New Post: The Art of Nursing

May is all warm and fuzzy with Nurse’s Week. May renews love for what my mentor once dubbed “The noblest of professions.” May also marks the birthday of Florence Nightingale, the founder of modern nursing. I am a fan of Nightingale, her work, her integrity, and her devotion to nursing’s science.

 

The Art of Nursing by jparadisi

The Art of Nursing by jparadisi

So, please, don’t misunderstand when I say there is a quote by Nightingale from 1868 in which I find the tiniest flaw:

 Nursing is an art; and if it is to be made an art, requires as exclusive a devotion, as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or cold marble compared with having to do with the living body, the temple of God’s Spirit? Nursing is one of the fine arts; I had almost said, the finest of the fine arts.”

The troublesome part for me is describing “canvas or cold marble” as “dead.” As an artist, I tell you that there is no such thing as a dead canvas or sculptor’s stone. Yes, both are inanimate objects — no disagreement there. But anyone putting brush to canvas or chisel to stone knows that an interaction occurs between the artist and the medium. Writers know that a blank page stares back in judgmental and deafening silence. Art is a result of the interaction between the medium and the artist. As an art student, I once told an instructor, “I just want what I paint to look like what I see in my head.” Sympathetically, she replied, “That’s what all artists want. It never happens.”

Michelangelo said it best:

“Every block of stone has a statue inside it and it is the task of the sculptor to discover it.”

The personality of a canvas, stone, or blank page is manifested by its grain (tooth), flaws, and innate characteristics. Artists do not simply impose their will on canvas or stone. Art is the interaction between the artist and the medium.

So what does any of this have to do with nursing?

The art of nursing lies within a broader spectrum of skills than IV starts, and medication administration. It requires a nurse to discover the unique characteristics of each patient asking for help. Nurses chisel away at fear, pain, and grief to reveal a patient’s inner strengths and natural resiliency. We hold up a mirror, so our patients can see the beauty of the human spirit that we uncover.

Like canvas or stone, some patients are resistant to brush or chisel. Through devotion to our craft, we adapt our nursing skills to the realities of their character. Artists and nurses know a vision cannot be impressed upon a unreceptive surface, so we do what we can, knowing the result may fall short of our vision.

The nurse’s art, much like that of an artist or sculptor, utilizes the naturally occurring strengths and flaws in patients to create beauty from potential. The art exists within this interaction.

Happy Nurses Week!

The JParadisiRN Art Store: In Time for Nurses Day & Graduation

Nurse mugs now available at the JParadisiRN Art Store.

Nurse mugs now available at the JParadisiRN Art Store.

The JParadisiRN Art Store is NEW, offering three paintings of nurses, including a brand new painting of a man-nurse, “Don’t Call Me Murse.”  Two of my most requested paintings, “Sometimes My Surgical Mask Feels Like a Gag,” and “The White That Binds (Pinning Ceremony)” are also available. You can choose a mug from seven different styles, and customize them with the options offered.

I will offer new items soon. Be sure to take a look.

There’s also a permanent link to the JParadisiRNArtStore on this blog’s right-hand column.

Nurses Week: New Posts For TheONC

From Cradle to Grave: The Color White, Charcoal, ink, watercolor on paper by jparadisi

Whether you’re an aspiring artist, writer, or cancer patient, support groups can offer encouragement and resources to help you on the journey. This week at TheONC, I write about unexpected pitfalls of support groups, and how to spot a healthy one in my post Support Groups: In Sickness and In Health.

Last week, TheONC posted my blog, Controlling Our Own Image. Identity is a theme I work with often both in paint, and words. I have some strong thoughts that it’s time nurses create the image we want the media to portray. The post received a flurry of well thought out comments. If you’re not a writer or artist, it’s worth thinking about how you can improve the image of nursing in your own practice.

TheONC is an online community for oncology health care providers to share information and resources. Follow us on Twitter @The_ONC and Like us on Facebook.

Happy Nurses Week!

Nurses’ Week: Sometimes The Best Recognition is None at All

The Broken Elevator photo: jparadisi 2011

Saturday morning, David and I woke to a noisy buzzing alarm coming from the elevator in the hallway of our building. It was stuck on our floor with its doors half open. Because it’s the weekend, I’m not hopeful of it getting fixed promptly. Next, as if we are under attack from a conspiracy of machines, our normally silent dryer started making a loud thumping noise, like tumbling canvas shoes, but all that’s in the drum is a small load of delicates. David is on his computer, looking for a repairperson as I write this post. The coincidental mechanical malfunctions remind me that as long as things meet my expectations, I often take them for granted.

At a social event, I was surprised to see an ex-patient and his wife also in attendance. I remembered them vividly, because of the longer than expected amount of time spent admitting him to our unit. The husband had the misfortune of being discharged from the hospital on a Saturday evening. Commonly, hospitals have a minimum of discharge planners on weekends, and the discharge planner’s job is frustrated by the fact that most of the outpatient services he or she needs to coordinate are closed. Also, he did not have a primary care provider, meaning no physician or nurse practitioner was in charge of his outpatient follow-up. To fix this problem, he was given a physician referral, and a phone number to call on Monday.

He arrived in our ambulatory clinic on a Sunday morning for daily treatment in pain, after a difficult night at home.  His wife and son accompanied him. The son was concerned about the eschar on his father’s wound, and I agreed with his assessment. Eschar is a dark, leather-like tissue formed on the surface of a wound. In the worst- case scenarios, it creates a tight band around an extremity, cutting off the blood flow to the body part below it. It increases the patient’s pain by preventing oxygen-rich blood from reaching the affected area. Fortunately, the body part below the eschar of this patient was warm to touch, with strong pulses, and a brisk capillary refill, so he wasn’t in imminent danger. He didn’t have a fever, and his vitals signs were normal, so pain control and obtaining a surgical consult became our priorities. We needed a doctor to write orders.

Luckily, the resident who treated my patient in the hospital was still there. I paged him, and told him what was happening. He agreed to see the patient in the clinic. This was generous of him, because once a patient is discharged from the hospital, technically, he is no longer responsible for his care. He wrote a script for breakthrough pain medication, and made a phone call for a surgical consult to address the eschar. In this way, the patient avoided a trip to the ER, the only other option on a Sunday. On Monday morning, a surgeon removed the eschar. I was pleased with myself for mobilizing the necessary resources on a weekend. The rest of the patient’s course flowed uneventfully until discharge.

The Dryer: Things That Go Thump photo: jparadisi 2011

At the social event, I approached the former patient and his wife to say hello. Looking at me blankly, they reciprocated, then awkward silence. Realizing I’d made a mistake, I said, “I didn’t mean to bother you. We’ve met before. I just wanted to say hello.” “Really?” said the wife. “Where would that have been?” Uh, oh. I mumbled the name of the hospital, but not the unit. Even the name did not prompt a recollection. They continued to stare blankly.  I desired to end the interaction, unsure if I was circling the drain of a possible HIPPA violation. Complementing the wife on her earrings, I retreated to another part of the room.

Later, it occurred to me that their discharge ordeal wasn’t an ordeal to them, because by means of coöperation and teamwork, I fixed it. They expected a smooth discharge with seamless follow-up care, and they got it. They took it for granted, because they didn’t experience the frustration of falling through the cracks. They didn’t recognize me, because I hadn’t stood out. They did not experience poor care versus quality care. In their mind, I did my job, and that did not merit recognition. They are right.

I appreciate the effort hospital administrators make each year during Nurses Week to thank nurses. Recognition for a job well done is one way of saying, “Thank you.” However, a lack of recognition, because the person served is unaware of the effort made on their behalf, is a form of reward too. The best recognition of a job well done comes from within.

What You Focus on Expands

    Yesterday morning, I attended an awards breakfast at the hospital I work for, honoring 105 nurses with Certificates of Nursing Excellence. My colleagues were recognized for developing patient safety and education programs, precepting, and academic or certification achievements. I received recognition because the American Journal of Nursing published my painting Love You to Death on its October 2009 cover. I was scheduled to work during the breakfast, but two days earlier, our manager arranged patient scheduling so I could attend, without burdening my coworkers with extra work.

     The usual hospital administrators, with the addition of a Chief Nursing Officer, presented the awards. This executive nurse sits on our hospital’s Board. To my knowledge, she is the first nurse to sit on the Board. She makes significant contributions to nursing management.

     Home from work, I checked my email and found that senior art editor Sylvia Foley mentioned both of my blogs, JParadisi RN’s Blog and Die Krankenschwester in a post on the AJN blog Off the Charts.

     Recognition for hard work feels good.

     There are more than 105 excellent nurses working at our hospital. Many simply did not fill out the form required to receive recognition. They choose to work hard without it. We are all wired a little differently, in that respect.  I used to prefer staying under the radar too. But part of taking care of me is taking time to celebrate accomplishments, instead of keeping track of failures. What you focus on expands.

     Happy Nurses Day.