Photos © background: Leslie Banks / flickr.com, Macie J. Noskowski, top photo: Navy Medicine / flickr.com, bottom photo: Fuse Collection / thinkstockphotos.com
Perspectives
Every Nurse Makes History
M Mary C. Brucker, PhD, CNM, FACNM, is an assistant professor, adjunct, at Georgetown University in Washington, DC, and she is the editor of Nursing for Women’s Health. DOI:10.1111/1751-486X.12170
http://nwh.awhonn.org
March is Women’s History Month, which prompts me to reflect on some notable health events in history. One hundred years ago Canada had already entered World War I and the United States would join in just a few years. What did the “war to end all wars” have to do with women and their health care? Although WWI didn’t cause influenza, the close proximity of soldiers enhanced contagion and modern travel involved in the conflict promoted spread over geographic borders. It has been estimated that as much as 5 percent of the entire world population died of this disease. And who were the most vulnerable? More than 95 percent of deaths occurred in people ages 20 to 40 years, especially pregnant women for whom various studies reported the death rate between approximately 20 percent and 70 percent of those who had the flu. Among the women who survived, approximately 25 percent lost their unborn children. Death rates like these
MARY C. BRUCKER are why this influenza pandemic has been called a “medical holocaust.” The last century brought amazing advances in health care, as well. The mid-century introduction of antimicrobials revolutionized the treatment of women with infections, especially tuberculosis and nephritis, which were among the top five causes of female deaths in 1915. Immunizations, including for influenza, diminished the risks of many communicable diseases. Contraception not only influenced the number of births, but also provided noncontraceptive health benefits. And with these advances came much greater life expectancy. A little girl born 100 years ago had a life expectancy of approximately 57 years; one born today can expect to live more than 80 years. However, despite advances, problems and challenges remain. Although maternal mortality
© 2015, AWHONN
7
in today’s health care, and it’s up to all of us to make sure that history reflects their importance decreased dramatically in the late 20th century, the numbers have stabilized or even increased, and a racial disparity is unfortunately all too obvious. Preterm babies face not only immediate problems, but potential lifelong consequences as we understand more about intrauterine programming. New infections and drug-resistant “superbugs” provide ongoing challenges. The lengthening of life for women is positive, but the burden of disease is higher for women than for men, and may mean that their extra years are spent suffering with chronic conditions. And physiologic pathology isn’t the only issue— intimate partner violence, nutrition, poverty, etc., all are integral components in health. So where is nursing in this picture? It fascinates (and frustrates) me that the stories of many of the nurses of the last century have been lost or minimized. Before Jonas Salk developed a polio immunization, an Australian nurse named Elizabeth Kenny identified physical therapy for individuals with the disease and her approach was promoted worldwide. Before the
8
Nursing for Women’s Health
combination oral contraceptive was on the market, Margaret Sanger was appalled by the implications for women’s lives subsequent to multiple unintended pregnancies, so she promoted barrier birth control. Mary Breckenridge brought nurse-midwifery to Appalachia and demonstrated better perinatal outcomes than those observed in the United States as a whole during the Great Depression. And the future? I have no hesitation saying that there will be more nurses making a difference, especially since they view women holistically and not just as potential vessels for disease. I recently attended an excellent perinatal nursing leadership meeting that concluded with a speaker asking every participant to stand if he or she is a nurse leader. She walked through the room and made sure every nurse stood, driving home the point that every nurse is a leader. I would expand that thought by saying every nurse makes history. Whether by working oneon-one with women and newborns, or by sharing information about implementing an evidencebased practice change, or by disseminating such information through group discussions or publications, nurses play a huge and vital role in today’s health care, and it’s up to all of us to make sure that history reflects their importance. It’s a good month for women and their nurses. NWH
Volume 19
Issue 1
Photo © CCNA Photos / flickr.com
Perspectives
Nurses play a huge and vital role
Perspectives
Every Nurse Makes History
M Mary C. Brucker, PhD, CNM, FACNM, is an assistant professor, adjunct, at Georgetown University in Washington, DC, and she is the editor of Nursing for Women’s Health. DOI:10.1111/1751-486X.12170
http://nwh.awhonn.org
March is Women’s History Month, which prompts me to reflect on some notable health events in history. One hundred years ago Canada had already entered World War I and the United States would join in just a few years. What did the “war to end all wars” have to do with women and their health care? Although WWI didn’t cause influenza, the close proximity of soldiers enhanced contagion and modern travel involved in the conflict promoted spread over geographic borders. It has been estimated that as much as 5 percent of the entire world population died of this disease. And who were the most vulnerable? More than 95 percent of deaths occurred in people ages 20 to 40 years, especially pregnant women for whom various studies reported the death rate between approximately 20 percent and 70 percent of those who had the flu. Among the women who survived, approximately 25 percent lost their unborn children. Death rates like these
MARY C. BRUCKER are why this influenza pandemic has been called a “medical holocaust.” The last century brought amazing advances in health care, as well. The mid-century introduction of antimicrobials revolutionized the treatment of women with infections, especially tuberculosis and nephritis, which were among the top five causes of female deaths in 1915. Immunizations, including for influenza, diminished the risks of many communicable diseases. Contraception not only influenced the number of births, but also provided noncontraceptive health benefits. And with these advances came much greater life expectancy. A little girl born 100 years ago had a life expectancy of approximately 57 years; one born today can expect to live more than 80 years. However, despite advances, problems and challenges remain. Although maternal mortality
© 2015, AWHONN
7
in today’s health care, and it’s up to all of us to make sure that history reflects their importance decreased dramatically in the late 20th century, the numbers have stabilized or even increased, and a racial disparity is unfortunately all too obvious. Preterm babies face not only immediate problems, but potential lifelong consequences as we understand more about intrauterine programming. New infections and drug-resistant “superbugs” provide ongoing challenges. The lengthening of life for women is positive, but the burden of disease is higher for women than for men, and may mean that their extra years are spent suffering with chronic conditions. And physiologic pathology isn’t the only issue— intimate partner violence, nutrition, poverty, etc., all are integral components in health. So where is nursing in this picture? It fascinates (and frustrates) me that the stories of many of the nurses of the last century have been lost or minimized. Before Jonas Salk developed a polio immunization, an Australian nurse named Elizabeth Kenny identified physical therapy for individuals with the disease and her approach was promoted worldwide. Before the
8
Nursing for Women’s Health
combination oral contraceptive was on the market, Margaret Sanger was appalled by the implications for women’s lives subsequent to multiple unintended pregnancies, so she promoted barrier birth control. Mary Breckenridge brought nurse-midwifery to Appalachia and demonstrated better perinatal outcomes than those observed in the United States as a whole during the Great Depression. And the future? I have no hesitation saying that there will be more nurses making a difference, especially since they view women holistically and not just as potential vessels for disease. I recently attended an excellent perinatal nursing leadership meeting that concluded with a speaker asking every participant to stand if he or she is a nurse leader. She walked through the room and made sure every nurse stood, driving home the point that every nurse is a leader. I would expand that thought by saying every nurse makes history. Whether by working oneon-one with women and newborns, or by sharing information about implementing an evidencebased practice change, or by disseminating such information through group discussions or publications, nurses play a huge and vital role in today’s health care, and it’s up to all of us to make sure that history reflects their importance. It’s a good month for women and their nurses. NWH
Volume 19
Issue 1
Photo © CCNA Photos / flickr.com
Perspectives
Nurses play a huge and vital role
