1. Ashland, Patricia S. MSN, RN
  2. Dasilva, Aguida BSN, RN-BC
  3. Laffan, Susan RN, CCHP-RN, CCHP-ADVANCED

Article Content

Positive home birth experiences

> Because Nursing2014 is a peer-reviewed journal, I found "Professional Perspectives on Planned Home Births" (September 2014)* very interesting. The topic is significant to me because one of my daughters chose to have her last two children at home. She researched her options carefully and found excellent midwives. I was very wary of home births because I'm a hospital-based pediatric nurse and the babies I see are those who had poor home birth outcomes. But because of her thorough knowledge, research, and excellent midwife, my daughter and her babies were fine. She had wonderful birthing experiences surrounded by her family.

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This article has helped further allay my qualms about home births. A compelling point in their favor is that pregnancy and birthing are part of the wellness continuum and aren't considered an illness that needs hospitalization. I'd like to see more research-based evidence to help garner support for home births from my hospital-based midwife, obstetric, and pediatric colleagues.


Being prepared for the unexpected

> I can't stress enough the importance of appointing a healthcare proxy and discussing advance directives regardless of age. Working as an RN, in an acute care setting, I often witness families disagreeing when it comes time to make end-of-life decisions. Disagreement at this time only adds to the stress of losing a loved one. Ongoing education is needed on end-of-life matters to promote understanding about the importance of appointing a proxy at an early age.1 In addition, educating healthcare personnel on the subject will help them assist their patients and families discuss end-of-life issues before life-limiting illness occurs.


Advanced age or terminal illness aren't required to start planning advance directives. Advance directives should be discussed routinely with patients at the primary care provider's office. Research shows that patients are very receptive when the healthcare provider introduces the subject to them.2,3


The healthcare system has made progress in recognizing the need for improvement on this issue, but we have a long way to go. With appropriate education and training, we can slowly break the taboo of discussing advance directives. Planning for the future helps patients and families avoid unnecessary disagreement and distress when saying goodbye to a loved one.


Memorable moments

> I enjoyed reading "Sharing Your Nursing Story" (Professional Growth, August 2014).* I presented an educational session in October at the National Commission on Correctional Health Care conference entitled: "My Pink Slippers: Rejuvenating Your Nursing Spirit." Participants were invited to write one of their memorable nursing stories, a poem, or quote that I'll organize and share with those who attended the session.



The article "Administering vaccines" (October 2014)* incorrectly stated that the measles, mumps, and rubella (MMR) vaccine once contained the preservative thimerosal. According to the CDC, the MMR vaccine never contained thimerosal. For more information, see




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1. Ryan D, Jezewski MA. Knowledge, attitudes, experiences, and confidence of nurses in completing advance directives: a systematic synthesis of three studies. J Nurs Res. 2012;20(2):131-141. [Context Link]


2. Morhaim DK, Pollack KM. End-of-life care issues: a personal, economic, public policy, and public health crisis. Am J Public Health. 2013;103(6):e8-e10. [Context Link]


3. Abarshi E, Echteld M, Donker G, Van den Block L, Onwuteaka-Philipsen B, Deliens L. Discussing end-of-life issues in the last months of life: a nationwide study among general practitioners. J Palliat Med. 2011;14(3):323-330. [Context Link]


* Individual subscribers can access articles free online at [Context Link]