At the Intersection of Hospice and Obstetrics, a True Test of Patient-Centered Care

By Jacob Molyneux, senior editor

Renee Noble with her newborn daughter, Violet. Photo by Heidi Ricks. Renee Noble with her newborn daughter, Violet. Photo by Heidi Ricks.

We’d like to draw attention to a particularly frank and thought-provoking article in the October issue of AJN. “A Transformational Journey Through Life and Death,” written by a perinatal nurse specialist who is also a bioethicist, describes a hospital’s experience in meeting the needs of a patient with two very different, potentially conflicting, medical conditions.

It was a sunny afternoon in mid-October when I first met Renee Noble. I had already heard about her from staff who had given Renee and Heidi Ricks, her friend and doula, a tour of the neonatal ICU and were taken aback when they asked to see the Hospice Inn as well. The nurses knew that Renee had been diagnosed with ovarian cancer, but no one had said anything about it being terminal. Heidi had insisted that after Renee delivered she would need hospice inpatient care. Alarmed, the staff had called me, the perinatal clinical nurse specialist, after Renee and Heidi left.

In addition, this is a patient with strong preferences about her own care, preferences that may be at odds with the more conventional approaches to treatment held by […]

2016-11-21T13:03:43-05:00October 22nd, 2014|narratives, Nursing, nursing perspective, patient engagement, Patients|4 Comments
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BRCA Gene Mutations: Knowing You’re At High Risk for Cancer

‘Autumn Washed Away,’ Diane Hammond/ via Flickr

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

October is Breast Cancer Awareness month. We thought we’d do our part with a feature article to help increase nurses’ awareness of some of the issues faced by women who find they are at high risk for breast cancer.

In the October issue, author Rebekah Hamilton describes her research with young women who learn they have a BRCA gene mutation that puts them at greater risk for cancer, especially breast and ovarian cancers. “Breast cancer risk ranges from 50% to 85% by age 50 in women with the mutation and is 12% in women without it.” Her study explores the consequences this knowledge has on decisions these women make about their future, especially those related to prophylactic surgery, relationships, and childbearing, and offers some recommendations for practice. The abstract is below, but I urge you to read the study, especially if your patients include young women.

Objective: Women who carry a BRCA1 or BRCA2 gene mutation face a risk of developing breast or ovarian cancer at an earlier age than women without such a mutation. Relatively little is known about the psychosocial consequences—especially regarding marriage and childbearing—in young women who test positive for one of these mutations.

Methods: In 2006, participants were recruited from Web sites for women with breast cancer or BRCA gene mutations. Forty-four women ages 18 to 39 from 22 states and Canada […]

2016-11-21T13:09:06-05:00October 15th, 2012|nursing perspective, nursing research|0 Comments
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AJN’s October Issue: Breast Cancer, Celiac Disease, the Fall Elections, More

AJN’s October issue is now available on our Web site. Here’s a selection of what not to miss, including two continuing education (CE) articles, which you can access for free.

All women who inherit a BRCA1 or BRCA2 mutation have a significantly increased risk of developing breast or ovarian cancer or both. This month’s original research article, “Being Young, Female, and BRCA Positive,” explores the psychosocial consequences in young women who test positive for one of these mutations—especially where it concerns marriage and childbearing. This CE article is open access and can earn you 2.1 CE credits.

Diagnosis of celiac disease in adults is often missed or delayed because clinicians often consider it to be a childhood disease. “Celiac Disease: A Medical Puzzle,” provides an overview of this widely underrecognized disease, outlines the pathophysiology and the four types of celiac disease, addresses diagnosis and disease management, and offers illustrative stories in the interest of raising nurses’ awareness of the disease. This CE article is open access and can earn you 2.1 CE credits. For more information, listen to a podcast with the authors.

Being unaware of the realities of licensure can damage a nurse’s career, even permanently. “Common Misconceptions About Professional Licensure” is part one of a three-part series that will discuss nursing disciplinary actions and provides tips for maintaining one’s license in good standing. For more, listen to a podcast with the author, […]

2016-11-21T13:09:11-05:00October 1st, 2012|Nursing|0 Comments
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Are We Trivializing Breast Cancer (and Demeaning Women) Even As We Raise Awareness?

Christine Moffa, MS, RN, clinical editor

I admit it. On January 7th my  Facebook status simply stated “Black.” Normally I’m not a joiner, but when I received a message from a FB friend that said the following, “This is fun put just the color of your bra in your status and send an email to the girls only and see if the guys can figure it out, it’s to raise breast cancer awareness,” I only paused for a moment. While a small part of me wondered if it was legit, I changed my status and forwarded the message on to other friends.

It seemed cute and harmless enough—until today, when I came across Donna Trussell’s article at Politics Daily. Her arguments—in which she interrogated her own feelings (as an ovarian cancer survivor) about our culture’s seeming obsession with breast cancer awareness, and distinguished between feel-good awareness and real action—made a lot of sense to me. The whole thing reminds me of the April 2009 cover of AJN (image below) featuring a piece from the Artful Bras Project by the Quilters of South Carolina, also created to raise breast cancer awareness.

We received a lot of letters about that one, both positive and negative. Either way, it does get people talking. Is doing something as silly (and, to some, either sexist or demeaning) as this justified in the name of increasing awareness about a disease?

2016-11-21T13:20:09-05:00January 18th, 2010|Nursing|1 Comment
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September Is Ovarian Cancer Awareness Month

By Jim Stubenrauch, senior editor

OvarianCancerArticleThis month, AJN is joining in the nationwide effort to raise awareness and promote education about ovarian cancer. The September issue contains an original research paper on “Women’s Awareness of Ovarian Cancer Risks and Symptoms” by Suzy Lockwood-Rayermann, PhD, MSN, RN, and colleagues. The authors analyzed data collected from an online survey completed by more than 1,200 women ages 40 and older and found that awareness of ovarian cancer symptoms and risk factors is low. This suggests that nurses have an excellent opportunity to educate patients and help them get diagnosed at earlier stages of the disease when it’s more treatable.

You can also hear an interview I conducted with Dr. Lockwood-Rayermann on our podcasts page.

I’ll summarize the study below, but first, you might want to know that cancer survivor, actress, and women’s health activist Fran Drescher wrote on a related topic in this month’s Viewpoint, “Women, Take Control of Your Bodies!” Drescher discusses her battle with uterine cancer and the crucial support her sister Nadine, a nurse, provided on her “medical oddysey.” After writing a book about her experience, Cancer Schmancer, Drescher started the Cancer Schmancer Movement, an organization dedicated to promoting education, legislation, and social reform aimed at early detection of cancer. […]

2016-11-21T13:22:49-05:00September 1st, 2009|nursing research|5 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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