My diverse career as a nurse

I wanted to be a nurse for as long as I can remember. I started volunteering at a local hospital as soon as I was old enough and when college application time care around I was certain that nursing school was where I wanted to be. After a 4 year program and with my BSN under my belt, I began working as an RN in the medical intensive care unit of a university hospital.

After a few years, I decided to return to school and further my education. While I remember considering a critical care nurse practitioner program, I ultimately decided to study women’s health. It took me about 4 years to get my Master’s Degree – working weekends while attending classes and clinicals during the week. Caring for women (mostly healthy and many pregnant!) in an outpatient setting was a very different experience than caring for critically ill patients in the hospital.

The next stop in my career was as a clinical editor. I just happened to see an ad for a position in a local nursing publication, and although I wasn’t entirely sure what “clinical editor” even meant, I decided to apply for the job and find out. What a change I was in for! I was in an office setting and wearing real clothes. I spent my first 6 months in a film studio helping to produce nursing videos. If anyone had ever said that as a nurse, I could someday be writing scripts on ECGs and I.V. insertion, recruiting talent, and spending time in an edit suite, I never would have believed them!

Of course, there were bumps in this road…financing my education, reality shock, planning and managing personal and family responsibilities, just to name a few. I’ll have to save those for another post! Well – that’s my story, what’s yours?

Posted: 2/24/2010 3:56:42 PM by Lisa Bonsall, MSN, RN, CRNP | with 0 comments

Categories: Education & Career

Everything I know about nursing, I learned in… wait – when did I learn that?

For those of you who follow me on twitter, you know that I try to write a daily nursing tip. Sometimes, these tweets generate discussion. One tip in particular that seemed to get people talking was this:

“Don't palpate both carotid arteries at the same time or press too firmly; pt could faint or become bradycardic.”

I did ponder posting this one, because really – don’t all nurses know this already? But then I got to thinking – did I know this already as a nursing student? As a new nurse? When did I learn this?

It’s been a while since I was in nursing school, but I do remember learning a lot about nursing theory, even more about care plans, and of course, I’ll never forget the steps of the nursing process (assess, diagnose, plan, implement, evaluate!) I can’t deny that all of these things built the foundation of my nursing knowledge. But what isn’t clear to me is when the clinical skills and knowledge became ingrained in my brain – when I learned how to calculate a dopamine infusion to maintain someone’s systolic blood pressure above 85 mmHg, when I learned to approach a family about end-of-life issues, or how I learned to prioritize the needs of critically ill patients. When did these things happen?

In 1984, Patricia Benner published From Novice to Expert: Excellence and Power in Clinical Nursing Practice. In her landmark work, the author describes nurses as going through five stages of development – novice, advanced beginner, competent, proficient, and expert – with each stage building upon the knowledge and skills of the previous one. Think of your own experiences – where do you fit in this model? How will you get to the next level? 

Posted: 2/8/2010 10:05:38 AM by Lisa Bonsall, MSN, RN, CRNP | with 4 comments

Categories: Education & Career

Trusting nurses to influence health care

Last week, Gallup released the results of the survey: Nursing Leadership from Bedside to Boardroom: Opinion Leaders' Perceptions. The results of this survey, performed on behalf of the Robert Wood Johnson Foundation (RWJF), revealed that nurses do not have as much influence on health care decision making as perhaps we should. The experts interviewed (insurance, corporate, health services, government and industry thought leaders, and university faculty) reported viewing nurses as trusted professionals and the majority said that nurses should have more influence on health policy, planning, and management.

So what are the barriers? Here is what they found:
• Compared to doctors, nurses aren’t perceived as important decision makers or money makers.
• Nurses focus on primary rather than preventive care.
• Nurses don’t have a single voice on national issues.

On a similar note, each year, Gallup surveys Americans about the most honest and ethical professions. 2009 marked the 8th consecutive year that nurses have been voted the most trusted profession in America.

So if the both the experts and the American public feel this strongly about our trustworthiness and decision making capabilities, and if we believe that we can truly make a difference, what are our next steps as a group? How about as individuals? How can we overcome the reported barriers?

Posted: 1/25/2010 4:17:45 PM by Lisa Bonsall, MSN, RN, CRNP | with 4 comments

Categories: Education & Career

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