Read these award-winners!

Okay, so I know the words of this title should be hanging in an elementary school somewhere (and probably are), but think about all the reading you do as a nurse. It’s a lot, isn’t it?

From the big textbooks in nursing school to policies, procedures, and protocols in your area of practice, there is a lot of reading that we do. We read to keep up on health care news, drug information, technological advances, and treatment recommendations. We are constantly reading charts, care plans, laboratory reports, notes from other health care professionals, journal articles, and the latest research studies. The list goes on and on!

Social media has expanded our reading list even more. We are connecting online and reading each other’s stories and experiences through status updates, tweets, and blogs. Whole conversations are taking place without any words being spoken. Pretty amazing, isn’t it? Over the past year (since really diving in to the world of social media), I’ve connected with some amazing nurses whom I would have never “met” had I not read their words. 

You can find the links to some of my favorite blogs here under Nursing Blogs (right column, about halfway down the page.) Do you have a favorite blog or even have your own? Please share the link ~ I’ll be sure to check it out! Thanks

Posted: 3/31/2011 1:21:48 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration

At home in a hospital

I love a hospital. There I said it. Now I know “love” is a strong word, but a recent trip over to our local hospital for an x-ray evoked some strong feelings in me. I miss it. I really do. The patients, the beeps, the smells, the camaraderie among the staff…. The itch to get back into the clinical setting is getting stronger.

As I waited in the hallway, I could hear nurses calling out for help and replies of “be right there” (while thinking to myself…Can I help too?), patients coughing up sputum (Can I see that? We might need to get a culture), and beeps of portable monitors (Excuse me…I think a lead came off). Even the familiar scent of hospital soap on the technician's hands smelled good to me.

I felt at home even as a visitor. Is that odd?

Posted: 3/27/2011 2:07:54 PM by Lisa Bonsall, MSN, RN, CRNP | with 2 comments

Categories: Inspiration

Six-second strip

It was Sunday night, 7 pm, and I was just starting my third 12-hour shift in a row. I was happy to see my assignment was the same as the previous two nights - two fairly stable patients. One was a “challenge-to-wean” patient who was recovering from ARDS and who had two restful nights on Friday and Saturday. The other was a patient who was post-stroke; she was not intubated, was minimally communicative, and had stable vital signs (I had been surprised that she had not been transferred out of the ICU during the day.)

I was a few minutes early so I went to print out telemetry strips for both of my patients before getting report. Part of our documentation each shift consisted of printing and interpreting each patient’s ECG intervals. We had a certain way to fold the strips so we could tape them in the appropriate spot on the flowsheet (next to the strip from the previous shift).

It was then, when I went to tape the strip on that I noticed something very different. The patient’s ST-segment was significantly elevated compared to the strip 8 hours before. The day shift nurse came over to start report and we compared the strips - same leads, definite ST-segment changes. She grabbed the 12-lead ECG machine and yelled for the resident while I assessed the patient. She was lying in bed and appeared comfortable. Her vital signs hadn’t changed and her oxygen saturation was 93%. She did not look like someone experiencing an MI. But she was.

Within minutes (or so it seemed), anesthesia had arrived to intubate her, cardiology was at the bedside, and we were hanging nitroglycerin and heparin infusions. After a very busy night and despite all of our efforts, this patient coded and died.

I tell this story because it is not often that “cutting & pasting” a six-second telemetry strip leads to this turn of events. As a critical care nurse, I was both exhilarated by noticing the change in her ECG and devastated by the outcome.

When I considered writing about this particular night, my first thought was that anyone could have noticed the change in her ECG. Would someone who was not a nurse have recognized the change and realized the implications? Perhaps. But is there anyone else but a bedside nurse who is present and in tune to the patients they care for 24 hours a day, 7 days a week, 365 days a year?

Nurses are there. Nurses are present. Nurses are paying attention.



Posted: 3/20/2011 3:17:05 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration

Things nurses say in the "real world"

This post is inspired by Joni over at Nursetopia, who recently posted Jargon Invasion and recounted the story of using public health jargon (“healthy BMI”) when discussing weight loss and exercise. I think Joni’s post makes sense to most of us nurses who regularly use words and phrases from our “nursing world” out in the “real world.”

My best friend is a nurse practitioner and when we are together with non-medical friends and family members, they often laugh at us or shake their heads at our choice of discussion topics and the words we use. The fact that both of us studied women’s health and think nothing of discussing the intricacies of women’s bodies and sexuality sometimes makes others uncomfortable. This has also added quite a bit of language to the vocabularies of our children which sometimes makes us uncomfortable as well!

Do you find that you use nursing or medical terms in your everyday life that might sound odd to others who are not health care professionals? Describing my daughter’s drug rash as diffuse and morbilliform might give her pediatrician a clue that I am a nurse. When my children use the word vomit instead of throw-up or puke, I know that they are listening to my choice of words (no, they haven’t picked up on emesis yet!) Other things I’ve said that have garnered some odd looks include disease process, laboratory analysis, and cardiac event. When I say umbilicus instead of belly button, my kids know exactly what I’m talking about. Using the word axillary to describe a temperature reading is normal at our house.

I even find myself using medical abbreviations in my everyday writing. For example, I’ve got to clean my daughter’s newly pierced ears b.i.d. My grocery list might contain veggies with ranch (but instead of with I’ll use ‘c’ with a line over it.) And I’ve been known to email a colleague to review something for me stat.

It’s all part of being a nurse, I guess. It sure keeps things interesting! Have a comment to share? I'd love to hear your assessment of this post...document your observations here!

Posted: 2/22/2011 3:00:39 PM by Lisa Bonsall, MSN, RN, CRNP | with 2 comments

Categories: Inspiration

Editorial round-up

When I receive a new issue of a journal, I eagerly turn to the editorial right away. I like to feel that connection with the person bringing me the content within the pages (or through the links of online journals.) I find that editorials often tell me more than what is featured in the issue. Oftentimes, editors share their views and opinions on current events, clinical experiences, and sometimes personal stories. I thought I’d share some of my favorite editorials from recent issues here in this “Editorial Round-Up.”

  • In Defining a Culture of Safety, OR Nurse2011 editor-in-chief Elizabeth M. Thompson, MSN, RN, CNOR, shares her beliefs about leadership and how a team approach by perioperative nurses has impacted the patient safety movement.
  • In Leading Change, Advancing Health, AnneMarie Palatnik, MSN, RN, APN-BC writes “If we don't control our practice, someone else will. If we stay focused on the goal of providing accessible, affordable, quality care, and promoting health, how can we go wrong?”
  • In LACE, APRN Consensus... and WIIFM (What's in It for Me)?, Kelly A. Goudreau DSN, RN, ACNS-BC teaches us about the LACE (Licensure, Accreditation, Certification, Education) model and how advanced practice nurses are stakeholders in this regulatory movement.
  • In the January issue of Nursing Management, Richard Hader PhD, NE-BC, RN, CHE, CPHQ, FAAN reminds us in Circle Back Before Moving Forward that “No one knows everything and you don't have to either!!”
  • In Year of Pain, Year of Promise, Maureen Shawn Kennedy MA, RN  reflects on events of 2010 and looks ahead to 2011 while asking the question “There's a way to move forward, but are we willing?”

This is just a sampling of what our editors are writing about. I hope you enjoy reading them!

Posted: 1/25/2011 1:38:46 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

Yes, I’m thankful for MS

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!

By Kim Fryling-Resare

Posted: 11/24/2010 2:21:08 PM by Lisa Bonsall, MSN, RN, CRNP | with 1 comments

Categories: Inspiration

Veterans Day should be everyday

Yesterday was Veterans Day and all around me I saw people saying thank you to veterans who have served our country by defending our right to freedom. Many of the nursing websites and journals posted messages thanking the veteran nurses who have served our country so well. I also tried to do a blog post yesterday to say thank you to our military nurses but, technology was not on my side and wouldn't allow me to post. As I pondered this experience on my drive to work this morning, I had another thought. It is not the day that is truely important, it's the overall feeling that we should say thank you to our military nurses everyday. They are truely the unsung heros in our profession. I have had the honor to work with many nurses who have served our country over the years. I am in awe of their dedication and devotion to helping individuals who are in need even if it means putting their safety in jeapardy.  The next time you are searching for an example of a nurse who really embody the spirit of giving; look no further than a nurse who is actively serving or who has served in the military.

By Anne Dabrow Woods, MSN, RN, CRNP, ANP-BC


Posted: 11/12/2010 8:42:42 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

When Monday is a good day

When I was in graduate school, my schedule was a little busy. I’m sure many of you can relate - juggling work, school, friends, family, and other responsibilities can be daunting. My weeks went like this: clinical Tuesdays and Thursdays, classes all day Wednesday, and work Friday, Saturday, and Sunday (three 12-hour night shifts).

It was exhausting, but fortunately the hospital where I worked paid 100% of my tuition and allowed me the flexibility of working 36 hours each week, while getting paid for 40 hours and receiving full-time benefits. This schedule didn’t leave much time for anything else, but I was pursuing a goal and luckily had a supportive (and understanding) network of colleagues, friends, and family.

My best day during that year and a half was Monday. I felt so free driving out of the city on Monday morning. While traffic on the other side of the highway was stop-and-go, I breezed home without any problem. Driving with the windows down (even in winter - had to stay awake!) and the radio on with some “snappy tunes” had such a calming effect after 3 shifts in the MICU. Having the entire day ahead to myself was such a gift. Of course, there was studying to do, and showers, meals, and sleep to squeeze in, but it didn’t matter. Monday was my best day.

What's your best day? Remember, nurses, no matter how busy you get or how overwhelmed you feel, take a little time to take care of yourself. Have a great Monday!


Posted: 10/25/2010 2:28:17 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

The First Lady Talks to Nurses

Last week, more than 5,000 nurses participated in a conference call with First Lady Michelle Obama and Mary Wakefield, PhD, RN, FAAN, the administrator of the Health Resources and Services Administration. The call focused on the role of nurses in educating the public about the Affordable Care Act. After sharing the personal experience of her daughter’s meningitis and the impact of the nurses who provided her care, Mrs. Obama went on to describe details of the Affordable Care Act:

“…insurance companies can no longer discriminate against kids because they have a preexisting condition.  Patients can no longer be dropped by their insurance companies because they get sick.  People suffering from a serious illness like breast cancer can focus on their treatment because they no longer have to worry about hitting their lifetime limit on coverage.  And college kids and young adults just starting out on their own can now get coverage through their parents’ plan.”

“And some of the biggest new changes and benefits are the reforms that deal with preventative care…Things like mammograms, cervical screenings, colonoscopies, childhood immunizations, prenatal and new baby care, high blood pressure treatment, all of these are included in new insurance plans with no deductable, no copay, no coinsurance, nothing.”

Mrs. Obama is calling upon nurses to “spread the word” of these changes and educate our patients and the public. You can read the transcript of the teleconference as well as the American Nurses Association's highlights of the newly enacted provisions of the Affordable Care Act for more information.

Posted: 10/4/2010 8:52:01 AM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

What is your passion in nursing?

My father-in-law is a retired professor of kinesiology and wrestling coach. He continues to be very involved with wrestling, often running clinics for students, athletes, and other coaches. While he may not hold the title “motivational speaker,” I believe him to be one. He stresses the importance of discovering one’s passions in life to his students, colleagues, friends, and family. He has several of his own passions and enjoys hearing about the passions of others, that is, what brings them the greatest fulfillment and joy.

The Level III nurses in the MICU where I worked each identified a diagnosis or patient population as their ‘specialty.’ It was part of the application process to attain that coveted position. I was always drawn to caring for patients with primary pulmonary hypertension (PPH), perhaps because many of the patients we saw with that diagnosis were young women, not much older than me at the time. These patients were often newly diagnosed and were admitted with only mild symptoms. Unfortunately, most of them had rapid progression of the disease and went home for only a short time, if at all.

It seemed only natural that this would be my clinical focus when I applied for my Level III position. I was the primary nurse for just about each PPH patient we admitted.  I delved into learning everything about the disease and its treatment. At the time, we would do trials of inhaled nitric oxide to assess the response of a patient’s pulmonary arteries to vasodilators. If the pulmonary artery (PA) pressure decreased, they’d be treated with either oral vasodilators or a prostacyclin infusion. We’d monitor PA pressures, cardiac output, and systemic vascular resistance closely to get the optimal dose while being alert for adverse reactions. Sounds simple, but it rarely was. This was about 10 years ago and additional treatment options are available now.

Primary pulmonary hypertension was definitely my passion in critical care. Why? It’s hard to say - perhaps I identified with the young patients admitted, perhaps because the treatment trials involved frequent assessment of hemodynamic parameters and the changes in the numbers and the patients symptoms were clearly evident, or perhaps because most patients were awake and able to communicate (unlike the majority of the patients in our unit).  Maybe all of the above!

Many of you may feel that nursing is more than a job and more than a career.  Is nursing your passion? What makes it your passion? And is there a certain patient or diagnosis that you are most passionate about?

Posted: 9/20/2010 2:18:32 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Inspiration

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