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?

Normal Is a Cycle on the Washing Machine

In my mind, as long as the weather is good, summer isn’t over. However, the beginning of the new school year, and the return of football indicates that ritual outweighs my imagination.

Sigh.

It’s good to let an imagination run free from time to time, so I took the summer mostly off from blogging.

Preparing paintings for display. Image and paintings by jparadisi 2014

Preparing paintings for display. Image and paintings by jparadisi 2014

I’m back.

I think there’s a tendency to view creative work as less taxing, dare I say less challenging, than nursing. I wouldn’t say less, so much as different: Different types of knowledge, different sets of skills. The biggest difference, I think, lies in accountability. Harsh criticism of their work can damage an artist’s psyche.Missing a deadline for a post or art exhibition is unprofessional and negatively affects the editors and curators writers and artists work with. It leaves them in the lurch, which in turn negatively impacts the artist’s career.

In nursing, however, medication errors can seriously impact a patient’s health, with potential life-changing consequences for patient and nurse.

I discovered something this summer: Taking time off from creative projects creates a vacuum into which other projects, out of nowhere, are sucked in, filling the “free” time I worked so hard to create. I see this phenomenon in the lives of the retired too. In fact, I often tell my Mom, “You’re scaring me; retirement looks twice as busy as working life, without the paycheck.”

Mom just smiles, and says, “Remember, ‘normal’ is a cycle on the washing machine. Don’t wait for things to slow down. They won’t.”

She’s right.

An unexpected project close to my heart this summer was the opportunity to hang my paintings and monotype (one of a kind) prints in a health care setting. It is a very satisfying experience to work with a design team to select and hang art with the intention of improving patient experience. In the past, I’ve sat on selection committees choosing artists for hospital art commissions, but this was my first experience as the selected artist.

For me, it came together when a patient, unaware that I am the artist, made this remark about the art, “It makes me think of other things than why I’m here.”

Bingo. That’s exactly the result I was looking for.

The Adventures of Nurse Niki is back too. The latest episode, At The Raleigh, posted Monday.

Summer vacation brought fresh insights, generating posts for AJN’s Off the Charts. In a drop-in life drawing studio I drew a connection between art and nursing. A road trip with my husband inspired this post. And a close call with danger inspired yet another.

Normal is just a cycle on the washing machine.

 

 

 

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!

 

 

 

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?

JParadisiRN Guest Post for RNFM Radio. Live Interview Monday March 18 at 9pm EST/6 pm PST

The Bride by jparadisi

The Bride by jparadisi

In preparation for the live interview with nurse co-hosts Keith Carlson and Kevin Ross on RNFM Radio: Nursing Unleashed! I’ve contributed a guest post Why Nurses Should Make Art.

We’ll discuss incorporating art into nursing practice. By the miracle of technology, the guys plan to Tweet images of my painting series From Cradle to Grave: The Color White. You can see them on Twitter after the hashtag #RNFMRadio.
If you aren’t able to listen during the live show, each episode is archived on the site for listening at your convenience.

Here’s the details:

  • JParadisiRN guests (live) on “RN.FM Radio: Nursing Unleashed!”, the newest internet radio station for nurses.
  • The LIVE interview is on Monday, 3/18/13 at 9pm EST / 6pm PST. You can listen in here: http://www.blogtalkradio.com/rnfmradio
  •  Even better – CALL IN with your questions, comments, thoughts, or just to say “hi!”
  • If you can’t listen in, bear in mind that the show will be immediately archived and available for listening on Blog Talk Radio (http://blogtalkradio.com/rnfmradio), and will also be quickly available as a free downloadable podcast on iTunes.
  • Call-in # is: (347) 308-8064.
  • The link to listen in on Monday, 3/18/13 at 9pm EST / 6pm PST again is: http://www.blogtalkradio.com/rnfmradio

I look forward to connecting with you then!

JParadisiRN Blog: 2012 in review

The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

4,329 films were submitted to the 2012 Cannes Film Festival. This blog had 20,000 views in 2012. If each view were a film, this blog would power 5 Film Festivals

Click here to see the complete report.

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:

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.

The Rise of Blogs in Nursing Practice

Joni Watson presents blogging’s validity as a useful tool for the professional growth of nurses in her article, The Rise of Blogs in Nursing Practice, published in the Clinical Journal of Oncology Nursing (CJON, April 2012, Vol. 16, No. 2). In the article, Watson guides nurses through integrating blog information into their practices.

Joni Watson authors the blog Nursetopia, and contributes posts for the ONS blog Re:Connect.

Joni opened her article with paragraph from a JParadisiRN post (used with permission). Citing blog posts in journal publishing indicates the growing legitimacy of the medium.

Other blogs noted in the article are Emergiblog, Nursing Center’s In the Round (Lisa Bonsall), The Nerdy Nurse, and of course, Off the Charts, the blog of the American Journal of Nursing.