Former Pediatric ICU Nurse: Where Are the Smart Guns?

Stars for the dead.

On the afternoon of Thursday, November 14, 2019, I visited our local art museum to see a retrospective exhibit by a conceptual artist. Walking into the museum gallery, the first piece you encounter is an installation of several dark blue banners suspended from the ceiling. On their blue fields are embroidered white stars; lots of white stars, 14,718 in all. Each star represents a person killed in the United States by another person with a gun in 2018.

It’s a sobering statistic, but what caught my attention was the half-dozen high school students seated cross-legged on the museum floor inside the circle created by the hanging banners. They faced each other silently. None of them was texting or taking selfies, which was remarkable in itself.

I hadn’t yet heard that earlier in the day two high school students died, and several more were injured in another school shooting, this one at Saugus High School in Santa Clarita, California. Later the shooter, a student, died of self-inflicted gunshot wounds.

As seen in the pediatric ICU.

As a former pediatric intensive care nurse, I have personally cared for several child gunshot victims. They were nice children from nice families who happened to have loaded guns in their homes.

Forgive […]

2019-11-20T10:13:03-05:00November 20th, 2019|Nursing, Public health|1 Comment
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Caregivers Home Alone-And Needing Our Support

Family caregivers performing complex care.

When my mother needed care at home in her final days, she was fortunate in that two of her daughters were nurses who were familiar and comfortable in providing her care. We were fortunate in that she did not require complex care like tube feedings or IVs or ostomy care or wound care or dialysis. But many people do, and must rely on family members to do these complex tasks.

I remember how I felt as a nursing student when I had to administer one of these complicated interventions. I remember being anxious, my hands sweating as I desperately tried to recall the list of instructions I had looked up the night before.

And yet I had an instructor with me to walk me through it. Family caregivers have no such support and often don’t even get adequate instruction beforehand.

Family caregivers need more than recognition.

November is National Family Caregivers month and I can’t think of a group more in need of recognition. But while naming a month in their honor is nice to increase awareness of the more than 40 million family caregivers in this country, they need much more than that. Specifically, they need more in the […]

2019-11-18T11:16:45-05:00November 18th, 2019|family caregiving, family caregiving, Nursing, Patients|1 Comment
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Addressing Harassment and Intimidation by Patients and Family Members

Since arriving at the skilled nursing facility after surgery for throat cancer, Ray had been attempting to touch female nurses inappropriately and had recently started making kissing motions at one of them whenever she entered and left the room.

Tacit acceptance of the unacceptable.

Though his behavior was recognized as unacceptable, most nurses had simply been redirecting him or telling him to stop, with no further consequences. Some explained the harassment away as the crude behavior of an old man who didn’t know any better. He’s from a different time; things were different back then. Some dismissed it as harmless. He thinks he’s being flirty. For others, his behavior was a mild though not particularly threatening irritation. He can’t even get out of his wheelchair—what’s there to worry about?

A symptom of cognitive decline, or plain old bullying?

The situation was complicated by the fact that Ray could not communicate verbally as a result of surgery, had short-term memory impairment, and difficulty concentrating. Although he appeared cognitively sound, there were just enough complications in communication and attention to cause some to speculate that he might be having neurocognitive decline that had disinhibited his self-restraint.

For others, Ray was a bully, maybe even a predator. He was taking advantage of access to female staff who were required to […]

2019-11-14T10:28:12-05:00November 13th, 2019|career, Nursing, nursing career|0 Comments
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Remembering Veterans – All of Them

In the November 2010 issue of AJN, we published an editorial, “Families are Veterans, Too,” recognizing the stress and sacrifices of families of those who serve in the military. On this Veterans Day, we’re sharing an excerpt of that editorial below, and also offering free access to “Caring for Families with Deployment Stress,” the article mentioned in the editorial. This article was also published in the November 2010 issue and, unfortunately, is still very much pertinent, given that many families are still experiencing the stress of having a loved one deployed to a conflict zone. We honor and thank all those who have served.

As Erin Gabany and Teresa Shellenbarger explain in “Caring for Families with Deployment Stress,” that stress can be considerable. In families with children, deployment means that a two-parent household becomes in effect a single-parent one; when a single parent is deployed, grandparents, aunts, or uncles may find themselves filling that role. The deployment period may be especially difficult for families of soldiers in the National Guard or in reserve units—they’re less likely to be living on or near a military base or to have access to its resources and to other families going through the same experience. They’re also likely to have less income when the reservist’s civilian pay stops. Such stressors can play a role in a range of physical, emotional, and behavioral problems.

Nurses in all settings—not just those in clinics serving military families—may […]

2019-11-11T13:44:06-05:00November 11th, 2019|Nursing|0 Comments
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Managing Cardiovascular Complications of Pregnancy

(click image to expand)

Over the past 30 years, the number of pregnancy-related deaths in the U.S. has more than doubled, from 7.2 women dying per 100,000 live births in 1987 to 16.9 women in 2016. By comparison, on average in high-income countries, 11 women die for every 100,000 live births.

CVD a leading cause of maternal mortality.

There are many reasons why more women die from pregnancy-related causes in the U.S. than in other developed countries; our dysfunctional health care system is, of course, a central problem. But is there more that nurses can do to ensure safe and healthy pregnancies?

“Cardiovascular diseases constitute a leading cause of maternal and fetal mortality in pregnant women… [In recent studies], inadequate peripartum follow-up—such as failure to evaluate new symptoms, reevaluate existing symptoms, or respond to changes without delay—was responsible for between one-quarter and two-thirds of deaths associated with pregnancy-specific cardiovascular diseases.”

That’s from “Gestational Hypertension, Preeclampsia, and Peripartum Cardiomyopathy:  A Clinical Review,” in the November issue of AJN. In this CE feature article, Maheu-Cadotte and colleagues at the Université de Montréal provide an update on the current management of gestational hypertension, preeclampsia, and peripartum cardiomyopathy.

Risks before, […]

2019-11-08T12:09:08-05:00November 8th, 2019|Nursing|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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