I Wish I’d Said It

I’m not saying that there aren’t occasions when entertainments transcend their aim and become art, and I’m certainly not suggesting that art must not entertain, but the ultimate aim of an entertainment is to confirm the reader’s existing sense of how things are and how things should be, while the aim of the literary artist is to upset and disrupt that vision.

Robert Boswell

Pondering Dreams

Gate Keepers by jparadisi 2011

Gate Keepers by jparadisi 2011

People who deny themselves the privilege of dreaming are doomed to failure.

Oscar Hammerstein II

I met a twenty-something student who wants to become a doctor. He’s completed a GED and is taking art classes at a community college. For some reason, he enrolled in a science class and became enchanted by the organisms floating on a glass slide he viewed through a microscope. That’s how he decided to become a doctor. He asked for my opinion. Not wishing to throw doubt on the dreams of another, I pondered my response.

His question reminded me of the only writers’ workshop I’ve ever attended. Introductions were made around the library table where we gathered. At my turn, I introduced myself as an artist and writer developing a body of work from my experiences as a registered nurse. The eye rolling, and general lack of enthusiasm expressed by the group clearly implied my dream was ridiculous. During lunch break, a fellow participant actually told me, “You know, it takes an MFA to become either an artist or a writer.”

There’s a saying in poker: If you look around the table and can’t tell who the rube is, it’s probably you. At this table, surrounded by other wannabe writers, I was the rube.

A few weeks later, despite the dissuasion of the workshop participants, I submitted two stories, “Voyagers” and “Icarus Again,” to the publisher of an anthology of nurse stories. Both were published. Encouraged by kindly, professional editors, my writing and artwork have been published nationally many times since. My first art exhibition, fresh out of art school, was favorably reviewed by a local art critic, which is more difficult to do than it sounds.

I am an artist and writer developing a body of work from my experiences as a registered nurse.

So there.

I think about this a lot when hooking up chemotherapy infusions to patients with advanced, metastatic cancers. Their prognosis is terrible. Though it’s impossible to know what I’d choose unless actually facing similar circumstances, sometimes I think I’d choose sitting on a tropical beach staring at the ocean until the end, and not spend my last few weeks or months in an oncology clinic fighting the odds. That’s when I remind myself that any patient perhaps belongs to that small statistic of people who survive or go into remission, allowing them one more birthday, one more Christmas celebration, a family wedding, or a grandchild’s graduation.

If there is no hope, then why am I an oncology nurse? Have we nurses witnessed so much human crisis that we’ve limited our capacity for dreams? Where lies the division between dreams and realism?

What are your thoughts? Which is the larger transgression: offering overly optimistic hope or being a gatekeeper? How is this idea reconciled with diminishing healthcare resources?

 

If You Can’t See It, You Aren’t Living It: How To Visualize Your Best Life

After cancer treatment, my hair grew back in wild curls that I dyed platinum blonde, symbolizing my pursuit of a more creative life. “Now what?” I asked. How does one pursue a creative life?

photo by jparadisi

photo by jparadisi

The same way nurses create a patient care plan: with a focused goal.

“Huh?” I hear you say.

Nurses ignore hunger. We rationalize it’s OK we haven’t peed for 12 hours, because we haven’t had anything to drink either. Is anyone surprised we’re numb in the creativity department? If you need a Doppler to find your dreams, take heart! There are tools for restoring creative perfusion.

The first tool is rediscovery

For me, it was drawing, riding horses, writing, collecting seashells, cooking, and hiking. I made greeting cards. Not much about nursing. I wasn’t particularly athletic, but maybe you were. What did your childhood self dream of doing? Write it down.

Make a scrapbook of images 

  • This exercise clears clutter: Tear pictures from old magazines of everything that catches your eye.

    photo by jparadisi

    photo by jparadisi

Using a glue stick, randomly paste the pictures into an inexpensive scrapbook. Don’t worry what it looks like. This is an exercise in free association. Do it over several weeks, compiling enough images to spot trends.

Pay attention: Your subconscious is talking! I discovered myself clipping pictures of lofts with contemporary furniture, a far cry from my country-style living room. Pictures of clothing were elegant, urban fashions, not my uniform of jeans and comfort footwear.

Maybe your pictures depict people, not things. In that case, what are they doing: traveling, creating something, dancing, or playing a musical instrument? Are they back in school for that BSN or advanced degree? If a picture is worth a thousand words, what are yours saying?

This project can be accomplished using Pinterest. However, the paper version provides privacy, perhaps fostering candid responses. If Pinterest works for you, go ahead.

Create a vision board

  • Our brains are trainable. Vision boards are a visualization tool. Training your brain to “see” the life you want helps achieve it.

Using the information you gathered from the previous two exercises, glue pictures from magazines representing the life you want on a large piece of poster board. A single mother at the time, my pictures represented falling in love and a happy relationship, along with pictures of an art studio, places I wanted to visit, learning Rieki, and living into old age. I made mine during cancer treatment — your patients might enjoy making this project too.

Through these exercises, I discovered I was cleaning a rarely used guest room. My dining room sat empty because I preferred impromptu dinners with girlfriends served on the coffee table while watching a movie from the couch. Clearly, I dreamt of a lifestyle very different from the one I maintained. I changed that.

Are you living the life of your dreams or simply the one you find yourself living? If you are, how did you find it?

 

The Art of Subtraction

Fascinated, I watched as a sculptor created a face from a lump of clay. With deft fingers, he tore into the pliable medium, pulling away bits and pieces. A pair of sightless eyes, cheekbones, a nose, and finally lips appeared out of the shapeless mass. No clay was added to create the facial features. Throughout the process, clay was only removed to reveal a face in the inanimate material. Before this, I added clay to form features and appendages.

Sergei by jparadisi

Sergei by jparadisi

I realized that the art of living well — like sculpting — is a process of subtracting clutter and revealing purpose.

I struggle with clutter. At home, David politely refers to my “three-dimensional filing system.” In part, it’s because I am an artist. I find potential for creating art from the seemingly useless. I don’t expect to change dramatically.

I Googled “creativity” and “clutter.” More than 3.5 million references popped up in 0.19 seconds. A single article embraced clutter. The majority reported that clutter siphons creativity through disorganization and inefficiency. One even linked to poor health and obesity. Clearly, subtracting clutter enhances creativity and efficiency.

In my nursing practice, I strive to remove clutter and maximize efficiency in patient care. Here are a few ideas to reduce clutter and increase efficiency during your shift.

  1. Embrace technology. Using a Smartphone eliminates hunting for calculators. Apps like MedCalc keep calculations for doses, BSA, ANC, and more at your fingertips. Several apps can help your own health by logging calories consumed and burned through exercise, and we all know the benefit of removing the clutter of extra weight. Some companies offer employee discounts for Smartphone plans so check your benefits.
  2. If your institution uses electronic health records, learn to use them. Creating “workarounds” is inefficient and defeats the purpose. Electronic records save time. Charting in real-time prevents the need to reconstruct events from memory at the end of your shift.
  3. Avoid mission creep. Stick to the care plan. In the ambulatory infusion clinic where I work, patients arrive with lists of concerns having little to do with their appointment. It’s easy to start calling physicians’ offices and making unrelated appointments for them. Handle the appointment-related work, and provide resources for the rest. Don’t confuse patient advocacy with enabling dependent behaviors.
  4. Bring your lunch to work. Sit down and enjoy your 30-minute break instead of standing in line buying food. You’ll save calories, and money too. Many nurses spend $5-$15 rapidly consuming a high-calorie takeout meal in a depressing staff lounge. Wouldn’t you prefer saving the money and calories for a leisurely meal with friends or family during off hours? Just saying.

I’ll leave you with one last thought:

The cost of a thing is the amount of what I call life, which is required to be exchanged for it, immediately or in the long run.

 Henry David Thoreau

 Now, if I could only do streamline at home. Any suggestions?

 

Ah Yes! Back in The Studio

I write so much about nursing and art that I sometimes forget I’m a painter. Low census yesterday meant I had a free day in the studio, with this result. I love the flexible hours of nursing!

Untitled (Woman Holding Baby Doll) oil on wood by jparadisi 2013

Untitled (Woman Holding Baby Doll) oil on wood by jparadisi 2013

Mental Clutter

Perhaps I have no business writing about clutter, because I am a clutterer. I’m clean. You won’t stick to any surface in our home, but you may have to move some magazines to find a spot for your glass on the coffee table.

Sometimes My Surgical Mask Feels Like a Gag by jparadisi

Sometimes My Surgical Mask Feels Like a Gag by jparadisi

The topic of clutter is larger than that unwieldy pile of unopened mail on the dining room table. In the words of Newman, the mentally unbalanced postal worker on Seinfeld, “The mail never stops. It just keeps coming.”

The relentless flood of mail is not unlike the emotional barrage facing nurses during a typical shift. The tragic diagnosis of a new patient, recurring cancer in a well-known patient, too many patients, not enough nurses, phones constantly ringing, and unfamiliar chemotherapy regimens are just part of it. Then there’s the work environment: difficult coworkers, budget cuts, and, oh, no time for lunch today. At times, it’s overwhelming.

These things create a work day mental clutter difficult to shed at the end of a shift. Mental clutter paralyzes creativity, interferes with relationships, and impedes sleep. Managing stress is essential to happiness.

Having a mental clutter shut-off switch between work and home is effective. A mental clutter shut-off switch is a ritual activity, which when performed, tells your brain that:

  1.  The shift is over.
  2. You are going home.
  3.  You are leaving the workday craziness at work.

Easier said than done, but it can be done. Don’t we teach patients methods for managing stress?

Here are ideas for creating a mental clutter shut-off switch between work and home:

  • Join a gym or yoga class near work, and avoid rush-hour traffic by exercising before driving home.
  • When driving home, turn off the car radio. Listen to soothing CDs or a book on CD, such as God On A Harley by Joan Brady. It’s the story of a nurse learning to simplify her life.
  • As soon as you get home, take a 20-minute walk. Put your walking clothes and shoes on your bed before you leave for work, so they’re ready and waiting for you.
  • Create a personal sanctuary in your home. Mine is a comfortable chair with an ottoman. Next to it are my laptop, paper, pens, a sketchpad, knitting supplies, reading glasses, and several books. A small table holds a cup of coffee or tea.
  • Limit discussions at home about work to 30 minutes. Set a timer if you have to, and then stop when time is up.
  • Limit your time watching the evening news. Avoid it before bedtime. Be informed, but remember that you can’t fix the world.

That brings me to my last point: You deliver the best care reasonably possible to your patients, but you are not responsible for their outcome. You are a nurse, not a superhero.

What would you add to this list?

Commitment Makes You an Artist or A Nurse

That I am an artist was never questioned by anyone other than myself. It took time for me to believe in myself as an artist, because I felt I would know when I became one. Some artists laugh at such thoughts:

In artistic work one needs nothing so much as conscience; it is the sole standard. — Ranier Marie Rilke

Self-Portrait. Pencil on paper by jparadisi

Self-Portrait. Pencil on paper by jparadisi

How do I know I’m an artist?
The same way I know I am a nurse: Not because I am paid for my work, but because of my commitment to nursing. Commitment manifests itself as time set aside for continuing education, and time to practice skills. It’s not enough to want to do something. You need time to practice skills, whether it be starting IVs, or developing a series of paintings for exhibition. You commit to nursing through education, taking boards, and continuing education. You have to commit to creativity, too.

Begin with one hour a week, every week. It needn’t be the same day or time each week, although a set schedule may make it easier, childcare and weird nursing work schedules may necessitate flexibility. Protect this hour as if it were a difficult-to-reschedule dental appointment.

What will you do with this hour each week? You will have a creative date with yourself. For now, don’t invite a friend. Free yourself completely of taking care of other people. You need to hear your voice to find your creativity. You may already know what you’ll do with the time: write a poem or short story or resume piano, dancing, or voice lessons. If you’re drawing a blank about what to do, here are a few suggestions:

  • Wander the aisles of an art supply or craft store. Give yourself $10-$20 to spend on pens, paper, stamps, inkpads, dried flowers — whatever. Need ideas? Check out MarthaStewart.com, or Pinterest.
  • Wander the aisles of an office supply or dollar store with $10-$20. Buy felt pens, stickers, glitter, glue sticks, and an inexpensive scrapbook. Tear pictures from old magazines of everything catching your eye. Paste them into the scrapbook using a glue stick. Decorate the pages with your glitter, stickers, and felt pens.
  • Buy a cheap rectangular or square flower vase made of clear glass. Fill it three-quarters full with small glass beads. You can use small, polished stones instead, but they tend to scratch the implements. Use it to hold pens on your home or work desk.
  • Go for a walk with your camera. Take snapshots of anything that attracts your attention. Take lots of pictures without over-thinking the process. You’re practicing how to “see.”

The important thing is to make a habit of allowing yourself at least an hour a week to explore and develop your creativity. What ideas can you add to this list?

Maintaining Curiosity in Nursing Practice

Insight is the unanticipated gift of creativity. It struck like lightning during a shift in the oncology infusion clinic.

A colleague asked, “Where does IV iron come from?”

Baby Doll in Conical Bowl by jparadisi

Baby Doll in Conical Bowl by jparadisi

I’ve infused the stuff into patients for years, but never wondered how the iron was obtained. From iron ore? By soaking rusty nails in water? It seemed unlikely it’s derived from blood products, as it’s often prescribed for bloodless surgery patients. However, what most impressed me was the curiosity that stimulated the question in the first place. It demonstrates thinking outside of the box, and beyond a task-driven mentality. Curiosity prevented her from mindlessly hooking an IV drip to a patient. She sought understanding.

Insight struck: curiosity is a foundation of creativity.

The questions “What, how, and why?” gave birth to science and art. They inspired Leonardo da Vinci to dream of contraptions which later became the basis of modern aviation. Artists ask themselves these questions standing before a blank canvas, a lump of clay, or the ingredients for tonight’s dinner.

My father, sitting at the head of our dinner table, told me many times, in his Italian accent (English was his second language), “Sweetheart, never stop devil-upping your coo-ree-os-ity.” I understood he meant: “Never stop developing your curiosity.” It remains excellent advice.

Maintaining curiosity in nursing compels you to create individualized methods for patients to organize and remember their home meds. Curiosity fuels your medication information searches and the creativity involved in formatting to educate people of various backgrounds: patients, their families, students, or coworkers. You create presentations that work best for any occasion: handouts, graphs, pie charts, or PowerPoint.

Curiosity leads you to use creativity in your nursing care plans:

Imagining what losing your hair feels like, you cheer up a chemo patient by helping her collect pictures from magazines of hairstyles — short, medium, and long — so she can visualize her new hair when it grows back. Maybe she’ll try a vivid new color too.

Wondering how to entice a patient to eat more, you explore recipes for textures and flavors of food that will appeal to him.

Why is the easiest question of all to answer: “Because I care.”

Nurses are creative in ways we care for patients. We don’t simply “push a button.” Neither do we stop developing our curiosity. This is the art of nursing.

By the way, IV iron solutions are man-made.

Learn to Say No

Developing creativity requires personal time. You’ve heard it before: Learn to say no.

I was a new-ish nurse working night shifts on a busy hospital unit. Our census exploded,

The Bride by jparadisiWhat are you married to?

The Bride by jparadisi
What are you married to?

and every evening the nurse manager called all off-duty staff begging until someone accepted the overtime shift. It is difficult to refuse extra shifts when it’s your manager asking. This went on for what seemed an inordinate amount of time. Answering machines were new back then, and I resisted owning one.

One afternoon, my daughter raced to the ringing phone, picking up the call before I could. I overheard my manager asking, “Hello, is your mommy there?” As I reached for the receiver, my daughter blurted out, “You’re not going to make my mommy go to work again, are you?” Embarrassed, I grabbed the phone. On the other end, the manager apologized: “I’m sorry, I guess I’ve been calling too often. Enjoy the evening with your daughter.”

The next day, I bought an answering machine, and learned to screen calls.

Not long afterwards, something unexpected happened: The manager took her overtime-paid hours to administration, along with the record of increased census. They discovered they’d save money by hiring another FTE. The overtime calls became occasional.

Moral of the story: it’s not my personal responsibility to fix my unit’s staffing problem. I’m not advocating nurses refuse shifts during staffing crunches. In nursing, being a team player is essential. However, I found that if I work more than two overtime shifts a pay period, I get a diminishing return on the extra income because of taxes where I live. Therefore, my flexible boundary is to limit overtime to two shifts a pay period. I learned to say, “No,” to more than that.

Recognizing which problems are yours to solve, and which are the responsibility of others is the key to learning to say “no,” to coworkers, patients, children, spouses, boyfriends, girlfriends, parents, soccer moms, whomever.

Write this down and tape it to your bathroom mirror:

I am responsible for my own stuff, and that is enough.”

The caveat to this affirmation is:

If you step in it, you’re going to have to clean your shoes.”

Remember:

▪ Avoid drama.

▪ Evaluate commitments carefully.

▪ Protect your personal time.

Our ability to say no is strongly connected to the important relationships in our lives. Nurses in particular are conditioned to believe that saying “No” in order to make time for ourselves is selfish. Add the nurturing nature of a nurse to this training, and saying “No” becomes nearly impossible.

You cannot grow creatively without time to yourself. Recognizing what stuff is yours, and what belongs to others is the first step towards self-care and personal growth.

Do you think nurses have more difficulty saying “No” than other professionals? Do you think this problem is gender related? What experiences have helped you learn to say no?

Are You Circling The Drain? Self-Diagnosing A Creativity Resuscitation

Voiceless mixed media on vellum by jparadisi

Voiceless mixed media on vellum by jparadisi

Productivity and creativity are not the same thing. Neither are they mutually exclusive, but they are not the same thing. I didn’t always know this.

Like most nurses, I have always been productive. Whether making things with my hands, painting the dining room, running 10Ks, growing my own vegetables, or hand-making pasta, I often sat down for dinner around 9:00 p.m. It wasn’t until a breast cancer diagnosis flattened me on a couch that I realized the artist inside of me was starving.

In retrospect, there were early symptoms before the differential diagnosis that a creative resuscitation was necessary. Do you have any of these symptoms?

  • You think, “I can do better than that,” when watching friends or colleagues succeed in a creative endeavor. Maybe you can. The question is, why don’t you?
  • You daydream about what your life would be like if you didn’t have commitments to a job, spouse, children, etc.
  • You use the universal sign of creative strangulation: When you talk, you tend to place one hand at your throat, with the thumb and index finger forming a V around it. What words and ideas are you choking back with that hand?
  • You use the universal sign of carrying the weight of the world on your shoulders: When you talk, you place one hand on the back of your neck. What burdens weigh heavily on that spot? Can you set any down?
  • You feel vaguely unfulfilled despite your accomplishments.
  • You hang out on the periphery of creative people. You have an inexplicable desire to help them succeed, but don’t believe you possess their level of talent.
  • You’re bored despite high productivity.
  • You fear releasing your creativity will destroy life as you know it. You believe you cannot be fulfilled creatively and hold a job or have a family. Or be a nurse.
  • You knew what you wanted to be when you were a child, and it is not what you are doing as an adult.

Nurses recognize when productivity is mistaken for quality in health care. We sometimes fail to make a similar assessment about ourselves.

Do you suffer from any of these symptoms? Can you add to the list?