Impact of Family Planning Nurse Practitioners

A survey of family planning clinics shows that over half of responding clinics utilize the services of nurse practitioners and delegate to them considerable responsibility for patient care. Reported benefits from the use of family planning nurse practitioners as primary service providers include improved utilization of physician time, wider range of services, greater patient satisfaction, and increased patient volume. Findings indicate that family planning nurse practitioners have become an integral and important part of the family planning delivery system in the United States.     

Neonatal Nurse Practitioners Who Are They?

A neonatal nurse practitioner (NNP) serves as the primary-care provider for in-hospital neonates. These practitioners receive different education and formal training than other nurse practitioners. The NNP's responsibilities may include managing patient care in an intensive-care unit, conducting normal newborn assessments and physical examinations, and providing high-risk follow-up visits. Career stressors, job satisfaction, and salaries vary among NNPs. The authors describe the variation in education and roles in this expanded nursing practice.     

Perinatal Nurse Practitioners and Health Care Reform

Health care delivery for pregnant women at high risk is changing in response to the nation's need to contain costs and improve care. Perinatal nurse practitioners can provide specialized care to women at high risk in a wide variety of settings. They provide quality, cost-effective care and can improve access to prenatal care for families at risk for untoward pregnancy outcomes.     

Family-planning risk-scoring system: updated

A 1-page check-off form that can be used to evaluate a woman's risk factors for oral contraceptives, IUD or diaphragm and spermicide, and provide a permanent health record of the evaluation, has been revised to reflect lower-dose pills and new information. Each risk factor is assigned points in columns under each contraceptive method, so that a score of 10 suggests that a contraindication may exist against that method. Some of the changes for orals are lower scores for age 40, unless other risk factors co-exist, especially smoking. Liver disease, hepatitis and gall bladder disease were eliminated, but liver tumors, endometrial cancer and cholestatic jaundice of pregnancy were each given 10 points. Scores were altered slightly for chloasma, hemoglobinopathies, hypertension and diabetes. Scores for the diaphragm were lowered for pelvic relaxation risk but 5 points were introduced for history of urinary tract infection. For IUDs, multiple sexual partners and abnormal bleeding are added as risks.     

Nurse Advocacy for Selective Versus Routine Episiotomy

Although episiotomy is one of the most commonly performed surgeries, little scientific support exists for this procedure. Furthermore, the suggested advantages of routine episiotomy are challenged easily and the surgery is not without risks. Adverse effects arising from episiotomy include an increased incidence of severe lacerations, blood loss, pain, delayed healing, dyspareunia, psychologic trauma, and medical cost. Nurses can assist women in avoiding perineal trauma resulting from unnecessary episiotomy through patient education, patient advocacy, and direct care.     

Psychological Characteristics of BDSM Practitioners

IntroductionIt has been generally thought that the practice of bondage-discipline, dominance-submission, sadism-masochism (BDSM) is in some form associated with psychopathology. However, several more recent studies suggest a relative good psychological health of BDSM practitioners.AimThe aim of this study was to compare scores of BDSM practitioners and a control group on various fundamental psychological characteristics.MethodsFor this aim, 902 BDSM and 434 control participants completely filled out online questionnaires. Associations were examined using χ² tests of independence with φ and Cramer's V as effect size measures and eta or Pearson's correlation. Group differences were tested using analysis of covariance, with partial η² as effect size measure. A priori contrasts were tested using α = 0.01 to correct for multiple testing; for all other tests we used α = 0.05, two tailed.Main Outcome MeasuresThe study used Big Five personality dimensions (NEO Five-Factor Inventory), attachment styles (Attachment Styles Questionnaire), rejection sensitivity (Rejection Sensitivity Questionnaire), and subjective well-being (World Health Organization-Five Well-being Index).ResultsThe results mostly suggest favorable psychological characteristics of BDSM practitioners compared with the control group; BDSM practitioners were less neurotic, more extraverted, more open to new experiences, more conscientious, less rejection sensitive, had higher subjective well-being, yet were less agreeable. Comparing the four groups, if differences were observed, BDSM scores were generally more favorably for those with a dominant than a submissive role, with least favorable scores for controls.ConclusionWe conclude that BDSM may be thought of as a recreational leisure, rather than the expression of psychopathological processes. Wismeijer AAJ and van Assen MALM. Psychological characteristics of BDSM practitioners. J Sex Med 2013;10:1943–1952.     

Implications for Mother and Infant, Challenge for the Nurse

A review of postterm pregnancy and the postmature newborn is presented. It includes definitions, problems encountered, guidelines for identification of high risk, and the psychological impact on the pregnant woman. A final section summarizes the special challenge postterm pregnancies present to the nurse.