The Two Hands of Mindfulness

The little dish of crystals I keep on my desk. I made the little dish from clay. Photo: jparadisi 2018

Late on a Friday afternoon I sat on the floor of a shared office space in semi-lotus position, dismantling the fax machine to clear a paper jam. I needed to fax a copy of one more cancer survivorship care plan to a primary care physician’s office to meet my weekly quota before going home. If you work for an accredited cancer institute, and particularly if you’re an oncology nurse navigator like me, the phrase “survivorship care plan” is enough to cause heart palpitations, and maybe make your palms sweat. If the phrase doesn’t hold meaning for you, count your blessings.

Sitting before the fax machine in semi-lotus position, trying very hard not to break its plastic drawer while reaching for the piece of paper stuck in its maw, I considered the difficulty of practicing mindfulness in the controlled chaos that is health care. At that moment, I felt more akin to George’s father on Seinfeld, Frank Constanza, screaming “Serenity now!” than to the Dali Llama.

How is it I have the nursing skills to manage a patient’s airway on a ventilator, but am defeated by a piece of office equipment?

The stress is worse for nurses working at the bedside: For instance, how many times does the ED call to admit a patient to a nursing unit only to be told the unit doesn’t have a bed? I don’t mean a room, I mean literally, a physical bed? The admission is delayed while some poor night shift nurse traipse through hallways into the bowels of the hospital in search of a bed.

There are medication shortages to contend with, including the lowly bag of saline, diphenhydramine, and flu shots. These scenarios are not new to nurses. They are common occurrences we problem solve during the course of a shift, while managing the health and safety of our patients, documenting for compliance standards, and meeting accreditation mandates such as survivorship care plans.

Some days I’m more successful maintaining mindfulness at work than other days.  That’s why mindfulness is a practice. Practicing mindfulness requires compassion not only for others, but for ourselves. In fact, it’s my opinion that a lack of self-compassion and self-care contributes to a general lack of compassion towards others, fueling a hostile work environment. I keep a small dish of crystals on my desk at work to remind myself to stay in the moment.

As I sat on the floor in front of the fax machine, late on that Friday afternoon, a coworker returned to our office. She asked what I was doing, and I vented my frustration. She got down on her knees, and took a turn at dismantling the fax machine to get it working. She was successful. I faxed the care plan to the physician’s office, meeting my quota for the week. I got out on time to take my barre class, where we practice breathing and mindfulness.

Gratitude and compassion are the two hands of mindfulness.

 

 

“The Kid Has the Nicest Parents” Chapter 7 of The Adventures of Nurse Niki is Posted!

The Adventures of Nurse Niki
The Adventures of Nurse Niki

The Adventures of Nurse Niki Chapter 7 is posted.

This week, Niki ponders physiological dependency on caffeine, expresses gratitude for having a healthy child, and receives an ominous report on her patient in the PICU.

I want to give a shout out to Off the Charts, the blog of the American Journal of Nursing, thanking them for including The Adventures of Nurse Niki in a Blog Round Up with some remarkable nurse bloggers. An excerpt from the post says some really nice things about Nurse Niki:

Episode six is now up at The Adventures of Nurse Niki, a newish blog written by Julianna Paradisi (her other blog is JParadisi RN). 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.

Thanks JM!

You can interact with Nurse Niki on her Facebook page, and don’t forget to “Like” it. Show Niki some love!

Many thanks to the readers following The Adventures of Nurse Niki, the retweets of  @NurseNikiAdven, and those who not only Like Nurse Niki’s Facebook Fan Page, but post comments too. The support is very much appreciated!

I Wish I Said It

“This nation will remain the land of the free only so long as it is the home of the brave.” -Elmer Davis

Today we remember our troops, both past and present, and honor them with our thanks for their sacrifices.

The Hostess With The Mostest

photo: jparadisi

It was a Saturday, my weekend “on” at the infusion clinic. Weekends are hit or miss: only a few patients needing daily IV antibiotics, or as busy as a weekday shift, which is how busy this shift was. My nurse colleagues, clever and cheerful, kept the mood of the shift lighthearted, however.

I don’t know if our positive attitudes contributed, or if it was the other way around, because our patients were also lighthearted. Considering we were spending a Saturday together in an oncology clinic, this speaks volumes about the resiliency of the human spirit.

On a whim, during a lull in the morning we served our patients buttered toast and juice. It was a modest, spontaneous celebration received with joy.

The shift ran long. Expected at a friend’s home for bubbles and small plates, I rushed to get ready.

I have written before: I don’t go out much.

Do other nurses find the sudden transformation from duty to party as unsettling as I do? A quick shower to remove any bacteria hitching a ride home from work; applying a new red lipstick to enliven my poor face that’s been up since O’Dark-Thirty, forcing my feet from comfy clogs into black pumps after standing on them for an eight-hour shift. Looking at the results in a mirror, I felt like a magician.

I’m glad I made the effort. My friend is The Hostess With The Mostest, and the party was fabulous, with platters of delicate finger foods, and chilled, sparkling wines. The guests were glamorous. I saw old friends, and met new ones. It was fun.

That particular Saturday, work and home life melded into a full day of celebration: first at work with colleagues and patients, then again in the evening with friends.

 “Let us be grateful to people who make us happy; they are the charming gardeners who make our souls blossom.” – Marcel Proust

A Blue Mason Jar Full of Post-It Notes Goals for The New Year

Blue Mason Jar of Dreams photo: jparadisi 2011

Every year I write my New Year’s resolutions on Post-It notes, filling a blue, vintageMason jar with them after reviewing the ones from the year before. I write the date on each Post-It note.  If a previous year’s resolution wasn’t met, and still holds merit, it remains in the Mason jar with the new ones.

Previous years’ resolutions in the jar:

  • “My health: that I may remain cancer-free” (1999)
  • “The continued good health of our families” (1999) I updated this one to “our families” in 2004, the year David and I married.
  • “David’s and my continued good health and happy marriage” (2008)
  • “To show a financial profit as an artist.” (2008)
  • “Gallery representation”(2008)
  • “Publish more stories in 2011” (2010)
  • “A book deal for my manuscript” (2010)
  • “The blog will have more than 1,000 visitors/month (2010)
  • “Lose ten pounds” (2011)

Most striking about the hopes and dreams on this list is that none of them are actually resolvable. They are ongoing. Sure, publishing my manuscript into a book would be great, however, knowing me, the next year I would resolve to write another book, one that won an award or topped the charts, or something like that. Artists are rarely satisfied with any level of achievement. We are always looking up the ladder at the next rung:

  • Gallery representation leads to the desire for critical recognition, increased sales, collectors, fame.
  • Publishing stories leads to writing more stories, longer ones, for larger audiences.

In general, human nature is much the same:

  • Health and happiness leads to the expectation for more of the same.
  • I lost ten pounds last year. For 2012 I expect to keep them off.

Resolution is the wrong choice of word. For me, setting New Year’s Goals is better phraseology. Most of the improvements I wish for in life take time and perseverance to achieve, and more hard work to maintain. To my way of thinking, New Year’s is a time to review the larger goals of my life, and see if they are still worth steering towards. If so, then I ask myself what small adjustments can I make this year to further them? These adjustments are written as goals on the Post-It notes, dated, and placed in the jar.

The most important part of opening the Mason jar each year is reading the hand written Post-It notes, and saying a small prayer of thanks or another expression of gratitude for the advances, which occurred over the past year towards each goal. There is no lasting joy in achievement without gratitude. This year, I am thankful for:

  • A clean bill of health when we were afraid my cancer had returned.
  • Editors who published my paintingsessays, and blog posts.
  • David and I lost weight. He avoided a prescription for blood pressure medication.
  • I was represented by Anka Gallery. I met wonderful people there and made lasting friendships.
  • I sold some paintings.
  • JParadisi RN blog has grown beyond my previous goals.
  • I have met inspiring people through blogging. Special thanks to: Dr. Dean Burke, Joni Watson, Brittney, Sean, poet Stacy Nigliazzo, and artist Matt Lamb.

So what’s on Post-It notes this year? What goals am I steering my life towards in 2012?

  •  Remain cancer free
  • The continued good health of our families
  • David’s and my continued good health and happy marriage
  •  A financial profit as an artist
  • Finish the Vessels of Containment painting series and start the new series
  • Gallery representation
  • Write and publish more stories in 2012
  • Increased writing income
  • The blog will continue to grow
  • Keep off those ten pounds

Here’s the cool thing about writing down goals: The Examined Life (Socrates). Today I see  each goal I’ve written down is focused on an unknown future. I haven’t written a single one, which applies to my present reality. So, until my dreams come true:

  • I will continue to develop my skills as a nurse so my patients remain safe in my care.
  • I will strive to be a better team player at work.
  • I will phrase criticism in a constructive manner.
  • I will remember that everyone has a difficult job. That’s why they call it work.
  • I will say Thank You at least once daily. It’s wrong to wait an entire year to give thanks for everything that is good in my life.

I wish to thank my family and friends (new and old) for your support of JParadisi RN blog. May your New Year be filled with Health, Love, Happiness, and Prosperity.

Thank You, Even If It Might be Random

Argonauta: My Back to The Beach mixed media on paper by jparadisi

If the only prayer you ever say is “thank you,” that would suffice.

Meister Eckhart

Thank You.

My oncologist called yesterday afternoon with the test results: I do not have cancer. I do have gi-normus bilateral implant ruptures, which need surgery. David and I saw the MRI results at the oncology office. The ruptures are so huge that the woman who used the word “explode” was actually right. The oncologist validates that my symptoms could definitely be the result of a spontaneous rupture this big. I’m waiting for the scheduler from the plastic surgeon’s office to call.

David was out on a bike ride when the oncologist called. I emailed all my family and friends with the good news before he came home, so he was the last to know. The expressions that flashed across his face when I told him I had the results went from tension, to fear, to joy in the span of a moment. I didn’t cry then, but tears are in my eyes as I write this post. I could see how worried he was, and I felt bad about being the cause of his concern. A part of the worry about recurrence is fear of becoming a burden to this man I love so much. I’m not the only cancer survivor I know who asked herself before she married if it is a fair thing to do to to someone you love. I counsel others that “cancer people need love too,” but I know how they feel.

When I went through surgery and chemotherapy twelve years ago, I made two wishes. I wished to become an artist, and I wished to fall deeply in love and be loved deeply back.

David and I worked together as pharmacist and nurse for ten years before we dated. I didn’t know him personally until I was working light duty during my cancer recovery. During that time, we sat on committees together, and developed a friendship. He knew about my treatment, all my coworkers did. He saw me lose my hair, saw me bald, and saw my hair grow back. Somewhere through all of that, he fell in love with me. I didn’t realize it at first. I mean, we’d worked together for ten years. What kind of man falls in love with a bald, breastless nurse? A damn fine man. The best person I have ever met, and that’s saying a lot, because I know lots of really good people.

We started dating a year after my recovery, and married three years later.

Two weeks ago, while we sat in the waiting room before my MRI, I took off my wedding ring for David to hold while I had the test. Out of his jacket pocket, he pulled the original cardboard box that held the small, velvet jewelry box our wedding rings came in. His ring was already inside the box. “They need to stay together,” he told me. If the tech hadn’t come to get me that moment, I would have cried. In fact, I did cry a little on the MRI table thinking about how good my life is, and how much would be lost if the cancer had recurred.
Thank You.
I don’t know why I am a lucky one. I’ve stopped wondering why I’ve been blessed with such a positive outcome when so many others are not. I am no more special than any of my patients or friends who have succumbed. Most of the time it feels like a poker game and all any of us can do is pick up the cards we are dealt. Maybe it is that random, I don’t know. But if it’s not, Thank You.

Thanksgiving Day 2009

photograph by Adriana Paradisi

Thanksgiving is the holiday of peace, the celebration of work and the simple life…a true folk-festival that speaks the poetry of the turn of the seasons, the beauty of seedling and harvest, the ripe product of the year-and the deep, deep, connection of all of these things…

David Grayson

     Wishing safe travel for everyone on the roads today.  Thanks to all of the nursing and medical professionals who are missing holiday meals with their loved ones so that patients can  receive care in hosptials and nursing facilities.  Happy Thanksgiving to all!

Color Theory: Anemia

     This week, it seemed all of our patients required blood transfusions. They came in with similar symptoms: fatigue, shortness of breath on exertion (SOB or dyspnea), headaches, and low hemoglobins, however, the causes of anemia vary. Anemia is a common side effect of chemotherapy, but renal disease, and nutritional malabsorption can cause anemia too. Then, there is  the anemia caused by a leakage of blood from the capillaries in the gastrointestinal tract. Insidious and slow, it takes awhile before the patient is aware of the onset of fatigue, shortness of breath on exertion, and headaches.

     I thought  of this slow- leaking anemia the other day when a colleague mentioned that last week she had “hit the wall” and could not add one more request to her list of commitments. It’s a metaphor describing the creative depletion artists, nurses, and most people feel when we lose control of our protective boundaries; when we forget to say “not today” to the ” just one more simple request” from someone needing our talents, our skill, our time; taking us away from our studios, our breaks, and the activities which nourish and renew our souls.

      I am learning I don’t have to catch every ball that’s thrown to me. I know it’s about choices. But I hate to turn away new experiences and opportunities, so instead of “no” I’ve learned to say, “not today.”

     I like to keep the door open….

Disclaimer: This post is not intended to dispense medical advice. If you suspect that you or someone you know has anemia, consult with a Licensed Medical Practitioner (LMP) for diagnosis and treatment.