I write so much about nursing and art that I sometimes forget I’m a painter. Low census yesterday meant I had a free day in the studio, with this result. I love the flexible hours of nursing!
Untitled (Woman Holding Baby Doll) oil on wood by jparadisi 2013
That I am an artist was never questioned by anyone other than myself. It took time for me to believe in myself as an artist, because I felt I would know when I became one. Some artists laugh at such thoughts:
In artistic work one needs nothing so much as conscience; it is the sole standard. – Ranier Marie Rilke
Self-Portrait. Pencil on paper by jparadisi
How do I know I’m an artist?
The same way I know I am a nurse: Not because I am paid for my work, but because of my commitment to nursing. Commitment manifests itself as time set aside for continuing education, and time to practice skills. It’s not enough to want to do something. You need time to practice skills, whether it be starting IVs, or developing a series of paintings for exhibition. You commit to nursing through education, taking boards, and continuing education. You have to commit to creativity, too.
Begin with one hour a week, every week. It needn’t be the same day or time each week, although a set schedule may make it easier, childcare and weird nursing work schedules may necessitate flexibility. Protect this hour as if it were a difficult-to-reschedule dental appointment.
What will you do with this hour each week? You will have a creative date with yourself. For now, don’t invite a friend. Free yourself completely of taking care of other people. You need to hear your voice to find your creativity. You may already know what you’ll do with the time: write a poem or short story or resume piano, dancing, or voice lessons. If you’re drawing a blank about what to do, here are a few suggestions:
The important thing is to make a habit of allowing yourself at least an hour a week to explore and develop your creativity. What ideas can you add to this list?
Insight is the unanticipated gift of creativity. It struck like lightning during a shift in the oncology infusion clinic.
A colleague asked, “Where does IV iron come from?”
Baby Doll in Conical Bowl by jparadisi
I’ve infused the stuff into patients for years, but never wondered how the iron was obtained. From iron ore? By soaking rusty nails in water? It seemed unlikely it’s derived from blood products, as it’s often prescribed for bloodless surgery patients. However, what most impressed me was the curiosity that stimulated the question in the first place. It demonstrates thinking outside of the box, and beyond a task-driven mentality. Curiosity prevented her from mindlessly hooking an IV drip to a patient. She sought understanding.
Insight struck: curiosity is a foundation of creativity.
The questions “What, how, and why?” gave birth to science and art. They inspired Leonardo da Vinci to dream of contraptions which later became the basis of modern aviation. Artists ask themselves these questions standing before a blank canvas, a lump of clay, or the ingredients for tonight’s dinner.
My father, sitting at the head of our dinner table, told me many times, in his Italian accent (English was his second language), “Sweetheart, never stop devil-upping your coo-ree-os-ity.” I understood he meant: “Never stop developing your curiosity.” It remains excellent advice.
Maintaining curiosity in nursing compels you to create individualized methods for patients to organize and remember their home meds. Curiosity fuels your medication information searches and the creativity involved in formatting to educate people of various backgrounds: patients, their families, students, or coworkers. You create presentations that work best for any occasion: handouts, graphs, pie charts, or PowerPoint.
Curiosity leads you to use creativity in your nursing care plans:
Imagining what losing your hair feels like, you cheer up a chemo patient by helping her collect pictures from magazines of hairstyles — short, medium, and long — so she can visualize her new hair when it grows back. Maybe she’ll try a vivid new color too.
Wondering how to entice a patient to eat more, you explore recipes for textures and flavors of food that will appeal to him.
Why is the easiest question of all to answer: “Because I care.”
Nurses are creative in ways we care for patients. We don’t simply “push a button.” Neither do we stop developing our curiosity. This is the art of nursing.
By the way, IV iron solutions are man-made.
Developing creativity requires personal time. You’ve heard it before: Learn to say no.
I was a new-ish nurse working night shifts on a busy hospital unit. Our census exploded,
The Bride by jparadisi
What are you married to?
and every evening the nurse manager called all off-duty staff begging until someone accepted the overtime shift. It is difficult to refuse extra shifts when it’s your manager asking. This went on for what seemed an inordinate amount of time. Answering machines were new back then, and I resisted owning one.
One afternoon, my daughter raced to the ringing phone, picking up the call before I could. I overheard my manager asking, “Hello, is your mommy there?” As I reached for the receiver, my daughter blurted out, “You’re not going to make my mommy go to work again, are you?” Embarrassed, I grabbed the phone. On the other end, the manager apologized: “I’m sorry, I guess I’ve been calling too often. Enjoy the evening with your daughter.”
The next day, I bought an answering machine, and learned to screen calls.
Not long afterwards, something unexpected happened: The manager took her overtime-paid hours to administration, along with the record of increased census. They discovered they’d save money by hiring another FTE. The overtime calls became occasional.
Moral of the story: it’s not my personal responsibility to fix my unit’s staffing problem. I’m not advocating nurses refuse shifts during staffing crunches. In nursing, being a team player is essential. However, I found that if I work more than two overtime shifts a pay period, I get a diminishing return on the extra income because of taxes where I live. Therefore, my flexible boundary is to limit overtime to two shifts a pay period. I learned to say, “No,” to more than that.
Recognizing which problems are yours to solve, and which are the responsibility of others is the key to learning to say “no,” to coworkers, patients, children, spouses, boyfriends, girlfriends, parents, soccer moms, whomever.
Write this down and tape it to your bathroom mirror:
“I am responsible for my own stuff, and that is enough.”
The caveat to this affirmation is:
“If you step in it, you’re going to have to clean your shoes.”
Remember:
▪ Avoid drama.
▪ Evaluate commitments carefully.
▪ Protect your personal time.
Our ability to say no is strongly connected to the important relationships in our lives. Nurses in particular are conditioned to believe that saying “No” in order to make time for ourselves is selfish. Add the nurturing nature of a nurse to this training, and saying “No” becomes nearly impossible.
You cannot grow creatively without time to yourself. Recognizing what stuff is yours, and what belongs to others is the first step towards self-care and personal growth.
Do you think nurses have more difficulty saying “No” than other professionals? Do you think this problem is gender related? What experiences have helped you learn to say no?
Voiceless mixed media on vellum by jparadisi
Productivity and creativity are not the same thing. Neither are they mutually exclusive, but they are not the same thing. I didn’t always know this.
Like most nurses, I have always been productive. Whether making things with my hands, painting the dining room, running 10Ks, growing my own vegetables, or hand-making pasta, I often sat down for dinner around 9:00 p.m. It wasn’t until a breast cancer diagnosis flattened me on a couch that I realized the artist inside of me was starving.
In retrospect, there were early symptoms before the differential diagnosis that a creative resuscitation was necessary. Do you have any of these symptoms?
Nurses recognize when productivity is mistaken for quality in health care. We sometimes fail to make a similar assessment about ourselves.
Do you suffer from any of these symptoms? Can you add to the list?
Nursing is a profession of permission.
I had this epiphany when a patient asked me, “Can I have a couple Tylenol for my
Twenty-One by jparadisi 2007
Inspired by the paintings of the Chauvet Cave.
headache?” The automated medication dispensing cabinet with a drawer full of Tylenol was in plain sight, but I could not give the pills, because I did not have a doctor’s order. I called her doctor and received the order (permission) to administer it.
Anyone can walk into any drugstore in America, purchase a bottle of the stuff, and eat it at will, but in my nursing role, I cannot administer medication without an order (permission). However, there is a reason for obtaining an order first. If this patient has liver disease or allergies, and I am unaware, calling her doctor for something as simple as Tylenol may prevent a medication error; the safety net of redundancy.
On a bad day, this lack of autonomy is tiresome.
Another example is staff meetings. Someone once told me, “For God so loved the world that He did not send a committee.” I did not fully appreciate the meaning of this statement before working in healthcare. Gathering consensus among nurses is like watching a freighter turned slowly by tugboats in a narrow harbor. It seems to take forever. In my opinion, I have the answer to the problem the nurses are discussing. It’s simple and cost effective, but no, everyone needs to give his or her input and sign off on it first. By the time the change occurs, I’ve mentally moved on.
Even using the bathroom during a shift requires asking another nurse to watch your patients while you’re off the floor. Nurses ask permission to use the restroom.
Nursing is a team activity. It’s the nature of our work. As individuals, we bring our unique experiences and voices to this work. Finding a place for self-expression is vital to our humanity — the wellspring of compassion.
Where do we find creativity in a job requiring permission to use the bathroom or eat lunch — after a 12-hour shift of caring for the sick on sore feet? For many of us, home life is just as demanding — shuttling children to soccer practice and music lessons, grocery shopping, making meals, paying bills, and finishing housework. Make time for a little exercise, and you fall asleep exhausted as soon as your head hits the pillow. The next day it starts over.
“Creativity?” I hear you say. “Yeah, right after I figure out how to sustain life on Mars.”
Consider this: Self-expression is so essential that 30,000 years ago, prehistoric humans drew pictures on cave walls to tell their stories. Their daily activities revolved around survival. Food was hunted and gathered. Marauding tribes threatened to take away what small comforts they possessed. Still, they made art.
So, forget Mars and ask yourself: Where can I find self-expression in nursing?
Three Horses by jparadisi
As much as I love making images of my heart’s desire as an artist, there’s something to be said for developing the ability to create an image on demand. It’s a little like working with a limited palette: it forces me to look at the available options, then push myself to create something I might not have imagined without the limitations/expectations. It reminds me of when I was in kindergarten and the other kids would line up at my easel with their sheets of paper and ask me to draw horses for them. It didn’t make me feel less of an artist, it told me I am an artist.
This week I ask Can Looking at Art Make You Well? in my post of the same title
Girl With Pearl Earring, after Vermeer. watercolor by jparadisi 2012
for TheONC.
I asked the question after re-reading a 1995 essay written by Lawrence Weschler for The New Yorker titled Vermeer in Bosnia. In his essay, Weschler interviews Antonio Casse, then the president of the Yugoslav War Crimes Tribunal, during the trial of Dusko Tadic for crimes against humanity.
Weschler asks Judge Casse how he maintained his sanity while listening day after day to grizzly accounts of torture, rape, and murder. Casse’s answer:
“Ah, you see, as often as possible I make my way over to the Mauritshuis museum, in the center of town [in the Hague], so as to spend a little time with the Vermeers.“
As do most nurses, I spend my workdays witnessing life and death among patients. At home, the evening news is full of world conflict and disaster. Can merely looking at art calm us and increase our resiliency from burnout, as Judge Casse asserted?
The Oncology Nurse Community (TheONC.org) is a new online social forum for oncology nurses and cancer care teams where they can leverage their collective knowledge, nurture professional growth and emotionally support each other in a secure environment, as registration is required.
Moderated by oncology nurses and key opinion leaders, TheONC features discussions and commentary covering key issues ranging from symptom management and palliative care to managing ethnic and cultural diversity.
Other resources in the community include:
▪ A Library of resources including patient education materials and presentations by community members
▪ Clinic Close-Up, where members can view video-based interviews with experts from large group practices, private practices, and academia covering a variety of topics
▪ News items relevant to clinical practice
▪ An interactive Quiz feature where nurses can test their diagnostic knowledge on a regular basis
▪ A Calendar of national and regional events and meetings specific for oncology nurses and cancer support team members
If you are a member of an oncology nurse or member of a cancer support team, Like TheONC on Facebook, and follow us on Twitter @The_ONC.
Listen carefully to first criticisms of your work. Note carefully just what it is about your work that the critics don’t like-then cultivate it. That’s the part of your work that’s individual and worth keeping.
-Jean Cocteau
Note: A reader emailed a request I write about bringing beauty and creativity to nursing practice. Here goes…
Nurse as Sisyphus by jparadisi 2012
Finding beauty and creativity in our daily lives is vital for happiness. Art is a path along which the breadcrumbs leading us to both are found. This statement seems pretentious in a society cutting the study of art (music, dance, literature, painting, and drawing) from its educational system, regarding it no more necessary than so much fat sucked away through liposuction. Access to art is also eroding: on a recent trip, my husband and I paid $15 each for admittance to an art museum. Without funding, art, like health care, may soon be accessible to a decreasing number of people.
Art is essential in bringing beauty and creativity to nursing practice because it provides the humanitarian tools needed to find self-worth in a job that is complex, and often overwhelming, with waves of life and death crashing over our heads. It’s easier to empty a bedpan if you consider Prometheus and his love of humanity while you clean. For other nursing tasks, the punishment of futility dealt to Sisyphus perhaps comes to mind more often. The longevity of Shakespeare’s plays speaks to their grasp of human psychology and motivation.
Art and literature provide archetypes we can apply to our modern lives. Excluding the arts from a life science curriculum leaves us searching for meaning without a compass. The ability to apply meaningful ideas from art and literature to our daily lives promotes sustainable happiness.
Connecting patient care to images from art and literature fuels my writing and painting. It protects me from burnout. I credit it with the fact I still love being a nurse twenty-five years after becoming one. In the words of James M. Barrie,
“It is not in doing what you like, but in liking what you do that is the secret of happiness.”
