NursingCenter’s In the Round

A dialog by nurses, for nurses

Join our nursing community!

clock September 30, 2014 02:54 by author Cara Gavin, Digital Editor

Since starting at Lippincott’s this past January as their Digital Editor, my favorite part about my job is talking with our nurses and members. I really enjoy the sense of community I get from speaking with nurses, whether it is in person at one of our conferences, over the phone at my desk, or on this blog. 

Another great resource for our community is our social media sites.  Both our Clinical Editor, Lisa Morris Bonsall, MSN, RN, CRNP, and myself regularly update our accounts and use them as important tools to reach out to our nurses. I love seeing what people are talking about, how they are responding to current issues, and getting feedback from our followers. 

Social media is one of the best ways to reach us, so I invite you to join our nursing community by following us on Twitter @NursingCenter or @CaraGavin, Google+, Facebook, and LinkedIn. We want to hear from you! 

The American Nurse Project

clock April 25, 2014 01:25 by author Lisa Bonsall, MSN, RN, CRNP

During a discussion with several nurses last night, we acknowledged the importance of nurses having a passion for the profession, and how this passion makes a difference in patient care. When I view the trailer for The American Nurse: Healing America, I feel the passion in the voices of those nurses featured. I can only imagine the impact that viewing this entire feature documentary will have. It premieres during National Nurses Week and I am really looking forward to seeing it! 

In 2012, Carolyn Jones, a photographer and filmmaker, traveled across the United States documenting the work of nurses. Her book, The American Nurse, was published that year and includes portraits, interviews, and biographies of nurses she encountered on her journey. An interview with Jones reveals her passion for this project, despite not being a nurse herself. She states, “Nursing is real. I'm fascinated by how a nurse can help all different people, even people that have committed terrible crimes, with the same compassion that they can treat a friend.” She learned a lot during her conversations with nurses and her journey is bringing our important work into the eyes of the public. For that, I am grateful. 

I will leave you with this powerful quote from the mission of The American Nurse Project: 

“At some point in our life each of us will encounter a nurse, whether it be as a patient or as a loved one. And that one encounter can mean the difference between suffering and peace; between chaos and order. Nurses matter.

I hope that many of you will get the opportunity to see this film. You can find a list of theaters here. I look forward to hearing what you think! 


clock January 7, 2014 07:23 by author Lisa Bonsall, MSN, RN, CRNP

On New Year’s Day, an interview on the Today Show with Jon Gordon, a motivational expert and author, caught my attention. Mr. Gordon’s advice for those of us making resolutions for 2014, was to keep it simple by selecting one word to focus on for the upcoming year. Joni, over at Nursetopia, has been doing this for a few years and has shared her reflection on her words from 2012 and 2013, as well as her word for 2014.

After much thought, I’ve decided that my one word for 2014 will be “listen.” I often find myself thinking of my to-do list or what I will say next while someone else is talking, and before I know it, I’ve missed out on what he or she has said. As nurses, being good listeners is incredibly important – patients often confide in us and share things that they don’t tell anyone else. If we miss it, how can we be the best advocates for them?

While it would be great to just say “I’m going to always listen well,” I know that even with my best intentions, this won't happen. Being a better listener is going to take some work. So I’ve dug through our library and searched the web for some strategies to help sharpen my listening skills. Here’s what I found…

Tips for improving your listening skills

1. “SOLER” up: 

*Squarely face the patient

*Open up your posture (keep your arms uncrossed)

*Lean toward the patient

*Eye contact


2. Eliminate distractions.

3. Be present in the current moment. Give your full attention and listen as if you will have to repeat what you are told.

4. Don’t interrupt.

5. Acknowledge the patient by nodding or using conversation cues, such as “yes” and “go on.”

6. Pay attention to nonverbal cues.

7. Use active listening or reflective listening to repeat back what a patient is telling you. This can encourage them to go on or to clarify what they are saying. For example, “It sounds like you’re saying the pain gets worse at night.”

8. When you notice that you are not listening, fix it by refocusing your attention. If necessary, apologize and ask the patient to repeat what you missed.

I realize some of these tips can be tricky depending on the environment in which you work. My advice? Do the best you can and try to ensure you’ll have ample time to hear responses when asking open-ended questions. Good luck!

Oh, and --- What is your word for 2014?



Calcagno, K. (2008). Listen Up...Someone Important is Talking. Home Healthcare Nurse, 333-336.

Jarrow, C. (2013, August 26). 10 Ways to Be Present and Be a Better Listener. Retrieved from Time Management Ninja:

McMullen, L. (2013, August 24). How to Actually be a Good Listener. Retrieved from Huffington Post:

Richardson, L. (2012). Motivational Interviewing: Helping Patients Move Toward Change. Journal of Christian Nursing, 18-24.

Peace and Health in ANS

clock September 19, 2013 03:47 by author Lisa Bonsall, MSN, RN, CRNP

The current issue of Advances In Nursing Science is a special one. The articles in this issue all are related to ‘peace’ and at a time when our country and our lives are faced with turmoil and violence, it is a welcome journal.

Here’s a look at some of the feature articles…

"No One Gets Through It OK": The Health Challenge of Coming Home from War
I was in a firefight one week and home in the next. And it was like, as an 18-, 19-year-old can't turn the switch off, you know what I'm saying? It was difficult for me to go home and make an instant switch to be a civilian. I didn't know how to act right. My energy was up here, but it needed to be down here.”

Critical Cultural Competence for Culturally Diverse Workforces: Toward Equitable and Peaceful Health Care
“…attaining equity-and ultimately peace-in health care delivery necessitates that nursing and other health care professions more carefully attend to the sociocultural context in which health care is delivered.”

Peace Through a Healing Transformation of Human Dignity: Possibilities and Dilemmas in Global Health and Peace
“Through personal experience in the region, I have witnessed the transformative power of Israeli-Palestinian relationship building through joint health initiatives. Yet, these experiences also reflect a reluctance of health care professionals working on such initiatives to explicitly address the conflict.”

The Language of Violence in Mental: Health Shifting the Paradigm to the Language of Peace
“…as language is a fluid medium that can be consciously reshaped just as a potter can reshape clay or an artist can rework a canvas, nurses can mold the language of nursing and health care to reflect the paradigm and the power of peace.”

I am happy to share this issue with you and I hope that it will inspire you to infuse more peace into your nursing practice and your life. All of the articles can be read at no charge on NursingCenter while it is our Featured Journal…now through 10/1/13. Enjoy…and I wish you peace. 

3 Communication Principles

clock July 30, 2013 02:07 by author Lisa Bonsall, MSN, RN, CRNP

I just came across a great piece on communication in the June 2013 issue of Journal of Perinatal and Neonatal Nursing. The author, Lisa A. Miller CNM, JD, is an educator who is “obsessed with communication.” As nurses, I think we all need to have a bit of an obsession with communication – it’s a big part of what we do! How we communicate with patients, caregivers, and our colleagues is important for both patient and staff satisfaction. 

Think about a recent day at work. Now pick an interaction that occurred between you and another person or persons. Was it a positive or negative interaction? Could it have been improved and if so, how? 

In her editorial, Ms. Miller identifies the following 3 principles for communication:

Communication Principle #1: It's not you against them, it's you against you.

Communication Principle #2: Don't take it personally.

Communication Principle #3: Know what you are talking about before you start talking.

Take a few minutes to go back and read the article in its entirety. It’s a quick-read and well worth it!

Miller, L. (2013). Parting Thoughts: Can We Talk? Musings on Communication. Journal of Perinatal and Neonatal Nursing, 27(2). 

Standardizing nursing handoffs

clock March 29, 2013 02:54 by author Lisa Bonsall, MSN, RN, CRNP

Handoffs are a known “trouble spot” when it comes to patient safety. As nurses, we participate in handoffs any time we transfer care to another provider, whether at change of shift, transfer to another floor or unit, or transfer to another facility. Errors that occur during these times can result from a variety of barriers, many of which are human factors, ranging from understaffing and interruptions to fatigue and information or sensory overload. 

The Joint Commission requires a standardized approach to patient handoffs; it is one of the National Patient Safety Goals (2006 National Patient Safety Goal 2E). During her presentation “Effective Handoff Communication: A Key to Patient Safety” at Nursing2013 Symposium, JoAnne Phillips, MSN, RN, CCRN, CCNS, CPPS, shared several acronyms that can be used to help guide a well-organized transfer of information and minimize errors and omissions during patient handoffs. 

SBAR + 2 (See also The Art of Giving Report and The impact of SBAR.)
  Question & Answer

5 P’s Model


  Safety Concerns

What is the standard for nursing handoffs where you work?


Cairns, L., Dudjak, L., Hoffman, R., & Lorenz, H. (2013). Utilizing Bedside Shift Report to Improve the Effectiveness of Shift Handoff. Journal of Nursing Administration, 43(3). 

Riesenberg, L., Leisch, J., Cunningham, J. (2010). Nursing Handoffs: A Systematic Review of the Literature. American Journal of Nursing, 110(4). 

Schroeder, S. (2006). PATIENT SAFETY: Picking up the PACE: A new template for shift reportNursing2006, 36(10).  

Thank you to a special nurse

clock March 4, 2013 04:19 by author Lisa Bonsall, MSN, RN, CRNP

Two days ago we received 2 cards in the mail. They come every year at this time. They are never late and there is always a personal note included.

My sons are 12 years old today. These cards, which have come every year for the past 11 years, are not from their grandparents or aunts or uncles. They are not from their friends or my friends. These cards are from one of the nurses who cared for them in the Neonatal Intensive Care Unit (NICU) after they were born prematurely.

So I write this to recognize the continued feelings of gratitude and awe that I have for one special nurse. How can I thank her for caring for my children when I wasn’t able? How can I thank her for showing my boys love and compassion when I couldn’t be there? How can I thank her for helping us through our most difficult days, weeks, and months?

My boys are grateful to receive these cards each year and to be remembered on their birthday; however I’m not sure they grasp how much the cards are appreciated by me and my husband. This day of celebration for our kids still brings mixed emotions to us, feelings which are understood by this special NICU nurse who reaches out to us each year.

As a nurse, I have not had a continued relationship with any patient after discharge, although I can think of several that I wish I had. How about you?


How do you greet a patient?

clock March 1, 2013 00:14 by author Lisa Bonsall, MSN, RN, CRNP

How do you greet a patient?
With a hello? A smile? An introduction?
Do you share your role? The plan for the day?
Do you make eye contact?
How do you address him or her? Mr., Mrs., or Ms.? By first name?

Then what do you do?
Do you wash your hands?
Do you write or type while talking?
Do you use therapeutic touch?
Those communication skills you learned in nursing school?

How do you include the family?
Do you share information?
Did you ask the patient if it's okay to do so?
Do you consider everyone's feelings?
Do you welcome visitors?

How about your assessment?
Do you go head-to-toe?
What questions do you ask?
Do you teach as you go?

How and when do you document?
Electronic health record? Paper chart?
Do you use a checklist?
As you go? Or toward the end of your shift?

How about medications?
Do you know the indications and recommended dosing?
How about interactions and adverse reactions?
Do you ask a colleague to check calculations?

How do you handle other interventions and procedures?
Do you provide privacy?
Do you explain what you are doing?
Do you ask if the patient has questions?
Are you able to answer?

Time to go home?
Did you get a break?
Did you eat? Use the restroom?
Are you ready to leave?

How do you say good-bye?

Pause and listen

clock February 4, 2013 02:53 by author Lisa Bonsall, MSN, RN, CRNP

How many times has a patient said “I feel funny” or “I don’t feel right” and then proceeded to code shortly thereafter? That happened to me twice.

How many times have you felt pulled in different directions – between call lights, alarms ringing, medications to be administered, dressings to be changed, patient education to be provided, etc.? For me the answer is TMTC (too many to count!)

How many times has a patient deteriorated quickly or coded without any warning signs? I’d say several.

I wonder if during any of those times a patient was trying to reach out to me to say “I feel funny” or “I don’t feel right” and the opportunity to intervene passed without my knowledge because I was busy with other tasks.

Just thinking…

I wish that we had enough time during our day to just pause and listen. Wouldn’t that be nice?


Honored by a Liebster Award Nomination

clock October 30, 2012 10:15 by author Lisa Bonsall, MSN, RN, CRNP

Thank you to Julianna Paradisi of JParadisi RN's Blog for the Liebster Award nomination! These awards are a way for bloggers to get to know one another better, recognize one another, and share favorite blogs with their audiences. To continue the trend, I must share 11 things about myself, answer 11 questions asked by Julianna, and nominate 11 other bloggers and ask them 11 questions. So, here we go:

Eleven Things About Me
1. I speak Italian. My parents met when my dad was in the Air Force and stationed near my mom’s hometown in northern Italy. They married, had my brother, and then moved to the U.S. I learned the language from visiting our family and studying it in school. 

2. I like wearing glasses. I tried contact lenses but couldn’t get used to them. I own several pairs of glasses at any given time and like to order different styles online.

3. When time and acuity allowed, I thoroughly enjoyed washing patients’ hair, which was not usually an easy task in the Medical Intensive Care Unit. It was time consuming and messy, but I hope that someone will do that for me if I’m ever critically ill. 

4. I always, always wear a watch and am usually early for everything! It drives my family a little bit crazy!

5. I don’t like to style my hair, but if I have to, I usually straighten it, and then curl it. It makes no sense, I know.

6. NICU nurses are my heroes. For 2 months, they were lifesavers and caregivers to my twin sons who were born at 29 weeks.

7. I enjoy gardening. I find weeding relaxing and I don’t mind cutting the lawn or trimming shrubs. The best part, of course, is having fresh vegetables and herbs on hand all summer!

8. I still have many of my books from nursing school. They have been updated with new editions and even with all the information that is now available online, I still can’t part with them.

9. I love to fold clean laundry but hate to put it away.

10. Math was always my favorite subject. I took Calculus I and II as my electives in nursing school and now I enjoy tackling math homework with my kids, although they are learning things very differently than I remember!

11. Nurse bullying, horizontal violence – whatever you want to call it – upsets me tremendously, especially when it involves students or new nurses. We really need to support one another! We all started as beginners!

Eleven Questions From Julianna
1. Who was your childhood hero? My older brother! I would do anything to get his attention! I remember even begging my mom to make him say “I love you” to me. 

2. What book (s) have you read more than once? Firefly Lane by Kristin Hannah.  It’s a wonderful tale of friendship, but a real tear-jerker! Also, The $64 Tomato by William Alexander.  I read it every year while prepping our garden for the upcoming season. Even my kids like to hear excerpts of the author’s trials and tribulations in the garden!

3. If you could do one thing in your life over, what would it be? I probably would have done my MSN in acute care. I enjoyed women’s health and am glad to have that knowledge and experience, but I think my real passion is critical care.

4. In one sentence or less, how would you describe yourself? This is tough! Ok, here goes… I am a mom, wife, daughter, sister, and aunt who thrives on being with and caring for others.

5. What is your favorite way to exercise? Walking with friends. It’s a great way for us to catch up on each other’s lives and put in some miles!

6. Name one person from any era, dead or alive, you would like to meet. Mother Teresa. 

7. What is your secret talent? I can tap dance; took lessons for 13 years!

8. Do you ever dance to music when no one is watching? Yes, but it’s definitely more fun when my whole family gets into it!

9. What is your all-time favorite TV show? Friends.

10. What TV show theme song do you know by heart? So many! Friends, Cheers, Brady Bunch…. Also, thanks to my kids – Phineas & Ferb and Good Luck Charlie. 

11. What is one ability you wish you had, possible or not? I wish I could control time – the possibilities are endless…

Eleven Nominations
These are my favorites – enjoy! (Full disclosure- two are LWW journal blogs)
Nurse Story
Infusion Nurse Blog
Nursing Staff Development: Behind the Firewall
ANS: Advances in Nursing Science Blog
AJN’s Off The Charts
3cs: coffee, children, and cancer
At Your Cervix
Crass Pollination: An ER Blog

Eleven Questions for My Nominees
1. What makes you laugh?
2. Have you ever written for publication?
3. What was your first nursing job?
4. What is your favorite blog post that you’ve written?
5. What’s your favorite TV or movie quote?
6. What is your biggest fear?
7. Do you sing in the shower? If yes, do you have a favorite genre or song?
8. What’s your favorite vacation spot?
9. Can you describe your best memory of nursing school?
10. When did you know you wanted to become a nurse?
11. What do you find most fulfilling about being a nurse blogger?

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