Why Do Pregnant Women Smoke?

 “My mother smoked [when she was pregnant] with me and I am fine.”

“I’d rather smoke a cigarette than take a drink of alcohol to relieve stress.”

“So you’re bored, what are you going to do? Sit down and smoke a cigarette.”

“It relaxes me.”

Tobacco use during pregnancy has been associated with many adverse effects, including abruptio placentae, fetal malpresentation, low Apgar scores, stillbirth, and birth defects such as gastroschisis and cleft lip or palate. Most nurses probably see these as no-brainer reasons for women to stop smoking once they become pregnant. Yet a new research study illustrates that the reasons pregnant women might continue to smoke are very individual, and that clinicians are not always skillful in supporting smoking cessation.

In this month’s AJN, researcher Geraldine Rose Britton and colleagues share the results of their qualitative study on the experiences of pregnant smokers and their health care providers. The researchers used a focus group methodology to learn about the smokers’ experiences and to better understand what motivated them to quit or prevented them from doing so.  There were also separate clinician focus groups to explore the approach of the 45 providers (71% RNs, 11% physicians, plus one NP, one nurse manager, four LPNs, and one PA) to pregnant women who smoke.

Not surprisingly, the researchers discovered that the issue is frustrating to both pregnant women and their maternity care providers. Some physicians and nurses felt unprepared to […]

Those Who Comfort Us

There was only a tiny drop of blood. I was worried, of course, but I went to my OB-GYN for reassurance more than anything else. Maybe she would tell me I was doing too much and needed to rest. Maybe it was just normal. But as soon as she looked at the ultrasound screen, I knew.

Usually when I went for a scan, she immediately turned the screen toward me. Until now, every scan had been great. I had just entered my second trimester. The barrage of tests given to women of “advanced maternal age” had all come back normal. The baby’s heartbeat was strong at every visit, and I was riddled with nausea, something I’d been told was a “good sign.”

This time she stared at the screen for what seemed like forever. Then, quietly, she told me that my baby of 16 weeks’ gestation no longer had a heartbeat. Moments later, the high-risk doctor came in to confirm this. I turned away as he talked to my doctor about the “degradation” he could see, suggesting the death had happened over a week before. Somehow this terrible word—and image—is what stuck with me, even weeks after the event.

Later I entered the ambulatory center where I would have a […]

How to Support the Nurse in Your Life

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse at Children’s Hospital Los Angeles and blogs at http://heartofnursing.blog. Her Reflections essay, “Intimate Strangers,” will be published in AJN‘s August issue.

A quick Google search for “how to support nurses” reveals an emphasis on recommendations for hospital management on developing structured support for nurses at an organizational level. The search also captures popular articles on how nurses provide support to their patients. Ironically, the query results provide no resources to inform the nurse’s closest support system—families and friends—as well as the general public about what kind of support the nurse really needs and how to better provide it.

I attribute these search results, at least partly, to the fact that we nurses don’t always know how to articulate what we need. Some forms of support, such as treating a nurse to a mani-pedi or a spa day (or a parallel form of relaxation for our male colleagues) are of course always appreciated. But I’m talking about support of a more substantial sort, and this is why:

The reality: Consider the real experience, and thus the real needs, of the nurse.

When I consider the experience of nurses shuttling between full 12-hour shifts immersed in the care of complex and sometimes dying patients and periods of comparatively calm […]

2017-06-14T09:59:31+00:00 June 14th, 2017|Nursing|3 Comments

New Warnings About Protecting Children from Dangerous Substances in the Home

Photo © Istock.

As we report in a June news article, findings from several recent studies have underscored the importance of educating parents on how to keep younger children as well as older adolescents safe from exposure to dangerous substances they might accidentally ingest or deliberately seek out. Nurses can talk to parents about safe storage, ask questions about the presence of potentially hazardous substances in the home, and provide information about risks and precautions.

MARIJUANA

A study of the National Poison Data System found an increase in the rate of marijuana exposure (including edible products) among children younger than six. The rates were higher in states that had legalized the use of marijuana—an implication to be aware of as more states do the same.

HAND SANITIZERS

Another study, conducted by the Centers for Disease Control and Prevention, identified health risks in young children who had ingested alcohol-based hand sanitizers. The researchers drew attention to dangers associated with inadequate safety precautions when these products are used with young children, as well as the possibility that older children might abuse them. […]

2017-06-12T09:32:38+00:00 June 12th, 2017|Nursing, pediatrics|0 Comments

Talking Nursing in Many Languages: Reporting on the International Council of Nurses

Shawn Kennedy and Amanda Anderson

AJN’s editor in chief Shawn Kennedy and editorial board member and contributing editor Amanda Anderson recently attended the ICN Council of Nurse Representatives and Congress in Barcelona and present the highlights here, along with podcast conversations with two nurse leaders. A full report will be available in the August issue of AJN.

The 300 or so members of the Council of Nurse Representatives (CNR, ICN’s governing body) meets just prior to the ICN Congress, the educational conference and exhibition, which drew 8,000 registrants to Barcelona, a beautiful city on the Mediterranean. It’s a wonderful meeting and collegiality is emphasized—everyone wears a name tag with name and country, no credentials or fancy titles: we’re all just nurses. Chance meetings in elevators and at break times lead to meeting for coffee and lunch, exchanging ideas and business cards. […]

2017-06-09T10:58:35+00:00 June 9th, 2017|Conference reports, Nursing|0 Comments