Well done, CVS!

cvs.pngMy very first job was at a CVS store. I worked as a cashier there in high school and for 2 summers during college. As a cashier, I was responsible for restocking the cigarettes behind the counter…not a part of the job that I enjoyed, but it passed the time when we were slow. The area behind the counter was pretty narrow, and I would often have to step over and around cases of cigarettes while working. They sold quickly back then and my hands would smell of cigarettes after an evening of work.

I was impressed when I read the announcement yesterday that CVS stores would no longer be selling cigarettes. What an example this organization is setting, and I am hopeful that this will start a trend among other pharmacies and retailers. 

""Ending the sale of cigarettes and tobacco products at CVS/pharmacy is the right thing for us to do for our customers and our company to help people on their path to better health,"" Larry J. Merlo, president and CEO of CVS Caremark, said in a statement. ""Put simply, the sale of tobacco products is inconsistent with our purpose.""



Along with this news, the company has announced the launch of a smoking cessation plan this spring. 

Well done, CVS! 

According to the 2014 Surgeon General's Report: The Health Consequences of Smoking—50 Years of Progress, there are 12 cancers and 20 chronic diseases linked causally to smoking. It is encouraging that the prevalence of cigarette smoking has declined from 42% in 1962 to 18% in 2012  (U.S. Department of Health and Human Services, 2014), however, it is even more encouraging that smoking cessation programs are continuing to be developed. There is more work to be done to educate the public and help people to not start smoking and to quit if they already do smoke.

More Resources:

U.S. Department of Health and Human Services. (2014, January). 50 Years of Progress: A Report of the Surgeon General, 2014. Retrieved from SurgeonGeneral.Gov: http://www.surgeongeneral.gov/library/reports/50-years-of-progress/50-years-of-progress-by-section.html 

Posted: 2/6/2014 1:36:08 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

Celebrate Nursing 2014: Part 1

As we move into 2014, let’s not forget to celebrate our hard work and that of our colleagues! Here’s the list of nursing recognition days and months for the first part of 2014*. Please let me know if you know of others.

*I will add/update links as they become available.

National Nurse Anesthetists Week
January 19-25, 2014

National IV Nurse Day
January 25, 2014

PeriAnesthesia Nurse Awareness Week
February 3-9, 2014

Critical Care Transport Nurses Day
February 18, 2014

GI Nurses and Associates Week
March 24-28, 2014

Certified Nurses Day
March 19, 2014

Radiologic & Imaging Nurses Day
April 12, 2014

April 16, 2014
May 2014
May 2014
May 6-12, 2014 (National Nurses Day is May 6)
May 7, 2014
May 7, 2014
May 12, 2014
May 11-17, 2014
May 11-17, 2014
Posted: 1/18/2014 1:29:54 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration


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: http://timemanagementninja.com/2013/08/10-ways-to-be-present-and-be-a-better-listener/

McMullen, L. (2013, August 24). How to Actually be a Good Listener. Retrieved from Huffington Post: http://www.huffingtonpost.com/2013/08/24/how-to-be-a-good-listener_n_3795849.html

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

Posted: 1/7/2014 2:20:25 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration

Peace and Health in ANS

ANS.jpgThe 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 kid...you 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. Enjoy…and I wish you peace. 

Posted: 9/19/2013 2:22:30 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

Exploring the lives of nurses

As Nurses Week is winding down, I am honored to share this excerpt from “The American Nurse.” Created by Carolyn Jones, this book explores the unique lives of nurses using photographs and personal stories. 


This infographic was shared with us by Erica Moss, who is the community manager for the online nursing programs at Georgetown University School of Nursing & Health Studies. Click the image to see its full size.

Posted: 5/11/2013 9:14:20 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

Thank you to a special nurse

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?

More Reading & Resources
My preemie story
From MICU nurse to NICU parent
Journal of Perinatal and Neonatal Nursing




Posted: 3/4/2013 2:53:48 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration

How do you greet a patient?

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?

Posted: 3/1/2013 2:57:07 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration

Last Words

I’ve seen a lot of patients die. And by a lot, I mean too many to count. Some deaths I remember clearly, perhaps because the patient was alone or had a large number of family and friends at the bedside, perhaps because he or she was close to my age, or perhaps because of religious traditions that took place during or after the death. It’s odd then, that when I think back to last words of patients before they died, I am at a loss. 

It could be because many of our patients followed a similar pattern prior to their death. Many were on mechanical ventilation which was withdrawn after many days, weeks, or months of progresses and setbacks. Most were unresponsive, either due to sedation or their disease process. They may have spoken their last words in my presence, but at the time I may not have realized that they were the last words they would ever speak. 

I do remember the last words of one patient in our unit. She was my grandmother. After a fall with a resultant hip fracture, she was transferred to us several weeks after surgical repair of her hip. Her oxygen requirements were increasing and she was becoming more and more agitated. In our unit she was treated for aspiration pneumonia, given anxiolytics, and supported with more and more supplemental oxygen each day.

We, her family, knew her wishes – she didn’t want to be intubated – and we respected that. I was working night shift, not as her nurse, but would stay much of the morning to help with her am care and to be there for rounds. On one particular morning, she was coughing and vomited. She had a hard time catching her breath. I called out for her nurse to suction her, when my grandmother grabbed my hand and said “No more.” We spoke of what that meant; it was a pretty intense conversation for a young nurse to have with her own grandmother. Then I called the rest of the family to explain our conversation and ask that they come to be with us. 

Everyone arrived throughout the day and we did what we could to keep her comfortable. We all spent time holding her hand and chatting with her when she was able. At one point, my grandmother asked for a grape soda. I found one for her and as she sipped it through a straw, she said to me “Lisa, I won’t be at your wedding.” “I know,” I said, “Grandmom, but you will always be with me.” Her response was “Yes… and grandpop knows what to give you.”

And those were her last words to me. I knew that she was referring to a wedding gift, and I laugh now when I think about it, because that was typical of my grandmother. She was an incredibly generous woman…always fighting over the check at dinner and pushing to pay at any cash register. These final words make me smile and think of who she was, not laying on that hospital bed, but as my grandmother.

What made me think of this was a recent book I just completed. In Looking for Alaska by John Green, the main character has a fascination with last words. He reads countless biographies and has memorized last words, even making it his mission to discover the “Great Perhaps” mentioned in the last words of François Rabelais. It was a good read, definitely thought-provoking, and I thank my niece for recommending it to me.

As nurses, some of us work with dying patients on a daily basis, while others, only rarely or sometimes. Regardless of your experience, do any last words stand out in your memory?

Posted: 11/25/2012 2:45:06 PM by Lisa Bonsall, MSN, RN, CRNP | with 5 comments

Categories: Inspiration

Top 10 Quotes from Nursing Management Congress 2012

Some wise words were spoken at Nursing Management Congress this year. Here’s my top list of quotes from the conference. Thank you to all of the experts who shared their experience and stories with us!

Without further ado…

1. “Our knowledge of what we do everyday is very limited; based on tradition, not science.”
Richard Hader, RN, PhD, FAAN, CHE, CNA, CPHQ, Conference Chairperson, Editor-In-Chief, Nursing Management Journal, Senior Vice President and Chief Nurse Executive, Meridian Health

2. “Intrapreneurs are ‘dreamers who do.’”
Kathy Russell-Babin, MSN, RN, NEA-BC, ACNS-B, Senior Manager, Institute for Evidence-Based Care, Meridian Health

3. “Prioritization is a fact of life in clinical practice.”
Sean Clarke, RN, PhD, FAAN, Director, McGill Nursing Collaborative for Education and Innovation in Patient and Family Centered Care, McGill University and the McGill Teaching Hospital Network

4. “We teach people how to treat us.”
Sharon Cox, BSN, MSN, Founder and Principal Consultant, Cox and Associates

5. “Shift from ‘busy’ to ‘productive.’”
Sharon Cox, BSN, MSN, Founder and Principal Consultant, Cox and Associates

6. “Don’t forget the patient in the shared decision making model.”
Richard Hader, RN, PhD, FAAN, CHE, CNA, CPHQ, Conference Chairperson, Editor-In-Chief, Nursing Management Journal, Senior Vice President and Chief Nurse Executive, Meridian Health

7. “As a patient, if a provider comes in with an unkempt appearance, do you want that person to touch you?”
Richard Hader, RN, PhD, FAAN, CHE, CNA, CPHQ, Conference Chairperson, Editor-In-Chief, Nursing Management Journal, Senior Vice President and Chief Nurse Executive, Meridian Health

8. “People can change when they are fighting for a cause bigger than themselves.”
John O’Leary, President, Rising Above

9. “When you know your ‘why’ you can endure any ‘how.’”
Victor Franco, Holocaust Survivor (shared by John O’Leary, President, Rising Above)

10. “One person always makes a difference.”
John O’Leary, President, Rising Above

Please keep in mind that I was not able to attend every session as the breakout sessions occurred concurrently. I'm sure I am missing many great quotes on this list! All of the sessions that I did attend were informative, but even more impressive to me, was how invigorating they were. From the enthusiasm in the audience and some of my conversations in the exhibit hall, I know I was not the only one feeling this way. 

Posted: 9/28/2012 8:51:25 AM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration

What a great idea!


I just spent a wonderful long weekend in Nashville, Tennessee at Nursing Management Congress 2012. What a great city, great venue (Gaylord Opryland Resort and Convention Center), and great event! I learned a lot, connected with lots of nurse managers and executives, and enjoyed my surroundings. I have lots to share with you over my next few blog posts, but I’m especially excited to share the following idea which was presented by one of the attendees and then shared by Sharon Cox, BSN, MSN during the opening session, titled “Nurse Managers: Adding Value in a Time of Volatility.”

During one of the preconference workshops, a discussion about staff recognition had begun, when one attendee (I wish I knew her name to give credit where credit is due) shared a means of recognizing staff members that has had positive results. Rather than recognizing a staff member with a pat on the back or a letter of recognition to be filed, this manager asks the staff member (and I’m paraphrasing here), “I’d like to let someone important to you know what a valuable asset you are to us. To whom could I send your letter of recognition?”  She then wrote a personal note to to the person selected. 

This manager said she’s written to parents, spouses, mentors, and children of her staff members and has gotten positive feedback from all involved. She even met one staff member’s parents at a wedding and was thanked in person for the note she had written about their daughter.  

What a great idea!

Posted: 9/18/2012 2:59:45 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration

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