RSV Prophylaxis for Infants and Children: Now Available, But Is it Accessible?

July, a month typically characterized by the relative hibernation of communicable respiratory illnesses, brought with it the U.S. Food and Drug Administration’s (FDA’s) approval of nirsevimab-alip (brand name: Beyfortus) and thus a reminder of the gearing up necessary for the respiratory disease season ahead. Nirsevimab, approved for the prevention of respiratory syncytial virus (RSV), is poised to mitigate the staggering effects of this lower respiratory tract disease. Since significant barriers remain related to distribution, accessibility, and insurance reimbursement for this drug, it is especially important for primary care RNs and nurse practitioners in clinics and medical homes to be well informed on this topic.

RSV: a significant public health burden.

Transmission electron microscopic image revealing morphologic traits exhibited by a human respiratory syncytial virus (RSV)/ CDC

RSV is primarily of concern in the youngest and most vulnerable of the pediatric population, such as those born prematurely, with chronic lung or congenital heart disease. As many of us know all too well, RSV carries significant public health burden, causing more hospitalizations than any other illness in U.S. infants and accounting for 100 to 300 deaths each year in children under […]

2023-09-21T11:10:58-04:00September 21st, 2023|infectious diseases, Nursing, pediatrics, pediatrics|0 Comments
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Primary Nursing of Medically Complex Children in the ICU Increases Parental Trust

Differing views about quality of life.

Photo by Pat Smith/Pexels

As medical care has become increasingly advanced in its ability to prolong life in the face of serious, chronic illness, it has also presented complicated challenges for both the caregivers and care-receivers alike. This holds especially true when we venture into the thorny, subjective realm of “quality of life.”

Sam was a patient with serious chronic illness and severe developmental disability who had been in and out of our pediatric ICU for many years. His most recent nine-month hospitalization had been the most frightening and uncertain thus far, and the gap between the perspectives of the medical team and Sam’s mom had became more apparent. The medical team speculated whether Sam was approaching the end of his life, while his mom asked us to continue doing all we could to maximize Sam’s physical longevity.

Unspoken questions also involved our struggle to measure what exactly comprises “enough” quality of life to justify the continued offering of health care resources. It’s an inevitable struggle with scarce resources and the monetization of quality of life, particularly with a chronically ill, severely disabled child who can feel so “other” to those of us living “normal” lives.

Parents come to our unit seeking care […]

2022-09-14T10:01:23-04:00September 14th, 2022|family experience, nursing roles, pediatrics|1 Comment
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Not to Save the World, But to Care, One Life at a Time

A nurse ponders the question of what makes her work matter.

Illustration by Janet Hamlin for AJN.

The Reflections column in AJN‘s August issue, “To Care When There Isn’t Enough,” is by Alison Stoltzfus, an obstetrics nurse at Evangelical Community Hospital in Lewisburg, PA. Stoltzfus describes her experience volunteering as a nurse at a medical clinic in the world’s largest refugee camp, the Rohingya refugee camp in Ukhiya, Bangladesh.

The work could be overwhelming at times. The camp she describes is a place where human illness and suffering often far exceed the capacities of available medical resources. She writes:

Some days the people would throng me in triage, pulling on my clothes and begging to be seen, desperation and longing in their eyes. A longing that at times I had to refuse.

Every day I would ask myself—“How can one care in a setting like this, and make a difference?” What good was it to make a difference to a few when there were so many lives I could not touch and so many problems we could not heal?

One life at a time.

The story centers around the author’s efforts to use the minimal medical equipment available to help […]

2022-07-28T09:41:40-04:00July 28th, 2022|Nursing, nursing perspective, nursing stories, pediatrics|0 Comments
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What Will It Take? When Will We Act?

Once again, we are sickened by another school shooting and the loss of children and teachers who tried to protect them from being mowed down by an assault weapon in the hands of an 18-year-old boy. This time Uvalde, Texas, is grieving for 19 children and two teachers, and it’s less than two weeks since a shooting in a Buffalo grocery store left 10 dead. Of course, we immediately see the messages from legislators offering their condolences and thoughts and prayers, but no promises to change anything. If not them, then who can?

I remember the awfulness of treating the occasional pediatric gunshot victim when I worked in the ER—usually an unintended target who was caught in crossfire. It was gut-wrenching, the kind of thing that should be a “never-event.” Today, ER nurses, paramedics, and physicians see young gunshot victims far too often. I don’t know how they can do it day after day, trying to comfort parents while dealing with their own trauma.

The leading cause of mortality in children and adolescents.

Firearm deaths are now the leading cause of mortality in children and adolescents (ages 1 to 19 years) in this country, according to a recent analysis by researchers at the University of Michigan reported in the New England Journal of Medicine. […]

2022-05-27T14:01:41-04:00May 27th, 2022|gun violence, pediatrics, Public health|3 Comments
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A Small Gesture of Kindness

Illustration by Janet Hamlin for AJN.

In our January Reflections column (free until March 1), “Just One More,” a nurse shares her memory of a family facing one of the most painful experiences imaginable—the death of a child.

In a situation like this, there is so little that can be done, and the usual gestures of expressing condolences or giving a pat on the hand feel inadequate and hollow.   

She writes:

“I knew that no words could lessen the unexpected heartbreak . . . But still, I wished there was something I could say, or do, that might make a small difference.”

Small gestures, lasting effects.

Most nurses can relate to such a situation. You may not be able to do anything to change a patient’s circumstances, and all you have left in your arsenal of care is a small gesture of kindness. […]

2022-02-11T09:39:23-05:00February 11th, 2022|Nursing, pediatrics, writing|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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