Exploring Irritable Bowel Syndrome

Illustration by Sara Jarret.

Irritable bowel syndrome (IBS) is one of those conditions that is maddening for patients and clinicians alike. Its pathophysiology is unclear, the symptom picture varies widely from patient to patient, there is no test to confirm the diagnosis, and treatment is directed at managing symptoms because there is no cure.

To make things even more difficult for the person with IBS, there is a recognized psychological component of the disease. Therefore some friends, family members, and clinicians might tell people with IBS that their suffering is “all in their head.” And yet there is demonstrable proof (via neuroimaging studies) of differences in central processing mechanisms related to the “brain–gut axis” between people who have IBS and those who do not.

Kristen Ronn Weaver and colleagues explore these and other aspects of IBS in a clinical feature article in AJN’s June issue. The authors review the latest findings related to IBS etiology and pathophysiology, the relationship between IBS symptoms and stress, and the updated Rome IV criteria that help guide diagnosis. Of particular interest is the authors’ presentation of research confirming the value of several nonpharmacologic interventions, including dietary modifications, probiotics, moderately increased physical activity, yoga, and traditional Chinese medicine.

See “Irritable Bowel Syndrome” in the June issue to learn more, and to find out how nurse-led initiatives can lead to long-term health benefits for people with IBS.

 

2017-06-26T09:07:44+00:00 June 26th, 2017|Nursing, patient experience|0 Comments

July Issue Highlights: Health and the Microbiome, Poststroke Depression, Need for Diverse Blood Donors, More

The July issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE Feature: Health and the Human Microbiome: A Primer for Nurses

The profound impact of the human microbiome on health makes it imperative that nurses understand the basic structures and functions of the various microbial communities. This article provides an overview of the current state of knowledge about the human microbiome—with a focus on the microbiota in the GI tract and the vagina, the two most commonly studied body sites—and discusses implications for nursing practice.

CE Feature: Early Intervention in Patients with Poststroke Depression

Nearly one-third of stroke survivors experience depression. Poststroke depression is associated with longer hospital stays, poor physical and cognitive recovery, poor quality of life, high caregiver distress, increased risk of recurrent stroke, and higher rates of morbidity and mortality. However, it often goes unrecognized and untreated. The authors of this article explain how poststroke depression often manifests, describe associated risk factors, and discuss the screening tools and therapeutic interventions nurses can use to identify and help manage depression in patients following stroke.

Clinical Feature: The Growing Need for Diverse Blood Donors

The chief nurse of the American Red Cross discusses how changing demographics in the United […]

2017-07-24T12:58:54+00:00 June 23rd, 2017|Nursing|0 Comments

Why Do Pregnant Women Smoke?

 “My mother smoked [when she was pregnant] with me and I am fine.”

“I’d rather smoke a cigarette than take a drink of alcohol to relieve stress.”

“So you’re bored, what are you going to do? Sit down and smoke a cigarette.”

“It relaxes me.”

Tobacco use during pregnancy has been associated with many adverse effects, including abruptio placentae, fetal malpresentation, low Apgar scores, stillbirth, and birth defects such as gastroschisis and cleft lip or palate. Most nurses probably see these as no-brainer reasons for women to stop smoking once they become pregnant. Yet a new research study illustrates that the reasons pregnant women might continue to smoke are very individual, and that clinicians are not always skillful in supporting smoking cessation.

In this month’s AJN, researcher Geraldine Rose Britton and colleagues share the results of their qualitative study on the experiences of pregnant smokers and their health care providers. The researchers used a focus group methodology to learn about the smokers’ experiences and to better understand what motivated them to quit or prevented them from doing so.  There were also separate clinician focus groups to explore the approach of the 45 providers (71% RNs, 11% physicians, plus one NP, one nurse manager, four LPNs, and one PA) to pregnant women who smoke.

Not surprisingly, the researchers discovered that the issue is frustrating to both pregnant women and their maternity care providers. Some physicians and nurses felt unprepared to […]

Those Who Comfort Us

There was only a tiny drop of blood. I was worried, of course, but I went to my OB-GYN for reassurance more than anything else. Maybe she would tell me I was doing too much and needed to rest. Maybe it was just normal. But as soon as she looked at the ultrasound screen, I knew.

Usually when I went for a scan, she immediately turned the screen toward me. Until now, every scan had been great. I had just entered my second trimester. The barrage of tests given to women of “advanced maternal age” had all come back normal. The baby’s heartbeat was strong at every visit, and I was riddled with nausea, something I’d been told was a “good sign.”

This time she stared at the screen for what seemed like forever. Then, quietly, she told me that my baby of 16 weeks’ gestation no longer had a heartbeat. Moments later, the high-risk doctor came in to confirm this. I turned away as he talked to my doctor about the “degradation” he could see, suggesting the death had happened over a week before. Somehow this terrible word—and image—is what stuck with me, even weeks after the event.

Later I entered the ambulatory center where I would have a […]

How to Support the Nurse in Your Life

Hui-Wen (Alina) Sato, MSN, MPH, RN, CCRN, is a pediatric intensive care nurse at Children’s Hospital Los Angeles and blogs at http://heartofnursing.blog. Her Reflections essay, “Intimate Strangers,” will be published in AJN‘s August issue.

A quick Google search for “how to support nurses” reveals an emphasis on recommendations for hospital management on developing structured support for nurses at an organizational level. The search also captures popular articles on how nurses provide support to their patients. Ironically, the query results provide no resources to inform the nurse’s closest support system—families and friends—as well as the general public about what kind of support the nurse really needs and how to better provide it.

I attribute these search results, at least partly, to the fact that we nurses don’t always know how to articulate what we need. Some forms of support, such as treating a nurse to a mani-pedi or a spa day (or a parallel form of relaxation for our male colleagues) are of course always appreciated. But I’m talking about support of a more substantial sort, and this is why:

The reality: Consider the real experience, and thus the real needs, of the nurse.

When I consider the experience of nurses shuttling between full 12-hour shifts immersed in the care of complex and sometimes dying patients and periods of comparatively calm […]

2017-06-14T09:59:31+00:00 June 14th, 2017|Nursing|4 Comments