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Toilet Talk: Leveraging a creative opportunity for educating staff nurses
Oct 21, 2019, By: Melissa Rathwell, Selina Fleming, Tasha Vandervliet
men and women washroom signs

Take away

  • Educational posters placed in staff bathrooms are a creative and effective way to disseminate information.
  • Toilet Talk is adaptable for use in any setting where education and communication need to be improved.
  • Including nursing humor and trivia keeps the posters from becoming too content heavy.


In today’s health care landscape, nurses are challenged to stay well informed of educational opportunities and practice changes in ways that are meaningful, cost effective, and easily accessible to them. Our organization, the Huron Perth Healthcare Alliance, comprises four geographically separated hospitals, staffed by 500 nurses and supported by three clinical nurse educators. This educator model requires a high degree of creativity in the design and delivery of the teaching and learning activities that we offer in order to reach a widespread audience who report that they have little time to read emails.

Toilet Talk issues are laminated 11 x 17-inch posters containing small blocks of information, updated monthly and posted in staff-only bathrooms located on the nursing units. The use of posters and newsletters on the back of bathroom stall doors is an information dissemination strategy employed by various organizations and agencies. For example, messages warning against the effects of alcohol consumption in pregnancy are found in college bathrooms, and hand hygiene reminders are commonly found in public restrooms. Knowing that the average person visits the restroom multiple times a day, we saw Toilet Talk as an opportunity to utilize a creative approach to engage and educate a captive audience.

Toilet Talk’s content reflects Knowles’s Principles of Andragogy, which in part stipulate that adults are motivated to learn information for which they understand the purpose and see practical applications (DeYoung, 2015). Each monthly issue typically contains 8 to 12 clusters of practical information, which may include upcoming educational opportunities, nursing practice changes, practice reinforcement based on metrics, tips and tricks for improving nursing skills, general nursing trivia and humour, as well as topics suggested by nurses themselves.

Implementing Toilet Talk

In order to implement Toilet Talk, in spring 2015 we put forth a proposal and met with key stakeholders that included the nursing management team, infection control practitioners, and the Space and Signage Committee, who granted us permission to affix hooks in 24 staff bathrooms at each of the hospital sites. Expenses are limited to paper, laminating pouches, wall hooks, and colour printing costs. Five months from conception to dissemination, we piloted the first issue of Toilet Talk in summer 2015 with the goal of imparting relevant nursing information, knowledge, and practice changes to staff nurses right where they sat (pun intended).

Nursing staff completed a Toilet Talk survey in February 2019, and the results reinforced the notion that Toilet Talk readership has remained exceptionally high since its inception 4 years ago. Feedback in response to Toilet Talk has been overwhelmingly positive: 95% of survey respondents reported that it was likely or very likely that any given issue of Toilet Talk would contain information that increases their knowledge, and 97% reported that in the average month, it was likely/very likely that Toilet Talk would contain information relevant to their nursing practice. Nurses continue to praise Toilet Talk for its ability to impart nursing knowledge in a unique, humorous, and creative way, and have even stated that it is their preferred method to receive information, rather than email.

As we worked toward gaining approval for Toilet Talk, we learned that time spent refining the draft by first piloting the initiative was well worth it. Our initial idea included printing Toilet Talk on an 8.5 x 14-inch template, but when it was printed, it wasn’t legible from its location on the wall in staff washrooms. We revised the template and produced a much more readable size while taking advantage of the additional space for content.

Outcomes to date

Toilet Talk has become so popular that we’ve shared the template with other departments within the organization as well as with a variety of community partners who have adapted it to their needs. In addition, we’re often asked by our Allied Health department leadership to include important messages on their behalf in the posters.

“One of the biggest barriers to learning in the hospital is lack of time” (Schneider & Good, 2018). It is our hope that by utilizing Toilet Talk as an ongoing, creative teaching and learning strategy, it will continue to meet the practical learning requirements of the Alliance’s staff nurses, while capitalizing on every spare moment to do so.


Deyong, S. (2015). Teaching strategies for nurse educators (3rd ed.). Hoboken, NJ: Pearson, p. 20.

Schneider, M., & Good, S. (2018). Meeting the challenges of nursing staff education. Nursing, 48(8), 16–17. doi:10.1097/01.NURSE.0000541402.97845.2f

Tasha Vandervliet, RN, BScN is a Clinical Nurse Educator in the four hospitals that make up the Huron Perth Healthcare Alliance in Southwestern Ontario; Stratford, St. Marys, Seaforth and Clinton.
Selina Fleming, MN, RN, BScN is a Clinical Nurse Educator in the four hospitals that make up the Huron Perth Healthcare Alliance in Southwestern Ontario; Stratford, St. Marys, Seaforth and Clinton.
Melissa Rathwell, RN, BScN is a Clinical Nurse Educator in the four hospitals that make up the Huron Perth Healthcare Alliance in in Southwestern Ontario; Stratford, St. Marys, Seaforth and Clinton.