Staff Longevity Leads to Patient Retention

Jan 01, 1970

Jan Fritsche will never forget how a small gesture made a huge impact on a patient living with AIDS. Fritsche worked as a nurse at a large academic medical center in Illinois as she earned her master’s degree in psychiatric nursing. The male patient was hospitalized as he awaited admission into Chicago House hospice care. He suffered from painful boils and when one of them was being lanced, Fritsche recognized that the two milligrams of morphine he had been given were not stopping his pain.

“I got him more morphine and removed my latex gloves so that I could hold his hand,” Fritsche recalls. “He looked at me and said it was the first time he had been touched in so long. I felt horrible that he had been so divorced from human interaction. Everyone else who came in contact with him would totally gown up. This really isolated him.”

She didn’t know it that day, but Fritsche would dedicate her career to caring for people living with HIV in Chicago. She has been working as a nurse at Rush University Medical Center for the past 18 years. She has also been a part of AIDS Clinical Trials Group (ACTG) Network’s site at the hospital. She is the manager of Rush’s outpatient infectious diseases clinic and coordinator of the ACTG’s Clinical Research Site there.

“That experience holding that gentleman’s hand has always stuck with me,” Fritsche says. “Back then, people had resigned themselves to dying. And then ACTG studies began to show the positive effects of taking protease inhibitors. People began to get better, but they also became depressed because they were not prepared to live. My background in psychiatric nursing became really helpful.”

Beverly Sha, MD, is the Clinical Research Site Leader at Rush. She has worked with Fritsche for 18 years.

“The thing that has most impressed me about Jan is her compassion for our patients and her willingness to go the extra mile,” says Sha. “As a manager, she has consistently encouraged all our research nurses to form that special bond with their research patients. I believe this has greatly contributed to our success as a clinical research site.”

Fritsche says the populations most affected by HIV currently in Chicago are minority women and young, black men who have sex with men. Fritsche serves on the ACTG’s Underrepresented Populations Committee or UPC.

“We met several women who could not swallow their HIV medications,” Fritsche says. “This was not because there was anything wrong with them physically, but emotionally they didn’t feel they deserved to feel better. I think the ACTG needs to work more with the National Institute of Mental Health and the National Institute on Drug Abuse to fund behavioral studies. We need to focus on a person’s wellbeing and determine what obstacles are keeping them from taking care of themselves.”

Fritsche has also sat on the ACTG’s Outreach, Recruitment and Retention (OR&R) subcommittee on and off for the past 15 years, serving as chair and vice chair. She says having some of the same staff at the Rush ACTG site for the past 20 years has been key to retaining people in care and on studies.

“I firmly believe in primary nursing in research.  Having the same investigators and nurses see our patients in long term follow-up over many years is what has kept patients with us,” Fritsche says. “We have built a relationship with our patients. Back at the beginning, friends and family would sometimes shun people living with HIV. The clinic staff was (sometimes) the only support many people had. To me, getting people into care and keeping them there is the crux of everything.”

Dan Gebhardt is the Information and Data Manager at MetroHealth Clinical Research Site in Cleveland. He served for many years on OR&R with Fritsche.

“I was relatively new to the ACTG and still trying to figure out how everything worked,” Gebhardt recalls. “Jan was, and is, an incredible mentor who had the patience and wisdom to teach me at my level and get me up to speed.  We went through some challenging and motivating times serving on OR&R together. Regardless of the situation, Jan has an incredible wit and sense of humor that she brings to even the most difficult of situations that always helps to put things in perspective. She had been a role model for me who has guided my time with the ACTG.”

Finding gratification from the work she does has kept Fritsche happily at Rush for nearly 20 years, and she shows no signs of going anywhere anytime soon.

“It is important to me to be involved in something with social value,” Fritsche says. “This feels important. You don’t see manifestations of AIDS any more. I’m not sure if the average person knows how well people living with HIV are doing. We still have work to do. But watching another infectious disease like hepatitis C virus become curable is so wonderful and inspiring. I hope to see HIV cured in my lifetime.”

When she is not running the infectious diseases clinic and ACTG research site at Rush, Fritsche enjoys gardening and spending time with her 12-year-old daughter Hannah.