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 administration’s […]

2025-03-07T10:02:20-05:00March 7th, 2025|health care policy, infection control, infectious diseases, Nursing, Public health|0 Comments
Read More

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 […]

2025-02-13T12:42:43-05:00February 13th, 2025|infection control, infectious diseases, Nursing, Public health|0 Comments
Read More

Norovirus, a Formidable and Underappreciated Hazard: What Nurses Need to Know

Norovirus, a highly contagious virus that causes acute gastrointestinal illness, is making its presence known across the United States. Symptoms typically begin 12 to 48 hours after exposure and last one to three days and include diarrhea, vomiting, nausea, and abdominal pain.

During the last half of 2024, the Centers for Disease Control and Prevention (CDC) reported close to 500 norovirus outbreaks, a significant increase when compared to the same time period in 2023. These outbreaks have occurred in health care facilities, restaurants, schools, and cruise ships and are continuing to occur in 2025. Norovirus is also the leading cause of foodborne illness outbreaks in the United States, but it is not simply a foodborne or food contamination issue. In fact, norovirus transmission is more complex—and therefore often underappreciated in its impact on human health, including patients and health care workers.

The vulnerability of health care settings to norovirus.

Based on electron microscopic imagery, this illustration provides a 3D, graphical representation of a number of norovirus virions. CDC/ Jessica A. Allen

Let’s look at some of the reasons why norovirus represents […]

2025-01-10T12:10:31-05:00January 10th, 2025|infectious diseases, Nursing, patient safety, Public health|0 Comments
Read More

The Pain Left Behind: Reflections on a Medical Mission and an Island’s Overwhelmed Nurses

“My family left after the volcanic eruption,” Sister said to me with a heavy heart. “But I asked myself, who will take care of my fellow Montserratians who stayed behind?”

These poignant words reflect the resilience and dedication of the nurses I encountered during my recent medical mission to Montserrat. During my time on the island, I collaborated with cardiologist Icilma Fergus Rowe of Mount Sinai Medical Center in New York City, who returns each year to provide much-needed cardiac care. The team serves over 100 patients in just five days, providing essential cardiac consultations, follow-up visits, and diagnostic echocardiograms, as well as referrals for further treatment or testing in Antigua or sometimes the United Kingdom (UK).

Local nurses under strain.

While many patients waited all year for consultation with our team and our presence was met with gratitude, local nurses who facilitated this care also revealed to me that our visit placed additional strain on the already overwhelmed nursing staff. Now, as I reflect on the benefits brought by medical missions like ours, I remain aware of the poignant reality that when you leave, you leave behind hurting colleagues whose pain stays with you.

The lasting effects of a devastating volcano eruption.

This small island in the Caribbean 25 miles southwest of Antigua, once a thriving community, has faced numerous challenges, […]

2025-01-08T10:20:14-05:00January 8th, 2025|COVID-19, disaster preparedness, Nursing, Public health, volunteering|0 Comments
Read More

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 who […]

2024-11-18T13:53:43-05:00November 18th, 2024|climate change, disaster preparedness, environmental health, Nursing, Public health|0 Comments
Read More

Comment ground rules

1. Please be respectful.
2. We moderate all comments.

Content disclaimer

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.
Go to Top