August Issue: CBT for Treatment-Resistant Schizophrenia, RNs’ Role in Transforming Primary Care, More

“It is not to save the world we are called—it is to care.”—Alison Stoltzfus in her August Reflections essay, “To Care When There Isn’t Enough”

The August issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

Original Research: Cognitive Behavioral Therapy for Symptom Management in Treatment-Resistant Schizophrenia

This integrative review examines the efficacy of CBT as an adjunct to antipsychotics—notably clozapine—in alleviating symptoms of treatment-resistant schizophrenia in various study populations.

A Tai Chi for Arthritis and Fall Prevention Program for Older Adults During COVID-19

The authors describe their experience converting an in-person tai chi fall prevention program to a virtual program during the pandemic, as well as participants’ responses to the virtual program.

The Role of RNs in Transforming Primary Care

A discussion of the need to improve primary care delivery in the United States, and how preparing RNs to practice at the top of their license can play an important role in this effort.

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2022-07-25T10:36:55-04:00July 25th, 2022|Nursing|0 Comments
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What Is Long COVID?

There are still many unknowns, but the need for comprehensive care is clear.

“There are days I don’t have any issues. Then I have terrible palpitations, or I’m short of breath when I walk. I think there’ll be long-term effects, I’m just not 100% sure what they’ll be.”

This is how one nurse with long COVID describes her symptoms—more than two years after initially contracting the virus—and the uncertainty that goes along with it. Her experience is highlighted in the July AJN Reports, “Long COVID: What We Know Now.”

Few definitive answers.

Photo by engin akyurt on Unsplash

Each wave of COVID infections results in more people not fully recovering from the acute illness. Instead, they experience a range of ongoing and new symptoms that vary in severity and duration.

Whether their symptoms are called long COVID, postacute sequelae of SARS-CoV-2, or post-COVID conditions, the reality is the same: there are few definitive answers about long COVID’s risk factors, causes, and effects.

Multidisciplinary care.

What is known, as the article discusses, is that it’s beneficial for patients to access a post-COVID care program in which a multidisciplinary team provides ongoing clinical evaluation, individualized treatment, and support services.

“The best thing you can do for a patient is get them involved […]

2022-07-20T10:11:25-04:00July 20th, 2022|Nursing|0 Comments
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Recent Supreme Court Decisions and Public Health Consequences

The overturn of Roe v Wade wasn’t the only decision with health effects.

Photo by Anna Sullivan/Unsplash

In the December 2021 issue of AJN, Caroline Dorsen and colleagues wrote a Viewpoint, “Why Nurses Should Care About the Supreme Court.” In it, they note:

“The court decides cases every year that have direct implications for our patients, our role as health care providers, and our profession. They decide cases that speak to our common humanity and affect the systems that influence health disparities. And we should all care about that.”

This certainly rang true for decisions recently handed down by the Supreme Court.

Other health consequences of the Dobbs case.

While much of the attention on the recent Supreme Court rulings has focused on the overturn of Roe v. Wade (in Dobbs v. Jackson Women’s Health Organization) and the effects that it will have for millions of women on their access to and choice of reproductive health care, we are starting to see many other potential effects of that decision.

An article at MedPage Today describes concerns that physicians may not choose obstetrics as a career because of worries over prosecution—what if a court doesn’t agree with their management of miscarriages or disagrees with their judgment that a mother’s life was in danger? Nurse midwives […]

2022-07-18T10:19:50-04:00July 18th, 2022|environmental health, Nursing|0 Comments
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The 12-Hour Nursing Shift: Preferred by Staff, but Good for Patients?

A new study finds reduced communication skills after consecutive shifts but no clinical deficits.

Twelve-hour shifts have been a mainstay of nursing schedules since they began as a staffing strategy in the 1970s, but debate continues about their effect on nurses’ health and ability to safely care for patients.

Studies have examined both aspects of the issue. Regarding staffing, researchers have found that a majority of nurses and hospital administrators prefer 12-hour shifts as a means to achieve continuity of care, ease of scheduling, and for nurses, work–life balance. Regarding patient care quality, research has shown an association between longer consecutive shifts and more clinical errors.

The latest findings. 

A recent study from Washington State University aimed to test the latter. The research team recruited 94 RNs working consecutive 12-hour shifts to examine the cumulative effect of shift work–related changes on sustained attention, cognitive effectiveness, and subjective sleepiness. Participants were evaluated in two 20-minute simulated care situations by other RNs trained to assess performance. Nurses working day and night shifts were randomized across fatigued and rested conditions, defined respectively as having worked three consecutive 12-hour shifts or having three consecutive days off.

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2022-07-15T10:14:05-04:00July 14th, 2022|Nursing|0 Comments
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A Long History of Abortion

Looking to the past for context and perspective as the U.S. abortion care landscape changes dramatically.

The Supreme Court decision overturning Roe v. Wade ended women’s nationwide legal right to abortion after nearly 50 years.

Photo by Ian Hutchinson on Unsplash

Several states with so-called trigger laws banning abortion moved to implement these immediately. Although some of these laws have since been challenged in court, within a few months it’s expected that women living in about half the states will have very limited or no access to abortion care. Most of these laws—predominantly in the Midwest, South, and Plains states—make no exception for rape or to safeguard a woman’s health, until she is at risk of death.

Limiting health care access amid rising maternal mortality rates.

These restrictions on women’s health care occur while the U.S. continues to have a maternal mortality rate much higher than in other developed nations. According to the latest statistics from the CDC, this rate is rising, and health disparities persist: Black women are three times more likely to die from pregnancy-related causes compared with White women.

Women who have historically been most marginalized will be disproportionately affected by the Supreme Court’s decision, which is expected to […]

2022-07-11T06:31:54-04:00July 11th, 2022|Public health, women's health|0 Comments
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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.
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