Since earning her master's degree in social work in 1994, Nancy has focused her attention on counseling disadvantaged substance abusers in New York City -- a focus that quickly became virtually inseparable from HIV counseling. It's difficult to imagine a more stigmatized, disenfranchised group of people than HIV-positive, low-income drug users from minority communities, which may be exactly why she decided she needed to do what she could to help them. "I have shared with patients the stigma, discrimination, hardships, heartaches and fears that are associated with their illnesses," she says. "I enjoyed listening to them. I enjoyed offering support. It was just something I truly loved to do. ... I loved learning about them."
Nancy works at Jacobi Medical Center in the Bronx and tackles the challenges of her work through a great sense of humor, a social support network of friends and the courage exhibited by her HIV-infected clients. She doesn't judge; she just listens, and then she heals. For many of her clients, that's the most important service she can provide. One of her clients wrote in nominating her, "She has changed many lives, including mine. Her great patience is inspirational!"
How long have you been working with people living with HIV?
I have been working in the social work field for the past 11 years. Having majored in psychology in college, I continued on to social work school at Columbia University right after graduation. Upon graduating, I took a position in a New York City public hospital, which delivers care to a low socio-economic population. My first position was on a detox unit. This was my first exposure to people living with HIV/AIDS. Since that first position, I have held various positions within the hospital, primarily with people struggling with substance abuse.
Can you describe how your work has changed since you first started?
Over the years, my understanding of what it is like to live with HIV has changed. I have shared with patients the stigma, discrimination, hardships, heartaches and fears that are associated with their illnesses.
People are definitely living longer with the illness. People aren't as sick as they used to be. In that regard, I'm working with patients more who are living longer. Financial resources are starting to not be as much as they were in the beginning.
If I were to follow you over the week, what would I see you do at work?
In my current position, I run support groups. I work mostly with the substance abuse population. I also see people individually who have a substance abuse history or are currently active users. I see them in interventions or on a crisis intervention basis.
I also supervise four case managers who do concrete services for people who are HIV-positive -- food pantry, transportation, etc. I also supervise a social work supervisor who works in the psychiatric emergency room. She supervises three people.
What's the best thing about your job?
The thing I enjoy most about my job is the dedicated and diverse staff and population that I work with. It has helped me to maintain a positive outlook and avoid burnout. Having a sense of humor has also helped greatly!
A common theme that arises when meeting with individuals is their feeling of being different than others, of being judged and ostracized by family and friends. It has been both challenging and rewarding to help people recognize the ignorance of others and to eliminate their own internal shame.
What's the worst thing about your job?
It sometimes can be really sad to see patients that are very ill medically and they still continue to use substances -- drugs and alcohol. They have a desire to stop, but they can't. They're shortening their lives because of the impact drugs are having on their lives. It's hard to watch.
What have been your greatest successes in your work?
Support groups have historically been difficult to organize. It has been rewarding to be able to engage patients and I now have a thriving group with a core constituency. This was definitely a challenging feat, but the most challenging part of my job is seeing people who want things to be better but don't have the ability or social support to make the positive changes that are needed at a particular time.
Do you work with any particular population of people?
The substance abusing population, predominantly low socio-economic and I work predominantly with the African-American and Latino population.
What is the biggest challenge you face as a case manager/social worker? Would other people in your profession give a similar answer?
Working with this population, a lot of the time it's difficult to engage patients. There are a lot of missed appointments. There are a lot of appointments they make, but they miss. In one day, you have a lot of missed or canceled appointments. Their medical issues overwhelm them. Their psychiatric issues take a back seat to the medical. I think other people in the profession would give a similar answer.
For the most part, what do you think is the biggest risk factor for HIV?
I think the biggest risk factor is ignorance, especially in kids. No one's dying anymore. They are engaging in unprotected sex.
What is the most important or memorable thing you have learned from the people you work with?
One of the most important and memorable things I have learned from working with the HIV population is their strength and perseverance. After all these years I continue to be amazed by the courage that people demonstrate in facing life's most challenging obstacles. Having a chronic illness often exacerbates these challenges.
How do you maintain a positive outlook and avoid burning out?
I spend a lot of time with staff and attending supportive meetings and having a sense of humor.
If you weren't a social worker what would you be?
I can't imagine doing anything else.
What do you think are the biggest problems people living with HIV face today?
Truly the stigma facing HIV-positive people is one of the biggest problems. Discrimination, hardships, heartaches and fears that are associated are also difficult.
Do you see a lot of women now?
I see a lot of women. I think it's more difficult for women, regardless if they're positive or not, because of child care issues. I think these are the services they often need that are different than what men need.
Who would you dedicate this award to if you could?
I would dedicate it to my parents.
Where did you grow up?
I grew up in the suburbs of New York City.
What kind of work did your parents do?
My father was a principal of a high school in the South Bronx and my mom was an administrative assistant; both have been retired for the past two years.
When did you decide you wanted to be a social worker?
It was during the latter part of high school and beginning of college that I realized my "calling" and how much I enjoyed helping others. This calling has since remained with me and I can't imagine working in a field other than the one I am in now.
What other jobs have you had?
Right when I graduated from college, I went into social work school. The hospital was my job, but I've only moved around the hospital.
What made you decide to do this kind of work?
I just really enjoyed working with people. I enjoyed listening to them. I enjoyed offering support. It was just something I truly loved to do. I loved hearing people's stories. I loved learning about them.
Who were the most influential people in your life, both professionally and personally?
I believe most of my understanding of diversity comes from my parents, both of whom immigrated to this country from Italy when they were in their teens. Through sharing their struggles and experiences with stigma and prejudices I believe it has helped my sister and I to be more mindful and understanding of people who are different.
What do you do in your spare time?
I just recently got into yoga, which I love. I enjoy spending time with friends and family.
Do you have a partner? Kids? Pets?
No partner and no kids. I do have a pet, a dog. She's nine.
Where do you live? What kind of community is it? What do you like/dislike about it?
I live in the suburbs of the New York City. I live in Westchester County. It's quite beautiful, tree-lined. It's very peaceful. I don't think it's as diverse as it could be. It's very similar people.
What's the best vacation you ever had?
In addition to instilling important values, I believe that my parents also encouraged my curiosity about different cultures and customs. This curiosity has sparked my interest in travel and foreign adventure. I've been to a lot of places -- Europe, South America, Cuba, the Caribbean, the West Coast. I love traveling so much. It's really difficult to select a favorite.
What's the biggest adventure you ever had?
When I studied abroad for six months in Italy, which I thought was an awesome experience. It was in Florence.
What's currently on your bedside table for reading?
I just read Random Families. It takes place in the Bronx. It depicts the population that I work with. The character herself, you sort of meet her when she's younger than an adolescent. It takes you through her teenage years and adulthood. It gave me the opportunity to understand the families that I work with more.
What book would you say has had the most impact on you?
It's definitely Random Families.