Sickle Cell Disease: Complications and Nursing Interventions

Our cover photo this month features three-year-old twins Ava and Olivia. Both have sickle cell disease. In this tender shot, one twin is comforting her sister during treatment at Akron Children’s Hospital in Akron, Ohio.

How much do you know about sickle cell disease (SCD)?

Did you know:

  • that children with SCD can experience “silent strokes” that become clinically evident only as progressive neurocognitive deficits?
  • that renal complications account for 16%-18% of overall mortality?
  • or that SCD-induced priapism in boys and men is not only excruciatingly embarrassing and often painful but may require emergency treatment?

Recognizing common complications.

“Two of the greatest challenges faced by clinicians caring for patients with SCD are the lack of evidence-based guidelines…and the underuse of the few recognized disease-modifying therapies.”

In “Understanding the Complications of Sickle Cell Disease,” a CE feature in this month’s AJN, Paula Tanabe and colleagues provide us with readable and practical information about the complications of SCD.

If, like me, you are not an expert in SCD, this article is an excellent primer on how to recognize the most common complications of the disease, what treatments that are available, and […]

2019-06-03T08:22:06-04:00June 3rd, 2019|family caregiving, Nursing, patient experience|0 Comments
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Healing Words: A Critical Care Book Club

I was always a reader. The days of the Scholastic book fair during elementary school were among my favorites. Although it doesn’t appear in my CV, my first job was working in the school store. With every shift I worked, the smell of blank sheets of paper, the thrill of a pencil awaiting to be sharpened to that perfect point, or the ballpoint and ink pens in a rainbow of colors stole my hard-earned quarters.

‘Is it on the NCLEX?’

But reading novels during nursing school was just plain hard. There were competing priorities, a brain brimming with vital information, and sheer exhaustion at the end of the day. Assigned readings presented an overwhelming amount of contextual information. And then there was the constant attention to evidence, protocols, and clinical practice guidelines. The “need to know” information took priority; the sheer pleasure of losing oneself in a story—whether novel or memoir—was lost.

During my senior year, in an advanced illness course, my professors assigned a novel-style memoir, Bed Number Ten by Sue Baier. To this day, I can remember the reactions to the assignment: “A book? Who has time for that?” “Are we going to be tested on this book?”

Or, most importantly: “Is it on the NCLEX?”

The influence of a patient’s story on […]

2019-05-29T08:45:40-04:00May 29th, 2019|narratives, Nursing, nursing perspective, nursing stories|2 Comments
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June Issue: Sickle Cell Complications, Stoma Skin Care, Promoting Nurse Retention, More

“I am as grateful to the nurses who work in hospitals serving the sickest and most vulnerable patients as I am to the nurses who have chosen a path focused on policy and public service.”—Virginia Reising, author of the June Viewpoint column, “What Is a Nurse?“

The June issue of AJN is now live. Here are some highlights.

CE: Understanding the Complications of Sickle Cell Disease

In this evidence-based review, the authors examine the genetic, hematologic,
and clinical features of sickle cell disease and describe its major
health complications—as well as the nursing implications of each.

CE: Stoma and Peristomal Skin Care: A Clinical Review

Written for nurses who are not ostomy specialists, this article provides information about the care of stomas, including the normal stoma, with a focus on early and late complications of the stoma and peristomal skin.

Original Research: Exploring Working Relationships Between National and Expatriate RNs on Humanitarian Aid Missions: The Perspectives of Liberian Nurses

The authors of this qualitative study explored the perceptions and concerns of Liberian RNs who work for international nongovernmental organizations in Liberia, yielding insights on how to improve collaboration between national and expatriate nursing staff.

EBP 2.0: Implementing and Sustaining Change: Promoting Nurse Retention Through Career Development Planning

This second article in a new series […]

2019-05-28T09:42:37-04:00May 28th, 2019|Nursing|0 Comments
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Nurses Getting Things Done: A Red Cross Volunteer’s Experience

Providing support after a local disaster.

Red Cross volunteer nurse Debby Dailey hugging her client, Janetta Sconiers. Photo by Eddie Zamora for the American Red Cross

Most people are aware of the important role nurses play in the American Red Cross, from its founding by Clara Barton—138 years ago this week—to nurses’ contributions during national and regional disasters. Yet the varied work of these nurse volunteers is often unseen by other nurses, health care providers, and the public.

Within the Red Cross, nurses hold leadership, teaching, and crisis response positions, providing crucial and sometimes long-term follow-up assistance to people who’ve been affected by disasters.

Nurses “are in an ideal position to do this work.”

Debby Dailey is a nurse and former firefighter and emergency medical technician. She currently works as a nursing clinical instructor and has been a Red Cross volunteer for 40 years, responding to national disasters and playing an important role in all aspects of Red Cross work in her region, California’s Central Valley.

This month’s In the Community column, “Advocating for Janetta,” features a rare look inside a Red Cross nurse volunteer’s daily work. In it, Dailey sequentially […]

2019-05-24T10:28:11-04:00May 24th, 2019|Nursing|0 Comments
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When Children Hurt

As an ER nurse, I saw a lot of people in pain, either arriving at our door to have their pain relieved or enduring the pain of needed treatments, knowing that the interventions were necessary. In my experience, though, there’s nothing worse than seeing a child in pain, and the younger the child, the more awful it was.

You began the encounter with a sick or injured child who was already frightened by the circumstances that had caused their parents or guardians to bring them to the hospital. It’s hard to get past the frightened eyes and tears, the little ones trying to burrow into their mother’s shoulder and not wanting to be put down on a paper-covered table. And this was before even attempting any assessment.

Nurse uses Wong–Baker FACES Pain Rating Scale to help assess patient’s pain. Photo by Gerry Melendez/The State/MCT via Getty Images.

Factors to consider in assessing a child’s pain.

We were taught that “pain is what the patient says it is,” and that still seems to be true of children’s reports of pain. But there are many factors that need to be considered, such as […]

2019-05-23T10:18:37-04:00May 23rd, 2019|Nursing, patient experience, Patients|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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