You Can’t Make This Stuff Up is this week’s new episode of The Adventures of Nurse Niki. Niki’s easy shift while floating on pediatrics takes a turn. If you’re new to the blog you may want to catch up by starting here, Chapter 1
The air temperature was below freezing, and because of all of the rain earlier in the week, the streets were frozen. Lots of car accidents were reported on the roads.
Because I walked to work I didn’t think too much about it, but as I progressed closer to the hospital the sidewalks, and particularly the asphalt streets became more slick with ice. I was wearing the wrong sort of boots and had to tread carefully to avoid slipping and falling.
Most interesting about the experience was that when I came to an intersection I waited to let the cars go first:
1. Because I had to walk gingerly, and slowly, and
2. Because the cars could slide too, and I didn’t want to be struck if they did.
Surprisingly, some drivers were annoyed when I refused to go first after they waved me on. One was so upset he shouted, “I was just trying to be polite to you!” from his vehicle as he passed. Intending to be thoughtful I had affronted him by not accepting his gesture of kindness, as though we were characters in an O. Henry story.
It made me think about how we are the stars of our own lives, and as such, often interpret the actions and motives of others through the lens of their effect on us. The driver didn’t understand I was being considerate too (and concerned for my safety). It didn’t occur to him that the road was as icy and slick for pedestrians as it was for those behind the wheel of a car.
I don’t know who originated it, but before reacting to someone’s words or actions it’s helpful to remember the meme, “People are not against you, they are for themselves.” I know I do it too, judge others’ actions by the effect they have on me. I hope I can become more mindful of doing it, and less self-focused.
It’s Not All Cute Print Scrubs and Bunny Blankets is this week’s episode of The Adventures of Nurse Niki. Niki ruminates about floating from PICU to pediatrics. If you’re new to the blog you may want to catch up by starting here, Chapter 1
Don’t forget to follow Nurse Niki on Twitter
After a long hiatus, I’ve posted a new episode of The Adventures of Nurse Niki, Chapter 54. I almost forgot how much I enjoy writing her. Look for new developments in the life of the nurse blogosphere’s favorite fictional pediatric intensive care nurse in the weeks to come!
“May your coming year be filled
With magic and dreams and good memories.
I hope you read some fine books
And kiss someone who thinks you’re
Wonderful, And don’t forget to make
Some Art – Write or draw or build or
Sing or live as only you can. And I hope,
Somewhere in the next year,
You surprise yourself!”
One of my favorite readers sent this wish to me in an email, and now I pass it on to you. Thank you, Mary and the same wish for you.
Opportunity is missed by most people because it is dressed in overalls and looks like hard work.
Wishes do come true, whether you believe or not. The caveat is that the answer doesn’t always align with the expectations of the wisher. This is why about half of the human population believes in wishes, prayers, or manifestation, and the other 50% does not.
This is also how someone like me finds herself in a fortunate predicament: my wishes were granted. I’ve obtained the proverbial three vocations I love. One makes money (as an oncology nurse navigator), another keeps me in shape (running and barre classes), and the third allows me to be creative (painting, drawing, writing, and blogging). Often the first and third converge as demonstrated in this local new feature.
The oncology nurse navigator role that I love so much is newish for me, and as such, takes hours a week of research and continuing education beyond the actual job. It is also a 40-hour workweek kind of job. Prior, I worked nearly, but not quite full time. That little bit of edge apparently makes a difference in my creative out put. I have not abandoned painting; for instance these portraits I made as a Christmas present for a family member.
More often, however, I get off work, make myself go for a run or to the exercise studio, and then, once home, gravitate like a moth to flame to the biggest time-waster for all creatives: the Internet. Weekends are consumed with household tasks. I realize most Americans live by this routine, and if I were suffering from creative block perhaps I could live with it too, but the truth is I have as much inspiration for writing and making art as ever. What I’ve lacked is the discipline to prioritize my time. Starting with baby steps, one of my goals for 2016 is to write or draw for 15 minutes every day. It can be a chapter of The Adventures of Nurse Niki, a post for this blog, a journal entry or a quick sketch of my sofa, but everyday I will make something. I’ve already started. I set a kitchen timer to keep me honest. Most days I end up going for more than 15 minutes.
Has anyone else had this experience?
I was at work with a headache. In the past, when I worked on nursing units, if I had a headache I did one of two things:
- Bum a couple of ibuprofen from a coworker
- Borrow a couple of ibuprofen from the satellite pharmacy, which is more honorable than leaving your shift because of a headache
Now that I work in an office, without a home-base nursing unit I had to fend for myself. So I took the elevator from the Lower Level (read “basement”) of the building where my office is to the first floor where the outpatient pharmacy is located to buy ibuprofen the way I imagine non-nurses do.
Staring at the shelf I was instantly confused by the small, and what appeared to be identical, generic boxes labeled “pain reliever.” I fished my glasses from out of my purse to read the small print labels so I could distinguish acetaminophen from ibuprofen, and aspirin-they were all packaged very similarly. Once that was accomplished, I had to further identify the dosage I wanted- 200mg tablets, from the low dose, “junior” strength of 100 mg tablets. I’m still confused if “junior” means suitable for children, but by now my headache was worse so I let that go for another time. There was also a formula for both doses labeled “sleep enhancing.” I assume that means it contains diphenhydramine. I just wanted #old-school #ibuprofen #thankyouverymuch.
I finally found the product I wanted. I waited my turn at the cash register. The box of ibuprofen cost $4.19. The clerk patiently waited for me to count the dollar bills in my wallet. I had four. I knew I had a bunch of change in my coin purse, so I told her I would pay in cash.
Has anyone else had this experience? I stared at the handful of coins in my palm trying to count out nineteen cents. Except for the pennies, I couldn’t tell the coins apart! When did quarters shrink to nearly the size of nickels, and what happened to the pictures of Jefferson, and Washington? The Roosevelt dimes looked familiar. The rest of the coins resembled foreign money.
The clerk showed me I had to turn the quarters over to find Washington, and I discovered there is new nickel, which is the Return to Monticello nickel bearing a full-face image of Jefferson, replacing his profile. She waited while I counted out nineteen cents. She said she has a difficult time telling them apart too.
My headache was raging by now. Furthermore, I suspected the clerk of being polite. After all, she serves the ill and the elderly all day long. I wondered if I had just experienced the first sign of oncoming dementia. I was spooked.
Since then, I’ve been reassured by friends and coworkers that the coins have indeed changed. They have stories similar to mine. I guess I should empty my coin purse more often. I can’t help but wonder, however, between the look-alike packaging of generic drugs, and our changing currency, how are patients getting by?
The April 2015 issue of the American Journal of Nursing is available. On page 43 of the print version is Yazzie, a 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.
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.
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.