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The barriers to effective communication also include cultural barriers, semantic barriers, gender barriers, and time constraints.
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Ethical Dilemmas I01:17

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Ethical dilemmas in nursing are of utmost importance, as they often arise from the tension between adhering to core ethical principles and the practical realities of healthcare delivery. These dilemmas require nurses to navigate complex situations where competing ethical considerations pull them in different directions.
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According to obedience research, we may harm others under the forceful pressures of an authority figure (Milgram, 1974). How about if the inappropriate orders were delivered with less force? The increasing interdependence between nurses and physicians compelled Hofling and his colleagues to explore nurses’ reactions to a potentially harmful medical request made by the perceived authority figure, the doctor (Hofling, Brotzman, Dalrymple, Graves, & Pierce, 1966). In this situation,...
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Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although...
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Updated: May 23, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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Inaction Despite Motivation: Assessing Systemic and Personal Barriers to Pediatricians' Post-Dobbs Emergency

Elizabeth Hovel1, Michelle Pickett2, Alexis Visotcky3

  • 1Medical College of Wisconsin, Department of Pediatrics, Division of Adolescent Medicine, Milwaukee, Wisconsin.

Journal of Pediatric and Adolescent Gynecology
|March 19, 2025
PubMed
Summary

Following the Dobbs decision, most providers believe adolescent emergency contraception (EC) is more important, yet few increased prescribing. Improved EC education and system support are needed.

Keywords:
AbortionAccess to careAdolescentsEmergency contraceptionPediatricsPrimary careQuality improvementSexual and reproductive healthTeen pregnancy

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Area of Science:

  • Reproductive Health
  • Adolescent Medicine
  • Healthcare Provider Education

Background:

  • The Dobbs decision significantly altered abortion access, increasing the importance of emergency contraception (EC) for adolescents.
  • Understanding healthcare providers' perspectives on EC is crucial for improving adolescent access post-Dobbs.

Purpose of the Study:

  • To assess pediatric primary care providers' knowledge, attitudes, and practices regarding emergency contraception (EC) for adolescents after the Dobbs decision.
  • To identify barriers and desired support for increasing EC prescription rates among adolescent patients.

Main Methods:

  • A cross-sectional internet-based survey was administered to providers in three pediatric primary care systems.
  • The survey collected data on EC knowledge, attitudes, perceived barriers, and desired support for EC prescription post-Dobbs.

Main Results:

  • 81% of providers viewed adolescent EC prescription as more important post-Dobbs, but only 7% increased their prescribing.
  • Mean provider knowledge score for EC was 71%. Factors associated with higher knowledge included proximity to training and willingness to prescribe EC.
  • Barriers to EC prescription most frequently cited were lack of awareness and knowledge. Over half of providers desired EMR-integrated decision support and education sessions to increase prescribing.

Conclusions:

  • There is a significant need to enhance emergency contraception (EC) education for pediatric providers.
  • System-level interventions, including EMR-based clinical decision support and targeted education, are essential to facilitate confident and increased EC prescription for adolescents.