A Tumultuous Seven Weeks for Public Health in the United States

Editor’s note: AJN news director Karen Roush, PhD, RN, FNP, will be providing regular updates on AJN Off the Charts about the details and implications of rapid and potentially momentous changes being made by the Trump administration to the public health system in the United States.

It’s been a tumultuous seven weeks since President Trump’s inauguration. Changes in leadership and priorities have swept across every federal department, bringing uncertainty and disruption. Trump signed more than 70 executive orders (EOs) in his first month in office, including orders to erase diversity, equity, and inclusion efforts from federal agencies and the military (EO 14151); limit the rights of transgender people and declare that only two “sexes,” biological males and females, would be recognized by the federal government (EO 14168); end birthright citizenship (EO 14160); and further limit access to abortion (EO 14182). Elon Musk’s Department of Government Efficiency, known as DOGE, has fired tens of thousands of federal employees, dismantled entire agencies, including USAID, and pulled grant funding from universities, nongovernmental organizations, and the National Institutes of Health (NIH).

The appointment of Robert F. Kennedy, Jr. to head HHS.

Many of the […]

In Times of Overwhelm as a Nurse and Citizen, Begin with One Intentional Act at a Time

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN

With the recent devastation and loss around our local Los Angeles wildfires as well as our country’s political disarray, one of the most difficult things about trying to remain empathetic, engaged, and informed as an individual and a nurse has been a sense of utter overwhelmedness.

I think most nurses are both empathetic and action-oriented, traits which can be helpful—but also sometimes crippling when we see needs for help and advocacy everywhere and don’t know where to start. Any action feels like such a miniscule drop in the bucket.

I was carrying this emotional, mental, and spiritual heaviness into work with me a couple of days ago. I sat down to get report on my patient assignment. My patient was so sick, so complicated; she’d been teetering between life and death in recent days. Her parents had been on a roller coaster of the worst kind. ‘Two weeks into this hospitalization, are we still holding onto hope for recovery? Are we gathering relatives to say goodbye?’

I knew I was walking into a space that was very loaded for the parents. They had seen many nurses, respiratory therapists, and doctors come through their doors. For as long as they had been in our […]

The Work Environment and Nurses’ Well-Being: And Other Recommended Reading from AJN’s March Issue

This month’s cover honors Thelma M. Schorr, nursing trailblazer and past editor of AJN. Read a tribute to Schorr here.

The March issue of AJN is now live.

This month, you’ll find two Original Research articles:

In “Leaving Against Medical Advice: What’s a Nurse to Do?,” the authors explore the nurse’s role and ethical responsibilities when a patient chooses to leave the hospital AMA, highlighting steps nurses can take to prioritize the patient’s well-being and advocate for the patient’s interests.

“Improving Discharge Education and Outcomes for Patients with Heart Failure,” the fourth article in a series on applying implementation science (IS), describes how a nurse-led team at […]

2025-02-24T09:40:43-05:00February 24th, 2025|Nursing|0 Comments

When Politics Overrides Nurse Workforce Diversity and Patient Care

(Guest opinion from a nurse practitioner and educator.)

Elizabeth Hanna, DNP, PMHNP, AGACNP

I am deeply concerned by recent legislative actions in my home state of Utah and a number of other states that undermine the foundational principles of diversity, equity, and inclusion (DEI) in publicly funded higher education. While I am fortunate to teach at an institution not subject to these restrictions, I am a proud alum of Utah’s state university system, which educates the vast majority of our nurses and nurse practitioners.

Utah’s “Equal Opportunity Initiatives” law (H.B. 261), which took effect on July 1, 2024, prohibits DEI practices, programs, policies, and initiatives in higher education and government employment. As a result, DEI offices and cultural centers have been dismantled at institutions such as the University of Utah, Southern Utah University, Utah State University, and Weber State University. Eliminating these initiatives threatens the quality and integrity of nursing education and undermines our commitment to culturally competent care.

The loss to patient care and workplace diversity.

It has been shown that more diverse and culturally competent nurses achieve better patient outcomes, including improved satisfaction, treatment adherence, and overall health. DEI initiatives help train nurses to recognize implicit biases and reduce health disparities. Furthermore, […]

2025-02-19T11:57:03-05:00February 19th, 2025|Nursing|5 Comments

H5N1 Avian Influenza (Bird Flu) Update for Nurses and Other Health Providers

Influenza is a clever virus and one that deserves respect. Current concerns with the H5N1 avian influenza virus strain demonstrate why public health around the world continues to watch and monitor for impact on human health. Although the situation is not one that currently affects us on a day-to-day basis, it is important that we have a basic understanding of why this remains newsworthy.

Spread and evolution of H5N1.

Since its emergence, H5N1 has spread across multiple continents, affecting wild birds, poultry, and mammals. In late 2023, the virus was detected in Antarctica for the first time, raising concerns about its impact on native wildlife. By 2024, H5N1 had been reported in various regions, including Europe, Asia, and the Americas, leading to significant poultry losses and economic challenges.

In the United States, H5N1 has been detected in wild birds, poultry, and mammals across all 50 states. As of early 2025, nearly 70 human cases have been confirmed, primarily among individuals with direct exposure to infected animals. In December 2024, the Centers for Disease Control and Prevention (CDC) confirmed the first severe human case of H5N1 in Louisiana, involving a patient hospitalized with severe illness.

We have seen H5N1 move across nonhuman animal species, to situations where humans have become mildly ill after contact with animals, and now to situations where animal contact has resulted in severe human illness.

Since this particular strain of influenza has been detected in a variety of animals, but rarely in humans, what is the concern? The concern […]

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