Art and Nursing: Exhibiting Art Within a Power Point Presentation About Oncology Nurse Navigators

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The above paintings are original works by Julianna Paradisi, and may not be used or reproduced without permission.

This year, I’ve had a few opportunities to try on the art of public speaking, a newish skill for me. The topics revolved around breast cancer, and oncology nurse navigation.

Recently, I was asked to speak to a group of inpatient oncology nurses about the role of nurse navigators for breast cancer patients, and the application to the hospital setting. Integrating the patient experience throughout the continuum of cancer treatment is a prominent part of what nurse navigators do, and inpatient nurses wanting to learn more (and earned CE) about oncology nurse navigation is exciting.  It demonstrates ONNs have an impact on patient care.

For the occasion, I decided to learn a new skill: creating a Power Point presentation. I know, I know, some of you were making Power Point presentations since your first elementary school book report, but you probably can’t write in cursive as well as an older nurse, or use a real typewriter.

Here’s the stipulation: because I am also an artist, I have a thing against using clip art or stock images from the Internet to illustrate my words. If you are familiar with my blog posts for Off the Charts you already know this.

So, not only did I learn to create, and present a Power Point slide show, I used jpegs from a series of paintings I made of mountains, illustrating the presentation from the perspective of my personal practice. For many, the word navigator connotes images of the ocean or GPS, but as a breast cancer survivor turned ONN, I see myself as a sherpa, someone who has climbed the mountain, familiar with its terrain and potential for treachery. I lead patients  up the mountain, summit, and then come back down. The paintings of mountains also suggest the barriers to care ONNs are tasked with removing for patients. The theme was woven into the closing remarks of the presentation.

Most of the paintings depict Mount Hood, the dominating peak and iconic symbol of Portland, Oregon, my home.

I gave the presentation with a sense of creative satisfaction in finding another way to merge art into my nursing practice.

 

 

 

 

Challenging Myself in 2016

Opportunity is missed by most people because it is dressed in overalls and looks like hard work.

Thomas Edison

Wishes do come true, whether you believe or not. The caveat is that the answer doesn’t always align with the expectations of the wisher. This is why about half of the human population believes in wishes, prayers, or manifestation, and the other 50% does not.

This is also how someone like me finds herself in a fortunate predicament: my wishes were granted. I’ve obtained the proverbial three vocations I love. One makes money (as an oncology nurse navigator), another keeps me in shape (running and barre classes), and the third allows me to be creative (painting, drawing, writing, and blogging). Often the first and third converge as demonstrated in this local new feature.

The oncology nurse navigator role that I love so much is newish for me, and as such, takes hours a week of research and continuing education beyond the actual job. It is also a 40-hour workweek kind of job. Prior, I worked nearly, but not quite full time. That little bit of edge apparently makes a difference in my creative out put. I have not abandoned painting; for instance these portraits I made as a Christmas present for a family member.

 More often, however, I get off work, make myself go for a run or to the exercise studio, and then, once home, gravitate like a moth to flame to the biggest time-waster for all creatives: the Internet. Weekends are consumed with household tasks. I realize most Americans live by this routine, and if I were suffering from creative block perhaps I could live with it too, but the truth is I have as much inspiration for writing and making art as ever. What I’ve lacked is the discipline to prioritize my time. Starting with baby steps, one of my goals for 2016 is to write or draw for 15 minutes every day. It can be a chapter of The Adventures of Nurse Niki, a post for this blog, a journal entry or a quick sketch of my sofa, but everyday I will make something. I’ve already started. I set a kitchen timer to keep me honest. Most days I end up going for more than 15 minutes.

Happy 2016!

 

 

 

 

 

 

 

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.

 

Nurses: Keeping Your New Job From Feeling Like The Titanic

Complaining about being overwhelmed by a job in this economy is a little like complaining about too much sunshine. It’s a complaint of the fortunate, particularly when the work involves caring for cancer patients: Certainly the grass is not greener on their side of the infusion chair.

by jparadisi

by jparadisi

Nevertheless, the reality for those of us fortunate enough to have jobs is that everyone works harder, for longer hours compared to when the economy was robust.

I’ve thought about this a lot during my job transition to a new employer. Learning new expectations is overwhelming for everyone involved, not only for my previous coworkers and myself, but for the new coworkers too. For instance, it takes a lot of trust to cosign chemotherapy administration with a nurse you’ve never met before. Both new and previous colleagues are confronted with this. Physicians I’ve never met have been welcoming, and willing to learn that I know what I’m doing. I am a new face for the patients too, earning their trust as well.

I’m relearning skills I’m already good at using new equipment. An example of this occurred when a new colleague asked me to start an IV. “I got this,” I thought, until opening the IV catheter package. In it, I found an over-the-needle system I’d never seen before. I asked my coworker how the safety gizmo worked, feeling a bit dull-witted. I practiced with it once on a tissue box, all the while thinking of that scene from the movie Titanic, where Jack makes Rose practice swinging the axe a couple of times before letting her take a swing at the handcuffs binding his wrists to a pole while the ocean water rapidly rises. Like Rose, I was successful on the first attempt. Whew!

For those of you making a job change in the clinical setting, here are some tips for managing new job-related stress:

  • Allow extra time. Something as simple as changing a PICC line dressing can take twice the expected time if you can’t find the special wrap the patient wants to secure his PICC in an unfamiliar storeroom.
  • Bring a water bottle, and keep hydrated. Have a packaged protein snack handy for low blood sugar.
  • Go to bed early. Stress often interrupts sleep in the form of processing thoughts during the night. Allow for extra rest.
  • Minimize outside obligations. Spend leisure time with your family or significant others. They benefit from your job, and will support you when the going is tough.
  • Remind yourself that you know how to be a nurse. You may not know where to find gauze or tape, but you know how to keep patients safe. Rely on those skills.

What other suggestions are helpful when starting a new job?

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!

Nurses Work in Tight Spaces Under Intense Circumstances

I’m standing in the patient nutrition nook, eating a mid-morning snack of yogurt with a plastic fork, because I can’t find the plastic spoons. Twelve feet away, a patient can see me from her infusion chair. She smiles and waves at me.

At the same time, another nurse joins me in the nook, which is so tiny we stand nearly shoulder-to-shoulder as she responds to a text from her kids. This doesn’t bother me; she’s just looking for a private moment, same as me.

Under Oregon law, farmers selling eggs are required to make changes in how their chickens are raised by 2026.

watercolor painting by jparadisi

watercolor painting by jparadisi

According to the article, egg farmers must increase the personal space of each chicken from 67 square inches to 116.3 square inches. I’m trying to visualize what this would translate to proportionately in private space for nurses.

I don’t know very much about chickens, but I do know a little about nurses. We work in tight spaces under intense circumstances.

Finding a private spot from which to make a phone call or even to enjoy a quiet half hour during a lunch break is nearly impossible for nurses. A staff lounge for breaks provides respite from direct contact with patients, but since it’s a common area, not only nurses you work with, but people from ancillary departments, usually share it too.

Here’s the thing about people — we’re all different. For some, a break means eating a lunch brought from home, catching up with friends’ updates on Facebook, or reading a book or magazine. Other nurses, however, are re-energized by using their breaks for socializing. There’s not a right way or wrong way to take a break from patient care; it’s a matter of personal diversity.

Regardless of either style, it’s not likely that hospital units or clinics will increase private space for nurses. While it’s acceptable for hens to be less productive when privacy needs are not met, it is not acceptable for nurses to be less productive or deliver unsafe care because of a lack of personal space.

How can nurses support each other’s privacy needs?

  • Respect each other’s different break styles by moderating the volume of conversation in the break room.
  • Exercise patience with coworkers who re-energize through socialization.
  • Text rather than talk on the phone whenever possible.
  • Be sensitive to signals the person you’re on break with may not want to talk, such as reading a book or magazine.

What is your personal privacy style at work? Does your institution provide a quiet space for nurses? What are your tips for finding moments of private time at work?

Simon’s Turn: The Adventures of Nurse Niki Chapter 21

The Adventures of Nurse Niki
The Adventures of Nurse Niki

The Adventures of Nurse Niki Chapter 21 is posted! In this week’s episode, Simon’s Turn, Niki experiences a life-changing moment.

The Adventures of Nurse Niki is a work of serial fiction. The blog is formatted so the most recent episodes appear at the top. New readers not wanting spoilers of The Adventures of Nurse Niki may begin at Chapter 1 and scroll up from there.  Chapters are archived by month (click on the lined square icon on the home page). New chapters post weekly on Thursdays.

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 not only Like Nurse Niki’s Facebook Fan Page. The support is very much appreciated!

“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!

Nurse is Not Gender Specific

Nursing has a media identity problem, and it extends to men in nursing. For every sexy nurse Halloween costume, there is a patient refusing care from a nurse who is also a man. For every nurse-bitch portrayal, there is a gay male nurse joke.

Don't Call Me Murse by jparadisi

Don’t Call Me Murse by jparadisi

Occasionally, I read comments saying something like, “It’s about time men are exposed to what women have to endure in the workplace: less respect, lower pay, fewer promotions.” Women experience these inequities, but punishing another group instead is not the way to promote equality in the workplace.

According to a report published by the WSJ, the number of men in nursing has tripled since 1970 to nearly 10 percent. Men choose nursing for the same reasons women do: job stability, flexible hours, skill variety, and opportunity for promotion. Interestingly, according to the same report, men in nursing earn more money than women in nursing. This is not attributed to gender bias, but instead to choices: Men are less likely to enter nursing as LPNs, more likely to enter nursing at the BSN level or higher, and more likely to become “nurse anesthetists (41 percent), who earn nearly $148,000 on average, but only 8 percent of licensed practical nurses, who make just $35,000.” Men are also more likely to work full time than their female counterparts.

Still, men in nursing report problems of gender bias within our profession. A few common complaints are:

  • The persistent myth that men are less caring than women. The statement is rather a paradox considering the volume of information about bullying among nurses.
  • Many men complain that they endure more scrutiny and criticism of their nursing skills than their female counterparts.
  • The existence of tenacious stereotypes, which belittle all nurses.
  • Don’t call me a “male nurse” or “murse.” Like firefighter, soldier, pilot, and physician, the title nurse is only gender specific from a gender-biased perspective.

Why wouldn’t a person of any gender not want to work in a profession combing the education, technical skills, and personal interaction found in nursing? Add in nursing’s flexible hours, stable employment, and its identity as the most trusted profession? It is a disservice to discourage anyone with what it takes from entering our ranks.

So the next time your child’s elementary school teacher invites you to Career Day, if you are a woman, bring along one of your male colleagues, and begin changing the image of nurses for the children we are raising.

And a word to the guys: If you’re the new nurse in a unit of women, please leave the seat down in the staff restroom. This can make or break your relationship with colleagues.

Will we ever reach a point in the nursing profession where stereotyping no longer exists? What experiences or suggestions would you share?

Using Perspective As a Tool Against Nursing Burnout

The death rate for humans on the planet Earth is currently 100 percent. I know this is not a pleasant thing to read while enjoying your first cup of coffee this morning, or perhaps you’re enjoying a calming glass of wine later this evening. It’s unpleasant enough that perhaps you will not finish reading this post, but it’s true nonetheless.

Ravens by jparadisi

Ravens by jparadisi

Running parallel to our fear of dying is our pursuit of eternal youth. Cosmetic surgery and procedures are a billion dollar industry. Many men and women consider regular treatments for balding, teeth whitening, the prevention and removal of wrinkles, and coloring gray hair part of normal maintenance. Some choose to have  the evidence of time wiped from their faces by a surgeon’s scalpel.

The struggle nurses face in striking the right balance between hope and realistic outcomes for our patients is in part due to society’s mythical belief that death is preventable, when in fact, it’s inevitable. As humans, nurses buy into the myth to some extent also.

Discussing this, a nurse friend and I joked about gray hairs and wrinkles. She remarked, “Getting old is terrible.”

“No,” I said, “It’s not. It’s what nurses do for a living. We help people stay alive so they can grow old.”

See? It’s a matter of perspective.

Whenever someone asks, “Is it hard being a cancer nurse working with dying patients?” the above thoughts come to mind. The answer is, “I don’t see oncology nursing from that perspective.”

Yes, oncology nurses work with the dying, but I perceive our practice as helping people live to their fullest capacity.

Nurses cannot guarantee patients a cure or how long they’ll live, but by promoting prevention, treatment, and providing tools for managing chronic disease, we encourage them to pursue their best life possible as things stand. If nurses lose this perspective, how can we hope to share it with our patients?

There is balance in the realization that death is part of life. Death and loss cause grief, a normal response. Grief and loss are painful. We fear death and loss, but they are a natural occurrence of living. Maintaining a realistic perspective is a tool for burn out prevention among nurses.

All people die. Nurses are here to help patients live until that day.

I grieve their loss, and mine, because I glimpse my mortality too in the faces of the dying.

Thank you for reading this entire post.