Welcome to Synapse Spotlight where we feature an interview with an inspiring NICU healthcare professional.
Today we are sharing an interview with Sharon Bonifazi, RNC-NIC on her work exploring HOPE in the NICU.
Tell us a little bit about you, your training, and what inspired you to work in the NICU?
I have been a NICU RN for 20 years and was inspired by a baby that I was able to study and write a care plan about in Nursing School. I found it fascinating how we looked at everything about this baby to help her succeed. After that NICU rotation, I knew and decided that if I could not be a NICU RN, that I didn’t really want to be a nurse. Oh, the naivete of the young! I was blessed to be a part of one of the first new graduate NICU courses at Loma Linda University Children’s Hospital and was taught and inspired by Kathi Randall since she was the NICU Nurse Educator there at that time. I still am being taught and inspired by Kathi.
Your lecture at the 2019 ONE Conference was about HOPE in the NICU. What inspired this presentation and what does HOPE in the NICU mean to you now?
I was inspired to dig more into the concept of HOPE when I was working as a NICU manager in Northern California. My boss had asked me about an issue we were facing in the NICU and I said, “I hope that it is getting resolved.” And she snapped back at me, “HOPE is not a plan, Sharon.”
I was immediately offended and felt that I needed to explore my feelings regarding this. So I threw myself into exploring the meaning of HOPE first as a personal journey, but it quickly became a passion when I saw how we could apply it to our work in the NICU.
I realized that everyone, including staff, leadership as well as our fragile patients depend upon HOPE to help us thrive in the NICU environment. After over a year of learning and sharing, my definition of HOPE has become — Helping (H) Ordinary (O) People (P) be,or thru the, Extraordinary (E).
Why is HOPE so important for nurses working in the NICU? And how can nurses support HOPE in the families we serve in the NICU?
Nurses convey HOPE to our patients and their families by employing neuroprotective strategies that can reduce the trauma of being in the NICU as well as protecting the brain at a very fragile time. By providing pain management, protected sleep, and skin to skin care, for our fragile patients we are creating an environment that fosters trust. Even the sickest infants can begin to learn to trust their caregivers, and their parents. Erik Erikson, in his psychosocial theory says that HOPE is the virtue that arises from the 1st year when infants face the life crisis of Trust vs Mistrust. We are the ONE at the bedside along with the parents that can provide this trust.
Since your presentation in February, have you continued to study the concept of HOPE in the NICU? Can you share any new insights? Tell us about your plans to present more about this topic in the future?
I have. I have been challenged with turning my personal reflection into more of a scientific exploration and have learned by studying others’ work.
Dr. Rick Snyder and Shane Lopez are two that have really studied hope. I have recently read the book “Hope Rising” by a renowned researcher on this topic, Chan Hellman out of the University of Tulsa and Casey Gwin who is the director of the Family Justice Center in San Diego and Camp Hope America.
I have presented some of this work in a workshop with Mary Couglin, entitled Quantum Caring for the NICU clinician. We just presented in Las Vegas in August of this year and have high hopes to bring HOPE to as many places as I can! I will be presenting a talk at next year’s Science and Soul 2020 Congress entitled, “Hope, the Science behind the Virtue.” I have been encouraged by friends and attendees to write an article, so am also exploring this too. I am very interested in research, although I am not real sure how to get started as it pertains to the clinician and the families that we serve. Happy to hear suggestions from the Synapse Community.
What is the most rewarding part of your current or past work in the NICU?
Can I pick 2? One is watching a family take home their baby and knowing we were a part of the journey. The second is seeing a new nurse “get it”! I love the look on the face of a new nurse who sees that she/he can make a difference in the life of a baby by implementing neuroprotective strategies.
What is your biggest struggle at work and how are you working through it?
My biggest struggle, believe it or not, is to practice what I preach.
12 hours is a long shift and sometimes a short shift.
I love the saying by Maya Angelou: “Do the best you can until you know better. When you know better, do better.”
So if I know that when I start an IV or do a heel stick, it is better to wait until a mother or another nurse can be there, then I must. If my patient is sound asleep and I have a lab or a task that I need to do to him or her. Do I wait? What if I can’t wait? I must do everything in my power to reduce and manage the stress that will come when I perform these sometimes life saving duties.
As a manager, (in my recent past) my challenge was knowing how best to support neuroprotective care and trauma informed care practices at the bedside when there are a variety of levels of “knowing” in the NICU. It is imperative for those in leadership to make changes at that level so that we can we assign staff and support education that allows for this kind of care to be done at the bedside.
How do you stay on top of the latest trends and technology coming to the NICU?
By reading, by becoming involved with like minded people. Learning from mentors. Attending conferences like the ONE Conference.(!!!)
What advice would you give to new nurses just starting their career in the NICU?
Know what inspires you, know why you are doing this work. You can learn lots of technical things, but really understand why you come to work everyday. Please know that each action that you perform with your patient and family can and will have lasting implications.
Be present, take care of yourself, become connected with colleagues that inspire you. Never stop learning. Read Mary Coughlin’s book, “Trauma Informed Care in the NICU”. Go to the ONE conference and expand your circle.
What is one thing you do every day to keep you sane in the midst of NICU chaos?
I make sure I have a moment to breathe. And I remind myself that I will do a better job when I practice GRACE by Joan Halifax:
Gather your attention
Recall your intention
Attune to the infant/family
Consider what my goal is
Engage and then end interaction
What neuro-related projects are you working on in your NICU/NICN? Can be a committee based project, a QI project, anything that you would like to share?
I have recently taken a job in a nursery that is going to open up a NICU in the next few years. So I am trying to participate in the creation of neuroprotective strategies as we grow.
I have also begun work with Caring Essentials as a consultant.
What makes the ONE Conference so unique?
I attended the first ONE conference in 2017 and every year since, and truly believe that attending the ONE Conference can be life changing to the bedside clinician. I was for me!
The ONE Conference is unique because it is planned by NICU nurses who have a passion for neuro-intensive care and neuro-protective care. It sounds “elite”, but is really all-inclusive since Kathi’s theory is “Every NICU is a Neuro NICU.” Every NICU nurse can learn and be inspired just by attending.
I’ve now been part of the ONE Conference planning committee for the last two years and this also has been an eye-opening , learning experience. It is an amazing lesson in reality and also a lesson in believing that “what is meant to be, will be.” We are always amazed at how everything comes together with overlaps in presentations that we didn’t even “plan for.” Getting more involved opens you to new relationships that you would not have made otherwise.
And, of course, presenting my topic at the ONE Conference was amazing. I didn’t understand how my personal journey with HOPE would resonate with so many others. The responses from the attendees was very encouraging. And, my new role as consultant for Quantum Caring and the opportunities to present at workshops alongside Mary Coughlin came directly from that original presentation.
I would absolutely recommend others to take a chance and present your passion to others, especially if it is in a safe place, like the ONE Conference. We all have things to learn from each other, and you never know who is struggling with a challenge that you have struggled with. I hope I see a few of the readers of this blog on stage at a future ONE Conference
Sharon began her life in the NICU as a premature infant. She has been a NICU RN for 20 years and has worked as a staff RN, caring for a diverse group of infants from those who were born premature as well the infant awaiting a cardiac transplant. She has worked as a charge nurse and a preceptor as well as a nurse manager. Sharon’s current role is a clinical supervisor for a 22 bed Community Level 3 NICU where she hopes to be a mentor and leader in the area of Trauma Informed Care. She is also currently a consultant for Caring Essentials. Sharon has been inspired by the nurses she works with and is honored to be part of the planning committee of the One Conference. She is a true believer in the power of ONE.