This Week: EHRs & The Nurse’s Voice, Collusion & A Nurse Asks for Help

A physician, standing in a busy hospital unit, was overheard telling a resident,

“If you want to be certain something gets done for your patient, find the busiest nurse in the unit, and ask her to do it.”

It’s true, nurses thrive on getting the job done.

Here at JParadisiRN blog, things are hopping. Besides transitioning to a new employment opportunity, I’ve been busy writing, and making art.

In case you missed it, Do EHRs Rob Nurses of Voice and Oversimplify Descriptions of Patient Care? is the title of my latest post for Off the Charts, the blog of the American Journal of Nursing. While I mostly love EHRs, the voice of bedside nursing is lost by reducing the nurse’s note to check boxes and smart phrases. However, not everyone agrees. What’s your opinion? BTW, the I made the collage illustrating the post; the text is from Florence Nightingale’s Nursing Notes.

Weekly, I write and illustrate a post for TheONC, The Oncology Nurse Community website. This week’s post, Which Came First, The Chicken or the Nurse? ponders the lack of privacy and personal space for nurses.

Chapter 13 of The Adventures of Nurse Niki is posted. In  Collusion, Niki’s creative solution for managing her patient’s under medicated post-surgical pain last week yields an unexpected result, in which she coaches a father how to ask his daughter’s surgeon to treat her pain. How do you handle similar situations?

I receive comments from nurses, some asking questions. A recent comment submitted to an older post, Of Medication Errors and Brain Farts is a single line,

I made a med error and lost my job how do you go on

If the comment touches you, please reach out with support and advice for this nurse in replies to this comment. Let’s help out a fellow nurse, yes?

Alopecia and the Pirate

Note:  In honor of International Talk Like a Pirate Day, I have republished this post. 

As I write this post, some scientists are searching for ways to prevent male baldness through genetic manipulation. Others are conducting similar research to cure cancer. Is hair really as significant a part of our identity as we are sold to believe?

My hair began falling out the 14th day after the first chemotherapy infusion. In preparation, I bought a wig, styled and colored the same as my real hair. Like a feral animal, it perched on its stand, awaiting an opportunity.

When I saw the first ungodly huge handful of fallen hair I was too stunned to cry. Instead, I mumbled, “F***,” repeatedly, like a demented chicken.

It didn’t fall out all at once. Each morning for a week, I’d step out of the shower holding gobs of hair in my hands to prevent clogging the drain. After blow-drying what was left on my head, I’d take a pair of manicure scissors, like a naughty three-year-old, and try to even it out and disguise the bald patches. When I no longer could, a coworker’s husband shaved my head while she collected the locks, tying them into small bundles with blue satin ribbons.

After a time, I stopped wearing the wig. I preferred to cover my baldness with a red bandana, pirate style. Image

It was summertime, and I was at downtown Portland’s Pioneer Square, when a young man wearing a pirate’s black hat, white blouse with buckskin laces, black britches, and boots approached me. He clutched an authentic-looking sword. This was years before Johnny Depp made pirates sexy. Despite fatigue and chemo brain, I understood:

“Oh, no, this guy sees my bandana. Pirate guy thinks he’s found pirate girl.”

There was no place to run.

He spoke to me. “Ahoy! Me beauty, how art thee this fine afternoon?”

“I art fine, thanks,” I replied. “Why are you dressed like a pirate? Is that sword real?”

“Aye.”

He belonged to a club, of sorts, of people in Portland who dress like pirates and act out sword fights. I puzzled over what he wanted until he reached into his blouse and pulled up a goddess pendant dangling from a leather thong around his neck. He brought the goddess to his lips, kissed it, and then pointed to the carved turquoise goddess I had worn on a silver chain since my diagnosis.

“My fair Muse hails from Hungary, where she symbolized the female spirit of war and led her people to victory. I see you wear the Goddess yourself.”

Doffing his hat, he bowed before swaggering back into the crowd.

He had approached because of the necklace, not the bandana. He hadn’t noticed that I was bald — or had he? Did I just have an encounter with an eccentric or a very kind man dressed as a pirate offering encouragement?

He left me smiling. There is more to each of us than what we look like.

This post was originally published by TheONC.

Vacation!

At The Pool photo by jparadisi 2013

At The Pool photo by jparadisi 2013

JParadisiRN is on vacation this week. I’ll write a new post soon from a refreshed perspective. Meanwhile, if you haven’t read my oncology blog for TheONC, or latest post for AJN Off The Charts, this is a good week to catch up.

Cheers!

What I Did This Summer: Wine Tasting and Flitting About the Internet

Here in the Pacific Northwest, Summer’s brilliant, white light has toned down to a golden hue, announcing that Fall is waiting in the wings.  I’m not ready for summer to end, so David and I are outdoors as much as possible.

On Saturday, we visited one of Oregon’s several wine regions, as our exploration of the state’s Pinot Noir continues. As far as wine tasting goes, I’m surprised to find I like playing the field. I’m not ready to commit to a case of any particular wine just now.

We tried a wonderful Blanc de Blanc, a white wine, paired with a Pasta Salad with Melon, Pancetta, and Ricotta Salata. We enjoyed it so much, I made it for Sunday’s dinner, although I left out the pancetta, instead seasoning with an artisan smoked salt to compliment the melon, and substituted shaved parmesan for the ricotta salata, forgoing a trip to the grocery store. I paired the salad with a chilled Chardonnay. See what I mean about not being ready to commitment to a case of a single wine?

Besides touring around Oregon, enjoying the last remnant of summer, JParadisi RN is also flitting around the Internet in places other than this blog:

Diet As Tolerated: This Week’s Post for TheONC

Diet As Tolerated watercolor by jparadisi 2012

In yesterday’s post A Social License III: Nursing Synchronicity I write about an impromptu discussion with a young woman in a department store while shopping for work pants. It’s  common phenomenon for strangers to reach out to nurses even when we are off duty. I pair this post like a fine wine with my post this week for TheONC.org,  titled, Diet As Tolerated, which describes another off duty encounter, this time at a cocktail party in a trendy restaurant.

Started in February 2012, with almost 7,000 Likes on Facebook, TheONC.org is an online social forum where oncology nurses and cancer care teams 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 (The Oncology Nursing Community) 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

TheONC is like having a weekly national oncology conference conveniently online. A wide range of topics have already been discussed, including Stem Cell Transplant, pediatric oncology, survivorship, nursing while going through cancer treatment, and much more. Once you’ve registered, posts can be saved for future reference.

Follow TheONC on Twitter @The-ONC, and Like us on Facebook.

Free Webinar on Thursday, July 12, 2012 “Melanoma: Beyond the Basics”

Just in time for the Summer, and with Melanoma on the Rise in the U.S.,  TheONC is hosting a very important webinar:  “Melanoma: Beyond the Basics,” on July 12, 2012 at 12:00 pm EDT. Here is the link to the webinar.

Key highlights of “Melanoma: Beyond the Basics” include:

•             Identifying common presentations of primary melanomas

•             Discussion about the importance of correct staging of primary melanomas

•             Learning about the current standards for treatment of early and later stage melanoma

•             Discussing the novel and investigation approaches currently being explored in advanced melanoma

•             A question and answer period following the presentation

When caught in its early stages, treatment of melanoma provides high rates of survival, but  left to metastasize, it becomes lethal. Recognition and assessment of patients for melanoma is useful for non-oncological care providers too. Click on the link above to register for this informative webinar.

You Can Find Me Here: New Posts for TheONC

Resurrection Chair by jparadisi

It’s been a busy lately, and when it’s not, I’m  out enjoying the sunshine. Nevertheless, I’m keeping up with new blog posts both here, and for The Oncology Nursing Community (TheONC).

In case you missed it, last week for TheONC, I wrote When a Partner Doesn’t Do in Sickness and In Health, about the painful reality of partners leaving cancer patients at diagnosis or during treatment.

This week, I discuss helping patients cope with cancer in Helping Patients Build a Cancer Toolbox.

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

TheONC is like having a weekly national oncology conference conveniently online. A wide range of topics have already been discussed, including Stem Cell Transplant, pediatric oncology, survivorship, nursing while going through cancer treatment, and much more. Once you’ve registered, posts can be saved for future reference.

Follow TheONC on Twitter @The-ONC, and Like us on Facebook.

New Post for TheONC: Can Looking at Art Make You Well?

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 BosniaIn 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.

Comparing Nursing to Journalism: This Week’s Post for TheONC

Nurse’s Note by jparadisi

In this week’s post for TheONC, I compare the effect of witnessing life and death in nursing to journalism. Both careers bear witness to the suffering of others. Compassion fatigue is documented in journalists similarly as in nurses.  I explain I’d rather be a nurse than a journalist, because nursing provides the skills and education I use as tools to give aid.  If I could only watch and record the suffering of others, I do not believe I could bear it.

As a young child, I loved connect-the-dots puzzles, discovering the larger picture revealed at completion. Follow the dots in Bearing Witness: Nursing Compared to Journalism, and see if it leads you to a fresh perspective about nursing.

What tips do you have for preventing compassion fatigue and burnout? How do you keep a fresh perspective on job expectations?

TheONC is an online community for oncology care teams. Like us on Facebook, and follow us on Twitter @The_ONC.

TheONC.org: Resources and More for Oncology Nurses

Untitled. by jparadisi 2012

By now, readers know I blog weekly for TheONC. This week I write about dual identities as nurse and artist/writer in Curbside Consultation. My colleagues, employer, and frequent patients know about my art and blogging activity. Sometimes worlds collide.

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

TheONC is like having a weekly national oncology conference conveniently online. A wide range of topics have already been discussed, including Stem Cell Transplant, pediatric oncology, survivorship, nursing while going through cancer treatment, and much more. Once you’ve registered, posts can be saved for future reference.

Follow TheONC on Twitter @The-ONC, and Like us on Facebook.