Pregnancy and COVID: What We Now Know

Meagan Garibay, RN, BSN, CIC, an infection preventionist at Comanche County Memorial Hospital in Lawton, Oklahoma, received the COVID vaccine in December 2020, when she was 35 weeks pregnant. Photo courtesy of WAVE 3 News.

Few aspects of pregnancy and birth have been unaffected by the COVID pandemic. In the past year, pregnant people and their health care providers have had to alter everything from the way they assess risk to the manner in which care is accessed.

Although little information about pregnancy and COVID was available early in the pandemic, emerging evidence is providing a clearer picture. As a result, in the past year recommendations have shifted—sometimes radically so—for both women and their health care providers. Based on the latest available research, this month in AJN Reports we cover what we now know about COVID and maternal health, including guidance about risk and vaccination.

Higher risks for pregnant people with COVID.

As the articles explains, research suggests pregnant people who have COVID are at higher risk […]

Isn’t It Ironic: A Nurse Reflects on Her J&J Vaccination

Irony: a state of affairs or an event that seems deliberately contrary to what one expects and is often amusing as a result. -dictionary.com

Vaccine, by Julianna Paradisi

On a recent Saturday afternoon I received the Johnson and Johnson/Janssen COVID-19 vaccine. The following Tuesday, its further administration was put on pause, “out of an abundance of caution,” after reports that six women between the ages of 18 and 48 developed a rare but serious form of blood clot six to 13 days after receiving the vaccine. One of the six women died.

There is nothing amusing about the irony that people seeking protection from COVID-19 may have developed a life-threatening adverse reaction from the vaccine. For health care providers, and perhaps especially for nurses, such events are heartbreaking.

Lifting the J&J pause.

On Friday, April 23, the Centers for Disease Control and Prevention (CDC) and the FDA lifted the 10-day pause on the J&J vaccine, without restrictions, instead issuing a fact sheet to medical providers warning them of the potential for the extremely rare but serious blood clots.

When the pause was lifted, over 7 million people had received the vaccine, with additional confirmed cases of blood clots that had been reported bringing the […]

Celebrating Earth Day: Connecting Health and the Environment

Photo by Fateme Alaie via Unsplash

Earth Day, celebrated on April 22, is an annual event to demonstrate support for environmental protections. First held in 1970, it now includes a wide range of events coordinated in more than 192 countries across the globe. The Earth Day celebration that stands out most for me was the 20th anniversary held in Central Park in New York. The event was estimated to have drawn more than 750,000 people—a big incentive being the free concert, which included a performance by the B-52s (who doesn’t love “Love Shack”?).

This year marks the 41st Earth Day, and amidst a global pandemic, activities will look a lot different. (Click here for more information on the virtual events taking place this year.)

Free articles from our environments and health column.

In honor of Earth Day, AJN would like to offer free access to the below selection of articles from our Environments and Health column until May 15. There’s a lot to unpack in these articles—from steps to reduce waste at the hospital level, to how nurses can get involved in fighting climate change, to how patients’ health can be affected by our environment, particularly the mental health conditions that may arise amid extreme […]

Nurse Volunteers on the Front Lines of the Vaccination Effort

Joanne Disch, PhD, RN, FAAN, is professor ad honorem at the University of Minnesota School of Nursing, Minneapolis, and Ellen Elpern, MSN, RN, is a retired advanced practice nurse, formerly at Rush University Medical Center, Chicago.

Nurse volunteers as an essential resource.

As of April 15, 2021, there have been over 31 million cases of COVID-19 in the United States and over 561,000 deaths. Sobering numbers. But there are some heartening numbers as well: 198 million vaccination shots have been administered so far, with 3 million doses now being given per day. To reach and continue to meet the current pace has required an extraordinary ramp-up of sites—and of the number of individuals administering the vaccines. An essential resource that’s emerged is the use of nurses as volunteers to help staff these sites.

For more than a year, the public has witnessed the compassion, competence, and heroism of nurses who are on the front lines of the COVID pandemic. Those of us who are nurses and not in the clinical setting watched with pride and empathy, knowing better than most what these nurses were experiencing—and wishing there were something that we could do. Stepping forward to volunteer for service in a vaccine clinic is one way to make a difference. These volunteer opportunities are as varied as the vaccination sites themselves, but in all cases the effort is being enriched by the active engagement of nurses, retired and otherwise.

Defuniak Springs, Florida

Assessing the Post-Pandemic Future of Virtual Care

The following is a condensed version of an upcoming news article by Joan Zolot scheduled for AJN’s May edition.

Studies of safety and quality will determine the optimum use of this option.

Photo by Anna Shvets from Pexels

The use of telemedicine surged during the COVID-19 pandemic. Phone and videoconferencing limited patients’ exposure to the virus while maintaining their access to care. One estimate found that virtual care peaked at 42% of all ambulatory visits covered by commercial insurers in April 2020. The February 2 JAMA published several articles* addressing the safety, effectiveness, and quality of virtual consults and their future in health care.

Some obvious and potential benefits.

Because of its efficiency, virtual care has been shown to be particularly suitable for mental health consults, prescription refills, and straightforward evaluations. It can reduce patient inconveniences such as travel to appointments and lost work time. It can also enable patients to receive needed care sooner, especially those with limited mobility, caregiving responsibilities, or who live in remote areas. It may also have the potential to improve care coordination by enabling primary care clinicians and specialists to confer jointly with patients.

Risks, concerns, ongoing questions.

Because virtual medicine does not allow for physical examination, it’s inadequate for common clinical situations […]

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