Finding Creative Permission, my new post exploring creativity and nursing, is up at TheONC.
And Happy Valentine’s Day!
New Post on TheONC: Finding Creative Permission
Reply
Category Archives: Posts About Nursing
TheONC: A New Blogging Community for Oncology Nurses and Teams
Last week CancerNetwork launched TheONC; an online community for oncology nurses and staff. TheONC is a gated site for professionals so login is required to participate. The video link below explains more fully:
video.asp?section_id=1687&doc_id=238579
TheONC features bloggers with a wide spectrum of expertise writing on various aspects of cancer care. As a contributing blogger, I write from the perspective of an artist working in oncology. Through weekly posts, readers and I will discuss creativity, and its pursuit, in nursing. Images of my artwork accompany the posts. My first went live yesterday.
Shift Observations: That First IV Start After Vacation
photo: jparadisi 2012
Why does that very first IV start on the first shift back from a vacation always cause just a little apprehension?
My patient waits silently while I collect the supplies I need: a sterile IV pack, the angiocath, a normal saline flush. I tear a few small strips of tape and stick them to the edge of the bedside table, easily within reach, ready to secure the IV once it’s in the vein.
How many IV’s have I started over the past twenty-five years? Why does the first one after a vacation always feel like the first one ever?
My gloved fingers palpate the chosen vein one more time before I swab it clean, leaving a glistening sheen and contrasting shadow along its hill, a cairn on his forearm.
Collecting my thoughts, I focus on the vein until they are as sharp as the needle I use to puncture his skin and thread the catheter into the vein. A flash of blood tells me I’m in. Using one of the strips of tape, I secure the IV, then cover the site with a transparent dressing. It flushes easily.
I release my breath, which I realize I was holding.
I’m back.
Staycation
Reflections on the Willamette River photo: jparadisi
I am on staycation this week. It means I scheduled a week off from the oncology infusion clinic, and spending the time here in Portland, where I live.
I admire nurse colleagues their ability to schedule travel vacations months in advance. They bring brochures of exotic places like Machu Picchu, Sidney, Tuscany, Spain, etc. to work, having booked cool hotels and fabulous dinner reservations. One coworker planned an extensive road trip, driving solo, through national parks. Besides being courageous, she has a sense of humor: she purchased an “inflatable man” to occupy the passenger seat of her car during the trip. Then she gave “Joe” away as a white elephant gift at our staff Christmas party. Better than a gnome.
My staycation reflects a lack of planning on my part. A few days after Christmas, I realized my mind wandered when I listened to small talk, the small talk my patients generate adapting to their role, connecting with me, making the experience pleasant for all of us. My sudden inability to concentrate on more than actual patient care signaled to me I let too much time lapse between vacations. There wasn’t enough time to coordinate David’s work schedule with mine, nevertheless, I needed a midwinter break sooner than later. Our scheduler received my request for vacation time that week.
So, how am I spending the time off? I booked a fallback Pedi Mani, then met a girlfriend for Happy Hour at a new tapas bar the first day. Over the weekend, David booked a two-night stay for us at a hotel on the Willamette River. The off-season rates were great. We saw the French film Le Havre, leisurely dined at restaurants we’ve only talked about, and slept in. I’ve booked a spa day for myself, complete with green tea service, and lunch later this week.
After that, who cares?
Learn and Live
Hawthorne Bridge photo: jparadisi 2012
American Heart Association, are you messing with me?
I was a wee bambina sitting at the dinner table the first time I heard the acronym CPR. My father, a volunteer firefighter for the small town where we lived, certified that afternoon. I remember him saying, “It’s a terrible thing to need to do, but everyone should know how to do it,” and his words are true. Everyone should know CPR.
I got my first CPR card in high school, recerting off and on until becoming a nurse. Now, I recert (renew) every two years. All hospitals I have worked for in two different states require Registered Nurses to have current BLS certification. There is no grace period. If the card expires, the nurse cannot return to work until he or she has renewed their certification.
I love The Heart, however, few things swizzle an experienced nurse’s placid pool of confidence more than CPR recertification, aka, BLS (Basic Life Support). I know this, because I renewed my card last week. Everyone in the class expressed anxiety. Anxiety occurs because, every two years, we have to relearn breath to compression ratios, and how many compressions per minute. For one rescuer or two? Is the victim an adult or a child? The ratios are different for each. And what the hell is that little rhyme you’re supposed to repeat while changing positions with the other rescuer because you’re getting chest pains yourself from the exertion of doing (how many, again?) chest compressions? Don’t forget, you’re trying to save a person’s life while doing this.
Our instructor assured us changes occur only every five years, but it seems different every time. Not only for staff I work with: once, I was running behind two women runners on the Hawthorne Bridge, and overheard them talking about CPR, and how confusing all the numbers are to remember. I sprinted to them, asked if they were nurses. They were. We ran together for a while, commiserating over this albatross of our working lives.
So you can imagine my chagrin, last week when our instructors explained the changing numbers confuses so many health care professionals and lay people, they were not even attempting CPR outside of hospitals, for fear of doing it wrong. This led the AHA to research hands-only CPR. They found:
• Hands-Only CPR (CPR with just chest compressions) has been proven to be as effective as CPR with breaths in treating adult cardiac arrest victims.
• The American Heart Association has recommended Hands-Only CPR for adults since 2008.
As of June 2011
I support the American Heart Association listening to our concerns. I applaud its continual research, which saves lives. Everyone should know CPR.
All the same, does this mean, these past twenty-five years I’ve been a nurse, whether it was one or two breaths between compressions has never really mattered?
American Heart Association, are you just messing with me?
Next Career, No Body Fluids
XXXL Pajama Pants pencil and pastel by jparadisi 2012
“Next career, no body fluids.”
That’s what I tell myself.
I admire hospital management their ability to wear cute dresses and pumps to work or, if they are male, slacks and sweaters. Oh, and jewelry: modestly dangling earrings and longish necklaces. I knew the most talented and charming surgeon who got away with it too, mostly because she’s so damn good at what she does. I once saw her come from the OR wearing green surgical scrubs, a string of black pearls around her neck, and pumps covered in paper surgery booties. I was so impressed I splurged on a string of black pearls for myself, and wore them to work with green surgical scrubs too. Imitation truly is the best form of flattery.
I digress.
I don’t wear cute dresses, few necklaces, or modestly dangling earrings to work because I do direct patient care. A pediatric nurse quickly learns dangling jewelry is a handhold for infants and children to grab, snapping them or ripping an earlobe. Adult patients suffering dementia put a nurse and his or her jewelry at risk too, and long necklaces tangle into stethoscopes.
The other day, in the adult ambulatory clinic, I started an IV. Unexpectedly, a gush of blood erupted, running warm down my pant leg as if it were the slope of a volcano. I couldn’t get my leg out of the way because I was trying to keep up a calm facade for my patient (“Everything is just fine, just fine.”) while frantically taping the IV in a successful effort to maintain it. When I saw the blood on my pant leg, it looked like I had stabbed myself.
I remembered the last time my clothes were soiled this badly at work. I was a new PICU nurse and a child threw up ALL OVER my pink scrubs. A nursing supervisor acquired clean scrubs from the OR dressing room for me, and I finished my shift.
I work in an outpatient setting now. There are no kindly nursing supervisors willing to go to the OR for fresh scrubs. I had to think of something else.
In ambulatory care, patients wear their own clothes. Our linen closet is not stocked with an array of gowns or pajama bottoms; however, I managed to find a pair of XXXL pale blue drawstring pajama bottoms stuffed behind the fitted bed sheets. They were so gi-normous, I had to hike and tie the drawstring waist at my bust line. The pant legs were three times wider than both my legs put together. You can imagine how ridiculous I looked (if you can’t, I drew a picture for you above) even with a white lab coat buttoned over the ensemble to hide it. My coworkers were busy, and unaware of my dilemma. When one noticed, all she could say was, “Uh oh.”
Clearly, I needed another plan. Fortuitously, David had the day off, and was near where I work. I called for help, and he brought a pair of pants for me from home. I changed, and resumed patient care.
Apparently, I need a preparedness plan for my clothing at work. Do any ambulatory care nurses have one?
Next career, no body fluids.
Shift Observations
photo: jparadisi
Three nurses at lunch break in the staff lounge, focus intently on their phones. A fourth nurse enters.
She asks, “What would we do without our smartphones?”
Silence.
One nurse looks up, smiles, and says, “Talk to each other?”
A longer pause, then shrieks of laughter.
All heads return to their phones.
Hand Knit Socks for the Journey of 2012
Mom's Hand Knit Socks photo: jparadisi 2012
It was a quiet New Year’s Eve in our home, as I worked the next day. It’s okay, because I’ve heard what you do on the first day of the year sets its character. With several hospitals in town looking at staff lay offs, I’m grateful.
I wore a pair of wool socks inside my nurse clogs, knitted and given to me by my mom. They inspired me to write, “Learn to knit socks” on a Post-It note, and add it to my Mason jar of goals and dreams for 2012. Another hastily written, last-minute Post-It note reads, “Research and purchase a case of Oregon Pinot Noir.” I am an accidental wine enthusiast (another post). I may have to work an overtime shift to accomplish it, unless of course, I am a casualty of the layoffs.
2012 is a year of uncertainty, waiting to learn if the economy will improve, or if the other shoe hasn’t yet fallen. I remain cautiously optimistic; I believe the opportunity for things to improve is about the same as for things to go wrong. Surprised by joy is a possibility.
So, I’m wearing the wool socks my mom lovingly knitted, put one foot in front of the other, and begin the journey that is the year 2012.
A Blue Mason Jar Full of Post-It Notes Goals for The New Year
Blue Mason Jar of Dreams photo: jparadisi 2011
Every year I write my New Year’s resolutions on Post-It notes, filling a blue, vintage Mason jar with them after reviewing the ones from the year before. I write the date on each Post-It note. If a previous year’s resolution wasn’t met, and still holds merit, it remains in the Mason jar with the new ones.
Previous years’ resolutions in the jar:
- “My health: that I may remain cancer-free” (1999)
- “The continued good health of our families” (1999) I updated this one to “our families” in 2004, the year David and I married.
- “David’s and my continued good health and happy marriage” (2008)
- “To show a financial profit as an artist.” (2008)
- “Gallery representation”(2008)
- “Publish more stories in 2011″ (2010)
- “A book deal for my manuscript” (2010)
- “The blog will have more than 1,000 visitors/month (2010)
- “Lose ten pounds” (2011)
Most striking about the hopes and dreams on this list is that none of them are actually resolvable. They are ongoing. Sure, publishing my manuscript into a book would be great, however, knowing me, the next year I would resolve to write another book, one that won an award or topped the charts, or something like that. Artists are rarely satisfied with any level of achievement. We are always looking up the ladder at the next rung:
- Gallery representation leads to the desire for critical recognition, increased sales, collectors, fame.
- Publishing stories leads to writing more stories, longer ones, for larger audiences.
In general, human nature is much the same:
- Health and happiness leads to the expectation for more of the same.
- I lost ten pounds last year. For 2012 I expect to keep them off.
Resolution is the wrong choice of word. For me, setting New Year’s Goals is better phraseology. Most of the improvements I wish for in life take time and perseverance to achieve, and more hard work to maintain. To my way of thinking, New Year’s is a time to review the larger goals of my life, and see if they are still worth steering towards. If so, then I ask myself what small adjustments can I make this year to further them? These adjustments are written as goals on the Post-It notes, dated, and placed in the jar.
The most important part of opening the Mason jar each year is reading the hand written Post-It notes, and saying a small prayer of thanks or another expression of gratitude for the advances, which occurred over the past year towards each goal. There is no lasting joy in achievement without gratitude. This year, I am thankful for:
- A clean bill of health when we were afraid my cancer had returned.
- Editors who published my paintings, essays, and blog posts.
- David and I lost weight. He avoided a prescription for blood pressure medication.
- I was represented by Anka Gallery. I met wonderful people there and made lasting friendships.
- I sold some paintings.
- JParadisi RN blog has grown beyond my previous goals.
- I have met inspiring people through blogging. Special thanks to: Dr. Dean Burke, Joni Watson, Brittney, Sean, poet Stacy Nigliazzo, and artist Matt Lamb.
So what’s on Post-It notes this year? What goals am I steering my life towards in 2012?
- Remain cancer free
- The continued good health of our families
- David’s and my continued good health and happy marriage
- A financial profit as an artist
- Finish the Vessels of Containment painting series and start the new series
- Gallery representation
- Write and publish more stories in 2012
- Increased writing income
- The blog will continue to grow
- Keep off those ten pounds
Here’s the cool thing about writing down goals: The Examined Life (Socrates). Today I see each goal I’ve written down is focused on an unknown future. I haven’t written a single one, which applies to my present reality. So, until my dreams come true:
- I will continue to develop my skills as a nurse so my patients remain safe in my care.
- I will strive to be a better team player at work.
- I will phrase criticism in a constructive manner.
- I will remember that everyone has a difficult job. That’s why they call it work.
- I will say Thank You at least once daily. It’s wrong to wait an entire year to give thanks for everything that is good in my life.
I wish to thank my family and friends (new and old) for your support of JParadisi RN blog. May your New Year be filled with Health, Love, Happiness, and Prosperity.
Merry Christmas and Thanks for the Wings
photo by jparadisi 2011
“Dear George, remember no man is a failure who has friends. Thanks for the wings, Love Clarence.”~
Clarence Oddbody, It’s a Wonderful Life
