Nurses have a role in AIDS careWhile it is not...

Letters

November 27, 1996

Nurses have a role in AIDS care

While it is not unreasonable for Dr. Robert Redfield to suggest that primary care for AIDS patients should be provided by someone highly specialized in AIDS care (The Sun, Nov. 17), many take strong issue with the notion that only physicians are competent enough to do that.

Since the beginning of the AIDS epidemic, advanced-practice nurses and physician's assistants have worked tirelessly alongside physicians to care for their patients. To suggest that only physicians are able to provide primary care HIV/AIDS patients not only slights these competent and compassionate professionals, but also deprives many patients of their right to care. . . . The Association of Nurses in AIDS Care has been on the forefront in establishing accreditation for nurses caring for AIDS/HIV patients.

The idea presented by Dr. Redfield raises questions. What does ''highly-specialized'' mean and how can one guarantee that these patients will receive ''highly-specialized'' physicians?

Will only board-certified infectious disease specialists be assigned to AIDS care? How can these physicians possibly take care of all the HIV/AIDS patients at a busy inner-city outpatient AIDS clinic? Is this an appropriate use of resources in this day of managed care?

AIDS care is complicated, frustrating, and challenging. To provide competent care, providers must be able to be flexible; medication and treatment regimens change rapidly. To suggest that only physicians are capable of weathering such changes severely limits a patient's access to care.

Also, AIDS care is greatly governed by the dollar. Funding for people with HIV/AIDS is dwindling quickly. Health care providers need to be creative and flexible in managing resources.

No matter how specialized, motivated, or compassionate a physician may be, he can only manage so many patients at one time. Why not balance the provider/patient ratio by adding several nurse practitioners (at a much lower cost)?

In advocating for AIDS patients, it is always necessary to question the status quo, to stretch boundaries and challenge rules. I encourage Dr. Redfield to re-evaluate his decisions about managing the AIDS/HIV patients at the Evelyn Jordan Center and to consider broadening his manner of delivering care to them.

Susan Bloomer

Baltimore

The writer is president of the local chapter of the Association of Nurses in AIDS Care.

Texaco allowed bigotry to fester

I read with interest Harry Gehlert's Nov. 19 letter regarding Texaco's support of the Metropolitan Opera.

I believe that Mr. Gehlert missed the point.

I recognize that bad organizations can do good things and good organizations, on occasion, may do bad things. In this case of racial bigotry, some of Texaco's executives did some reprehensible things and got caught.

Most reasonable members of our society would agree that Texaco is a good company which, in this case, provided an atmosphere where bigotry was permitted to fester. We, as a society, cannot permit such behavior to continue.

As a stockholder in Texaco I am sending the management a message that I am outraged at the behavior of some of their former top executives and will not tolerate the atmosphere of bigotry recently uncovered.

Patrick H. Birmingham

Baltimore

Proposed tax cut: hot air from Annapolis

According to calculations in the Nov. 20 Sun, the saving from the proposed 10 percent tax cut would be $167 annually for a family with an adjusted gross income of $50,000.

Well, that $3.21 a week should really get the economy moving. I know I'll be on a shopping spree every week.

How much hot air will be wasted over this in Annapolis?

Why bother? Give it to all the schools in the state instead.

Jeff Thorssell

Towson

Income tax cut is good beginning

We are pleased that Gov. Parris Glendening finally has realized that the Maryland economy needs tax relief (Nov. 20 editorial).

Maryland's extraordinarily high personal income tax (fourth highest in the nation) has burdened our economic activity for far too long, and has been a major cause for the state's poor showing in job growth (46th in the nation).

We must add, however, that the cut proposed must only be a good beginning, as it merely drops us a notch or two when compared to other states, and in fact only takes full effect in the year 2000.

The cut, in reality, may be ''too little and too late.` We need to begin to think more strategically regarding the matter of taxes.

States all along the eastern seaboard have already cut taxes up to 30 percent in the past couple of years, making Maryland's competitive position even more dire. A more thoughtful approach would have been a restructuring plan that would have significantly cut spending thereby allowing an eye-catching and competitive 25 percent reduction in taxes.

Such an approach is done every day in business, which cannot raise prices (taxes) at will, but must depend on creative cost-cutting and productivity improvements to remain competitive.

Richard E. Hug

Baltimore

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