Access to Abortion Medications: Why Should Nurses Care?

She sat in my office, tissue in hand, tears rolling down her cheeks as she tried to process the news I’d just confirmed: she was pregnant, and really, really needed to not be. She was living in her brother’s small house, her seven-year-old son with her, sleeping on a sofa while trying to put her life back together after a divorce. She had chronic kidney disease, and had been told that another pregnancy could cause kidney failure.

She didn’t really believe abortion was a good thing to do, but also couldn’t imagine that God would want her to go on dialysis. For the most part I listened, asking a question here and there to help her clarify her own thoughts. Ultimately, she decided on an abortion, so I referred her to the closest clinic, several hours away from the rural town we met in.

Medication Abortion in the United States

By Robin Marty/Flickr Creative Commons

Even before the Dobbs decision overturning Roe v. Wade, abortion was difficult to access for people living in many regions of the country. TRAP (targeted regulation of abortion providers) laws forced many clinics to close, making abortion access challenging if not impossible even though every American was legally, constitutionally permitted to make her own decision.

Last […]

40-years of Forensic Nursing and Current Opportunities in Remote Sexual Assault Care

Remembering an influential article.

Patricia Speck

Timing is everything. Forensic nursing service through telehealth is possible today, as reported in a recent Kaiser Health News story, but it wasn’t always that way. Fifty years ago, Ann W. Burgess, a psychiatric–mental health nurse working in the emergency room, wrote a paper with a sociologist colleague about what she was seeing in patients who complained of being raped. “The Rape Victim in the Emergency Ward” (pdf), published in AJN, was reported nationally and informed 1970s kitchen table conversations about what rape is, is not, and when “no means no.”

Naming the trauma and its effects.

The ideas in this article were new at the time. Burgess wrote that sexual assault causes acute emotional trauma, requiring time for recovery, and she named phases of what she eventually called “rape trauma syndrome.” Prior to the article, victims of sexual assault often did not report the assault, and when they did they waited hours for a newly minted physician intern who had been punished with “rape-duty.” These physicians had no knowledge about what to do.

In accordance with societal views at the time, victims were often blamed for their rape—the way you dress, how you act, […]

Collaborating with Medical Interpreters: Best Practices for LEP Patients

Limited English proficiency and adverse event risk.

As a native San Franciscan, I grew up surrounded by bilingual people who represented cultures from all over the world. It is a privilege for me to be surrounded by such rich diversity, but many patients who are limited English proficient (LEP) are at risk for adverse events once they enter a health care setting. Identifying a patient’s preferred language at the initial point of entry can ensure that resources are available to support the patient as they navigate the health care system. Medical interpreters are vital to our LEP patients and serve as a bridge for translating both language and other crucial cross-cultural elements of communication.

Letting patients and families know their rights.

Providing interpreting services reduces health inequities for LEP patients and is also required by Title VI of the U.S. Civil Rights Act (1964). This law states that hospitals that receive funding from the U.S. Department of Health and Human Services must notify LEP patients of the availability of free interpreting services, which should not include their own friends and family. As nurses, we must advocate for our patients who may not be aware of their rights and may have fears about perceived consequences if they admit to not being proficient in English. Perform a […]

2023-02-13T10:32:40-05:00February 13th, 2023|Nursing, patient engagement, Patients|1 Comment

When Studying Mental Illness in Nurses Means Studying Yourself

Carrying the burden of depression as a nurse.

As I read Anna’s (not her real name) description of how much effort it took to drag herself into work, how much she felt like a burden to her family, and her fear of being “found out,” tears welled up.

“I know,” I said to myself.

I was analyzing an interview transcript for a qualitative study of psychiatric-mental health nurses (PMHNs) who have experienced mental illness. More specifically, my colleagues and I wanted to know how their illnesses impacted their work as nurses.

I have been a PMHN for over 40 years, with an even longer experience of a mental illness. I recognized many of the participants’ stories in my study as my own, but none affected me the way hers did. An alarm bell inside my head went off. If I couldn’t create a clear boundary in my mind between Anna’s experiences and my own, I might be at risk of unduly influencing the study results.

Reflecting on shared experiences of depression.

I was grateful that a colleague was also analyzing these transcripts; to minimize the effects of my own potential bias, I took the opportunity to write down my thoughts and feelings in my reflexivity journal. This is […]

2023-02-02T10:33:57-05:00February 2nd, 2023|mental illness, Nursing, patient experience|1 Comment

Every Patient Needs an IV, or Do They?

(This post is by an author of AJN‘s January CE feature, “Evidence-Based Practice for Peripheral Intravenous Catheter Management.”)

Questioning the status quo.

As a former critical care nurse and now a vascular access nurse researcher, I’ve had the good fortune to travel widely and work with nurses from around the globe on multiple projects. As a researcher, part of my role is to question clinical practices we often take for granted and to ask, “Is this the best way? Could there be a better way?” Identifying practice that may not always be evidence-based is how research often begins.

Prior to the Covid-19 pandemic, I undertook a two-month fellowship in the US and visited several hospitals where, time and again, I noticed the majority of hospital patients had a peripheral intravenous catheter (PIVC) in place, but many were not in use. When I asked the nursing and medical staff why patients had a PIVC that was not in use, I was repeatedly told, “Every patient needs an IV, just in case.” When I pointed out that some patients had two or three PIVCs not in use, or a central venous access device as well, it became obvious that this is a common problem.

An ‘idle’ catheter is a PIVC that has not […]

2023-01-11T11:41:34-05:00January 11th, 2023|Nursing, patient safety|0 Comments
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