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When It’s Not Just Heavy Menses: A Nurse’s Guide to Recognizing von Willebrand Disease

By Sylvia Foley, AJN senior editor

Blood red sky by Micky Zlimen, via Flickr

Quick, what’s the most common inherited bleeding disorder? As you might have guessed from the giveaway title, it’s not hemophilia. It’s von Willebrand disease, and it affects about 1.3% of the U.S. population.

Yet many nurses and other clinicians, as well as the public, are unaware of this disease, its symptoms, and the associated risks. Sequelae can include complications during pregnancy and childbirth, chronic joint disease, even death. In girls and women, menorrhagia is the most common symptom; while the disease is equally prevalent in both sexes, it can be more problematic for menstruating females. In our June CE article, “Just Heavy Menses or Something More? Raising Awareness of von Willebrand Disease,” author Josie Weiss seeks to improve the odds that nurses will know when to suspect that a patient has the disorder and what to do once diagnosis is confirmed.

Simply put, von Willebrand disease is caused by “genetic defects in the concentration, structure, or function of von Willebrand factor,” which is a protein essential to blood clotting. These defects result in episodes of excessive or prolonged bleeding, which can be mild to severe in intensity. Weiss describes the three main types of […]

2016-11-21T13:09:56-05:00June 11th, 2012|Nursing|0 Comments
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Staffing: Hot Topic as Usual for Nurses

Karen Roush, MS, RN, FNP-C, clinical managing editor

Our recent Facebook post on an article on nurse staffing at the NPR Shots blog (“Need a Nurse? You May Have to Wait”) got a lot of responses. Staffing is a hot topic for nurses—from both a personal  and a patient care perspective. And I say “hot” because it never fails to raise emotions.

Everyone agrees that adequate nurse staffing is essential for safe, high quality patient care and nursing job satisfaction. Research has shown that it significantly improves patient outcomes.

Yet we—nurses, as well as the larger health care community—continue to debate how to determine what “adequate staffing” is and how to best achieve it. Acuity-of-care measures? Unit-by-unit mandated staffing plans? State-mandated staffing ratios? What do you think?

We’ve published numerous articles and news pieces on this topic in recent years; here are a few examples:

News, reports, and analysis (open access articles)

“Nurse Staffing Matters—Again”

“California Mandated Nurse–Patient Ratios Deemed Successful”

“Nursing Shortage—or Not”

Feature. Requires subsciption or purchase; abstract only

“Nurse Staffing and Patient, Nurse, and Financial Outcomes”

And here are some blog posts that deal either directly or indirectly with issues related to nurse staffing.

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2016-11-21T13:10:00-05:00May 31st, 2012|nursing perspective|1 Comment
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Emergency Contraception: Why It Matters and How Nurses Can Improve Access

By Sylvia Foley, AJN senior editor

Unintended pregnancy can, in some circumstances, be detrimental to the health of both the women who become pregnant and the children born as a result. And such pregnancies happen far more often than you might think, accounting for nearly half of all pregnancies in this country, with even higher rates among women ages 18 to 24 and low-income women. Yet we have had the means to safely prevent such pregnancies for decades, through emergency contraception. Why isn’t emergency contraception used more often?

That’s a question author Kit Devine explores in “The Underutilization of Emergency Contraception,” one of April’s CE features. First, Devine describes the four methods currently available: conventional oral contraceptives and the copper intrauterine device (IUD)—both are used for birth control and can also be used to prevent pregnancy after intercourse has occurred—and the agents levonorgestrel and ulipristal acetate, which are FDA-approved for emergency contraception. Effectiveness ranges from 51% to 62% (for conventional oral contraceptives) to as high as 99% (for IUDs).

Known and likely barriers to their use include […]

2016-11-21T13:10:18-05:00April 16th, 2012|Nursing|1 Comment
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National Women’s History Month–What’s Nursing Got to Do With It?

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

Back in the late 60s, when I was trying to figure out what I wanted to be when I grew up, one particular piece of advice kept popping up: “Become a nurse. That way, if anything happens to your husband, you’ll be able to get a job and support your family.”

This month we celebrate National Women’s History Month. The theme is Women’s Education–Women’s Empowerment. I think back to that advice and how it captures the journeys of both nursing and women over the last 45 years.

That one piece of advice reflected so many beliefs of the time. The husband (and there should be a husband for any self-respecting woman) is the breadwinner. A woman doesn’t really want to work and shouldn’t work; her role is to take care of husband and home. She doesn’t need the fulfillment of a career—only the ability to pay the bills if she suddenly finds herself alone.

Nursing was the safety net job. Not something to pursue for its own sake—for the intellectual, emotional, and financial rewards it could offer. Women who did pursue it found themselves earning their own paycheck—but still subjugated, the handmaiden to the physician.

Thankfully, that has changed. Women pursue all kinds of careers and are surpassing men in numbers of […]

2016-11-21T13:10:32-05:00March 7th, 2012|nursing history|1 Comment
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New Nurses: Committed to Their Current Jobs—Or Biding Their Time?

By Sylvia Foley, AJN senior editor

It’s no surprise that the recent economic recession caused many older nurses to return to the workforce or to delay retirement and work longer hours, thus easing the projected nursing shortage—at least for the time being. But nurse researcher Carol S. Brewer and colleagues wanted to understand how the recession affected new nurses’ work attitudes and behaviors, in particular those related to turnover. What they found has many implications, both now—although the recession is reportedly over, we’re still in an economic slump—and as the economy recovers.

To learn more, Brewer and colleagues compared data for two cohorts of newly licensed RNs. The first cohort consisted of 983 new nurses licensed between August 2004 and July 2005 who were surveyed before the economic downturn; the second cohort consisted of 1,765 new nurses licensed between August 2007 and July 2008. The survey tool included questions on attitudinal variables in four areas: personal characteristics, work attributes, work attitudes, and job opportunities. The researchers report the results in this month’s CE–Original Research feature, “New Nurses: Has the Recession Increased Their Commitment to Their Jobs?”

Among the key findings:

2016-11-21T13:10:33-05:00March 5th, 2012|nursing perspective, nursing research|1 Comment
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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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