A Black Nursing Professor’s Personal Calculus in Choosing a Birth Center

“I knew getting pregnant meant that regardless of my socioeconomic status or education, as a black woman I was more than three times as likely to die during labor or in the weeks afterward compared to my white counterparts.”

Recent news stories have drawn attention the dismaying medical experiences of black women during and after childbirth, with even celebrities like Serena Williams and others finding their concerns about potentially life-threatening symptoms going dangerously unheeded by nurses and physicians. The statistics about maternal death from pregnancy or childbirth complications among black women tell us that such stories aren’t isolated examples but part of a larger pattern.

Illustration by Annelisa Ochoa.

A thoughtful professor weighs her options.

All of which makes the personal story told by Sheria Robinson-Lane, an assistant professor of nursing at the University of Michigan, in this month’s Reflections essay (“Birthing by the Numbers“) particularly timely. And yes, nuanced. She knows the numbers and she knows the stories about communication issues experienced by black women with their providers. However, she’s also affiliated with a respected major medical center.

So when she gets pregnant with her second child at age 39, what’s her best course of action in deciding where to have her child? It’s not […]

October Issue: Treating Hemorrhagic Shock, Pain Management and Opioid Use Disorder, Workplace Violence, More

“Violent behavior seems to be an . . . increasingly frequent occurrence in hospitals and nursing care facilities. More and more, such violence is the result of intentional harm.” —editor-in-chief Shawn Kennedy in her October editorial

The October issue of AJN is now live. Here are some of the articles we’re pleased to have a chance to publish this month.

CE: The Use of Resuscitative Endovascular Balloon Occlusion of the Aorta in Treating Hemorrhagic Shock from Severe Trauma

Efforts to prevent death from hemorrhagic shock have resulted in the emergence of a new tool—resuscitative endovascular balloon occlusion of the aorta (REBOA), a less invasive option for controlling hemorrhage in noncompressible areas of the body. This article outlines REBOA, describes its evolution, and discusses various considerations, pitfalls, and nursing implications.

CE: Perspectives on Palliative Nursing: Acute Pain Management for People with Opioid Use Disorder

The authors of this article—one in a series on palliative care developed with the Hospice and Palliative Nurses Association—discuss how to manage acute pain effectively in patients receiving medication-assisted treatment for opioid use disorder, which incorporates methadone, buprenorphine, or naltrexone.

Original Research: Journalists’ Experiences with Using Nurses as Sources in Health News Stories

The authors of a 2018 replication of the 1997 […]

2018-09-28T10:05:14-04:00September 28th, 2018|Nursing|0 Comments

A Mother and a Nurse

Kristy Rodriguez, BSN, RN, works as a nurse in Florida.

As a mother and a nurse, I have often found myself with the dilemma of whether to inform others in a health care setting that I am a nurse. I say this because it can go either way: some look at it as a blessing that they can easily explain things to you using medical terminology, while other nurses may take it as a threat. And I understand these concerns. As a nurse I have come in contact with both attitudes—the helpful and the threatening—among family members and patients who work in health care. It has been helpful to have a family member or patient who understands at least the basics and is eager to learn. Then, on the other hand, it can be a nightmare with the patient or family member who uses the statement “I’m a nurse” as a kind of threat.

A son’s troubling symptoms.

My story all started about three years ago, a day that my son’s life would forever be changed, and mine with it. It was the spring of 2012 and my son was 12 years old and developing as a normal boy should develop. A stomach virus had recently swept through our house and sickened my son and his […]

2018-09-28T14:34:00-04:00September 27th, 2018|Nursing|2 Comments

2017 Gold Report Refines COPD Treatment Algorithms

“As with many other chronic diseases, laboratory measures don’t always consistently reflect the extent of a person’s clinical symptoms or quality of life.”

Updated recommendations for managing COPD.

(click image to expand)

It’s nearly autumn, the time of year when we start to see exacerbations of chronic lung disease, including COPD. That’s why we’ve included an informative and readable COPD update in this month’s AJN.

Authors Amy O’Dell and colleagues discuss the latest recommendations from the Global Initiative for Chronic Obstructive Lung Disease (GOLD). GOLD was launched 20 years ago in order to disseminate strategies for the prevention and management of this disease. The most recent GOLD report was released in 2017, with its recommendations further tweaked this year.

Treatment category based on spirometry plus symptoms and history.

One of the most exciting aspects of the 2017 recommendations is the way in which spirometry and a person’s clinical symptoms and history of exacerbations have been put together in order to determine a patient’s treatment category.

In the past, spirometric measurements have been key drivers of treatment. Yet as with many other chronic diseases, laboratory measures don’t always consistently reflect the extent of a person’s clinical symptoms or quality of life. Some people have “off the charts” lab readings for some condition, yet they […]

2018-09-21T08:52:41-04:00September 21st, 2018|Nursing|0 Comments

Quality of Life? Whatever the Patient Believes It Is

Illustration by Eric Collins / ecol-art.com

“What kind of life is that? That’s not how I would want to live.”

In AJN‘s September Reflections essay, “His Wonderful Life,” nurse Elizabeth Buckley interrogates her own judgmental response to a patient with a bluff, abrasive personality (he calls her ‘Nurse Ratchet during their first encounter) who requires nearly nonstop care to stay alive.

The patient has little hope of a meaningful recovery even if he survives the current hospitalization. The reader is surprised when, after a first grueling night of touch-and-go care, the author decides to take him on as her primary patient because she thinks it might be “a good learning opportunity.” (“I texted my friend who worked the day shift to sign me up; she replied that I was crazy.”)

A good life is in the eye of the beholder.

‘Philip,’ obese and with progressive dyspnea and multiple comorbidities, is sure he’ll soon be able to return to his bedbound existence at home watching old movies and chatting on Facebook; the physicians and other nurses are less hopeful. Gradually, over the course of five nights, the author’s respect and affection for the patient grows. He loves his life, however narrow it may seem to an outside observer. […]

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