Managing Cardiovascular Complications of Pregnancy

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Over the past 30 years, the number of pregnancy-related deaths in the U.S. has more than doubled, from 7.2 women dying per 100,000 live births in 1987 to 16.9 women in 2016. By comparison, on average in high-income countries, 11 women die for every 100,000 live births.

CVD a leading cause of maternal mortality.

There are many reasons why more women die from pregnancy-related causes in the U.S. than in other developed countries; our dysfunctional health care system is, of course, a central problem. But is there more that nurses can do to ensure safe and healthy pregnancies?

“Cardiovascular diseases constitute a leading cause of maternal and fetal mortality in pregnant women… [In recent studies], inadequate peripartum follow-up—such as failure to evaluate new symptoms, reevaluate existing symptoms, or respond to changes without delay—was responsible for between one-quarter and two-thirds of deaths associated with pregnancy-specific cardiovascular diseases.”

That’s from “Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy:  A Clinical Review,” in the November issue of AJN. In this CE feature article, Maheu-Cadotte and colleagues at the Université de Montréal provide an update on the current management of gestational hypertension, preeclampsia, and peripartum cardiomyopathy.

Risks […]

2019-11-08T12:09:08-05:00November 8th, 2019|Nursing|0 Comments
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The Underlying Connection Is Nursing

Angel sculpture on grave marker photo by author

Marcy Phipps, BSN, RN, CCRN, ATCN, TNCC, an ICU nurse who recently took up flight nursing, is an occasional contributor to this blog.

I recently experienced a series of events that seemed interconnected and orchestrated.

It started with my usual morning run. I was jogging out of my neighborhood, already sweating in the summer heat and absorbed—coincidentally—in an audio podcast about trauma care, when I came upon a man sprawled in the middle of a usually very busy thoroughfare. His motorcycle, badly damaged, was lying on its side next to a car with a crumpled door panel. The accident had clearly just occurred—traffic hadn’t yet backed up and no sirens could be heard heralding imminent assistance.

I had the weird sensation that I’d been running to the accident all along. I held his C-spine and monitored his neuro status while an off-duty paramedic managed the scene. Unexpectedly, a cardiologist I sometimes work with emerged from a nearby café and held his fingers to the man’s radial pulse, and then several more off-duty paramedics arrived.

It seemed fortuitous to me at the time—not the accident, of course, but the proximity of medical personnel who were so quickly available. And I had the impression that, despite not having worn a helmet, the motorcycle rider would be okay. […]

2016-11-21T13:03:52-05:00September 22nd, 2014|career, narratives, Nursing, nursing perspective, Patients|12 Comments
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A Focus on Meaning and Attitude: This Week’s Nursing Blog Post Suggestions

By Jacob Molyneux, AJN senior editor

'Autumn Washed Away,' Diane Hammond/ via Flickr ‘Autumn Washed Away,’ Diane Hammond/ via Flickr

Here are a few recent posts by nurses that you might find of interest. As I put this together, a theme emerged, so it seemed fair to just go with it. Maybe the approach of these bloggers has to do with the time of year, the shorter days and colder weather as we approach the winter holidays . . .

At the intriguingly titled Nursing Notes of Discord blog, there’s a short reminder post with a fairly straightforward descriptive title: “Anyone Can Make a Positive Difference.” And, the author points out, you “don’t even have to be a nurse” to do so.

At Digital Doorway, Nurse Keith has a recent post that also focuses on positivity, this time about one’s profession: “For Nurses, ‘Just’ Is a Four-Letter Word.”

At HospiceDiary.org, in the lovely post “Leaves, Geese and Other Ramblings”—as the below quote may suggest—we find another angle on this theme of being present and focusing on the good in the midst of sometimes constant, poignant awareness of change, loss, dying, and rebirth:

2016-11-21T13:06:05-05:00November 13th, 2013|career, healthcare social media, nursing perspective|0 Comments
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Ms. Nightingale as an Applied Statistician

By Sue Hassmiller, PhD, RN, FAAN (latest in a series of posts by Hassmiller, who’s spending her summer vacation retracing crucial steps in Florence Nightingale’s innovative career)
 
Here at the home of Florence Nightingale, Embley Park (for more on Embley Park, see last week’s blog post), approximately 100 people have convened to study the impact of the “Lady with the Lamp.” The lady herself was multifaceted, and so is this crowd of scholars. There are nurse leaders, of course, but also museum curators, historians, educators, and biographers. They are all interested in their own piece, but also in how their piece fits into the bigger whole of her life. Today we heard Professor Thomas from the University of Southampton School of Business discuss her contributions as an applied statistician.
   

Representing mortality. Early in her life, Ms. Nightingale identified the need for hospitals and healthcare systems to collect and use data to improve care. She asked what use are statistics “if we don’t know what to make of them?” She is credited with developing the famous “coxcomb” illustration, which was a multidimensional way of depicting mortality rates. She used statistics at Scutari Hospital (also called Selimiye Barracks) in Turkey to guide her actions and used statistics and data in the London Times to […]

2016-11-21T13:16:32-05:00July 20th, 2010|health care policy, nursing history, nursing perspective|1 Comment
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Are Nursing Strikes Ethical? New Research Raises the Stakes

By Shawn Kennedy, MA, RN, AJN interim editor-in-chief

Nurses at Temple University Hospital in Philadelphia have been on strike since March 31st over a number of issues including wages, health benefits, and a “gag order” that could prohibit nurses from speaking out against the hospital. Nurses walking picket lines is not a new phenomenon. What is new is research showing that patients suffer harm when nurses strike.

In March, a paper (subscription only) published by the National Bureau of Economic Research provided some evidence that nurses’ strikes have harmful effects on patients. The authors analyzed strikes (in all, 50 strikes in 43 hospitals) in New York State over a 20-year period and looked at what happens to inpatient mortality rates and 30-day readmission rates for patients admitted during a strike. They found that inpatient hospital mortality increased by 19.4% and that readmission within 30 days increased by 6.5%. The researchers asked, “Is this because [patients] receive less care, or because they receive worse care?” And, in an analysis to see if the results were different in strikes where management hired replacement workers, it showed they were not—outcomes were still worse.

These findings really shouldn’t come as a surprise. How can care be safe when there are fewer nurses than the normal levels (which often are already less than adequate for providing optimum care)? How can care be safe when replacement nurses—whether newly hired or shifted from other positions—are plopped onto units […]

2016-11-21T13:18:09-05:00April 16th, 2010|career, Ethics, nursing perspective|5 Comments
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