NursingCenter’s In the Round

A dialog by nurses, for nurses

CE Collections on NursingCenter

clock May 29, 2013 04:30 by author Lisa Bonsall, MSN, RN, CRNP

In the hustle and bustle of everday life, obtaining the correct number of contact hours for licensure and recertification can get pushed to the bottom of the 'to-do' list. If you’re anything like me, when license renewal time comes around, it’s a bit of a scramble to get organized and count up the number of hours I’ve accumulated since my last renewal and figure out how and when I’ll finish up in time. 

Since launching NursingCenter’s new CE Connection, we’ve had the opportunity to bundle topical collections of continuing education articles and made them available at a discounted price.  So far we’ve put together a collection around Understanding BRCA and Cancer Risk (9.9 contact hours for $24.99) and one on Caring For Veterans Suffering from War-Related Injuries (11.4 contact hours for $28.99). I’m working on some more of these collections, but would like to best meet your needs! So, please let me know – what types of collections would be of interest to you? Is there a certain clinical topic or patient population that you’d like me to address?  

Also, are there any special requirements for your state or your certification? For example, New Jersey now requires at least one hour of continuing education related to organ and tissue donation and recovery. We will do our best to keep you informed based on your profile selections on Lippincott's If you’re not yet a member, you can certainly join now – it’s free!

We want to help you keep up with your requirements – please let us know your needs by leaving a comment or you can always email me at


Headlines from the ADA

clock July 8, 2011 01:39 by author Lisa Bonsall, MSN, RN, CRNP

The American Diabetes Association's 71st Scientific Sessions took place at the end of June and several headlines have come across our newsfeed .  Here are some highlights that you might be interested in:

Access more information from this meeting, including video highlights, webcasts of select presentations, and links to abstracts, at DiabetesPro: Professional Resources Online.

American Heart Month

clock February 1, 2011 00:58 by author Lisa Bonsall, MSN, RN, CRNP

February is American Heart Month! Here are some links to resources about heart disease and the campaign:

...and some patient education tools from our journals:

Help spread the word! Have more resources to share? Please do so by leaving a comment! Thanks!

Getting ready for the future of nursing

clock January 13, 2011 18:15 by author Lisa Bonsall, MSN, RN, CRNP

Have you made any adjustments in your career goals or education plans based on the RWJF and IOM Report , The Future of Nursing: Leading Change, Advancing Health, released last October?

I have been away from clinical nursing since 2001. I can’t believe that it has been 10 years. I’ve always believed that someday I would go “back to the bedside” and I really do miss taking care of patients. It’s been a little more noticeable to me lately just how much I miss the clinical side of nursing. I’m not sure if it’s because the fact that it’s been 10 years overwhelms me or because I am excited about the direction in which our profession is headed. Perhaps it’s a little of both.

The question that really gets to me is where do I want to be? Critical care was my home for most of my clinical career.  I loved the thrill of caring for acutely ill patients and their families. Titrating vasoactive drugs, assisting with invasive procedures, using the latest technologies - all so cool! Admissions from the ER, “road trips” to diagnostic tests, end-of-life discussions, and the list goes on…

However, my “other list” is quite impressive to me also. As a women’s health NP, it was so fulfilling to be in the community and make a difference educating women about preventive care. Also, contraceptive counseling, prenatal care and teaching, helping someone find some relief from her symptoms of menopause, and so on…. Primary care practitioners have so much to offer and the need is so great.

The very first key message from the IOM report states “Nurses should practice to the full extent of their education and training.” Does this mean that it is my duty to practice as an NP because I have the degree and license? Would I be disregarding this message by returning to staff nursing in the ICU? I sure hope not. Then again, I could always pursue another degree…critical care NP might be the answer. Now there’s something for me to think about!

Perhaps as we prepare for the future of our profession, we should all take this time to look at our individual goals as well. What is your future in nursing?

Yes, I’m thankful for MS

clock November 24, 2010 06:01 by author

As Thanksgiving approaches, I try to remind myself of all that I am thankful for. I’m thankful for my friends and my family and I’m thankful for my health…as strange as that may be from a person with relapsing-remitting MS. I am thankful for MS because to quote Thoreau “most men lead lives of quiet desperation” and MS has given me perspective on life.

I’ve come a long way since the initial diagnosis seven years ago and it has been quite an introspective journey. I’ve learned not to worry about things out of my control and I’ve learned to value everything. For example, I enjoy jogging, something I used to hate, because I can do it. My legs are working and I can do it. I cherish sunsets, beautiful birds soaring through the skies and every smile that crosses my son’s face because I can see them. My eyes are working and I can do it.

MS has taught me that we make out of life what we choose. We have the power and the strength within us to overcome anything. I do not take anything for granted because you just never know what tomorrow will bring. So thank you MS for giving me that view of life because it is so precious and I intend to enjoy every minute of it.

Happy Thanksgiving to all!

My preemie story

clock November 17, 2010 03:05 by author Lisa Bonsall, MSN, RN, CRNP

My preemie story began about 10 years ago. Pregnant with my first child, I watched as friends and family progressed through their own pregnancies without incident. I had planned to do the same. Sometimes plans change...

At my 20 week OB visit I was feeling pretty good. Then came some surprising news - twins? A little panic, a little excitement, and we were on our way to confirm with ultrasound. Yes, twins! The babies looked fine and we shared the news and changed some of our plans. I worked less, we stepped up the house search, and bought a few more of, well, of just about everything!

Then….29 weeks. My blood pressure sharply rose, hands and feet swelled, and I didn’t feel well at all. Bedrest was ordered and within 24 hours, I was experiencing pretty bad back pain. My OB had me meet her at the hospital just “to check me out” since a big snow storm was forecast. Good news…I was not contracting and had not dilated at all. The bad news came a bit later when lab results revealed I had developed HELLP syndrome. All I remember hearing is “You are going to have your babies today.”

HELLP is a syndrome of pregnancy identified by the presence of hemolysis, elevated liver enzymes, and low platelets (less than 150,000/mm3.) It occurs in 0.5 to 0.9% of all pregnancies and in 10-20% of cases of women with severe preeclampsia. It can also develop without changes in blood pressure. Signs and symptoms include headache, nausea and vomiting, upper abdominal pain, and vision changes. Serious complications can include DIC, hemorrhage, renal failure, and ARDS.  Treatment consists of corticosteroids, magnesium sulfate, and delivery.

So, my twin sons were born at 29 weeks by stat cesarean section. We experienced the roller coaster ride of the NICU for 2 months. I spent most of that time in a daze as we navigated our way through many of the preemie complications - NEC, IVH, sepsis, aspiration, ROP, PDA, A’s & B’s, and then some - a whole lot of abbreviations and acronyms that I had never heard of as an adult ICU nurse. Sure I knew the effects of dopamine, but administration through an umbilical vein? Never did it.

The story did not end there in the NICU however, as most parents of preemies are well aware. My sons came home on cardiac monitors, oxygen, and several medications. Growth was slow and development delayed. Lots of therapists, evaluations, pediatrician visits, and emergency room visits ensued. We remained isolated for 2 years for fear of RSV and handwashing became an obsession. It was a tough journey and I am lucky to report now that my boys have caught up to their peers. They are in fourth grade, do well in school, and play sports and video games just like their buddies.

We are lucky. Not every preemie catches up. Not every preemie goes to school. Not every preemie can feed themselves. Or talk. Or walk. Not every preemie survives. We are so lucky.

November is Prematurity Awareness Month. Did you know that one in eight babies is born prematurely? That more newborns die from prematurity than any other cause? And that the effects of prematurity can last a lifetime?

I hope sharing my own story can help raise awareness. As nurses, patient education is a top priority. Please remind women that while pregnancy is a natural process, no pregnancy is without risk. Tell women to listen to their bodies. No one else knows how they feel. Back pain is typically not a sign of preeclampsia and HELLP. I am lucky. My boys are lucky.

The HELLP Syndrome: Clinical Issues and Management: A Review
The March of Dimes
Emergency Care for Patients with HELLP Syndrome

Warning of vaccine administration errors

   Recent news about pertussis outbreaks that have resulted in infant deaths is causing serious concern in the healthcare community. Back in August 2006 and again in July 2010 the Institute for Safe Medication Practices (ISMP) issued a warning about confusion of Adacel and Daptacel which are vaccines for the prevention of tetanus, pertusis, and diptheria. ISMP explained how administering the incorrect vaccine to infants can result in ineffective immunization leaving babies vulnerable to infection. The IMSP Medication Safety Alert from July 1 2010 reported that "Part of the problem is that the official names of the products are very similar although stated in different order on the labels. One of them, diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP), is sold under the brand names DAPTACEL and TRIPEDIA (Sanofi Pasteur), and INFANRIX (GlaxoSmithKline). This formulation is for active immunization of pediatric patients 6 weeks through 6 years of age. The other vaccine, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap), is sold under the names BOOSTRIX (GlaxoSmithKline) and ADACEL (Sanofi Pasteur), and is meant to be used as booster shots for older children, adolescents, and adults."

   This is back to school season and vaccines are on the minds of parents, schools nurses, pediatric nurses and NPs. This is a perfect time to review our procedures for prescribing and administering childhood vaccines to ensure that the correct vaccine is ordered and administered each time. For more details on the recommended vaccine schedule, go to the Center for Disease Control and Prevention website at

Nurses - truly a special population

clock August 26, 2010 05:57 by author

I was recently reading an article from the Journal of Neuroscience Nursing about the role of the nurse in the treatment of Multiple Sclerosis.  This article struck a cord in me. (Perhaps a spinal cord?  OK, bad pun.)  I started to think about all of the nurses that I’ve come across…not only in the work setting but in my personal life. 

In 2003, I found myself in a whirlwind of something new and strange and at the time, very scary.  I was diagnosed with Multiple Sclerosis.  I’ve come a long way since that initial diagnosis and I credit a lot of it with the assistance of some terrific nurses.

I have the deepest respect for nurses.  You are truly a special population and do not get enough credit for all that you do.  So I wanted to say thank you to all nurses out there from the bottom of my heart and especially…
Thanks to the emergency room nurses who listened to my story and were a little more tactful and delicate than the physician who told me that the “good news” was that I didn’t have a brain tumor or brain cancer and I didn’t have a stroke. 

Thanks to the nurse in the hospital who, after my diagnosis, stood by my bedside at night when the tears would come.  She tried to ease my anguish when I could no longer keep on the good face that I put on for my family during the day.   

Thanks to the neurology nurses and the IV nurses at the MS clinic who continually take the time to talk, give me information about the disease and treatment options, offer support and insight, and most of all, always have a smile. 

Thanks to the nurses I work with who amaze me with their knowledge, passion, and desire to pass it on.  When people find out what I do for a living, they excitedly ask “Oh, are you a nurse?!” And my cheeky response is usually, “No, but I play one on the Internet" or "No, but I stayed at a Holiday Inn Express last night," and usually quickly follow up with "…and I work with some great clinical editors who really know their stuff.”

And of course, I have to say thanks to that special labor and delivery nurse who helped bring my son into the world in 2006. 

You all hold a special place in my heart.  Keep doing what you do. 

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