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Leading sexual health nurses from Australia and the US have reflected on recent shifts in patient outreach, including those forced by COVID-19, during a panel at last week’s Joint Australasian HIV&AIDS and Sexual Health Conferences.

Speakers at the recent event, ‘Celebrating nursing champions — Innovative nurse-led responses to the changing times,’ were often upfront about the challenges they needed to overcome throughout 2020, while also pointing out the successes of their respective approaches.

The panel’s overseas guest, Professor Jeffrey Kwong, from the Division of Advanced Nursing Practice at Rutgers State University of New Jersey, spoke about the his HIV-related work with the Gotham Medical Group in New York City during the crisis, with New York the early epicentre for the American COVID experience.

He said that circumstances forced many Sexual Health Service Providers both across the US and within New York State to reduce their testing and treatment services significantly, and that a re-evaluation of the best types of care provision was required.

“We needed to really look at what kinds of resources we had available to us and how to maximise those services to the fullest extent,” he said during his presentation, suggesting that models such as telehealth, empiric treatment, self-testing and direct laboratory visits were used.

Jude Armishaw, Clinical Nurse Consultant at the Alfred Hospital’s HIV Prevention Service, described a process where her organisation were constantly re-evaluating and updating their response to COVID through the first and second Victorian waves.

At one point, staff at the service were furloughed for 14 days after contact with a patient who returned a positive COVID-19 result, forcing further shifts in their response. However, Ms Armishaw said how the workplace responded to the virus showed how adaptable healthcare caould be.

“We certainly learnt some lessons from COVID and I think like most services we’ve realised just how quickly we can change in response to needs, so it’s been a good learning [experience],” she said.

Meanwhile, Wendy Machin, Clinical Services Manager at the Kirketon Road Centre, an outreach healthcare program connected to the South Eastern Sydney Local Health District (which is part of NSW Health), described their clinic’s success in running multiple pop-up testing stations for vulnerable members of the community.

Responding to multiple clusters, they eventually tested more than 4,000 patients, and Ms Machin said that their model has got to the point where they can now use it as part of their broader outreach program, and not just as an individualised COVID testing program.

“This has demonstrated that we have an ability to adapt to a new public health challenge,” she said, adding, “we have now this highly skilled and flexible workforce, and we’ve got this adaptable model.”

Also during the panel, Joanne Leamy, Sexual Health Clinical Coordinator at the Torres and Cape Hospital and Health Service, spoke openly about the advantages and challenges of the Fly-In, Fly-Out, or Drive-In, Drive-Out model of care, where staff travel to and from regional and remote sites of work.

“We’re able to provide specialist services to a large geographical area,” Ms Leamy said. Though she said there were issues with the distance between staff who were spread across three sites and coordinated from Cairns.

“It just makes it difficult to keep up the teamwork and be in contact with each other all the time.”

Hosted by the Australasian Sexual Health and HIV Nurses Association (ASHHNA), last Thursday’s panel was co-chaired by Judith Dean, Senior Research Fellow at the University of Queensland, and Rebecca Houghton, Nurse Unit Manager at the Sydney Sexual Health Centre.

The Joint Australasian HIV&AIDS and Sexual Health Conferences ran virtually from 16-20 November, and were organised by the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine.