Autism Spectrum Disorder: A Critical Role for Nurses in Screening and Interventions

“‘What’s the scoop with our autism screening?’ a concerned mother asked the nurse upon realizing that the autism spectrum disorder screening questionnaire she had completed wasn’t addressed during her daughter’s well-child visit. The nurse brought the mother’s concern to the primary care provider, who replied, ‘Don’t worry, I only look at screenings if I think there’s a problem. I can spot autism during a patient visit.’”

Is this provider’s confident claim a realistic one? Almost certainly not, as will become clear to anyone who reads the CE articles on autism spectrum disorder (ASD) in the October (“From the CDC: Understanding Autism Spectrum Disorder“) and November (“Autism Spectrum Disorder: The Nurse’s Role“) issues of AJN. As a result of such casual attitudes toward screening, many autistic children are almost certainly not receiving the early treatment and monitoring that can make a big difference in their quality of life.

Delayed diagnosis reduces the window for effective interventions.

ASD is the most common developmental disability in the United States, yet according to the November CE article, screening rates across the U.S. range from a low of 17.2% in Mississippi to a high of less than 60% in […]

2020-11-12T10:16:12-05:00November 12th, 2020|Nursing|0 Comments
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Notes from the AIDS/HIV Epidemic for Nurses Working in the COVID Pandemic

The accounts of nurses working in the midst of this pandemic vividly remind me of my work as a nurse in the early days of the AIDS epidemic. I am reminded of the period when we did not know how the disease was transmitted, when we believed that caring for them involved great personal risk. I remember masking, gowning, and gloving every time I entered a patient room. I still recall the wonderful patients I had the opportunity to care for, and I understand that watching a patient die alone is the probably the most difficult experience that we will ever face as nurses.

I spent years on the front line of the AIDS epidemic and now am teaching future nurses. I am dedicated to helping nurses cope in times of crisis. We have chosen difficult work. Work that is more difficult than we could have possibly understood when we entered nursing school. Work that can also be extremely rewarding. I am proud to be a part of this noble profession, and I hope that it may be useful for me to share some of the things that I have learned.

1. It is extremely important to take care of your physical health.

I remember days I didn’t have time […]

2020-11-09T09:46:50-05:00November 9th, 2020|infectious diseases, Nursing, nursing perspective|1 Comment
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Emergency in the ED: Treating Hemorrhagic Shock

Emergency nursing isn’t all drama and adrenaline.

As any ED nurse knows, most of what a nurse sees in the ED is not what would classify as real emergencies—the kind of exciting, life-threatening situations that might have actually been the reason they chose emergency nursing. That’s how it was for me, and getting hired as a new grad to work at New York City’s Bellevue Hospital, one of the country’s premier emergency services, was a dream come true.

However, I quickly learned that most of the people who came through our doors did not have exciting, life-threatening emergencies but rather the more humdrum “urgencies” of life—gastroenteritis, a sudden high fever, a small laceration that needed a few sutures, sprains, and minor fractures. Minor, comparatively speaking, but certainly not minor to the patient, and all requiring attentive care. (For a vivid and poignant inside view of emergency nursing today, see the photo essay in the September issue; the essay is based on Carolyn Jones’s new film, In Case of Emergency, to be released this week for Emergency Nurses Week.)

When the ED doors slam open.

But then there were those sudden life-or-death emergencies that raised everyone’s adrenaline levels—a patient bleeding out was one of the more dramatic scenes. They usually arrived without […]

2020-10-15T10:16:25-04:00October 15th, 2020|Nursing|0 Comments
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How Do Nurses Feel About Assessing for and Promoting Safe Gun Storage?

My grandfather and uncles were hunters, and they always looked forward to their forays into Michigan’s Upper Peninsula during deer hunting season. But while I was well aware of their activities, they never brought their guns into our house. So I never gave any thought to gun safety issues, even after I became a nurse—not even after caring for one memorable patient, a young man my own age who had been accidentally shot by a companion during a hunting trip.

What can nurses do?

“…a child finds an unlocked loaded gun and accidentally shoots themselves or someone nearby, a despondent teenager makes a rash decision to end their life with the family gun, a homeowner mistakes a family member for an intruder.”

It seems that we read about tragedies like these every day. Can nurses help prevent them? The American Academy of Nursing has recommended that health care professionals “assume a greater role in preventing firearm injuries by health screening.”

In “Nurses’ Knowledge and Comfort with Assessing Inpatients’ Firearm Access and Providing Education on Safe Gun Storage” in the September issue of AJN, Kimberly Smith Sheppard and colleagues report on their original research study, which examined nurses’ knowledge and comfort with assessing patients’ access to […]

2020-10-05T10:43:01-04:00October 5th, 2020|Nursing, nursing research, Public health|0 Comments
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Staying Away, Reaching Out: Offering Parents Support During the Pandemic

The ‘circuit breaker.’

Image by Wokandapix from Pixabay

I brace myself as I look over the names printed on my patient list. Our developmental pediatric unit has started an initiative to call our more vulnerable families during the COVID-19 pandemic.

Chan J. DOB: 12/10/2001. As I scan the electronic notes, I learn that mum is the main caregiver of not one but two boys with autism spectrum disorder who require a high level of support. They both usually attend special school, but the school is currently closed because of social distancing measures. We are in lockdown, or ‘circuit breaker’ as we call it in Singapore, and both children have been at home for the past three weeks. My heart sinks in anticipation as I punch in the numbers.

“Hello,” a voice hesitates at the other end.

“Good morning, Mrs. Chan,” I say, putting on a cheery tone. “My name is Jia Yi and I am a nurse from the child development unit. We are checking in with our families and I wonder if you have some time to speak with me?”

“What about?” This mother sounds tired.

“Oh, just checking in on how you are getting on and whether there is anything we can do to help.”

‘”It’s hard,” she says. I […]

2020-10-01T10:18:14-04:00October 1st, 2020|Nursing, nursing stories|0 Comments
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