Ode to a Pair of Nursing Clogs

This year I took a summer vacation, one of the joys of which was time painting in the studio.

I’ve migrated to three different studios over the years, but a single constant in each was my old pair of nursing clogs, converted to painting shoes.

My Nursing-Converted-to-Painting Clogs

My Nursing-Converted-to-Painting Clogs

In their earlier life, they spent ten years traipsing across a PICU, and even flew in a helicopter a time or two while transporting sick children in Oregon to Portland.

When I transitioned from PICU to adult oncology, they retired. In their new-found leisure, they started a second career as my painting shoes, where we continued to do good work together.

Anyway, over the weekend I returned to the studio and painted, changing out of my street shoes into the old, faithful clogs. They felt funny. In fact, one foot was suddenly closer to the floor than the other. I looked down, and entire sections of the right foot clog’s rubber sole had disintegrated and fallen off in chunks. As I moved about, the left foot clog did the same. I stared at them in disbelief.  I had not foreseen their imminent demise.

The Disintegrated Soles of My Nursing/Painting Clogs

The Disintegrated Soles of My Nursing/Painting Clogs

I did not have a second pair of studio shoes to change into, so I continued wearing them while painting, standing and walking, balancing on what remained of the core of their sole. We made one last painting together. I tried remembering the last patient I’d nursed while wearing these clogs, but could not.

When I finished painting for the day, I washed my brushes, and swept up the trail of black, crumbled rubber left behind on the studio floor. Removing the old, familiar clogs, I put on my street shoes, and placed the paint spattered, destroyed clogs into the garbage.

Move on. They’re just an old pair of clogs.

Besides, there’s another pair, retired when I left the infusion clinic for the oncology nurse navigator job, waiting in my closet at home to take their place in the studio.

 

 

 

Found Time for Creativity and Mindfulness: Make The Most of Waiting

Around the beginning of the year, I wrote about setting a timer for 15 minutes each day and during that time write or make something. Although the product of that commitment hasn’t been evident on this blog, I am honoring it, by continuing to write and illustrate posts for Off the Chartspaint, and an unusual way to use found time.

Part of my job as an oncology nurse navigator is meeting or checking in with patients during their course of treatment. These face to face meetings often occur before, during, or after one of their oncology appointments.

Cancer treatment involves doctor appointments, and doctor appointments involve waiting. As a ONN, I wait my turn to see the patient, although not usually in the  patient waiting room. Sometimes I’m in a MOB lobby. Often I’m invited in the back office area. If it’s a lengthy wait I go back to my office cubicle, and try to connect with the patient later.

But when the wait is about 15 minutes, sometimes I use the time drawing. Actually, it’s more like advanced doodling. Nothing fancy: I use the simple, lined notepad I bring to appointments, and a cheap, ball-point pen used to write notes. I select a random object. Flower arrangements and office plants are common subjects, but capturing enough details to visually describe a piece of medical equipment is a fun favorite. Rarely is a sketch completed before I’m called back to work.

Drawing without pressure to create product is a delightful form of mindfulness I’m fortunate to merge into my work day on occasion. The illustrations above are examples from my notebook.

Modern Nurses: Audio/Video Girl

Digital Microscope ink on paper 2016 by Julianna Paradisi

Digital Microscope ink on paper 2016 by Julianna Paradisi

Preparing materials for tumor conferences is part of my role as an oncology nurse navigator. It involves, among other responsibilities, reviewing the cases, printing copies of the agenda for the attendees, managing the sign-in rosters, and providing updated lists of available clinical trials. It also requires powering on the projector, the screen, and setting up the digital microscope necessary for the pathologist and radiologist to project slides of the tumor cells, and the MRI or Cat can images on the large screen for discussion.

Suddenly, and unexpectedly, I’ve become Audio/Video Girl. Other nurses of my generation will appreciate the humor in this.

Does any one remember watching film strips and movies in grade school classrooms? Did your hand shoot up when the teacher asked for volunteers to set up and run the projector? Mine did, but it was always a boy who was chosen. Eventually, I stopped raising my hand.

Years later when I became a pediatric intensive care nurse, I discovered an aptitude for tubes and wires, or rather I learned to get one fast. The ability to troubleshoot a ventilator until a respiratory therapist could fix it became handy too. I realized the level of skill I’d developed when as a single mom I set up my stereo system (you who grew up with bluetooth streaming have no idea how easy you have it), and a desk top computer with printer/fax using a dial-up modem. In case you are to young to know, we could not use our computers and phones at the time in those days.

I digress.

Learning to set up the electronic equipment for tumor conference was a lot like how I learned almost everything as a nurse: someone showed me how to do it once, and then I was on my own. However, as mentioned, I have developed an aptitude for technology: during the demonstration I snapped pictures of the wire connections with my phone, creating a visual reference guide to use later.

I was anxious the first time I set up by myself. While lifting the digital microscope which I imagine costs a hefty portion of my annual salary from its cart to the conference table, I distracted myself from my fear of dropping it by imagining twenty doctors staring at me because it didn’t work. Tumor conference would be a disaster if I failed..

The microscope and projector worked. Relieved, I glanced at the doctors, men and women, seated around the table. Some of the male faces resembled grown up versions of the boys in grade school my teachers chose to run the projectors. Some of them probably drive cars electronically more complex than the audio video equipment I had just set up.

To be clear, I am treated respectfully as part of the multidisciplinary team at tumor conference. I’m proud to be part of this valuable service offered to our patients. I am happy with my life choices. However, I wonder what might be different if girls were chosen equally with boys to run the projectors when I was young?

 

 

 

 

Breast Cancer Issues: Physical Activity During Treatment

The following post is the second of a series resulting from preparations for a forthcoming breast cancer conference panel discussion on survivorship.

by jparadisi 2012

by jparadisi 2012

When I was diagnosed with breast cancer I was a pediatric intensive care nurse working twelve-hour shifts, a long-distance runner, practiced weight-training, and a gardener. After the diagnosis, these activities came to an abrupt halt. Surgical procedures meant no running for weeks at a time. Weight training was limited by restrictions. Chemotherapy meant avoiding infectious patients, let alone managing critically ill children with my chemo-brain. Gardening was okay, but only so long as I didn’t get cuts or wounds that could become infected due to a lowered WBC.

Surrendering an active lifestyle in exchange for the other side of the bed was not an easy adjustment, and I held out for as long as possible. During treatment I didn’t have the energy to participate in these activities to the same levels as before. I continued running after my first chemotherapy infusion until one day I completed 1 1/2 miles and then completely bonked. I had to walk back home that 1 1/2 miles with bone deep fatigue. Grudgingly, I gave up running while on chemo.

For some, physical activity is a go-to method of stress relief. For many cancer patients, when this tool is needed most, it is unavailable.  It requires developing new tools for managing stress.

It’s important for nurses and health care providers who are not physically active to understand that a lack of physical activity actually creates stress for patients who are. It’s one reason your adolescent and young adult patients often become sullen. Physical activity is part of their mind-body connection.

The median age of breast cancer diagnosis is 61, so It follows that many hospital-based exercise classes for breast cancer survivors are structured with the intent of increasing physical activity and function for older, sedentary survivors. While beneficial, these classes may not meet the needs of the physically active, regardless of their age. Breast cancer patients who beg to continue swimming, running, bicycling, and even skiing are not uncommon. Here’s some exercise tips for physically active breast cancer patients:

  • Review your level of physical activity with your medical oncologist and surgeon before resuming or starting an exercise program. Surgery remains the cornerstone treatment for breast cancer, and physical restrictions apply post-operatively to promote healing. Mastectomy, reconstruction, and lumpectomies require different periods of recuperation. Some chemotherapy regimens used to fight specific types of breast cancer have potential to affect the heart. Those with metastatic disease may have other restrictions. Forgoing your activity of choice is difficult, but it’s important to remember that taking the time to heal is an investment in overall wellness.
  • Consider alternative forms of exercise. Walking is commonly prescribed during treatment. Meditation labyrinths are a great way to get some exercise and practice mindfulness at the same time. Some hospitals, spiritual centers, and churches have them. Ask about stair climbing-I used a Stair Master (once cleared by my surgeon), and did not have the energy to run outdoors. Running machines are another option: If you get tired, you can stop without having to get back home.
  •  If you are medically cleared to use a gym make sure to bring antibacterial wipes to wipe down the machines before use, if they’re not provided: If you are receiving chemotherapy, you are more prone to infections from opportunistic germs. If you take a yoga class, (another commonly recommended activity for breast cancer patients) bring your own mat, and wear plastic flip-flops to avoid fungal infections from the studio floors.
  • Remember, physical fitness is not what you do in the short-term, it’s an accumulation of activity throughout a lifetime. Going through breast cancer treatment tests your body; it’s working hard. Support its healing through good nutrition and adequate rest.

Issues in Breast Cancer: Meditation for The Action-Oriented

The following post is the first of a series resulting from preparations for a forthcoming breast cancer conference panel discussion on survivorship.

Mediation is a popular “prescription” handed out to patients for stress management, especially in the oncology setting. As an oncology nurse navigator, I encourage cancer patients to try meditation. I’m also a breast cancer survivor, and realize that for those of us who thrive on productivity, practicing meditation is comparable to a form of torture. Before the diagnosis, I enhanced my feelings of productivity by checking off tasks from lengthy to-do lists I made every night for the following day. “Take 15 minutes to sit quietly and find out how you’re feeling” was never on one of those checklists. However, as a cancer patient I discovered busy-ness sometimes functions as protective mechanism that prevents connection to our feelings.

Shaving My Head oil on canvas by Julianna Paradisi

Shaving My Head oil on canvas by Julianna Paradisi

Chemotherapy induced fatigue allowed me to sit still and learn to quiet my mind. Meditation formed a mind-body connection promoting the healing process.

Here are some tips for the action-oriented to incorporate mediation into their cancer healing experience:

Start a journal. An over-abundance of random thoughts is a barrier to a quiet mind. Don’t fight it! Writing is a meditative way to process thoughts and identify feelings. Avoid buying fancy blank books that make you feel the need to write something profound. Buy a cheap 81/2” x 11’ lined composition book, the kind used in high school instead. Daily, set a timer for 15 minutes and write whatever comes into your mind, even if it’s  “I don’t know what to write” over and over. Recording random thoughts on paper helps declutter your mind. Other methods are filling the book with inspirational quotes, or start a gratitude journal by listing everything you are thankful for each day. With consistent practice your thoughts will sort themselves out into recurring themes, illuminating your deepest feelings.

Create a vision board. Divide a large piece of poster board into three sections. In the first paste images from magazines or newspapers representing past memories and things you enjoyed. In the middle section, choose images representing your life now. For the last section, choose images representing your hopes for the future: Include pictures of clothing, hairstyles, home furnishings, activities, places to travel, and the type of people/relationships you want to fill your life. I find most people are readily able to list things they dislike, but have trouble detailing what they really want. You can’t steer towards a goal without a clear image of it. This exercise can be done using Pinterest if you are digitally inclined rather than analog.

Walk a mediation labyrinth if one is available in your community. Some hospitals, spiritual centers, and churches have them. It’s a great way to get outdoors and practice mindfulness at the same time.

Consider counseling. A therapeutic, “paid for best friend” who knows how to ask the questions leading you to discover the answers to your life’s questions can be well worth the investment of time and money. Treatment for breast cancer is as emotional and spiritual as it is physical. Addressing your emotional and spiritual needs aids the healing process.

New Nurse Niki Episode! Bruises Not Scratches

The Adventures of Nurse Niki

The Adventures of Nurse Niki

Bruises Not Scratches is this week’s new episode of The Adventures of Nurse Niki. Niki finishes the story of her “easy” day of floating on pediatrics, and ends up giving shift report to an old friend.  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 @NurseNikiAdven and “Like” The Adventures of Nurse Niki on Facebook!

You Can’t Make This Stuff Up: New Episode of The Adventures of Nurse Niki

The Adventures of Nurse Niki

The Adventures of Nurse Niki

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

Don’t forget to follow Nurse Niki on Twitter @NurseNikiAdven and “Like” The Adventures of Nurse Niki on Facebook!

The Stars of Our Lives

Mixed Media on Paper 2016 by Julianna Paradisi

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.

 

New Episode: It’s Not All Cute Print Scrubs and Bunny Blankets

 

The Adventures of Nurse Niki

The Adventures of Nurse Niki

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

@NurseNikiAdven and “Like” The Adventures of Nurse Niki on Facebook!

The Adventures of Nurse Niki Are Back!

The Adventures of Nurse Niki

The Adventures of Nurse Niki

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!

Don’t forget to Like the Adventures of Nurse Niki Facebook page, and follow her @NurseNikiAdven on Twitter.