeling hopeless and unable to imagine how they were ever going to manage their condition when they arrive at The Sussex Beacon, to then leave here feeling optimistic and able to cope with day-to-day life really makes you feel like you have achieved something”, concludes Anita.