Volunteers: How to GetThem, Train Them, and

Keep Them

By Cathy Sears

You could say it is the new age ofvolunteerism. An unprecedentednumber of individuals have re-

sponded to the AIDS crisis by providinghundreds of hours as volunteers—ashotline operators, counselors, buddies,and in countless other roles.

Many of these volunteers met recentlyin New York City at what has been de-scribed as the "Woodstock of volunteerconferences," to share experiences andlearn how to meet the challenges ahead.Chief among the concerns, says Dr.Richard Arno, health economist at CityUniversity of New York and a speaker atthe conference, is "whether this highlevel of volunteerism will be main-tained." The landscape of AIDS is rapidlychanging from predominantly gay to in-travenous drug users, their sexualpartners, and their babies (a group tradi-tionally lacking any community-basedsupport structure).

Health care centers have either reliedentirely on outside groups to providesupport services or have not developedany in-house support structure. In fact,most hospital-based AIDS volunteer pro-grams are in their infancy, with small or

nonexistant funding and staff.Several hospital volunteer directors,

however, are leading the way and thosepresent at the conference, sponsored byUnited Hospital Fund, discussed the

nuts and bolts of their own unique volun-teer AIDS programs. Here's how hos-pitals from San Francisco to New YorkCity have recruited, trained, and main-tained their AIDS volunteer force.

Consider Outside Groups"Although most hospital-based AIDS

volunteer programs begin ad hoc, withno formal initiative, your best bet is tostart with the key resource at hand—your in-house volunteer director," saysEllen Fralick, head of volunteer initiativesfor for the United Hospital Fund, a NewYork City-based research and policygroup. "You then have two choices tomake: train volunteers already there, oruse ones from the community. Utilizingyour hospital's auxiliary program is fine,but tapping outside groups will bringnew energy into the program. They willalso help reduce costs by providing readyaccess to already-existing servicesranging from fundraising to outpatientcare," adds Ms. Fralick.

Another reason to consider outsidegroups, notes Virginia Crosby, executivedirector of the Friendly Visitor volunteerprogram at St. Luke's-Roosevelt HospitalCenter in New York City, is that the gen-eral hospital volunteer may not be thebest choice to pair with a terminally illpatient. "You'd think everyone who vol-unteers wants to work on the wards, butmany actually prefer working in giftshops or offices. It really takes a specialtype of person to work with the termi-nally ill, especially those with AIDS."

Friendly visitor volunteer gives birthdayparty for a patient on the AIDS unit, St.Luke's-Roosevelt Hospital Center. (Photocourtesy of St. Luke's-Roosevelt HospitalCenter)

Recruitment MeansTargeting Publicity

Everything from church bulletins tocommunity group newsletters to speakerforums can help bring recruits into yourprogram. "The key is to tailor recruit-ment to each organization," says BridgetProust of Project BRAVE (a volunteerprogram for IV drug users and theirsexual partners at Montefiore Hospital,Bronx, New York). "Talking to a commu-

nity group is different from talking to

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AIDS PATIENT CARE / AUGUST 1988 19

//,Most hospital-based AIDS volunteerprograms are in their infancy, with small

or nonexistant funding and staff.

professional health care workers. Youhave to speak as a neighbor, not justthrow statistics at them." Ms. Proust alsofinds it helpful to bring along an experi-enced volunteer when speaking to a

group.Media also play a major role in getting

hospital-based AIDS programs off theground. A New York magazine article was

responsible for bringing in one-third ofthe volunteers for a St. Luke's-Roosevelttraining session, says Virginia Crosby.

Recruiting from community-basedgroups, especially those most affected bythe AIDS crisis, has proven to be highlysuccessful for San Francisco General Hos-pital. With an initially high gay patientpopulation, the AIDS-designated hos-pital tapped well-organized gay groups,such as the SHANTI Project and the SanFrancisco AIDS Foundation, for coun-

selors, buddies, and helpers. Coupledwith extensive support from local com-

munity and church groups, the nation'sfirst hospital-based volunteer program(which began in 1983) has helped cuttotal patient care costs nearly in half, ac-

cording to Phyllis Cardozo, executive di-rector of volunteer services. On average,40 volunteers visit their 20 to 30 PWAs.

At Harlem Hospital in New York City,volunteer director Nettie Richards hasbeen particularly successful in reachingwithin the community to single, career-oriented women to take care of the 40 in-fants (seven have AIDS) in the BabyBorder program. Her next target: recruitfoster-care parents for the border babiesand find care givers for the estimated 60

outpatient infants and children withAIDS who are increasingly being aban-doned at the inner-city hospital.

The babies at St. Luke's-Roosevelt,notes Virginia Crosby, also have begunto attract the "American Express" type.In general though, the mix of volunteersat the midtown division of St. Luke's-Roosevelt is rather diverse. In 1985, theFriendly Visitor program (the first in thecity and considered a model for otherhospitals) started with 18 volunteers and12 PWAs. Now Crosby averages 30 to 40volunteers for adult PWAs.

At Montefiore Hospital, religious orga-nizations have been a particularly strongsource for recruitment for ProjectBRAVE. "The church is the sole intactsocial institution in the Bronx," explainsBridget Proust, director of the two-year-old project. And, like other programs,Project BRAVE's mix of volunteersmirrors the population of the communitysurrounding the hospital: many have haddirect exposure to IV drug use and/orAIDS within their community or family.They generally are working class, with a

segment on public assistance, and morewomen than men participating. Socialwork students from four neighboring col-leges help out as well. Proust averages 15hands-on volunteers and 50 to 60 on-callhelpers for special projects such as foodor clothing drives.

But for hospitals with small AIDS pa-tient populations, such as St. Patrick's inMissoula, Montana (four cases to date),the local Missoula AIDS Council providesthe trained volunteers. The same is true

Sticky Issues in HospitalAIDS Volunteer Programs

• Letting a volunteer go: As Ms.Crosby puts it, how to fire someonewhom you are not paying? She triesto offer alternative projects in placeof letting someone go.

• Young volunteers: St. Luke's-Roose-velt soon will require college kidshave their parents sign a "parentalacknowledgement form." Mostprograms do not allow anyoneunder the age of 18 to participate."Dealing with the terminally ill isvery difficult," notes Ms. Proust.

• IV drug users—more trouble? Yesand no, says Ms. Proust. "An IVdrug-user in the early stages ofAIDS can be a problem, but all sickpeople can be manipulative. IVdrug use is just an excuse really."The real problem, she feels, is thegeneral lack of education within thecommunity about this particularrisk group and AIDS. "There are so

many misperceptions out there,"adds Ms. Proust. Ms. Crosbyagrees, adding, "It's important tonip this issue in the bud. Thenumbers of PWAs who are IV drugusers in hospitals are increasingdramatically."

• To buddy or not: Several hospitals,such as Montefiore, recruit some oftheir volunteers as buddies or emo-tional-support volunteers. How-ever, Ms. Crosby does not utilizeher volunteers this way. Aside fromother groups providing this impor-tant service, Ms. Crosby's prior ex-

perience with hospice volunteershas shown that "buddies burn outmuch faster. By the third death,they are usually finished with vol-unteering." Crosby has strongfeelings about the role of a hospitalvolunteer: "They are not socialworkers—not anything other thana friend. I want them to use theirinstincts, like they would with anext-door neighbor."

20 AIDS PATIENT CARE / AUGUST 1988

Volunteer Programsand Contacts

Virginia Crosby, Executive Director ofVolunteer ServicesSt. Luke's-Roosevelt Hospital Center428 West 59th StreetNew York, NY 10019(212) 554-7151(Crosby currently is applying for a

grant to produce a video for hospital-based volunteer programs.)Larry Cohn, Director of VolunteersThe Whitman-Walker Clinic1407 S Street, NWWashington, D.C. 20009(202) 797-3500

Bridget ProustProject BRAVECommunity Health ParticipationProgram3320 Rochambeau Avenue, 1st floorBronx, NY 10467(212) 920-4301

Phyllis Cardozo, Executive Director ofVolunteer ServicesSan Francisco General Hospital1011 Petero, Rm 7F10San Francisco, CA 94110(415) 821-8193

The National AIDS Network1012 14th Street, NW, Suite 1201Washington, D.C. 20005(202) 347-0390(Provides general information onhow to set up a volunteer program.)VOLUNTEER: The National Center1111 North 19th, Suite 500Arlington, VA 22209(703) 276-0541(Provides general information on

training, promotion, and informationsharing.)SHANTI Project525 Howard StreetSan Francisco, CA 94105(415) 777-CARE(Ask for information about their com-

prehensive training program, whichincludes 22 videotapes and amanual.)

//The key is to tailor recruitment to each. '. tt

organization.

in Phoenix, where the Arizona AIDSProject provides "emotional support"volunteers for their hospitalized clients.The volunteer works directly with thehospital-based social worker.

Interviews and PhysicalsFollowing a recruitment drive, the hos-

pital volunteer coordinator should con-

duct personal interviews to carefullyscreen applicants. "You don't needanyone with a chip on his shoulder—AIDS patients have already sufferedenough discrimination," notes VirginiaCrosby. Look for mature, relaxed adultswith a sense of humor.

Application forms also help in thescreening process. Most questionnairesare brief, though the Washington, D.C.-based Whitman-Walker Clinic uses a six-page form. Most should cover the basicsincluding: reason for volunteering, avail-ability, transportation, preferences, andspecial skills. Some hospitals also requirethe standard hospital employee physicalto assure the hospitalized patient will notbe exposed to communicable diseases.Others, like Harlem Hospital's BorderBaby program, require a drug test and a

background check for child abuse. SanFrancisco General, Harlem, Montefiore,and St. Luke's-Roosevelt all welcomePWAs as volunteers. A basic rule standsfor all volunteers, however, that anyonewith an active infection, be it a cold or

AIDS, cannot visit patients.

Orientation and TrainingThe key to developing a strong and vi-

brant volunteer program, says Virginia

Crosby, is twofold: "Tailor training toyour own program, but cover thebasics." For most programs that includeshospital philosophy, AIDS epidemi-ology, program overview, and a wrap-up(checking-in, name tags). The hospital'sprofessional staff should also participatein the training program, as well as a sea-soned volunteer or two. Some programsask PWAs to share their own experi-ences. "It's important to be specific inyour orientation and educational pro-grams, but don't over do it," says Ms.Crosby. "Overtraining volunteers can

cause burn out."Larger, more established programs

may find the need to develop their own

comprehensive training manual. SanFrancisco General's AIDS VolunteerHandbook has been shared with over 400other hospitals around the country. The42-page manual includes such things as:

• AIDS: questions and answers;• glossary of terms (Candida, Kaposi's

Sarcoma);• drugs used in AIDS care and some of

their side effects;• infection control; and• death and dying issues.

"Some hospitals also feel supportgroups are important for maintaining a

volunteer staff and avoiding burnout. Weencourage people to step back and talkabout how they feel. Otherwise, if peopleget too involved they become ineffectivehelpers," notes Ms. Crosby. D

Cathy Sears is a staff reporter/writer at Amer-ican Health magazine in New York City.