JParadisi RN Painting in AJN Art of Nursing

The April 2015 issue of the American Journal of Nursing is available. On page 43 of the print version is Yazziea painting I made The Art of Nursing Column. In the accompanying  text I discuss the challenge hanging original art in a health care setting. You can view a pdf of Yazzie and the accompanying text at AJN Online.

The  paintings on exhibit in the clinic, including Yazzie, are for sale. I will donate 20% of the sales prices  to The Knight Cancer Challenge, dedicated to raising research money to find the cure for cancer. The fundraising ends in February 2016. You can learn about the Knight Cancer Challenge by watching their cool video here.

If you watched the recent airing on PBS of The Emperor of All Maladies, you’ll recognize Dr. Brian Druker, the inventor of Gleevec, as the face of OHSU cancer research.

If wishes were horses, this 17-piece collection titled, Works on Paper: Monotype Prints and Paintings would be purchased and donated to the walls of the clinic where they are now hanging, so the patients can continue to enjoy them.

 

Doing Nursey Things

Except attending local meetings of organizations representing oncology nursing, and doing continuing education required to maintain my OCN certification, I don’t otherwise do a lot of nursey things on my time off. However, now that I’m an oncology nurse navigator, I feel compelled to get more involved to better serve patients.

Recently, I attended the local Komen Breast Cancer Issues conference. There’s been so many advances in breast cancer treatment since I became a survivor.

A unique feature of this particular conference is that the attendees are a mix of oncology health care providers, breast cancer survivors, and their friends and family. It was the largest gathering in the support of the cure I’ve ever attended.

The keynote speaker was the highlight of the conference: Lillie Shockney, RN, BS, MAS. Patient navigation was created by Dr. Harold Freeman, but Shockney, administrative director of the breast cancer center at Johns Hopkins, is the champion of nurse navigation, and founder the Academy of Oncology Nurse Navigators. While the organization welcomes lay navigators as members, the AONN is dedicated to scientific data supporting patient navigation as a nursing specialty. The author of numerous books, Shockney is also a breast cancer survivor, and I was lucky enough to hear her personal story. Her humor, candor, and authenticity made her an overwhelming success at the conference. At every break, people talked about her, describing which parts of her story most resonated for them.

I briefly met Lillie Shockney at the table where she signed copies of her latest book, Stealing Second Base, about her breast cancer experience. Standing in line with my newly purchased copy, I couldn’t help overhearing the woman in front of me tell Shockney how much she appreciates her work, and listing the multiple times she’d attended her lectures. Pausing, she added, “It sounds like I’m stalking you, but I’m not.”

Every comedian needs a straight man, and this line was too good to let pass. It was my turn. Placing the book on the table for Shockney to sign, I quipped, “I’m a new nurse navigator, and I am stalking you.” She laughed big, and genuine. We talked for a minute or so. She radiates warmth.

Another nursey thing I’m doing: I began reading The Emperor of All Maladies, the Pulitzer-prize winning biography of cancer by Siddhartha Mukherjee. I plan to watch Ken Burn’s three-part documentary based on the book, too. Part one airs tonight (Monday) on PBS (check listings for time), and parts two and three air consecutively the next two nights. Answering the questions and concerns of oncology patients requires an awareness of information presented by the media, and I anticipate being asked if I watched.

So, for a little while, it’s all cancer all the time, on and off working hours.

The funny thing is, I’m enjoying the process.

Nursing School is Just The Beginning of a Career of Learning

One aspect of changing nursing specialties, or being a new nurse for that matter, is the agreement to do homework to get up to speed. Being a certified oncology infusion nurse, while helpful, does not make me an expert in my new oncology nurse navigator position. Though working with preceptors who generously share learning, the responsibility of identifying my knowledge gaps, and seeking resources to fill them is mine.

Newly graduated nurse, I hate to break this news to you: graduating from nursing school doesn’t mean you’re done with homework. It’s the opposite. Nursing school provides the tools for finding information you need to succeed in any nursing job throughout your career. I’m serious. When early in my career a pediatric intensive care nurse befriended me, and agreed to be my mentor, the first thing she did was hand me a hardcover, 1,000+ page copy of Mary Fran Hazinski’s then gold standard text, Nursing Care of The Critically Ill Child, saying, “Read it. You can keep it too, because I just bought the newest edition,” cluing me in that expert level nurses continue learning.

I read the tome twice: the first time by looking up the diagnoses of every patient I was assigned to learn their assessment, and then understand the medical care plan. The second time, a few years later, I read it cover to cover preparing for pediatric CCRN certification.

In similar fashion, these days my evenings and days off are occupied with an hour or more of reading about nurse navigation. Yes, I’m a bit of a nerd, but the fact is I haven’t been this excited about nursing in years. Nursing school is just the beginning of a career of learning.

Shifting Closer to “Where Science, Humanity and Art Converge”

A goal is a dream with a deadline.

-multiple Internet attributions.

 

I have a new job, one that I envisioned when I transitioned from pediatrics to oncology nursing in 2001.

I am an oncology nurse navigator.

If you don’t know what an oncology nurse navigator is you’re not alone. Most of the time when I tell another nurse about my new job, his or her eyes go blank, and I get a sincere, but confused, “Oh congratulations!” Surprisingly, or maybe not, it’s my layman friends who get it right away, “It’s about time the medical profession started hiring people to help us find our way through the complexity of health care.”

I can’t agree more.

Patients are referred to a navigator after a diagnosis of cancer. The role involves patient education, distress assessment, providing resources, and emotional support throughout treatment. The goal is patient-centered care that prevents patients from “falling through the cracks” of the health care system. Confusion arises because some duties of the nurse navigator resemble those of case managers and social workers, however, nurse navigators offer comprehensive oversight of patient care needs, and advocacy. Further, the American College of Surgeons’ Commission on Cancer mandates patient navigation for cancer program accreditation. A source of more information is the American Academy of Oncology Nurse Navigators’ website.

One of many adjustments is my work hours have increased from nearly full-time to full-time. But there’s so much to write about! As I get a handle on things, I suspect the focus of JParadisiRN blog will shift closer than ever to “where science, humanity, and art converge.”

 

Hope is a Feathered Thing

Hope is the thing with feathers t
hat perches in the soul,
 and sings the tune without the words, 
and never stops at all,

And sweetest in the gale is heard;
 and sore must be the storm
 that could abash the little bird
 that kept so many warm.

I’ve heard it in the chillest land, 
and on the strangest sea;
 yet, never, in extremity, 
It asked a crumb of me.

Emily Dickinson

A few weeks ago I witnessed a miracle.

No, really, I did.

While running along the Willamette River in Portland’s Waterfront Park, a flock of seagulls (not the punk group; the kind with feathers and wings) scavenged for food several yards ahead. From the neck of one of the birds a plastic grocery bag dangled in the sight breeze like a cape.

In 2011 Portland’s city council outlawed the use of plastic grocery bags by retailers for environmental reasons. This sea gull’s plight illustrates one.

The bag was a death sentence. Besides scavenging, gulls feed by dipping for small creatures from the river, and this action will fill the bag with water. When the bag becomes heavy enough, it will sink below the river’s surface and drown the gull.

From habit, my nurse’s brain searched rapidly for an intervention. Briefly, the ludicrous image of me somehow restraining the bird and removing the bag flashed by, but before I was completely convinced of this impossibility, the birds took flight and landed on the river including the unfortunate gull with the plastic bag cape fluttering behind.

“Oh no,” I thought.” I’m going to watch the poor bird drown.” Mesmerized the way people become when they can’t avoid watching a train wreck I stopped running and leaned against the rail of the sea wall, following the bird with my gaze.

The gull bobbed on the river’s current, the plastic bag making him easy to spot. He dipped forward and placed his beak beneath the surface of the water. I saw the bag fill, then sink. Pulled down by the weight of it, the gull fought, flapping its wings wildly as it struggled to take flight.

“This is it, I said out loud, though no one else was watching.

But it wasn’t it. Miraculously, the bag slipped away from the gull and he was airborne. I watched the bag, half submerged, float down the river like a malignant cell seeking another victim.

Okay, maybe it wasn’t a miracle, but it felt like one. I had been so sure the gull was doomed.

Maybe the miracle is that I received an object lesson about embracing phenomenon, to stay hopeful, to marvel.

Because hope is a feathered thing.

Book Review: Nursing From Within, a Fresh Approach to Putting Out Fires and Self Care Work Arounds

In her book, Nursing From Within, a Fresh Approach to Putting Out Fires and Self Care Work Arounds, Elizabeth Scala, MSN, MBA, RN takes on the chronic dissatisfaction most nurses experience at some juncture in their career. With change rapidly dominating the landscape of health care delivery, nurses are stretched to the breaking point in their ability to provide safe, patient centered care.

Nursing From Within, a Fresh Alternative to Putting Out Fires and Self Care Work Arounds by Elizabeth Scala, MSN, MBA, RN

Nursing From Within, a Fresh Alternative to Putting Out Fires and Self Care Work Arounds by Elizabeth Scala, MSN, MBA, RN

This problem is not new in nursing, according to Scala. In fact, it’s existed in some form or another for decades. Scala considers,

It is possible that nursing, the entire profession as we know it today, is stuck. Bogged down from the energy that is created with the funnel. Looking left and right, turning around or glancing above us-who do we see? What do we hear? Where do we go for answers?

We hear the same things, talk about the same things, and live the same things.

While nursing has come a very long way in terms of scientific skills and critical thinking, can we say the same thing for our own personal and professional evolvement as a whole? Are we developing in a way that will help us to thrive and move forward as a group? Or is the mindset of ‘this is how it’s always been done?’ keeping us stuck in the funnel of nursing limitation?

 In a conversational voice, Scala uses stories from her personal experiences to illustrate how she changed from a nurse on the brink of burnout into one with an expanded viewpoint of where an open mind and change from within can lead. The creative career solution she chose at the book’s ending surprised me. It validates the versatility of a nursing license, but I’m not sure it answers the question at the heart of the book’s premise.

However, this does not take away from the truth of Scala’s observations, or the value of the  tools she presents for self care. Scala’s openness and authenticity shine through. Her topic is important, demanding recognition and discussion among nurses. I found much of what she wrote inspirational.

Nursing from Within: A Fresh Alternative to Putting Out Fires and Self-Care Workarounds is available now. Get your copy today by visiting Elizabeth Scala’s website or purchase directly from Amazon

Normal Is a Cycle on the Washing Machine

In my mind, as long as the weather is good, summer isn’t over. However, the beginning of the new school year, and the return of football indicates that ritual outweighs my imagination.

Sigh.

It’s good to let an imagination run free from time to time, so I took the summer mostly off from blogging.

Preparing paintings for display. Image and paintings by jparadisi 2014

Preparing paintings for display. Image and paintings by jparadisi 2014

I’m back.

I think there’s a tendency to view creative work as less taxing, dare I say less challenging, than nursing. I wouldn’t say less, so much as different: Different types of knowledge, different sets of skills. The biggest difference, I think, lies in accountability. Harsh criticism of their work can damage an artist’s psyche.Missing a deadline for a post or art exhibition is unprofessional and negatively affects the editors and curators writers and artists work with. It leaves them in the lurch, which in turn negatively impacts the artist’s career.

In nursing, however, medication errors can seriously impact a patient’s health, with potential life-changing consequences for patient and nurse.

I discovered something this summer: Taking time off from creative projects creates a vacuum into which other projects, out of nowhere, are sucked in, filling the “free” time I worked so hard to create. I see this phenomenon in the lives of the retired too. In fact, I often tell my Mom, “You’re scaring me; retirement looks twice as busy as working life, without the paycheck.”

Mom just smiles, and says, “Remember, ‘normal’ is a cycle on the washing machine. Don’t wait for things to slow down. They won’t.”

She’s right.

An unexpected project close to my heart this summer was the opportunity to hang my paintings and monotype (one of a kind) prints in a health care setting. It is a very satisfying experience to work with a design team to select and hang art with the intention of improving patient experience. In the past, I’ve sat on selection committees choosing artists for hospital art commissions, but this was my first experience as the selected artist.

For me, it came together when a patient, unaware that I am the artist, made this remark about the art, “It makes me think of other things than why I’m here.”

Bingo. That’s exactly the result I was looking for.

The Adventures of Nurse Niki is back too. The latest episode, At The Raleigh, posted Monday.

Summer vacation brought fresh insights, generating posts for AJN’s Off the Charts. In a drop-in life drawing studio I drew a connection between art and nursing. A road trip with my husband inspired this post. And a close call with danger inspired yet another.

Normal is just a cycle on the washing machine.

 

 

 

Where Science, Humanity and Art Converge

JParadisiRN blog began by discussing art and nursing. For the most part it remains so, through observations of the way science, humanity, and art converge, transferring these observations into blog posts.

Nursing is a tactile profession, at least when practiced at the bedside. It’s difficult to do the work of a nurse without actually touching people. Nurses learn that some skin or veins are so tough they almost repel an IV catheter, while other types are so fragile, even the paper tape used to secure a dressing or IV can easily tear it.

Nurses bathe the newborn’s firm, plump flesh, or rub lotion into the loose, wrinkled flesh of the elderly to prevent its breakdown. We measure and weigh the under and overweight, then calculate body surface area to administer the correct dose of chemotherapy.

This summer, I enrolled in an open life drawing studio. A model sits for a few hours, while artists, in meditative silence, draw the human body on paper.

Drawing is also a tactile experience: holding charcoal against toothed paper, making shapes and lines into limbs and torso, adding shadow to give them volume.

Patients and models allow nurses and artists into the sacred space of their nakedness. This privilege demands respect. Administering nursing care to a patient, or capturing the model’s likeness on paper requires concentration, skill, and love of humanity.

 

Latest Posts: AJN’s Off the Charts & New Nurse Niki

Drawing From Life is my latest post for Off the Charts, the blog of the American Journal of Nursing. It posted yesterday. Often the lines between art and nursing easily blur, like soft charcoal lines smudged on paper. You might want to check it out, or leave a comment.

The Adventures of Nurse Niki now posts new episodes on Mondays, instead of Thursdays. Be sure to read week’s episode, Moving On..

The Adventures of Nurse Niki Moves to Mondays!

The Adventures of Nurse Niki

The Adventures of Nurse Niki

I’m having fun re-prioritizing a few things, one of which is my other blog, The Adventures of Nurse Niki: fiction so life like, it’s almost real. I’m enjoying writing fiction more than I’d expected. Niki and her friends have integrated into my waking life, and the story lines come faster than I can write them down. Therefore, The Adventures of Nurse Niki will post on Mondays instead of Thursdays.

I am not shutting down JParadisiRN blog. This is a shift, not an ending. I’ll still post thoughts and images. In the meantime, tune in on Mondays for new episodes of  The Adventures of Nurse Niki: fiction so life like it’s almost real, starting today.

You can discuss or interact with Niki on The Adventures of Nurse Niki’s Facebook page. Please don’t forget to “Like” it too. Show Niki some love! Thank YOU!! to the readers following The Adventures of Nurse Niki, the retweets of @NurseNikiAdven (Hashtag #NurseNiki) and those who Like Nurse Niki’s Facebook Fan Page. The support is very much appreciated!