Back From The Digital Future: My Return to Paper and Ink Books

Tiny Lending Library ink on paper by Julianna Paradisi 2018

My adult life I’ve had an unreasonable fear of being without a book to read. The anxiety is triggered when I travel, particularly by air. I trace its beginning to childhood when, on a family vacation to visit my grandparents in Italy, our plane was delayed in Germany for hours due to bad weather. Eventually, all passengers were shuttled by bus from Frankfurt to an airport in Stuttgart, continuing our flight to Rome.

I was in the fifth grade, stranded in a foreign airport with nothing to occupy me for twelve hours. My personal Hell was exceeded only by my parents’: they had to manage my boredom along with my six year-old brother’s, and toddler sister’s, also stranded. Fun times.

From then on, I travel with whatever book I’m reading, and if nearing its end, at least one other book, or more, depending on the planned length of stay. I know books are sold at airports, but I’m unwilling to take a chance on their selection. Problematically, my books take up space, and add weight to my luggage, interfering with my desire to travel light.

The invention of digital readers changed this. I live near one of the best independently owned book stores in America, and I apologize to all small, independent book store owners, but the ability to download books to a slim, lightweight device, and buy more books from virtually anywhere I travel was a game-changer, until last year.

Last year, the hospital  where I work installed a Tiny Lending Library in its Healing Garden.

In case you’re unfamiliar with Tiny Lending Libraries, they’re a thing, with their own organization, and website. The movement began when people built cases, or sometimes simply placed boxes filled with books in their neighborhoods, inviting their neighbors to “take a book, and leave one behind.”

Besides the satisfaction derived from the printed page of a book, the experience of handling a used book left by someone wanting to share it provides a connection to the neighborhood, and the people who live there.

At work, I stop to see what’s on the shelves in the Tiny Lending Library if it’s not already being examined by staff or neighbors. The selection changes often. So far, I’ve borrowed six books, and left twice as many.

Once again, there’s a stack of unread books on my nightstand. I carry the one I’m reading with me to work, in case I have time on my lunch break to read a page or two. Eventually, it will take its place in the Tiny Lending Library.

I wonder how many of the books from the Tiny Lending Library make their way into hospital rooms, carried there by family or friends visiting a patient who is stranded by illness or injury, and worried about not having enough books to read?

 

 

 

Applying Nursing Process and Knowing When to Quit

The Queen of Cups II
Collage 6.5″ x 4.75″ by Julianna Paradisi 2017

It was several more days later   before I ripped out the knitted sleeve I wrote of in my last post. I blame part of my reluctance on nursing process: Nurses are trained (to the point of reflex) when confronted with a problem or undesirable outcome to devise further interventions to create the desired outcome. Likewise, I attempted to apply nursing process to the problem of the knitting mistake.

I measured the sleeves of my favorite sweaters, discovering I habitually wear sleeves an inch or so longer than the pattern I’m using prescribes. Then I did some math, and calculated I could still make all the required increase stitches, if I were willing to accept a longer sleeve, but it would be a very close call between longer and too long. As an artist, and nurse, I felt compelled to take the challenge. Artists like to work with process too.

The hard part about nursing process, however, is knowing when to call it quits: How far backwards is one willing to bend to make something work? This can also apply to dysfunctional relationships or work environments. Carrying out interventions beyond the limits of healthy boundaries quickly becomes denial and co-dependence.

In the end, I conceded the sleeve was too long. I ripped out every stitch, turning my head away so I didn’t have to look, the way a patient undergoing a procedure with only local anesthetic does while the doctor takes a scalpel to their skin.

The deed is done. There’s no more anxiety about the outcome. I did what I had to do.

Plateaus, New Goals, & My First Failure of 2018

2017 was a challenging year for me in many ways, some good, some not so much, but it ended positively.

In October, I had opportunity to show ten new paintings where I work, part of an exhibition titled Healers, Artists, and Breast Cancer Survivors. A local TV news station covered it. Around the same time, I was interviewed for a local magazine, also about being an artist, oncology nurse navigator, and breast cancer survivor. I admit, I felt very good about both, because 2017 was a difficult time for pursuing my goals as an artist.

Part of the hospital exhibit was an artist talk. I spoke about how my arts career was launched when I completed cancer treatment, and was told I had a 32% chance of dying in 10 years from disease recurrence. Blah, blah, blah, I decided if I were to die in 10 years there were three things I wanted to do:

  • Become an artist
  • Fall deeply in love with, and be deeply loved by the same person
  • Give people reasons to say nice things about me when I die.

As I spoke these words to the audience, I realized I have achieved the first two of the three, and it’s too soon to know the outcome of the third. I need new life goals.

I spent the past weekend reflecting on what these new life goals should be. I did some deep soul work, and came up with new intentions. They include questions I’m hoping to have the answers to this time next year. I’m not going to write them here. They’re personal.

I started 2018 with a bang. I spent time with some of my closest family, which  was a goal for 2018 (there’s a difference between yearly goals and life intentions). Afterwards, I went to my barre class, and the instructor talked about breaking plateaus. That resonated for me. I’ve reached a plateau in my life goals. 2018 will be the year to break through.

I came home from that class ready to write a post for this blog about how to know if you’re stuck in your life goals, and methods to get unstuck. I was on fire.

The too long knitted sleeve photo by Jparadisirn 2018

I forgot to mention, I began knitting a sweater last week. I’m a pretty good knitter, but the pattern I chose, though it builds on skills I’ve gained by making smaller projects, is the most complex pattern I’ve worked. It’s knit from the bottom up, beginning with the sleeves, which are joined to the body of the sweater before making the yoke. I’ve been working on the first sleeve for several days. It’s over a foot long.

That’s when I noticed it’s too long to accommodate the rest of the rows needed to make the remaining necessary stitch increases. I re-read the pattern. I had misunderstood the increase rows sequence. Now I have to rip out all of the knitting I’ve done, and start over. Arrgh!

I felt defeated, the wind let out of my sails. It’s the first day of 2018, and already I’ve made a mistake!

Then it came to me: That’s how plateaus are broken. You try something new, and you’re not good at it yet, so you make a mistake, maybe more than one. You have to start over, and keep trying until you get it right. That’s how you get unstuck. That’s how progress is made.

I haven’t ripped out the stitches yet. I decided to write this post first. I feel better because I did. I feel motivated to rip out all those hours of knitting, and start over.

2018 is going to be a transformative year.

 

A Nurse’s Sketch Book

 

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Nearly a year ago, I wrote a post about mindfulness and found time for creativity, in which I described how I used downtime spent in waiting rooms to draw, or more accurately, for advanced doodling.

The practice continues. This year, I purchased an inexpensive set of crayons, which I keep in a desk drawer. During my lunch break, I take a minute or two to add a splash of color to the ballpoint pen ink drawings. None took longer than 15 minutes to sketch, usually much less.

These rough sketches don’t take the place of painting in my studio, but, there’s a certain satisfaction that comes with adapting to challenges of managing time, learning to juggle purpose and passion. Nursing provides purpose rooted in service, and passion (or a reasonable facsimile of art) blossoms from its branches. Like spring flowers following a severe winter, it will not be denied.

 

money-bagIn my latest post (and illustration) for Off the Charts, the blog of the American Journal of Nursing, I share clinical observations about oncology care, before and after the ACA was signed into effect.

Art & Nursing: New Work

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Writing to The So What?

First of all, I apologize to my friends and family on Facebook for the uncharacteristic political updates.  Thank you to those  who continue to follow me, whether or not we share   viewpoints.

xxx

Detail/artist: JParadisi (2009)

Since I began publishing JParadisiRN blog, I strive to maintain a balanced voice. Drama is not my thing, not as a nurse, not as a blogger (with the exception of The Adventures of Nurse Niki). Before hitting the “publish” button, I use my So What? filter, as in “Why did I write this, and so what?” It is my practice to write to the So What?

At least part of this instinct as a writer is traceable to my former role as a pediatric intensive care nurse, where I learned to report my concerns about a patient in concise, direction-oriented sound bites, in the middle of the night, by phone, to a doctor I’d just woken. For instance, if I assessed fluid overload, and suspected the patient needed a dose of furosemide, I presented the numerical values of fluid intake, urine output, central venous pressure, blood pressure, heart rate, etc, sometimes finishing the report with, “Would you like to give an extra dose of Lasix?” Most often the answer was, “Yes,” and I received an order for the desired dose before the doctor went back to sleep.

So what, all nurses do this to some degree,” a reader might respond. They are right.

However, there’s another kind of nurse-call to a physician. It’s born of anxiety, a feeling that something isn’t right; that an otherwise stable-looking patient is on the verge of  downward spiral. Their vital signs are within accepted limits, the lab values unchanged. But, standing at the bedside, “eyeballing” the patient, a subtle change is noted: they’re just a little dusky, a touch mottled. Sometimes those are the only signs warning a perceptive nurse of her patient’s declining status. It’s intuitive: The heart monitor still beats a normal sinus etching across its screen. The numerical values of pulse, blood pressure, and respirations remain unchanged. You keep a watchful eye on your patient, perhaps pulling a bag of normal saline, and a bottle of albumin to keep at the bedside, just in case.

As I grew into my PICU role, I learned to trust this intuition, my nurse’s gut. It saved more than a few lives. I joined the ranks of my more experienced colleagues, nurses who, when they call a doctor and say, “You need to get in here now,” the doctor does just that. He or she can’t explain our intuition either, but once they know a nurse has it, they listen, regardless of what the numbers say.

“So what?”

Here’s what: My nursing intuition is going berzerk in the current political climate. I can’t shake this feeling of impending doom. I am not an anxious person by nature; it’s my training to maintain order and calm. But I can’t shake this feeling: Where there’s smoke, there’s fire.

So what?

Art and Nursing: Exhibiting Art Within a Power Point Presentation About Oncology Nurse Navigators

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The above paintings are original works by Julianna Paradisi, and may not be used or reproduced without permission.

This year, I’ve had a few opportunities to try on the art of public speaking, a newish skill for me. The topics revolved around breast cancer, and oncology nurse navigation.

Recently, I was asked to speak to a group of inpatient oncology nurses about the role of nurse navigators for breast cancer patients, and the application to the hospital setting. Integrating the patient experience throughout the continuum of cancer treatment is a prominent part of what nurse navigators do, and inpatient nurses wanting to learn more (and earned CE) about oncology nurse navigation is exciting.  It demonstrates ONNs have an impact on patient care.

For the occasion, I decided to learn a new skill: creating a Power Point presentation. I know, I know, some of you were making Power Point presentations since your first elementary school book report, but you probably can’t write in cursive as well as an older nurse, or use a real typewriter.

Here’s the stipulation: because I am also an artist, I have a thing against using clip art or stock images from the Internet to illustrate my words. If you are familiar with my blog posts for Off the Charts you already know this.

So, not only did I learn to create, and present a Power Point slide show, I used jpegs from a series of paintings I made of mountains, illustrating the presentation from the perspective of my personal practice. For many, the word navigator connotes images of the ocean or GPS, but as a breast cancer survivor turned ONN, I see myself as a sherpa, someone who has climbed the mountain, familiar with its terrain and potential for treachery. I lead patients  up the mountain, summit, and then come back down. The paintings of mountains also suggest the barriers to care ONNs are tasked with removing for patients. The theme was woven into the closing remarks of the presentation.

Most of the paintings depict Mount Hood, the dominating peak and iconic symbol of Portland, Oregon, my home.

I gave the presentation with a sense of creative satisfaction in finding another way to merge art into my nursing practice.

 

 

 

 

Flu Shot? Yes, Check That Box

This week I got a flu shot, free of charge from the hospital. I bared my deltoid muscle, allowing a nursing student to practice her immunization and injection skills. She did a pretty good job. It barely hurt. Those are penguins on the adhesive strip she covered the tiny bead of blood from the needle prick with, in the photo to the right.

Flu shot? Yes. Check that box

Flu shot? Yes. Check that box

I hardly thought twice about getting a flu shot this year, which hasn’t always been the case. In fact, in the past I opposed mandatory flu shots for nurses; arguing against someone else making rules about my body. While I was never threatened with job termination for refusing flu shots, some hospitals did make nurses refusing them uncomfortable with policies mandating they wear respiratory masks in patient care areas during flu season, or producing notes from their primary care provider explaining the nurse’s choice to avoid it; stuff like that.

What changed my mind about flu shots? I don’t know it has actually changed. What’s changed is my attitude: I don’t feel it’s worth the fuss anymore. It’s not a battle I choose to fight. I don’t know if this is a sign of maturity, or aging, but it’s lost its importance in the greater scheme of my life.

This year, and the last, I got a flu shot, and then I went back to work.

What about you? Are flu shots still a hot topic for nurses like they were in 2009, during the height of the H1N1 virus epidemic?

Art & Nursing in The Clinical Setting: An Interactive Experience

Recently I had a unique experience as an artist and nurse.  At the hospital, I was stopped by someone I vaguely thought was a former patient, or perhaps a family member or supportive friend of a former patient, I really don’t remember.

Lung Ta (Wind Horse) oil stick on vellum 2007 by Julianna Paradisi

Lung Ta (Wind Horse) oil stick on vellum 2007 by Julianna Paradisi

This person, however, not only recognized me, but knew I painted the art hanging in the infusion clinic where I once worked.

“You sold the horse print.The one over the reception desk.”

“Yes.”

“I really liked it. It was good. It was a print, right?”

“Thank you. Well, actually no. It was an original painting. I used oil sticks to make it.”

“What are oil sticks?”

“They’re similar to oil pastels, but big, like cigars. In fact, painting with them feels like how I imagine painting with a big, greasy cigar might feel. But they air dry over time, unlike oil pastels.”

“That sounds really messy, but your painting looked neat and precise.”

“Thank you.”

Mt Hood Triptych #2 oil on canvas 2016 by Julianna Paradisi

Mt Hood Triptych #2 oil on canvas 2016 by Julianna Paradisi

“I really liked it.”

“Thank you. So what do you think of the painting of Mt Hood I made to replace it?”

The the expression on her face gave her away, so I threw her a bone.

“Not so much, right?”

“It’s okay. I liked the horse.”

“I really appreciate your comments,” and I meant it.

As an artist I’ve stood through many gallery openings and art receptions. It’s rare for anyone to ask about what inspired the art, or how it was made. No offense intended to anyone, but a common experience for artists at gallery receptions is being approached by people wanting to talk about themselves or their art, not yours. They didn’t come to view the art.

I’m enchanted by this woman who spends her time in an infusion clinic considering the artwork on its walls; becoming fond of a particular painting, and wondering how it was made. She wasn’t there to view the art either, but she did. Not only that, but she had access to the artist, who is a nurse going about her nursing duties, until this brief respite, when the two of us discussed the art.

I do not believe such things happen very often to artists or nurses. I am grateful it happened to me.