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?

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!

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.

Latest Posts: AJN’s Off the Charts & New Nurse Niki

Drawing From Life is my latest post for Off the Charts, the blog of the American Journal of Nursing. It posted yesterday. Often the lines between art and nursing easily blur, like soft charcoal lines smudged on paper. You might want to check it out, or leave a comment.

The Adventures of Nurse Niki now posts new episodes on Mondays, instead of Thursdays. Be sure to read week’s episode, Moving On..

The Adventures of Nurse Niki Moves to Mondays!

The Adventures of Nurse Niki

The Adventures of Nurse Niki

I’m having fun re-prioritizing a few things, one of which is my other blog, The Adventures of Nurse Niki: fiction so life like, it’s almost real. I’m enjoying writing fiction more than I’d expected. Niki and her friends have integrated into my waking life, and the story lines come faster than I can write them down. Therefore, The Adventures of Nurse Niki will post on Mondays instead of Thursdays.

I am not shutting down JParadisiRN blog. This is a shift, not an ending. I’ll still post thoughts and images. In the meantime, tune in on Mondays for new episodes of  The Adventures of Nurse Niki: fiction so life like it’s almost real, starting today.

You can discuss or interact with Niki on The Adventures of Nurse Niki’s Facebook page. Please don’t forget to “Like” it too. Show Niki some love! Thank YOU!! to the readers following The Adventures of Nurse Niki, the retweets of @NurseNikiAdven (Hashtag #NurseNiki) and those who Like Nurse Niki’s Facebook Fan Page. The support is very much appreciated!

 

 

 

The Adventures of Nurse Niki: Nurse Characters Doing Nurses’ Work

This post was originally published on RNFM Radio‘s blog October 2013

JParadisiRN

JParadisiRN

I’m one of those nurses other people hate watching TV medical dramas with. I shout out: “Intubate her now!” or congratulate myself on guessing a diagnosis from a minimal amount of script information. People watching these programs with me say, “It’s just a TV show.”

But the truth is, it’s not.

When the same nurse characters are recreated over and over for public consumption by the entertainment industry they become woven into public awareness, and accepted as fact. I wrote about this in a previous post for RNFM Radio.

After my appearance on RNFM Radio earlier this year, I realized I want to create nurse characters closer to the truth, struggling with feelings of social isolation caused by intimate association to the trauma of others, and the accountability to act on it.

Nurses do not only witness the suffering of others, nor do we only hold the hands of patients in pain, or their hair out of their faces while they puke. We assess their needs, get them the treatment needed to alleviate their symptoms, and administer it. Other times, we cover their profuse bleeding with our gloved hands, yell for help, and initiate the ministrations designed to help them hang on.

Except on TV. On TV, physicians do all of this work. In real life, I have had the pleasure of working with doctors who actually did hold the basin while a patient puked, and I’ve even had one assist with cleaning a code brown. These are special people, performing outside of the work doctors are usually expected to do, not because doctors wouldn’t necessarily do so, so much as because doctors are not usually present when these things happen, and nurses usually are.

Anyway, in The Adventures of Nurse Niki, nurses do the work of nurses. Physician characters appear proportionately to how they normally do in real hospital units: during rounds, when summoned from the call room, during codes, procedures, and for admissions and discharges. Doctors are not constantly at the hospital coordinating and administering patient care, because that is not their job. It’s the job of nurses.

None of this information is new to either nurses or anyone who has spent a lengthy time hospitalized, but it appears to be new information for producers and TV writers who continue to populate TV hospitals with doctors doing patient care, while the nurses stand by waiting to, or asking for, help. Some TV nurse characters enter medical school, I suspect, so they too can get a starring role.

The Adventures of Nurse Niki is an attempt to make a 3-dimensional main character whose life is interesting because she is a nurse, not because she works in the proximity of doctors.

 

The Adventures of Nurse Niki Episode 31 & Real Nurses Featured in Call Lights Magazine

The Adventures of Nurse Niki
The Adventures of Nurse Niki

There’s Always PhotoShop The Adventures of Nurse Niki Chapter 31 posted this morning. In this new episode Niki attends the Call Lights Magazine photo shoot, and meets an old friend from high school.

Call Lights Magazine, is a fictional plot device of The Adventures of Nurse Niki. Nonetheless features factual articles about real nurses and their creative projects. Featured in the past two weeks are Scissored Moon, a book of the collected poems of Stacy Nigliazzo, an emergency department nurse in Texas. Nigliazzo’s poems are published in many venues, including the American Journal of Nursing, where I first read her work. Links for purchasing a copy of Scissored Moon are included in the article.

Included this week is an interview of Peggy McDaniel, RN, BSN, a nurse living abroad, who’s ocean-inspired photography is available as notecards through Sailgirl Designs.  McDaniel the sole proprietor of this nurse-owned and operated business. The proceeds from sales of her notecards help orphaned children in Kenya. Read her exciting story. Links to the Sailgirl Designs website, and Redbubble (for purchasing the cards) are included in the article.

Follow Call Lights Magazine on Twitter @CallLightsMag and Like Call Lights Magazine on Facebook.

The Adventures of Nurse Niki has a new format. The homepage is now static with Chapter One, like a book. The latest chapters are found by clicking the chapter number above the blog’s header, or from the Chapters drop down box at the upper left corner. Each chapters now has a brief description. The changes are in response to suggestions by faithful readers (you know who you are) and are intended to make The Adventures of Nurse Niki friendly to first-time readers, while keeping navigation easy for those following the story from its beginning.

Off the Charts has this to say about The Adventures of Nurse Niki:

This blog is made up entirely of first-person episodes told by a fictional nurse named Niki. Each episode is short, detailed, and engaging, and it’s easy to keep up with it on a regular basis, or quickly catch up if you haven’t yet read any episodes. Jacob Molyneux, AJN senior editor/blog editor

Kevin Ross, aka @InnovativeNurse wrote a review of The Adventures of Nurse Niki, with this highlight:

Julianna has embarked on something special for the nursing community. The Adventures Of Nurse Niki is one of the most intelligent perspectives of life as a nurse. These are the experiences of a “real nurse” if you ask me. Nurse Niki is a smart and dynamic character who works night shift in the PICU at a California hospital. A good television show or fiction novel could certainly draw out the sexiness of working in the ICU, but with Niki’s story we quickly discover that this dynamic character is also struggling to cope with life at the bedside, and as a mother and wife. Hidden within each chapter the discovery is that Nurse Niki is in fact you. She’s me. Well that is of course if I was a woman.

You can interact with Niki on The Adventures of Nurse Niki’s  Facebook page. Please don’t forget to “Like” it too. Show Niki some love! Thank YOU!! to the readers following The Adventures of Nurse Niki, the retweets of  @NurseNikiAdven (Hashtag #NurseNiki) and those who Like Nurse Niki’s Facebook Fan Page. The support is very much appreciated!

New Episode! Is There a Doctor in The House? The Adventures of Nurse Niki

The Adventures of Nurse Niki
The Adventures of Nurse Niki

Is There a Doctor in The House?  The Adventures of Nurse Niki Chapter 29, posted this morning. Niki and her sister Raquel go out for cocktails and girl talk, but their evening out is interrupted.

The Adventures of Nurse Niki has a new format. The homepage is now static with Chapter One, like a book. The latest chapters are found by clicking the chapter number above the blog’s header, or from the Chapters drop down box at the upper left corner. Each chapters now has a brief description. The changes are in response to suggestions by faithful readers (you know who you are) and are intended to make The Adventures of Nurse Niki friendly to first-time readers, while keeping navigation easy for those following the story from its beginning.

Off the Charts has this to say about The Adventures of Nurse Niki:

This blog is made up entirely of first-person episodes told by a fictional nurse named Niki. Each episode is short, detailed, and engaging, and it’s easy to keep up with it on a regular basis, or quickly catch up if you haven’t yet read any episodes. Jacob Molyneux, AJN senior editor/blog editor

Kevin Ross, aka @InnovativeNurse wrote a review of The Adventures of Nurse Niki, with this highlight:

Julianna has embarked on something special for the nursing community. The Adventures Of Nurse Niki is one of the most intelligent perspectives of life as a nurse. These are the experiences of a “real nurse” if you ask me. Nurse Niki is a smart and dynamic character who works night shift in the PICU at a California hospital. A good television show or fiction novel could certainly draw out the sexiness of working in the ICU, but with Niki’s story we quickly discover that this dynamic character is also struggling to cope with life at the bedside, and as a mother and wife. Hidden within each chapter the discovery is that Nurse Niki is in fact you. She’s me. Well that is of course if I was a woman.

You can interact with Niki on The Adventures of Nurse Niki’s  Facebook page. Please don’t forget to “Like” it too. Show Niki some love! Thank YOU!! to the readers following The Adventures of Nurse Niki, the retweets of  @NurseNikiAdven (Hashtag #NurseNiki) and those who Like Nurse Niki’s Facebook Fan Page. The support is very much appreciated!