Hospice Education: BP<130/80 with ACE and Calcium blocker; Pandemic Burnout in Hospice Nurses

The new target for BP control is to be less than 130/80. Further, there is a recommendation to start control of BP with two classes of drugs. This article discusses that using an ACE inhibitor and Calcium blocker is an effective way to start. For our patient population, reducing medications may be more appropriate.

TITLE
Achieving the Latest American Heart Association and American College of Cardiology Therapeutic Goals for Hypertension With Combination Therapy and Its Effects on Blood Pressure and Central Hemodynamic Parameters.

JOURNAL
The American journal of cardiology

DOI
10.1016/j.amjcard.2021.12.030

Author(s)
Ram|C Venkata S|CVS|;Muppalla|Baby Shalini|BS|;Parthasaradhi|Sarvepalli Vijaya|SV|;Kumar|Gajjela Praveen|GP|;Ray|Saumitra|S|;Jadhav|Uday|U|;Sawhney|J P S|JPS|;Unni|Govindan|G|;Desai|Nagaraj|N|;|||

Abstract
The present United States and European treatment guidelines recommend that antihypertensive therapy be initiated with a combination of agents from different classes to facilitate the achievement of control of blood pressure (BP). Combination therapy with an angiotensin receptor blocker and a calcium antagonist effectively reduced BP to below the new <130/80 mm Hg target and had favorable effects on central hemodynamics.

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This article echoes what our nurses have surely experienced. Discussing issues as mentioned by the four nurses interviewed may help solve problems of burnout.

TITLE
Running on Empty: Diminished Empathetic Reserve in Frontline Nurses.

JOURNAL
Journal of hospice and palliative nursing : JHPN : the official journal of the Hospice and Palliative Nurses Association

DOI
10.1097/NJH.0000000000000838

Abstract
The COVID-19 pandemic has created a global health crisis. Novel and intolerable pressures have been placed upon nurses affecting their capacity to provide care. The aim of this exploratory study was to determine the impact of the COVID-19 pandemic on nursing care delivery, the empathetic response of nurses to their patients and family members, and the emotional and physical well-being of the nurses. Four frontline nurses were interviewed while in the midst of the pandemic. Common themes emerged from analysis of the nurses' narratives and included changes in role, increased workload, depersonalized and mechanical care delivery, communication challenges with patient and family members, deficits in palliative care education, perceived poor administrative support, and physical/emotional exhaustion. Clinical leaders and nursing staff have opportunities to engage in supportive endeavors, which can restore focus and regain positive perceptions, strengthen coping skills, and deliver palliative care education in response to the ongoing challenges and stressors created by the COVID-19 pandemic. Together, they can build resilience in frontline nurses and ultimately impact delivery of compassionate and empathetic care to patients.

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