Adult Learning: Identifying Clouds, Nursing and The Freedom to Be Wrong

Clouds-Nature Journal Page ink and watercolor 2020 by Julianna Paradisi

I mentioned in previous posts I’ve taken up nature journaling as a new hobby. I enjoy it for many reasons: It promotes spending time in nature, increases meditative observation, and improves my drawing skills.

An unexpected benefit of nature journaling is that close observation of nature has revealed gaps in my knowledge of natural science. For instance, as a child I learned there were different types of clouds. I remember and can identify by sight cumulus, stratus, and lenticular, but after that, they just become pretty things to look at.

In Oregon, we have LOTS of clouds. I decided I want the ability to identify them. There are 10 major types of clouds, not including subtypes. They are identified not only by shape and color; altitude is also a factor. Altitude is difficult to judge unless there’s a mountain or tall building of known height to use as a reference point.

Despite their ubiquity, the more I research, I discover identifying clouds by type is not as easy as I’d expected.

I became discouraged about achieving my goal, until I remembered my science classes, prerequisites for nursing school. Microbiology required I learn to identify and draw various bacteria viewed on slides under a microscope. And what nurse can forget learning to identify the psoas muscle by sight in anatomy? It’s not easy to differentiate the fine borders and connections distinguishing individual muscles from what initially looks like a solid slab of tissue! At the time, both tasks appeared overwhelming, but I learned to see, receiving A’s in these classes. This memory persuades me I have the capacity to learn the different types of clouds, too.

Which brings me to another benefit of nature journaling: learning that I am not too old to learn new things, including about myself.

Perhaps, as we age, it’s not the ability to learn that is lost, so much as it’s the  fear of being wrong that is developed.

Generally speaking, nurses need to be competent, and competency is sometimes confused with being right. A nurse can be highly competent, but still make a mistake. In our worst fears, the mistake involves the safety of a patient. What saves us then is the level of accountability we bring to our practice. Nurses remain number one in the Gallup poll list of most trusted professions, not because we never make mistakes, but because of the overall accountability, characteristic of our profession. Society trusts nurses.

It appears counterintuitive, to be trusted because of how we handle our mistakes. I’m reminded of the saying,

Integrity is doing the right then even when no one is watching.*

 

I mull over these thoughts while drawing outdoors between rain showers, making ink and watercolor sketches of clouds in the rapidly changing Portland sky. Typical of Oregon weather, to the south is blue sky as the sun breaks through. Looking north, more rainclouds gather, ominously. Shortly thereafter, the heavens open, releasing heavy showers of rain. I gather my supplies, and go inside, where I ponder the names of the clouds I’ve just sketched.

And then I realize, they’re clouds, beautiful in their own right, with or without names. I am grateful for the brief moment outside, the morning’s sun break, the beauty of the day. I’ll look up the cloud names later. For now, I’ll make a cup of tea, and enjoy having the opportunity to learn something new without having to worry about being wrong.

* Various attributions, often to C.S. Lewis, but possibly a paraphrase of a Charles Marshall quote in Shattering the Glass Slipper

New Post By JparadisiRN on Off The Charts Addresses Under Staffing

I’ve written and illustrated a new post for Off The Charts, the blog of the American Journal of Nursing, addressing the chronic issue of understaffing, and effect on the safety of nurses and patients. Below is the link to the post.

Understaffing: A Policy Oblivious to the Unforeseen Swerves of Life and Nursing Shifts

Julianna Paradisi (JParadisiRN) Painting Included in With Bated Breath Group Show at Gallery 114

Happy New Year!

Waiting For Clarity: Sunbreak Over The Broadway Bridge, mixed media 12″ x 16″ by Julianna Paradisi 2019

The above painting, Waiting For Clarity: Sunbreak Over The Broadway Bridge, is included in the juried invitational group show With Bated Breath, at Gallery 114, opening First Thursday, tomorrow evening, January 2, 2020 6 pm – 9 pm. The show features work by artists from Oregon, California, Washington, Wyoming, Ohio, Arizona, New Mexico, Arkansas, Texas and Montana.

I’m pleased to invite my Portland readers to attend the opening and artist reception at Gallery 114 

Show runs through February 1, 2020.

JParadisiRN’s 11 Favorite Things of 2019 List

 

A page from my nature journal By Julianna Paradisi 2019

As a final commemoration of the 10th year anniversary of blogging at JParadisiRN, I decided to create my first-ever 11 Favorite Things of The Year list, you know, like Oprah’s.

This list is a compilation of movies, books, music, and experiences that challenged me to reflect on my life, perspective, and personal growth. I have not received compensation to include any item.

For clarification, many of these items were not new or created in 2019.  It’s simply a list of the things that surfaced to my consciousness as I reflected on my year.

Favorite Movie: Blindspotting second runner up: Yesterday

Favorite Big-Ticket Event: Michelle Obama: Becoming at the Rose Quarter

Local Music Event in a Small Venue: May Arden and Last Man at Bloodworks

Local Music Bigger Venue: The Dandy Warhols at The Crystal Ballroom

Favorite Art Exhibition: Hank Willis Thomas: All Things Being Equal at the Portland Art Museum- runs until January 12, 2020. If you’ve waited to see it, DO IT!

Favorite Book: Braiding Sweetgrass by Robin Wall Kimmer, second runner up: It’s a tie between The Once and Future King, by T. H. White, and Hild by Nicola Griffith,

Favorite New Experience: Glass-blowing a pumpkin in Astoria, Oregon

Favorite Renewed Pleasure: Writing and receiving letters on paper with ink second runner up: cooking

Favorite Outward Transformation: Becoming a blonde. I’ve returned to the first hair color I chose when my hair grew back after chemotherapy. I love it, and it compliments the helix and conch cartilage piercings I got in 2018.

Favorite New Hobby: Nature journaling

Favorite Fashion Purchase: High-waisted mom jeans are back, and mine are leopard print corduroy!

Wishing all a Happy, healthy and prosperous New Year! May your 2020 vision be full of insight, and scarce on hindsight.

 

Of Med Errors and Brain Farts

 

Glasses ink 2019 by Julianna Paradisi

Giving an Unfamiliar Medication

I read the physician’s order carefully, looked up the medication in the nurses’ drug book, and consulted with a pharmacist before I gave it. Afterward, while signing the medication administration record (MAR), I read the order again, and I did not see the same dose I had read the first time.

Accountability for My Actions

Immediately the blood in my feet rushed up to my ears and I was lost in pounding waves of white noise. Fuck, fuck, fuck, I made a med error, and it’s a serious one! Of course, I didn’t say these words out loud. Instead, I carried the patient’s chart and the empty, pre-filled syringe to the nurses’ station. Putting them in front of the charge nurse I said, I think I just made a med error, a bad one. Look at the order and the syringe label. Tell me what I’ve done.

Relief: The Patient was Safe

She stopped what she was doing. She read the order and examined the syringe. You gave the right dose. You didn’t make a med error. Now breathe. The pounding breakers of white noise in my ears subsided into the gentle lapping of my breathing. Another nurse came to my side saying, I know exactly what you’re feeling.

I felt relief. My patient was safe. It was an unfamiliar medication. That’s why I read the order carefully, looked it up, and consulted with the pharmacist. The only explaination I have for my confusion after giving the dose is that I had a brain fart. Somehow my eyes and my brain disconnected after giving the medication, and the order unexplainably failed to make sense. That’s the best I can come up with: a brain fart.

Everyone Makes Mistakes

Later, my coworkers told me their stories of making med errors. We all make them. I didn’t know that when I was a new grad.

It is unbelievable to me as I type this, but it is true: in nursing school  I had an instructor who told our class that she had never in her thirty year career, ever made a medication error. Never. And I was young, and shiny, and idealistic enough to believe her. Seriously, I did. So when I made a medication error during the first couple months of my new-grad job, I was sure that I was not cut out for nursing. At that time, my coworkers didn’t gather around offering support like they did recently. No, I was written up, and had to call the pediatrician and tell him I had forgotten to hang a dose of ampicillin. He was more sympathetic than the day shift charge nurse back then. I made other medication errors too, nothing serious, but enough to consider quitting nursing during my first six months of practice.

Nurses Supporting Nurses

Then I met one of the best nurses I have had the pleasure to work with. For some reason, she decided to mentor me. I confided to her that I considered quitting nursing, because I made med errors, and that my instructor never had.  She laughed. If that instructor of yours never made a med error, then I’m thinking she’s too dumb to catch them. You are so crazy. Let me tell you about med errors… She was a great nurse, not a perfect one.

Eventually I gained the confidence needed to stay in nursing these past thirty-three years. I still make mistakes from time to time. I take responsibility for them. I learn from them. I am compassionate towards my coworkers when it happens to them. Nursing is not a risk-free profession.

And sometimes I have brain farts.

This post was originally published on January 30,  2011. I feel reposting it may be beneficial for nurses new to my blog. It has been updated. 

New Post for AJN’s Off the Charts Contemplates Nurses Missing Time with Our Families Because of Work

My latest post and illustration for Off the Charts, the blog of the American Journal of Nursing is posted. Heralding in the holiday season, it’s a contemplation of missing celebrations and family events when the needs of our patients require it.

Lovingkindness: My Experience Growing Grandiflora Magnolias From Seed

Magnolia Grandiflora watercolor and ink by Julianna Paradisi 2019

Two years ago, I became enamored of magnolia trees. It began with my observations of a particular tulip magnolia tree I passed by while walking to work and home from work, almost daily.

Portland’s neighborhoods are rich in many varieties of magnolias, and soon I found myself fascinated by the multi-lobed pods of other varieties such as Little Gem, and of course, Magnolia grandiflora, also known as the southern magnolia, or bull bay.

I collected a few fallen pods from sidewalks, and decided to try growing seedlings. I’ve grown houseplants and gardens most of my life, and supposed growing magnolia grandiflora from seeds would be as simple as planting them into potting soil, placing them on the windowsill, and providing lovingkindness. After a couple of months of trying to cajole growth from the pots, I was disappointed: Nothing sprouted. So I did some research. Magnolia grandiflora seeds require several steps of preparation before planting. There’s actually a 6 month process to starting magnolias from seed.

A year ago this autumn, I collected new pods with fresh seeds, and tried again. This time I was successful, but magnolias seeds are so fussy, it’s a wonder to me they are able to survive in the wild at all. They require a great deal of lovingkindness.

I planted nine seeds, and this spring eight of them sprouted, but not without complications. Three broke ground upside down, roots skyward. With the gentleness of a nurse who once cared for tiny, premature babies, I replanted them roots down. Only one survived the procedure.

Another pair could not break free of their seed casings even though I had removed the tough outer shells with sandpaper before planting as instructed. Their tender leaves withered within their tiny prisons.

Four hardy seedlings survive. I gave one to my mother-in-law, who is a master gardener and I suspect will have the ultimate success with her tiny charge. It sits on a table facing west, with a view of the Pacific Ocean; what or who wouldn’t thrive with expert lovingkindness in such a favorable location?

The other three seedlings face east on my windowsill in Portland with a partially obstructed view of the Willamette River. So far, they too are thriving.

Above is an ink and watercolor painting I made of the largest of the trio.

According to Wikipedia, magnolias produce their first seed pods at ten years of age, but the height of production occurs at 25 years.

Really, it’s a wonder magnolias have survived through the centuries at all.

Memorial to Nurses Who Served in the Spanish American War

Memorial Honoring Spanish American War Nurses in Portland, Oregon, photo by Jparadisirn 2019

I’ve been running through Portland’s Tom McCall Waterfront Park for years, but this morning I discovered something there I’d never noticed before. It was a war memorial to nurses serving the Spanish American War. The memorial was erected on September 14, 1938.

The small memorial is part of a larger monument to the USS Oregon, a battleship commissioned on March 19, 1898 to serve its country. According to this article in the Oregon Encyclopedia  the USS Oregon (and her crew) made a significant contribution towards the US winning the war. Her captain was a veteran of the Civil War.

At one time, the entire ship docked at Portland’s waterfront, but it was taken back by the US government during WWII and its hull was used for munitions storage in Guam. Eventually, most of the vessel was sold for scrap, and today only its mast remains in Tom McCall’s Waterfront Park.

The above article doesn’t mention the nurses’ memorial, and I’ve not been able to locate more information. Still, it was a pleasant surprise to find nurses serving in a war recognized over eighty years ago.

My Wild Oregon: The Wreckage of The Peter Iredale

The Wreckage of the Peter Iredale watercolor and ink by Julianna Paradisi 2019 (sketchbook)

David and I spent several days in Astoria, Oregon last week. The town is steeped in history, and not only as the final destination of Lewis’ and Clark’s historic cross continental trip, wintering at Fort Clatsop.  Astoria is notorious in Maritime history through the present for the difficulty encountered by freighters and fishing vessels crossing the bar, the point where the mighty Columbia River and the Pacific Ocean converge. In present day, crossing The Bar requires the expertise of pilot ships and their captains to navigate safely. And yet, occasionally there are mishaps

If you’re interested in the history of the Pacific Northwest, I am, and the history of Astoria in particular, I recommend reading Astoria: John Jacob Astor and Thomas Jefferson’s Lost Pacific Empire, a Story of Wealth, Ambition, and Survival, by Peter Stark.

David and I drove to the Clatsop Spit to see what remains of  the wreckage of the Peter Iredale, a cargo ship with an empty hull that went aground on October 25, 1906. It was sailing to Portland to load with wheat for export in the UK. Although the ship was a total loss, fortunately, the crew survived.

The weather was beautiful this particular day, and lots of people had the same idea as David and I. There were children joyously climbing the rusted steel and iron wreckage as though it were a jungle gym, laughing and playing while their parents supervised.

The Wreckage of the Peter Iredale watercolor and ink by Julianna Paradisi 2019 (sketchbook)

I found a spot in the sand and began to draw…

 

The Perfect 15th Wedding Anniversary Gift : Glassblowing Workshop in Astoria, Oregon

David and I celebrated our 15th wedding anniversary last week. The traditional gift is crystal, but the modern one is glass or a watch. So David came up with a truly unique idea. He took me to Astoria, on the Oregon Coast, and treated me to a workshop at a glassblowing studio where I made a glass pumpkin. It was my first experience learning the craft of glassblowing.

We made an appointment at Fernhill Glass Studio where we met Claude and Chris. Claude let me choose the glass colors, and explained the process of making a glass pumpkin from beginning to end. It was a lot of information, but Chris made sure I used the right tool the right way at the right time. It was a lot of fun. At one point, I even used a blow torch half as big as I am tall to heat the glass stem, giving it its mirrored finish. I’d never used a blow torch before. There’s no photo of me with it; I suspect David, who took these photos, ducked for cover and I don’t blame him.

Click on images to enlarge.

I love my new Fall decoration! I had a blast, and can’t wait for our next trip to Astoria and trying my hand at another project.