Inspired Nurses Calendar 2017: Giving Care to "Throwaways"

Lippincott is partnering with Lippincott Solutions to bring you an inspired nurse’s story every month. Here is December’s nurse story, Giving Care to “Throwaways.”
Giving Care to “Throwaways”
Carol Hodge, Retired
December-2017.jpgWhile working as the Director of Nursing in a Medicaid only nursing home, I had the pleasure of taking care of the many "throw-away" people in the county. These were the homeless, prostitutes, and drug abusers, as well as others who needed long-term care but did not have the resources to pay for it. When a patient, an elderly former prostitute, was admitted to the hospital, I visited her, finding her in a room alone and unresponsive. I sat and talked with her for a while even though I did not get any response or acknowledgement. We weren’t particularly close, so I wasn’t expecting much from our visit. But as I left the room, I heard a weak cry. I turned around, and she was looking straight at me with a tear sliding down her face. It was a moment that confirmed I was on the path that had been chosen for me. I will never forget that day. And now that I am no longer able to work in my chosen career, I know it was truly the hardest job I have ever loved. God Bless our nurses!


Posted: 12/27/2017 7:48:47 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

Influence with Storytelling

nobc-logo-small.pngThis blog is the third in the series, Nurses on Boards: Building a Healthier America. Wolters Kluwer is a Founding Strategic Partner of the Nurses on Boards Coalition
In September, we attended the American Hospital Association (AHA) Advocacy Day in Washington D. C.. Prior to our attendance on the Hill, we attended a board meeting that consisted of physician and nurse executives. The agenda and conversations concerned practice issues. Participants were expected to be informed to provide evidence around the topics being discussed. We observed one strategy that constantly refocused the group and highlighted ideas –  storytelling. Storytelling is an effective way to manage sensitive issues and influence people’s emotions to redirect the topic and to influence others. 

What are the benefits of telling a brief story on a board?

  1. Storytelling provides context and meaning to the situation or topic.
  2. Storytelling brings out creativity.
  3. Storytelling rekindles the passion for the topic.
  4. Storytelling generates empathy for the agenda item.

How do you create a compelling or powerful story?

  1. Keep it short (about three minutes).
  2. Start with the context.
  3. Use metaphors.
  4. Include an element of surprise.
  5. Appeal to the emotion.
  6. Make it tangible and concrete.
  7. Use a style appropriate for business.
  8. Be culturally aware.
  9. Acknowledge the composition of the board to ensure sensitivity and appropriateness of the story.
According to Mary Ann Fuchs DNP, RN, NEA-BC, FAAN, Vice President of Patient Care, System Chief Nurse Executive, Associate Dean of Clinical Affairs at Duke University, and AONE Board member, “Storytelling is a very effective strategy that helps to build relationships, demonstrate effective communication and engage others in issues important in health care and especially to the health of our country.”.

Call to Action!
Inform and engage others through storytelling to bring relevant perspective and connectedness to board topics, and to bring about good outcomes.
Nurses on Boards Coalition (2017). Board Core Competencies.

Schawbel, D. (2012, August 13). How to Use Storytelling as a Leadership Tool. Retrieved from Forbes:
M. Lindell Joseph, PhD, RN, AONE Board of Directors and The University of Iowa College of Nursing & Laurie Benson, BSN, Executive Director, Nurses on Boards Coalition

For more information or comments contact us: and/or



Posted: 12/15/2017 6:02:55 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Leadership

SHARE the Flu Vaccine Recommendation

The Centers for Disease Control and Prevention offers the SHARE method to approach the conversation on flu vaccination. This is a great way to help patients make informed decisions.

Centers for Disease Control and Prevention. (2017, December 11). Make a Strong Flu Vaccine Recommendation. Retrieved from Centers for Disease Control and Prevention:


Posted: 12/13/2017 12:46:46 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Diseases & Conditions

Staying Healthy This Flu Season

Here we are in mid-December and influenza season is in full swing. In fact, while flu activity was low during October 2017, activity has been increasing since the start of November, with more cases of influenza A viruses, specifically influenza A(H3N2). In the United States, flu season typically ranges from late fall through early spring and while many who get the flu recover without sequelae, serious illness and death can occur, especially in high risk patients, including:
  • older adults
  • young children
  • pregnant women
  • those with certain chronic medical conditions, such as:
    • chronic lung diseases, such as asthma and chronic obstructive pulmonary disease (COPD)
    • diabetes
    • heart disease
    • neurologic conditions.
get-your-flu-shot.pngSo, how can you stay healthy and keep those around you healthy this flu season?
The best way to avoid getting and/or spreading the flu is to get vaccinated! The CDC recommends that everyone six months and older get an injectable flu vaccine this season. And here’s why…
  1. While there are certain high-risk groups, anyone can get very sick from the flu, including otherwise healthy people.
  2. As a health care provider, you can get sick from coworkers or patients who have the flu.
  3. If you get the flu, but don’t feel sick, you can still spread the virus.
  4. By getting vaccinated and protecting yourself, you are also protecting your family and friends, and your patients. 
Educating Patients: Be ready to answer some of these frequently asked questions
How does flu spread?
Flu viruses spread through droplets when people with the flu cough, sneeze, or talk. The droplets can reach the mouths or noses, or be inhaled into the lungs of others, up to six feet away. A person can also get the flu by touching a surface or object that has flu virus on it and then touching his or her own nose or mouth.

What are the symptoms of the flu?
The flu usually comes on suddenly with a wide range of symptoms:
  • Fever and chills, although not everyone with flu develops a fever
  • Cough and sore throat
  • Runny or stuffy nose
  • Muscle or body aches, headaches, fatigue
  • Vomiting and diarrhea (more common in children).
When is a person with flu contagious?
Most healthy adults are contagious starting one day before symptoms appear and up to five to seven days after feeling sick. So, it is possible to spread the virus before someone feels ill and even if no symptoms are present.

What if someone has an egg allergy?
Often, a question arises regarding ability to get the flu vaccine if a person has an egg allergy. According to the CDC, “People with egg allergies can receive any licensed, recommended age-appropriate influenza vaccine and no longer have to be monitored for 30 minutes after receiving the vaccine. People who have severe egg allergies should be vaccinated in a medical setting and be supervised by a health care provider who is able to recognize and manage severe allergic conditions.”

Our Role as Health Care Providers
As health care providers, it is our responsibility to keep our knowledge up-to-date and educate patients, so they can make informed decisions about vaccination. How do you stay informed? And how do you approach the conversation on vaccination
Centers for Disease Control and Prevention. (2017, December 11). Influenza (Flu). Retrieved from Centers for Disease Control and Prevention:

Flannery, B., Reynolds, S., Blanton, L., SAntibanez, T., O'Halloran, A., Lu, P.-J., . . . Fry, A. (2017). Influenza Vaccine Effectiveness Against Pediatric Deaths: 2010–2014. Pediatrics, 1-9.

HealthDay. (2017, December 8). Influenza Picking Up in U.S., Predominantly A(H3N2). Retrieved from Lippincott


Posted: 12/13/2017 12:29:27 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments


Why Handwashing Makes Us Healthier – and Happier too!

handwashing.jpgAs nurses, we all know the importance of handwashing. We understand that germs can spread disease, and that hand hygiene can help defend against it. But still, 78 percent of all healthcare professionals tested in a recent study presented at a conference of the Association for Professionals in Infection Control and Epidemiology (APIC) didn’t wash up to the standards of the World Health Organization’s guidelines for reducing the risk of spreading infection to patients. So, why so many slackers?

Perhaps sinks or hand sanitizer dispensers aren’t always in the most convenient locations in hospitals. And if they are conveniently located, there might not always be soap or sanitizing gel in those dispensers. Or maybe it’s just that we’re rushing from one emergency or critical situation to the next, and taking time to stop and wash our hands consistently doesn’t get prioritized. Or simply because, given those same circumstances, we merely forget.

It seems so obvious, yet the importance of handwashing wasn’t always known. In 1847, a physician working in a Viennese maternity hospital with two separate clinics, one run by physicians and one run by midwives, discovered that babies delivered by physicians had nearly triple the infant mortality as babies delivered by midwives. The reason was that the doctors coming into the hospital to deliver babies had just finished up duties in the autopsy ward, thereby infecting mother and child with numerous germs acquired from their deceased patients. Once doctors were instructed to wash their hands with an antiseptic solution before delivering babies, the mortality rate plummeted.

Getting Nurses to Wash Their Hands
Solutions to promote more frequent handwashing can run the gamut for many hospitals. Implementing one of several newfangled, automated hand hygiene monitoring devices such as video-monitored direct observation systems, electronic dispenser counters, and automated hand hygiene monitoring networks can work for some. And while there is empirical proof that these types of monitoring systems work, with the budgetary constraints many hospitals face, adoption can be cost-prohibitive and therefore not an option.

While there is no universal solution, many hospitals have taken steps to further encourage handwashing by investing in alcohol-based hand rub solutions (significantly more efficient in reducing hand contamination than antiseptic soaps), both by installing wall-mounted dispensers and by providing individual containers for each healthcare worker. Changing posted messages around the hospital from, “Wash Your Hands to Protect Yourself” to “Wash Your Hands to Protect Your Patients" can be helpful, along with peer pressure and personal incentives like drawings for free monthly manicures (yes, we all know the toll that constant handwashing can have on our skin and nails).
New incentives
It’s apparent that handwashing keeps us healthier, but what isn’t noticeable is the additional, subtle psychological effect handwashing has on us all as well. The Dalai Lama tells us, “as human beings we all want to be happy and free from misery… and we have learned that the key to happiness is inner peace.” So, what if you could achieve inner peace and happiness through the simplest of daily activities – like handwashing?

A study from the University of Cologne in Germany examined how the act of washing one’s hands can positively affect us after a bad experience or stressful event while also making us feel more optimistic after recent failure. Earlier research from the University of Michigan also found that handwashing can be physically and emotionally cleansing, suggesting that this simple act can make us feel more comfortable about decisions we’ve made or actions we’ve taken.

Personally, when I finish a workout at the gym, the first thing I do is wash my hands. Somehow, this simple ritual of washing my hands afterwards provides a sense of finality and accomplishment. The workout ritual, however, is far more complex (at least for me).

The act of seeking cleanliness has two distinct meanings to us humans. The first is the obvious physical hygiene benefits. The second is more psychological in nature. Psychological studies have shown that the simple act of washing one’s hands can help you feel more optimistic, less doubtful, and even a bit morally superior – as “clean” people have been found to be more judgmental towards other people’s bad behavior. Think Lady Macbeth.

So, maybe now as we endeavor to wash our hands for the hundredth time today, recalling the Nightingale Pledge and our duty to protect our patients’ safety, we can also reflect on our own goals for self-improvement, including eating healthier, trying to exercise more, and being kinder to others and to our planet, knowing that this simple act of handwashing might be a more logical path to happiness and inner peace. Or, at least we can tell ourselves that. 
Brun-Buisson, C., Girou, E., Legrand, P., Loyeau, S., Oppein, F., (2002, August 17). Efficacy of
handrubbing with alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial. Retrieved from NCBI, US National Library of Medicine National Institutes of Health
Johnson, N., Niles, M. (2016, June 2). Hawthorne Effect in Hand Hygiene Compliance Rates. American
Journal of Infection Control, Volume 44(Issue 6), S28-S29. Retrieved from AJIS
Kaspar, K. (2012, April 10). Washing One’s Hands After Failure Enhances Optimism but Hampers Future
Performance. Social Psychological and Personality Science, Volume 4(Issue 1), 69-73.
Retrieved from
Psyblog (n.d.). 6 Purely Psychological Effects of Washing Your Hands. Retrieved from
Deborah Baldwin
Wolters Kluwer Health


Posted: 12/3/2017 10:52:56 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Patient Safety

Inspired Nurses Calendar 2017: It’s My Pleasure

Lippincott is partnering with Lippincott Solutions to bring you an inspired nurse’s story every month. Here is November’s nurse story, “It’s My Pleasure.”
it-s-my-pleasure-November-2017.jpgIt’s My Pleasure
Katie Fadell-Mann, RN
Ebenezer Lake City Care Center
My Dad was a double lung transplant recipient in 2006. What inspired me to be a nurse was seeing the difference his nurse made in his care. His nurse, Sara literally did not leave his side for the first two days after his surgery. When I asked where I could send a gift to for her to thank her for all she had done, she said, "There's no need, it's my pleasure to take care of your Dad."
I started going to school for nursing a few months later.


Posted: 11/30/2017 9:52:16 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

Happy Nurse Practitioner Week!

NP-week.pngMany of you know I still practice on the weekends as a nurse practitioner for Penn Medicine Chester County Hospital and I’m adjunct faculty for Drexel University in Philadelphia. I am currently teaching a course on using evidence in practice and this week is focused on using change theory to implement evidence. Change – one of the hardest things for us to do. We become stuck in doing things the way they have always been done. All you have to do is look at your current practice setting and see others who resist change. Courage and perseverance are the necessary ingredients to implement change. How many of us really have the so-called “right stuff” to make changes in our own practice settings? 

As I look back on our nurse practitioner profession, I am amazed at the courage and perseverance it took for Drs. Loretta Ford and Henry Silver to step out of the so-called “healthcare norm” and decide there needed to be a better way to provide care. A nurse and a physician worked together to change practice. They did not do this for recognition. Rather, they did it to improve access to quality care for those who were in need. They implemented change in a healthcare system by using courage and perseverance.

Why did you become a nurse? Why have many of you gone on to be advanced practice nurses? Were you afraid of making a change? When I think about why I became a nurse practitioner, it was because I saw an opportunity to connect the art and science of nursing and medicine in my own practice to improve patient care. I am sure many of you have a similar story.

This is Nurse Practitioner Week and I want to thank each of my NP colleagues for the work you do each day. You emulate what Drs. Ford and Silver did over 50 years ago; you meet each day with courage and perseverance to implement change and improve patient outcomes one patient at a time.
Chief Nurse, Wolters Kluwer, Health Learning, Research & Practice
Adjunct Faculty, Drexel University
Nurse Practitioner, Penn Medicine Chester County Hospital
Posted: 11/13/2017 2:05:21 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

The Opioid Epidemic: Are Women Most Vulnerable?

The opioid epidemic is a serious public health problem that impacts us professionally, as well as many of us personally. Asking about drug use is something we were taught while in nursing school. Assessing and managing pain has always been a big part of our training too. Now, as the United States is in the midst of an opioid epidemic, our assessment and communication skills must reach a new level. Those of us who are advanced practice nurses who are also prescribers, have even more to consider when it comes to pain management.

women-and-opioids.pngAs a women’s health nurse practitioner, new research on age and gender trends related to the opioid epidemic caught my eye. Findings revealed excessive opioid prescribing with persistent use among women. This new report, conducted by the QuintilesIMS Institute, states that “middle-aged women are prescribed more opioids than any other group – twice as many as middle-aged men – making them particularly vulnerable to opioid use.” The research report, The United States for Non-Dependence: An Analysis of the Impact of Opioid Overprescribing in America, shows individuals undergoing surgery are at particular risk, due to the prescribing of opioids to manage postsurgical pain.

Here are some interesting facts from the report that you should know:
  • Patients receive an average of 85 pills following surgery.
  • Overprescribing leads to 3.3 billion pills left unused-leaving them available for misuse.  
  • In 2016, three million surgical patients became persistent opioid users.
  • The majority of opioid addictions start with prescription medications.
  • Surgery is an unintentional gateway to the opioid crisis.
  • 40% more women than men become persistent opioid users after surgery.
  • Women ages 40-59 are prescribed more opioids than any other age group and have the highest death rates from misuse.
Another report from the Office on Women’s Health demonstrates that between 1999 and 2015, the rate of deaths from prescription opioid overdoses increased 471 percent among women, compared with an increase of 218 percent among men; and heroin deaths among women increased at more than twice the rate than among men. Also, the differences in how prescription opioid and heroin use impacts women and men are often not well understood. There are potentially many factors that affect a woman’s path to opioid misuse and dependancy, including biological and social influences, past experiences, geography, and demographic characteristics. However, many knowledge gaps remain on how these relate to the opioid misuse.

According to the The Centers for Disease Control and Prevention (CDC), women are more likely than men to experience chronic pain, and use prescription opioid pain medications for longer periods and in higher doses. Women tend to use substances differently than men, sometimes using a smaller amount of drugs for a shorter period of time before they become dependent. In March of 2016, the CDC issued the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016, which summarized the research literature on the benefits and risks associated with prescribing opioids and provides an evidence-based guide for prescribers and patients to share decision-making responsibility about opioid use, and alternative treatment options for chronic pain management.   

As a women’s health nurse practitioner, this has significant impact to my practice, and my licensing. Some states now require opioid education in order to renew prescriptive authority. Combatting this problem requires a multi-factorial approach. We all need to be more aware and vigilant with prescribing, confirming orders, patient education, and post-surgical follow up.
Dowell, D., Haegerich, T., & Chou, R. (2016, March 18). CDC Guideline for Prescribing Opioids for Chronic Pain — United States,  2016. Retrieved from Centers for Disease Control and Prevention :

Office on Women's Health. (2016, December). White Paper: Opioid Use, Misuse, and Overdose in Women. Retrieved from Women'

Pacira Pharmaceuticals, Inc. . (2017, September 26). Plan Against Pain . Retrieved from The United States for Non-Dependence: An Analysis of the Impact of Opioid Overprescribing in America:
Lynne Centrella Rudderow, MSN, RN, CRNP, WHNP-BC, CCE



Posted: 11/6/2017 8:30:56 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Patient Safety

Inspired Nurses Calendar 2017: Beautiful Colors

Lippincott is partnering with Lippincott Solutions to bring you an inspired nurse’s story every month. Here is October’s nurse story, “Beautiful Colors.” 

Beautiful Colors
Leeann Vidt, R.N. supervisor
Oakmont Center for Nursing
beautiful-colors_october-2017.jpgAs all life must come to an end, some families find it difficult to face emotionally. I observe them looking scared to talk with or touch a dying loved one, so I will often enter the room, sit on the bed, and take the patient’s hand in mine, then I will ask them if they think the fall leaves are beautiful with all those wonderful colors. They always answer, yes, and look at me puzzled. I then tell them that those leaves are actually dying and that something so beautiful should not be feared. I tell them the greatest gift to give their loved one is loving memories. I ask starter questions, such as what their favorite vacation or holiday spent together was. As they answer with smiles across their lips, I quietly exit the room and close the door. Nothing warms my heart like hearing the laughter behind that door. And then after the patient passes, I am thanked for making the passage from this life a better memory for them. I tell them that their loved one left within a circle of love, just as they had lived.

This is why I love nursing. To be able to help someone change such a scary situation into a sweet memory, makes those difficult, stressed shifts well worth my nursing cap.

To see all 2016-2017 stories or to share an inspiring story of your own about being a nurse, or how you were inspired by another, and enter to win prizes, visit  Be sure to check our blog every month for a new inspired nurse’s story.


Posted: 10/29/2017 7:53:23 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

National Conference for Nurse Practitioners (NCNP): Fall 2017

anne-woods-lisa-bonsall-at-ncnp-(1).JPGEarlier this month, we had a great showing of advanced practice nurses for our fall National Conference for Nurse Practitioners (NCNP). It was one week after Nursing Management Congress2017 and one week after the deadly mass shooting in Las Vegas. Being in town for both conferences was an experience – as we shifted gears for a different group of nursing professionals and also remained a presence in a city that was dealing with tragedy and starting to heal.

As a frequent attendee at NCNP, I often attend a wide variety of topics and speakers. With my background in critical care and women’s health, I am interested in both the acute care and primary care sessions. I had the opportunity this time to meet and learn from new experts and I found myself picking up on a certain theme, which I didn’t realize when I originally registered and picked my sessions! I think you’ll pick up on this as you read through some of these clinical and professional pearls that I picked up at the conference…

“Isn’t it time that nursing is referred to as one of the STEM [science, technology, engineering, and mathematics] professions?”
Keynote Address: Finding Your NP Voice
Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP
“A high HDL cholesterol is only as good as a low LDL.”
Dyslipidemia: Going Beyond the Current Treatment Options
“One in four heroin users started with prescription opioids.”
New Trends in Street Drugs and Legal Highs Part 1
Andrea Efre, DNP, ARNP, ANP-BC
“The opioid OD triad: unresponsive/coma, respiratory depression/failure, and CNS depression (mioisis).”
New Trends in Street Drugs and Legal Highs Part 2
Andrea Efre, DNP, ARNP, ANP-BC
“When calculating the anion gap, for every one gram decrease in albumin from normal, add 2.5 to anion gap.”
Understanding Sepsis
Sophia Chu Rodgers, FNP, ACNP, FAANP, FCCM, FAANP
“Repeated doses of ibuprofen and acetaminophen can prolong the duration of a viral illness.”
Antimicrobial Update: A Focus on Respiratory Infections
Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC, FNAP
“Adverse drug reactions are responsible for an increase of two days for hospital length of stay.”
Pharmacogenomics and Chronic Pain: Putting Science Back Into the Treatment of Pain
Brett Badgley Snodgrass, MSN, FNP-BC
“Herbal and dietary supplements are at least the fourth most common cause of drug-induced hepatic disease necessitation liver transplant.”
5 Things I Wish I Knew Last Year
Louis Kuritzky, MD
“Prescribing cascade refers to when a new problem arises that is associated with the side effect of a medication and additional medications are added to treat it.”
Polypharmacy: What the Nurse Practitioner Should Know
Audrey M. Stevenson, PhD, MPH, MSN, FNP-BC
The theme I’m referring to above is drug information. These pearls are just a handful from the sessions I attended. There were also sessions on pharmacologic management of dementia, biologics, hormone replacement, direct oral anticoagulants, sleep medications, medical marijuana, opioid prescribing, non-opioid analgesics, and pharmacologic management of obesity. Wow!
I also attended back-to-back sessions on street drugs and spent some time with the Drug Enforcement Agency in the Exhibit Hall. The current opioid epidemic in the United States is not just a big city problem; it’s happening no matter where you are, among all ages, and it’s a big concern. Think about the prescribing you do on a daily basis. Drug approvals, indications, and warnings are constantly changing, and we must keep our knowledge up-to-date. Now, think about the number of drug overdoses you see, or patients and families that you know are dealing with addiction. These numbers are rising and, as nurse practitioners, we have a responsibility to appropriately assess and manage pain, and prescribe responsibly.



Posted: 10/27/2017 11:00:34 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Continuing Education

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