Modern Nurses: Audio/Video Girl

Digital Microscope ink on paper 2016 by Julianna Paradisi

Digital Microscope ink on paper 2016 by Julianna Paradisi

Preparing materials for tumor conferences is part of my role as an oncology nurse navigator. It involves, among other responsibilities, reviewing the cases, printing copies of the agenda for the attendees, managing the sign-in rosters, and providing updated lists of available clinical trials. It also requires powering on the projector, the screen, and setting up the digital microscope necessary for the pathologist and radiologist to project slides of the tumor cells, and the MRI or Cat can images on the large screen for discussion.

Suddenly, and unexpectedly, I’ve become Audio/Video Girl. Other nurses of my generation will appreciate the humor in this.

Does any one remember watching film strips and movies in grade school classrooms? Did your hand shoot up when the teacher asked for volunteers to set up and run the projector? Mine did, but it was always a boy who was chosen. Eventually, I stopped raising my hand.

Years later when I became a pediatric intensive care nurse, I discovered an aptitude for tubes and wires, or rather I learned to get one fast. The ability to troubleshoot a ventilator until a respiratory therapist could fix it became handy too. I realized the level of skill I’d developed when as a single mom I set up my stereo system (you who grew up with bluetooth streaming have no idea how easy you have it), and a desk top computer with printer/fax using a dial-up modem. In case you are to young to know, we could not use our computers and phones at the time in those days.

I digress.

Learning to set up the electronic equipment for tumor conference was a lot like how I learned almost everything as a nurse: someone showed me how to do it once, and then I was on my own. However, as mentioned, I have developed an aptitude for technology: during the demonstration I snapped pictures of the wire connections with my phone, creating a visual reference guide to use later.

I was anxious the first time I set up by myself. While lifting the digital microscope which I imagine costs a hefty portion of my annual salary from its cart to the conference table, I distracted myself from my fear of dropping it by imagining twenty doctors staring at me because it didn’t work. Tumor conference would be a disaster if I failed..

The microscope and projector worked. Relieved, I glanced at the doctors, men and women, seated around the table. Some of the male faces resembled grown up versions of the boys in grade school my teachers chose to run the projectors. Some of them probably drive cars electronically more complex than the audio video equipment I had just set up.

To be clear, I am treated respectfully as part of the multidisciplinary team at tumor conference. I’m proud to be part of this valuable service offered to our patients. I am happy with my life choices. However, I wonder what might be different if girls were chosen equally with boys to run the projectors when I was young?

 

 

 

 

Nursing School is Just The Beginning of a Career of Learning

One aspect of changing nursing specialties, or being a new nurse for that matter, is the agreement to do homework to get up to speed. Being a certified oncology infusion nurse, while helpful, does not make me an expert in my new oncology nurse navigator position. Though working with preceptors who generously share learning, the responsibility of identifying my knowledge gaps, and seeking resources to fill them is mine.

Newly graduated nurse, I hate to break this news to you: graduating from nursing school doesn’t mean you’re done with homework. It’s the opposite. Nursing school provides the tools for finding information you need to succeed in any nursing job throughout your career. I’m serious. When early in my career a pediatric intensive care nurse befriended me, and agreed to be my mentor, the first thing she did was hand me a hardcover, 1,000+ page copy of Mary Fran Hazinski’s then gold standard text, Nursing Care of The Critically Ill Child, saying, “Read it. You can keep it too, because I just bought the newest edition,” cluing me in that expert level nurses continue learning.

I read the tome twice: the first time by looking up the diagnoses of every patient I was assigned to learn their assessment, and then understand the medical care plan. The second time, a few years later, I read it cover to cover preparing for pediatric CCRN certification.

In similar fashion, these days my evenings and days off are occupied with an hour or more of reading about nurse navigation. Yes, I’m a bit of a nerd, but the fact is I haven’t been this excited about nursing in years. Nursing school is just the beginning of a career of learning.

Nurses: Telling Our Stories Can Help Others

In art school, I once presented a painting entitled, “Recuerdo (I Remember)” for class critique. The painting was inspired by my experiences as a pediatric intensive care nurse.

The image sparked an enthusiastic discussion among fellow students, during which I answered many questions about the role of nurses. One classmate told the story of her baby’s stillbirth decades earlier. She thanked me for the sensitive rendition, allowing her to share her story.

The instructor said, “You’ve got something here.”

Recuerdo (I Remember) by jparadisi

Recuerdo (I Remember) by jparadisi

Recuerdo appeared in the college’s continuing education catalog the following spring. I was pleased with the painting’s reception, but I realize it could as easily have had the opposite effect: bringing a classmate to tears. Nurses’ stories are proverbial double-edged swords. When wielded thoughtfully, they heal. Even so, they can easily cut someone else to the bone.

I am aware of the power of story when practicing oncology nursing. I was occasionally a patient at the infusion clinic where I now work. My coworkers view the story I bring from the experience favorably. That I can teach tying scarves into attractive head coverings for chemo-induced alopecia is a plus. However, through trial and error, I have gained judiciousness about telling patients I am a cancer survivor.

Here are some self-imposed rules I follow about story telling in the patient care setting:

  • Know your patient’s prognosis. It’s one thing to tell a newly diagnosed stage 1 breast cancer patient that you are a survivor, and that her hair will grow back. It’s something else entirely to say the same thing to a woman with metastatic disease. Tailor the story to the patient’s needs.
  • Talk about cancer treatment in universal terms. Some cancers do not have the same level of news exposure and financial support as breast cancer. Cancer patients should not feel they have a less “special” kind of cancer.
  • If you are not ready to answer questions about your experience, don’t bring it up. It’s natural for patients in similar circumstances to ask what treatment options you chose. If we’re talking about breast cancer, they may ask if you had a mastectomy. If so, one or two? They may ask about sexuality, too. You might be judged for your answers. You have to stay therapeutic anyway.
  • Allow patients to have their own experiences. Cancer treatment is not one size fits all. Do not assume that a patient shares your concerns. Exchanging information is often best done through asking questions rather than offering opinions. Let the patient direct the conversation.
  • Know when to let go. Being a cancer survivor does not make me the world’s best oncology nurse. The experience is simply a tool at my disposal. What’s best for most patients is a team of expert, compassionate caregivers bringing their unique experiences to the conversation.

Have you had a health condition that impacts your approach to nursing — or a coworker who has? What advice would you share?

New Year Resolution: Don’t Wait Until Late in the Afternoon

It was late in the afternoon when my patient arrived at the oncology clinic. The treatment

Kaboom (ceramic) by jparadisi

Kaboom (ceramic) by jparadisi

prescribed required more hours than we were open. The oncologist prioritized his treatment for that afternoon and scheduled a second appointment for the next morning to complete it. The only problem with this plan was my patient didn’t realize he needed two appointments until I told him. His eyes expressed disappointment, but it was an expletive that escaped his mouth. He immediately apologized. “I’m sorry; it’s just that I don’t have that kind of time anymore.”

I understood exactly what he meant.

It was on a New Year’s Eve when I discovered a lump in my breast. At that time, I was a pediatric intensive care nurse working 12-hour shifts and a single mother. Life as I knew it came to a grinding halt. Once chemotherapy started, my oncologist prescribed light duty.  No longer a bedside nurse, I worked on office projects for the PICU manager instead.

My oncologist was hopeful. Still, I remember hearing her say there was a 32 percent chance I would die in 10 years. I was afraid. However, as a PICU nurse, I knew life could be short. This knowledge helped me gain perspective on my predicament. I’d had a good life. If this were it, how would I spend the next 10 years?

Since childhood, I wanted to be an artist. At 15, I announced my plan at the dinner table. In his thick Italian accent, my father said, “Sweetheart, you are talented and can be whatever you want, but get a job first. You will gain life experience, and then you will have something to make art about.”

Eventually, I became a nurse.

I thought about this while my chemo-bald head perched like a cue ball on the armrest of the sofa, eyes staring at the ceiling. I still wanted to be an artist. If this was the last decade of my life, I would spend it making art. I needed to start right away, because I may not have that kind of time anymore.

After recovery, I enrolled in art school and then transitioned into adult oncology nursing. In 2009, I completed a certification in fine arts and became certified in oncology nursing.

Today I am an artist and an oncology nurse. Cultivating creativity not only adds joy and accomplishment to my personal life, but it also flows into patient care. I believe it sustains my love for nursing after 26 years of practice.

Are you setting aside your creativity until late in the afternoon of your life?

Are you waiting for retirement or for the kids to leave home?

What if you discovered you don’t have that kind of time anymore?

What would you change?