The urge to start early appears to be a trademark for Pitt, a nurse and HIV research coordinator in Torrance, Calif.: Today, her work focuses on investigating primary infection, the earliest stage of HIV disease. Of course, that's only one of many roles that Pitt fills in her job as Project Coordinator for the Harbor-UCLA Research and Education Institute. Pitt is responsible for training research staff, managing budgets, recruiting study patients, and collecting data. She also writes and lectures on HIV for the community, and supervises 150 HIV-positive participants in various clinical trials.
To her patients, though, it's Pitt's dedication and devotion that set her apart. In fact, she was nominated for an HIV Leadership Award by a person who's been under her care for six years, longer than any of her other patients. "Jacqui was in the room when I received my HIV diagnosis, and she helped steer me through those critical first months of dealing with its implications," the patient wrote. "She has always made herself available to me at any time."
That availability, and the warmth and compassion with which Pitt treats her many patients (she ends each visit with a hug, she says), speaks volumes about the type of person, and nurse, she is. It's no mystery how she won an HIV Leadership Award.
How has nursing affected your life?
I always wanted to be a nurse, from the age of five. I had my tonsils out when I was 7 and told the nurses I wanted to be a nurse. When I was 15, I did my work experience through school in that same hospital. Nursing has given me a different outlook on life: Anything can happen at any time and we need to be mindful of our lives and live them!
Do you try to pass that on to your patients?
Of course. Doing this job, I learned that anything can change quickly. Because I see firsthand that anyone's health can completely change in 24 hours, I realize that you shouldn't put off what you can do today. There's no point in waiting. You're only young once. There are more things that can happen to my patients than HIV, so I try to encourage them to live every day. I deal with many patients who have just found out about their infection. With proper treatment they could live for quite a long time.
Can you talk about your program?
The main study I run is an observational study of people who are in the active seroconversion stage of HIV. We are just watching them. When they first come in, I see them every week, then every month, then every other month, then every three months. They can take treatment, but they are not administered through us. The extra support I provide keeps them in the study.
I sympathize with their struggle and understand they get confused sometimes when they are going through all these new situations. Sometimes their initial diagnosis feels like a death sentence, and they think the seroconversion symptoms means that they have AIDS. I stay with them and I know that in a year's time they won't be talking about HIV anymore but life experiences, boyfriends, jobs, all kinds of daily life -- it isn't all seriousness.
What's the key to a great healthcare provider/patient relationship?
Communication, communication, openness from both sides and communication! Communication throughout the whole provider team. Too many patients are treated as an illness, and not as a whole person. But they are more than an appendix and bedpan, as I like to say. Patients may be under stress because they can't pay the bills or any other of the thousands of reasons for certain attitudes and behaviors. Unless I communicate with patients about all areas of their lives, I won't get the full picture of their situation. I hate having my blood drawn, and I know that other people must not like it too much, so that's when I do all my chitchatting.
Do you have a favorite patient since you have been practicing nursing?
I don't have one favorite (sorry, guys!) but I have lots of favorites, some that I really look forward to their visit. I am always saying that I have the best-looking cohort [group] of patients in town!
Do you find the period of HIV that you deal with most -- the early stages -- as particularly challenging?
All the participants in the main study I work on have tested HIV negative in the last year. That is a guideline of the study so that we can prove that it is a new infection. I am also working on a study with patients with less than a 100 T-cell count. We're actually having a problem finding patients for that one; 10 years ago we wouldn't have had a problem. Current medications allow people to manage their lives better, and that's a good thing.
The patients who are seroconverting or becoming HIV positive go through a phase where they get the worst flu they've ever had -- some of them confuse this period of symptoms for a sign of immediate death. I have a bunch of older patients who are willing to talk to my newer patients, and that helps ease some of the stress that comes with the beginning stages of knowing you're HIV positive. There is a really good support group in Los Angeles that a lot of my patients are in. Sometimes I send new patients to that group, and new patients come to my study as a result of attending those meetings.
Are your patients mostly men?
It's notoriously difficult to find women for any AIDS research study. Some women think they are immune, because their risk factors are low; some may not know that they have it; or for some other reason, I definitely see a majority of men.
How do you feel about patients who take an active role in their own treatment?
All patients should take an active role in their treatment regardless of their health condition. Most of my study patients are proactive, which is probably why they are in a long-term observational study. Why else would they keep seeing me for years, when I offer nothing but blood draws and support? Some of them volunteer at AIDS events or organizations. Many attend community information meetings and support groups. They search for information on the Internet or other places to find out more and learn about what their bodies are going through.
Do you think today's HIV prevention efforts are sufficient?
I think we have ambiguous prevention campaigns, and the morals of the majority will not allow for more direct ones.
Have you had encounters where you didn't feel you were being allowed to educate "to the point"?
I was once asked to talk to teenagers about HIV prevention without talking about sex. I refused. High schools should have much more education on HIV, including how to have safe sex. Teaching abstinence does not work. Kids are going to have sex regardless of what they are told. I would want them to know how to do it safely if they are going to do it. No one asks for HIV, no matter what they do, or what situations they get into to. New cases could be avoided, if people are informed thoroughly.
What are your hobbies?
Aside from trying to keep up with my four-year-old daughter, I very much enjoy craft hobbies. I knit, sew, scrapbook and cross-stitch, though finding the time is hard. I also love Middle Eastern music and love to belly dance. I have danced in public a couple of times with a dance group, but those days are over! Belly dancing was originally a dance for women by women. It was performed by high priestesses. They used to dance around a woman when she was giving birth, and at all sorts of celebrations and cultural passages. It really doesn't have anything to do with the belly, it's all in the hips.
I also love to travel. We go to England at least once a year. When I'm in the UK, I usually try to go somewhere else as well. I do a lot camping locally with my daughter, hiking a little, only short trails because her legs aren't that long. We get to sit around the campfire and roast marshmallows and sing songs. I know all the words to all of her songs. I love Queen. I went to one of their last concerts in 1986. I really wish I had met Freddie Mercury.
Where do you live?
I live in a small city in Los Angeles County called Culver City. It is a very community-oriented city and they have lots of family-focused events, which we attend as often as we can.
If you weren't a nurse, what other profession would you be interested in working in?
I never really considered anything else, but I sometimes think I would love to be a marine biologist, because I love the ocean. Or to be in the chorus on Broadway, although I can't sing, so that's out!
Is there anyone who you would like to dedicate this award to?
How could it be anyone other than my patients? They are the ones who make me the nurse I am and keep me doing what I do.