Recognizing Postnatal PTSD

After the birth of her son, pediatrician Tricia Pil struggled with post-traumatic stress disorder (PTSD). The delivery had been complicated by hemorrhaging, large blood clots, invasive emergency medical care, and fear that she and/or her infant might be dying.

“In the months after my son’s delivery,” she recalled, “it was as if a curtain had descended over my life. In addition to a terrible feeling of numbness, I was haunted by flashbacks and nightmares . . . . Billboards for the hospital where I’d delivered, people dressed in scrubs, pregnant women, . . . and worst of all, my own baby—the sight of any of these could trigger flashbacks and bouts of heart-stopping, sweat-drenched panic.”

Though we typically associate the birth of an infant with relief, joy, and adjustments to a new family member, in some cases the picture is complicated by postnatal PTSD (also referred to as postpartum or birth-related PTSD).

Some women are at higher risk for postpartum PTSD.

Photo by Alexander Grey on Unsplash

Research by Slade and Murphy found that “one-third of women experience giving birth as traumatic, and consequently 3-6% of all women giving birth develop postpartum post-traumatic stress disorder,” adding that many more are likely to […]

2024-12-04T07:29:16-05:00December 2nd, 2024|Nursing|0 Comments
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Wound Debridement: And Other Recommended Reading from AJN’s December Issue

This month’s cover photo shows a surgeon performing a total knee arthroplasty. See our “On the Cover” column for more.

The December issue of AJN is now live.

This month’s CE, “Evidence-Informed Nursing Clinical Practices for Wound Debridement,” provides nurses with a wound management framework, an overview of wound debridement options based on the potential for wound healing, and scope of practice considerations for developing a plan of care.

Two Original Research articles in this issue explore aspects of care following orthopedic surgery:

Various types of water can be used to flush enteral feeding tubes, but which type of water is best supported by evidence? Read

2024-11-21T10:01:50-05:00November 21st, 2024|Nursing|0 Comments
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The Critical Role of Nurses in Intravenous Fluid Conservation

Image credit: AHVAP.org (Association of Healthcare Value Analysis Professionals)

Baxter International’s North Cove Facility in North Carolina was severely damaged by Hurricane Helene on September 26, 2024. The temporary closure of that facility and production interruption has resulted in significant shortages in intravenous, dialysis, and irrigation fluids and supply disruption impacting health care facilities across the United States. The responsibility to effectively and responsibly manage these critical resources has fallen heavily on the shoulders of nursing teams and health care supply chain professionals.

The crucial role of nurses during shortages.

Nurses are responsible not only for administering IV fluids but also for monitoring fluid needs, assessing patient status, and adjusting plans of care accordingly. When these lifesaving fluids become scarce, nurses must ensure that every intravenous fluid or irrigation product is used wisely, balancing patient safety with resource availability.

Why conservation is essential.

The consequences of IV fluid shortages extend beyond inconvenience. Fluids such as 0.9% normal saline and Lactated Ringer’s are vital in stabilizing patients, hydrating those who cannot take fluids orally and serving as carriers for essential medications. Shortages can lead to critical delays in patient care, increased length of stay, and negative outcomes for patients […]

2024-11-18T13:53:43-05:00November 18th, 2024|climate change, disaster preparedness, environmental health, Nursing, Public health|0 Comments
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Pertussis Rates Have Been Rising: What Nurses Need to Know

Pertussis, or whooping cough, remains one of the leading causes of vaccine-preventable deaths worldwide, with most deaths occurring in young babies who are either unvaccinated or incompletely vaccinated.

During the COVID-19 pandemic, many of the infection prevention and control measures such as masking, social distancing, and remote learning for children resulted in decreases in reported cases of pertussis. However, in 2023 and 2024 a return to routine activities has resulted in an increase in pertussis cases. Preliminary data from the Centers for Disease Control and Prevention (CDC) show that more than five times as many cases of pertussis have been reported as of October 19, 2024, compared to the same time period in 2023. This is higher than was seen during the same time period in 2019, prior to the pandemic. Compounding this problem are the alarming trends showing lower rates of routine vaccination among adults and children, trends which indicate reduced vaccine confidence and increases in vaccine hesitancy in the U.S. population.

Key points of knowledge and action for nurses

Epidemiology of pertussis

Pertussis is caused by Bordetella pertussis, a gram-negative coccobacillus and is highly contagious and easily spread person-to-person via respiratory droplets or through direct contact […]

2024-11-11T11:32:08-05:00November 11th, 2024|infectious diseases, Nursing, pediatrics, Public health|0 Comments
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When Nurses Are Caught Between Hospital Policy and Frustrated Family Members

A difficult exchange

Photo by Riccardo Chiarini on Unsplash

She was one of those patients who remind me of my own daughters, who make me consider up close what it would feel like to watch a terrible disease process insidiously take over my own child’s body. Her cancer had spread and she was struggling to breathe.

The team had told the parents it was likely we might have to give her a breathing tube before my shift was over. The parents were teary-eyed as I told them I would do my best to walk with them through a difficult day. They went downstairs to get food, at which point the patient, who had been dozing in bed, sat up and looked around. I went to her immediately, rubbed her back, and assured her that her parents would return shortly.

When her parents returned to the room, they brought more visitors than the three that our hospital policy allowed. I was a little anxious because I had already heard that this had been an issue overnight and that the parents had pushed back on efforts by another nurse to hold them to the policy.

I did my best to wait for a moment when bringing up the hospital […]

2024-11-04T09:49:56-05:00November 4th, 2024|Nursing|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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