Effects of COVID-19 on School Nurse Mental Health Intervention Practices.

Mental health issues have been exacerbated by COVID-19; therefore we examined how the school nurses' role in addressing mental health changed during the pandemic. We administered a nationwide survey in 2021, guided by the Framework for the 21st Century School Nurse, and analyzed self-reported changes in mental health interventions by school nurses. Most mental health practice changes after the start of the pandemic occurred in the care coordination (52.8%) and community/public health (45.8%) principles. An overall decrease in students visiting the school nurse's office (39.4%) was seen, yet the frequency of students visiting with mental health concerns had increased (49.7%). Open-ended responses indicated that school nurse roles changed due to COVID-19 protocols, including decreased access to students and changes in mental health resources. These insights into the role of school nurses in addressing student mental health during public health disasters have important implications for future disaster preparedness efforts.

Challenges Facing Public Health Nursing Faculty in the United States: COVID-19 as a Catalyst for Change.

We present an analysis of challenges facing public health nursing faculty members (PHNF) in the United States and their broader societal implications. The COVID-19 pandemic has exacerbated these challenges, making them untenable. Current academic structures-influenced by the broader sociopolitical climate-are problematic for PHNF: they disincentivize PHNF from researching social determinants of health and public health systems, teaching systems-level content that may be deemed "controversial" and that is not included on licensure exams, and engaging in service through advocacy and community partnerships. The fault lines within health care, public health systems, and higher education indicate that it is time to reevaluate how to incentivize socially just and equitable outcomes. Toward this goal, we propose that collective action and systemic change, including the perspectives of PHNF, is needed to better realize our shared goals. The analysis serves as a catalyst for conversations about academic structures, health care systems, the role of public health, and the kind of society we envision for ourselves and future generations. (Am J Public Health. 2022;112(S3):S314-S320. https://doi.org/10.2105/AJPH.2022.306819).

Mobilizing Support for the Future of Advanced Public Health Nursing Education

As a public health nurse educator, I was deeply disappointed when our advanced public health nursing (APHN) master's program shuttered in the late 2010s. I therefore found Harris et al.'s description (p. S231) of the evolution oftheir APHN program and health policy specialty at the University of California San Francisco (UCSF) to be an inspiring example that should compel nursing education leaders nationwide to consider how they can garner support for APHN education in their own institutions and communities. As evidence mounts regarding the influence of social determinants of health and our world continues to endure a time of upheaval that has magnified inequities on multiple fronts (e.g., the COVID-19 pandemic, climate change, racial injustice, violent geopolitical conflicts), our moral obligation to prepare a workforce that can effectively address structural drivers of health is stronger than ever. If nursing is to reach its potential in influencing health equity, we must teach nurses how systems outside the human bodywork (e.g., political systems) as well as how systems within the human body work (e.g., the cardiovascular system). We cannot do this without nursing faculty who have advanced preparation in public and population health nursing.1,2Although analyzing the future of APHN education is not their primary purpose, Harris et al. briefly recommend expandingthe number of APHN and policy programs nationwide. Their recommendation-which I wholeheartedly support-compels me to reflect on and amplify what others have said regardingthe state of APHN education, including our struggle within nursing to recognize the value of the APHN specialty.2,3 If nurses are to effectively step up as the systems-level practitioners that this pivotal point in history demands, we must begin by advocating for support for APHN education and the value of the specialty from both within and outside the profession.

Redefining the Relationship: Palliative Care in Critical Perinatal and Neonatal Cardiac Patients.

Patients with perinatal and neonatal congenital heart disease (CHD) represent a unique population with higher morbidity and mortality compared to other neonatal patient groups. Despite an overall improvement in long-term survival, they often require chronic care of complex medical illnesses after hospital discharge, placing a high burden of responsibility on their families. Emerging literature reflects high levels of depression and anxiety which plague parents, starting as early as the time of prenatal diagnosis. In the current era of the global COVID-19 pandemic, the additive nature of significant stressors for both medical providers and families can have catastrophic consequences on communication and coping. Due to the high prognostic uncertainty of CHD, data suggests that early pediatric palliative care (PC) consultation may improve shared decision-making, communication, and coping, while minimizing unnecessary medical interventions. However, barriers to pediatric PC persist largely due to the perception that PC consultation is indicative of "giving up." This review serves to highlight the evolving landscape of perinatal and neonatal CHD and the need for earlier and longitudinal integration of pediatric PC in order to provide high-quality, interdisciplinary care to patients and families.