Older mothers have more birth complications compared to younger mother-Why?

Older maternity is accompanying with an increased risk of problems during gestation period with a greater likelihood of delivering a child that is premature or born small. Older motherhood is an important to understand the consequences for these children in adulthood. Children born to elder mothers may have more heart threats later in life. Older mothers will face more complications during pregnancy and delivery, as did the risk of premature birth and infant death also sometimes

Complications include:  

·         Extreme bleeding during labour,

·         Extended labour lasting time more than 20 hours,

·         Dysfunctional labour that does not advance to the next stage.

Mother age is compared to 30 to 34 years are old. Mother’s age is in three groups - 35 to 39, 40 to 44, and 45 and older. According to researchers view they found that older women were at much higher risk for problems during pregnancy and delivery. Whether or not the women had before given birth also affected their risk of certain complications. Women giving birth at age 45 or older were also the most likely to have high blood pressure and diabetes while pregnant. The oldest mothers were also at greatest risk for excessive bleeding during delivery, premature delivery (before 32 weeks) as well as Caesarean delivery.

Older mothers can be understood from two perspectives –

·         First the actual medical risks: it related to ageing on reproductive system and body condition.

·         Second, the suitability of the risks as defined through social discourse among different groups within society: pregnant women can evaluate the risks subjectively, through their own experiences, whereas healthcare providers assess the risks in an apparently more objective way.

 Pregnancy Outcomes in Women of Advanced Maternal Age: a Retrospective Study

Risks of pregnancy after age 35

·         There are recognized health hazards to both mother and child when the mother is older.

·         Females are born with all the eggs they’ll ever have during their life. With age, the number and quality of eggs starts decreasing, especially after a woman reaches her mid-30s. That’s one reason it can be tougher to get pregnant at older ages.

·         Both older women and older men are additional likely than younger parents to have pre-existing health disputes.

·         In older age pregnancy raises the risks of complications such as hypertension, fetal growth restriction, premature birth and sometimes death.

·         Older mothers have the higher the probability of chromosomal abnormalities as well as age goes from 25 years old 1 in 1,064 chance of having a child with Down syndrome to 1 in 19 for a 45-year-old

·         At age 20-24 Miscarriage is 9 %  and for a 45-year-old or above is 75%

·         The rate of stillbirths almost doubles when mothers are more than 35 years of age,” he continued.

·         Diabetes and emergency caesarean delivery are among the other possible complications of older mothers.

·         Older father’s sperm also has the potential of having more genetic errors.

Benefits of older parenthood

·         Now a day many women aged 35 and beyond are venturing into parenthood for the first time, as well as there is good news for these older mothers and fathers.

·         There are some projections that note, depending on socioeconomic status, the children have more probability of going to college. There may be less verbal and physical punishment, and it can be financially more stable,” said Shapiro.

·         A important observational study stated that higher maternal age was associated with better health and development for children up to 5 years of age.

·         The children of older mothers in industrialized countries are healthier, taller, and get more education than the children of younger mothers.

·         Prenatal vitamins and physician follow-ups are vital.

·         Older parents should also speak with their doctors about checking sugar levels as well as standard testing for chromosomal abnormalities. If older parents will eating, sleeping, and exercising well, this will improve outcomes.

Pregnant women over 35 years old, have issues and concerns to which Midwives must pay attention when in professional contact with these women health care. In order to meet the needs of older pregnant women, midwifery themselves, need more information concerning the experiences of older women during pregnancy, in order to increase their understanding and knowledge of age-related pregnancy risks. Nursing in healthcare providers should remember that pregnancy can evoke a broad range of feelings in women of advanced maternal age, which can vary from happiness to anxiety.

Why Precision Medicine Is Good for Nursing ? - Precision Health Science in Nursing Research

Precision Medicine is an incorporation of Genetics and Genomics into Nursing in Health care Practice. Nurses are being called upon to play an important role in the national Precision Medicine Initiative (PMI), which will result in an identification of biological, environmental, and behavioural influences on diseases and chronic conditions of patient’s health.  Nursing field and nurses are  the largest sector in the health care work force, will interact with more patients from various socio-economic groups – the very people who are needed as volunteers in the Initiative.  Nurse will be trusted to explain what participation will mean for the individual and encourage them to participate in this critical program.

Precision health will focuses on the use of scientific exploration and genetic testing advances to forecast what diseases will most likely to occur in patients, then initiate and customize as well adopt the interventions to prevent these diseases before they strike.  In precision health, not just talking of genetics and genetic analysis and their stimulus with regards to a patient’s risk for developing diseases and how a patient responds to medications. Nurses will also consider where a patient will work and lives, what they eat, their hobbies and how they will play, their culture, and how these social determinants will affect their health risks and health goals.

Precision Medicine have Initiated in 2016, dedicating more than $200 million for research into this area of medical science, the term "precision medicine" became is more familiar for many people, it includes nurses also. While precision health is a relatively new and current concept of health, it is an area of continuous scientific research that is correlated with precision medicine.

Issues related to precision health will lead to more exact analysis, treatment and care, analytic approaches to make the most precise use of symptom and other person-cantered data. Application of hypothetical outlines to guide precision research and practice as well as challenges to the conduct the survey of precision health science. Tying it all together is a explanation can be written by leading nursing scientists who address the challenges and opportunities for nursing science in the precision health era. Nurses started their research in precision health science and with their research related to precision health, including methods to individualizing prevention and healthcare management techniques using multi-omics (e.g., genetics, transcriptomics, metabolomics, epigenetics, microbiome, etc.), technologies, and other physiological, psychological, imaging, environmental, and ethical factors for persons, families, and communities. 

The goals of precision health science

·         Organizations and staff diving into precision health research have high hopes for accomplishing its objectives.

·         To precisely uncover the predictors of disease and the specific responses to treatments.

·         There are four components of the precision health program

v  Genomics

v  Pharmacogenomics

v  Digital health and

v  Community engagement,

·         Patient’s genetic information to predict disease development and select the best course of prevention and treatment.

·         Pharmacogenomics uses genetic information from a patient regarding their predicted response to medications, so the most effective ones are used for each patient and decreasing the incidence of adverse drug reactions.

·         The use of digital health is multifaceted and involves the use of electronic health records, collecting and culling health data for individuals and populations, using technology for remote monitoring of specific conditions and for conducting patient outreach for testing and appointment reminders.

Accelerating Innovations Fostering Advances in Holistic Nursing

Mental Health is a state of emotional, mental and social wellness demonstrated by satisfying interpersonal connections, effective behavioural personalities and coping, positive self-concept and emotional strength. Mental health and Psychiatric Nursing is a particular field of nursing which focuses on meeting the mental health needs of the consumer, in partnership with family, significant of others and the community in any location. It is a specialised interpersonal process embodying a concept of caring….      

Importance of Psychiatric & Mental Health Nursing:

·         Mental state assessment skills

·         Early intervention- Reduced stays, improved recovery rates.

·         Improved client outcomes.

·         Nurse more comfortable, confident in working with clients with mental illness.

Psychiatric Nurses should follow

·         Nurses should acquiescent patients as exactly as they are and the goal is to convey to the patient as a respect for him/ her as a separate human being who possesses worth and dignity.

·         Nurses should maintain contact with reality. Patients tend to see reality as they want it to be rather than what it is. Nurses must not be support for the unrealistic ideas, assumptions or behaviour. Certainty must be called to the patient's attention.

·         Seeking validation from patient. Feelings and behaviour from the patient’s point of view thus the nurse has to chequer against the nurse's interpretation of how he sees things. ?

·         Nurses should develop Self-understanding therapeutic tool for patients.  The nurse should feel the atmosphere is having some security about her ability to respond properly to patient behaviour by understanding her behaviour and approach towards mental illness. Nursing in Health care can spheres of health care of patients Mental state and the nurse can involve in group conferences about patient Health care.

·         Nurse’s individual influence and self-understanding will resemble nurse how really feels is so important and stereotyped behaviour response to situations and patients is potentially daring. The inconsistency between feelings and actions lessens the nurse's effectiveness in a connection.

·         The influence of prospects of behaviour is important to see the prospective for growth in every patient this makes the nurse to be active as a resources person.

·         Consistency and patient security is important and nurse has to be reliable in attitude, behaviour, and feelings and tedious in the psychiatric hospital to help the patient to reduce the number of conclusions he is called upon to make.

·         Reassurance can be given to patient by an attention to matters that are important to him/her behaviour. Allowing patient to be as sick as he needs to be c. complete awareness and acceptance of how the patient actually feels. d. Doing things without asking anything of the patient in return, such as improved behaviour or a show of appreciation.

·         Variations in patient behaviour through emotional experience will help patient to go through experience and grow their own feelings toward subject. This involves the use of receipt, discriminating listening, focus of relationships upon the patient and involvement with the patient.

·         Evading increased patient nervousness will demands upon the patient that he obviously cannot meet. For example have to insist that a depressed patient cheer-up, that an over energetic patient sits down and keeps quiet. Failure causes anxiety to patients.

·          Contemplation of reason for behaviour and viewing patient's behaviour is objectively important in understanding why the patient behaves in a specific way. Objectivity is the aptitude to evaluate a situation of the patient's behaviour, on the basis of what is actually happening rather than on the basis of one's personal feelings.

People with lasting mental illness are ideal victims. They are often too ill to battle for their rights or too denounced to want to draw attention to their illness. The most severely unwell are the least likely to recognise they need treatment, let alone be able to afford private medical insurance. 

Oncology nurse: It is not just a profession, it truly is a calling and is also the most rewarding thing in Nurses Career

Oncology nurses are a particularly specialized nurse who treats for cancer patients. These nurses need advanced certifications and clinical experience and knowledge in oncology.  Oncology nursing care can define as a convention the numerous needs of oncology patients during the time of their disease as well as appropriate screenings and other preventative practices, symptom management, care to retain as much normal functioning as possible, and supportive measures upon entire life. Oncology nursing should have nursing skills, knowledge, care and compassion to create the patient and family familiarity as positive as possible before and after cancer patient journey. It obliges the unique facility to construct strong relationships and act as a connection between the patient, family, and caregivers. Oncology Nursing care is very tuff role but it needs to be humbled by the kindness and grateful nature of our oncology patients and their families. Oncology is truly a great field to work in. 

The responsibilities of oncology nurses:

• Create an individualized precaution plan on the patient under their observation and care.
• Nurses have to recognize and treat cancer-related issues.
• Cooperate with a team of healthcare professionals to stake the expertise and knowledge related to the patient’s health history. 
• Nurses have to perform the cancer research to enhance treatment protocols assigned to cancer patients.
• Nurses have to provide supportive resources on the patient and the patient families to promote a positive outlook.
• Communicate with patients and families regarding treatment prospects.
• Nurses have to monitor and record the patient’s progress on a constant basis.
• Chart the patient’s response and history to treatment and medication.

Things should know about Oncology Nurses:

·         Oncology nurses should have close bonds with their patients: Oncology nurses perform a key and important role in getting patients and caregivers through an outside illness, often forming lasting bonds that continue for years after the last treatment. Patients can remember nurses who showed them compassion after a biopsy and acquired the time to explain the side effects of treatment as well as explain them through a difficult procedure.

·         Oncology nurses synchronize cancer care: Oncology nurses are indispensable followers who help for patients and navigate multifarious and complex treatment protocols as well as they have to explain the age symptoms and side effects to patients. Patient’s treatment will weave through a lot of phases and he or she may see several different professionals from different medical specializations in the entire treatment. Oncology nurses are the ones who provide dependable information and management across the treatment plan.

·  Oncology nurses should know their patient's history and advocate for them: Nurses have to witness the grace and compassion of nursing care and have to understand the lived experience of patients and families. Nurses should have knowledge and update on Advanced Health care Transformation techniques related to oncology.

]

Oncology Nurses have been countless times when nurses are helped to clarify details about a patient’s situation that would have been missed otherwise. Nurses should have their own professional development as well as rebuked, praised, humbled and inspired by my nursing colleagues. For many cancer patients, when this tool is needed most, it is unavailable.  It requires developing new tools for managing stress.

It’s important for nurses and health care providers who are not physically active to understand that a lack of physical activity actually creates stress for patients who are. 

The oncology nurse can serve the patient population in several different ways. Nurses can provide direct patient care, and also have opportunities to work as practitioners, educators, administrators, researchers, patient navigators and more.

Home Health Care Nursing

Home health care nursing is a field accessible to registered nurses (RNs) as well as licensed vocational nurses (LVNs) and nurse supporters. Home health nursing staff is answerable for caring for patients in their homes and they have perform various tasks if patients and or their families are incapable to care for themselves.

Skills from many different specialties are necessary in the field of home health:

·         Medical-surgical Nursing care

·         Mental health Nursing care

·         Gerontology Nursing care

·         Paediatric Nursing care and

·         Community/ public health Nursing care

Home Health Care is the provision of medically connected  experts, Para- professional services and equipment’s to individuals and their families in their place of residence for the resolution of  promoting, preserving or repairing of  health or of  minimizing the effects of disease and disability.

Home Health Nursing includes

·         Home health nursing services empower the individuals of all ages to remain in the comfort and security of their homes while receiving healthiness care.

·         Family maintenance, familiar surroundings and participation in the care process contribute to spirits of worth and dignity.

·         Services may include skilled nursing, physical therapy, speech language therapy, occupation therapy, social services, intravenous therapy, nutritional support, home health aide, respiratory therapy, acquisition of medical supplies and equipment, and homemaker and companion care

Most home healthcare agencies required nurses who have a BSN and at least 2 years of experience as an RN in medical-surgical situations. Nurses who've operated in medical-surgical or critical care areas are generally succeed in home healthcare settings due to their comprehensive range of assessment skills. Although no specific certification is obtainable for home healthcare nursing, some nurses choose to maintain certification in medical-surgical nursing. Most patients in home healthcare settings are older than 65 and have numerous medical identifies and chronic health issues. Some of the more common include heart failure and other cardiac problems, diabetes, chronic obstructive pulmonary disease, pneumonia, and osteoarthritis. 

Nurses with knowledge and experience in these areas are a good fit for home healthcare:

·         Cardiac diseases

·         Pulmonary disorders

·         Orthopaedics

·         Diabetes

·         Wound care.

Different Perspectives –

·         Official - Services are provided to persons and their relations in their place of residence for the purpose of promoting, maintaining, or restoring health or of minimizing the effects of illness, disability and incapacity

·         Patient - Skilled and concerned care is provided on a one-to- one basis in the comforting and familiar backgrounds and surroundings of the home

·         Family - It is a means to keep the family together as a functioning, integrated unit.

·         Provider - All disciplines involved are challenged to provide excellent care in often less-than-excellent conditions and surroundings. 

Where do Home Health Care Nurses Work?

Home health nursing staff can work within the patients' homes. They usually have a facility in which they bang to receive their task. After receiving their assignment, they drive to patients' home to perform the particular indicated nursing care as ordered by the physician.

What does Home Health Care Nurse Can do?

Based on their identifications, home health care nursing staff performs a variety of responsibilities.

Registered Health care nurses perform the following duties:

·         Medication administration, including intravenous infusions

·         Wound care/ dressing changes

·         Taking vital signs

·         Performing head-to-toe physical assessments

·         Drawing labs

·         Assisting with activities of daily living (ADLs) such as bathing, toileting, grooming

·         Assisting with mobility

·         Developing a plan of care with the physician

Licensed Vocational Nurses perform the following duties:

·         Medication administration, excluding intravenous infusions

·         Wound care/ dressing changes

·         Taking vital signs

·         Reporting to the supervising RN any concerns the patient may have

·         Assisting with ADLs

·         Assisting with mobility

Nurse Assistants perform the following duties:

·         Taking vital signs

·         Report to the supervising RN any concerns the patient may have

·         Assisting with ADLs

·         Assisting with mobility

Roles and responsibilities for Home Health Care Nurses

The roles and duties of home health nurses are dependent upon their separate identifications.

Registered Health care nurses are responsible for:

·         Assessing the patient's needs

·         Developing a plan of care based on individual patient needs

·         Collaborate with the patient, family, physician, and additional support staff to provide individualized care

·         Direct LVNs and nurse assistants, and provide oversight to their care

·         Evaluate patient's response to treatment

·         Monitor progress of healing/ mobilization

·         Case management

·         Direct nursing care

Licensed Vocational Nurses (LVN) are responsible for:

·         Collecting data and presenting findings to the RN

·         Direct task-based nursing care

Nursing assistants are responsible for:

·         Task-based nursing care

·         Report concerns/ findings to registered nurse