Is There a Doctor in The House? The Adventures of Nurse Niki Chapter 29, posted this morning. Niki and her sister Raquel go out for cocktails and girl talk, but their evening out is interrupted.
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!
Few life-threatening or terminal diseases present themselves in otherwise healthy, alert, and charming hosts the way cancer does.
From the get-go, oncologists are not only captain of the ship; they hoist life preservers in the form of treatment to patients drowning in waves of shock after a cancer diagnosis.
In my opinion, oncologists’ hearts closely resemble those of nurses. This is attributed to the fact that although oncologists do not spend the same quantity of time with patients as nurses do, the quality of the time they spend is intense. They often form relationships with patients over years. It’s common for an oncologist to know close members of their patient’s family, also like nurses.
During my last episode of possible (it wasn’t) recurrence, I experienced this truth.
My oncologist and I share a professional relationship. One of the reasons he’s my oncologist is because I know he’s good at what he does. My husband likes him, too. They share an easy communication, which is another reason for my choice. If/when cancer recurs, I know they will cooperate on my care, freeing me to be the patient, not the nurse. This arrangement brings me peace of mind.
Anyway, I had suspicious symptoms, which landed me face down in an MRI. My appointment to receive the MRI results was scheduled at end of a workday for my oncologist.
David accompanied me. Dr. My Choice entered the exam room holding the films, clipping them to the light box.
“I haven’t looked at these yet,” he explained. “I thought we could see them at the same time.”
It hit me in a flash: Dr. My Choice likes us too. He is about to find out if he will tell a nurse he enjoys working with, and her husband, whether or not her cancer has recurred.
Snap! What have I done to him?
Fortunately, the films revealed I am still cancer free. The look of relief on Dr. My Choice’s face nearly equaled David’s.
Oncologists, (doctors) have feelings, too. This knowledge affects the professional relationships of nursing practice in the following ways:
- When questioning an order, assume the doctor has good intentions toward his or her patient, same as you.
- Avoid framing questions to a doctor with your personal inferences, such as opinions of whether or not the physician is “good” or “bad.”
- Consider that doctors suffer from work overload, and burn out, as do nurses.
- Remember: Being part of a team is catching one another when we fall. No one is on top of his or her game every time.
- Protect the Rock Star Doctor (every unit has one) by double-checking their orders the same as you do for any other physician. Don’t let them fall to earth because you were not diligent in providing a safety net for their patients.
Education is the tool of our trade. It is our demeanor, which makes us professionals.
The Adventures of Nurse Niki Chapter 2 is posted. This week, Niki begins discussing her workplace. On Facebook, Niki explains some of the differences between Pediatric Intensive Care Nursing, and Neonatal Intensive Care Nursing. These two nursing specialties are often misunderstood by lay people. I let Niki post one of my drawings to her Facebook page too. Please be sure to Like Nurse Niki’s Facebook Page, and you can Follow Nurse Niki on Twitter @NurseNikiAdven
“To relieve a full bladder is one of the great human joys.” Henry Miller
When I hear the word inertia, the meaning I think of is actually paralysis:
The loss of the ability to move (and sometimes to feel anything) in part or most of the body, typically as a result of
illness, poison, or injury; inability to act or function in a person, organization, or place.
The actual definition of inertia is:
A property of matter by which it continues in its existing state of rest or uniform motion in a straight line, unless that state is changed by an external force. Inertia is the inability to change course.
Nurses experience inertia when we are unable to switch gears from the high emotional output of our jobs to the more “normal” activities of our personal lives.
I wrote about my difficulty changing course in “The Hostess With The Mostest.” In that post, I describe struggling to transform from on-duty nurse into a party guest at the end of a shift. The difficulty is not only in physically changing from work clothes to party wear. It’s also in retooling my brain for party talk. I have to remember how to talk about favorite restaurants, or the latest film I have not yet seen, instead of cancer nursing, blogging about nursing, or the other related things I spend large amounts of my time doing, casting a shadow over a perfectly good cocktail party.
I think about this while observing people who are not nurses enjoying themselves by taking funny pictures with their cellphones while I avoid being caught in any photographs I wouldn’t want an employer to find on Facebook. Do I worry too much, or is it this a characteristic that makes me a nurse?
It’s healthy for nurses, like myself, to avoid inertia and change course through external activities after leaving our places of work. I find it easier said than done, however, not because I can’t relax, but because “normal” life sometimes fails to hold my attention.
I suspect other nurses find normal life less interesting than their nursing roles, too. If we aren’t over-scheduling ourselves with committee meetings, working overtime, all the while being the World’s Best Soccer Mom, we don’t feel busy enough.
This point was brought home to me by a friend who commented that I seemed tired after I said I was going for a run after getting off a 12-hour shift early. I told her, “No, I’m not tired. I only worked eight hours today.” She replied, “For most people, eight hours is a full day’s work. Go home and get some rest.”
I didn’t. I went for the run. I do my best thinking while running, not meditating on a yoga mat. It’s hard to walk when you’re born to run.
Do you think preferring a busy and sometimes-hectic lifestyle is a characteristic of nurses?
Horrified, I watched helplessly on the esplanade as a fuzzy, yellow gosling struggled to right itself from his back in the high water of Oregon’s Willamette River. Four feet away, his mother placidly treaded water, making no attempt to help.
The Willamette River runs swift and cold, with a notorious undertow. Impulsively, I considered jumping in to save the gosling, but the imaginary headline on the evening news played inside my head:
Crazy Nurse Drowns in Failed Attempt to Rescue Gosling. Pictures at Eleven.
Luckily, the gosling righted itself and swam away with its mom and siblings.
I feel a similar sense of helplessness caring for the occasional patient (and sometimes a family), drowning in profound grief expressed as anger.
They present at each appointment with unending lists of complaints. They antagonize their families, find fault with every caregiver, and disparage the home cooked meals generously provided by neighbors. They complain until you contact the oncologist on their behalf, only to find this patient refuses the prescription you are requesting every time his doctor offers it.
Your co-workers snigger when you tell them; they’ve made the same phone call for this patient. You believe your patient is stuck in the grief process at anger, expressing it by making everyone around him crazy. These patients are not violent, nor verbally abusive to nurses. The problem is the amount of energy they require, without solution or resolution. Eventually this may cause nurses to emotionally shun them, like the goose watching her gosling drown.
How can you help these patients without drowning along with them?
- Enlist the help of nurse navigators, social services, and spiritual care. Some patients will refuse or sabotage this help, but ensure that it’s offered. These experts have experience dealing with these situations. Enlist their help.
- Resist triangulating yourself between the patient and family, or patient and oncologist. Encourage the patient to interact with caregivers directly by scheduling her own appointments, rides, and prescription refills.
- Using input from the nurse navigators, social services and spiritual care, create a care plan for this patient. Through consensus, gain buy-in from staff caring for him or her. Some patients benefit from consistent staff assignment — however, beware of establishing “favorite nurses.”
- A characteristic of dysfunctional grief/anger is playing people (especially nurses) against each other. Ensure the care plan is ethically sustainable for the nursing unit. Other patients know when another receives “special” treatment. Keep things fair.
I think about the goose watching her gosling struggle helplessly, accepting that he may drown. It’s difficult to reconcile this image with the role of a nurse. Not every patient will die a good death, but with a little help, some, like the gosling, may right themselves.
What suggestions do you have for nurses with patients stuck in the grief process?
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.
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!
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.
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:
- The shift is over.
- You are going home.
- 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?
You will build a body of work, but you will also build a body of affection, with the people you’ve helped who’ve helped you back. This is the era of Friends in Low Places. The ones you meet now, who will notice you, challenge you, work with you, and watch your back. Maybe they will be your strength.
I don’t do chain letters or emails. I prefer ignoring them, incurring whatever god-awful threat I received them under.
However, Joni Watson at Nursetopia, nominated JParadisiRN for a Liebster Award. She said some really nice things. I like Joni. We are also blogging colleagues at TheONC, so I’ve decided to play. Besides, there are talented and generous bloggers I am over due to recognize. This Liebster award is a way to say, “Thanks.”
I plagiarized the following two paragraphs from Joni’s post because they explain the responsibilities of accepting a Liebster Award:
The premise of the Liebster Award is simple; it is a meme-ish way, a chain-letter so-to-speak, for bloggers with reading audiences of 200 to 2,000 to honor one another. As I’ve followed previous blog nominations from post to post, I’ve picked up several great blogs for my own reading pleasure, so surely the Liebster Award is functioning as intended.
For the nomination, I must tell readers 11 things about myself, answer my nominator’s 11 prepared questions, nominate up to 11 other bloggers for the Award, and prepare 11 questions for them to answer in their subsequent posts. I’m not sure what the fascination is with the number 11, but hey, let’s roll with it!
Joni and I share the same nurse blogger community. I wish to also tip my hat to the bloggers she mentioned, especially Dr. Dean Burke.
- City Girl Farming: Kerrie’s genius for raising chickens, and incorporating country living into an urban environment makes her one of my favorite bloggers.
- Digital Doorway: Not only is Keith Carlson a talented writer, he and fellow nurse Rob Fraser are collaborators on the innovative RNFM radio.
- Rob Fraser RN: Has written a book on nursing social media, besides collaborating with Keith Carlson at RNFM radio.
- Body of Works: This new blog is a collaboration between a surgeon and an artist.
- Ultra Sounds: “An online forum for Creative Exploration of the Cancer Experience.”
- NursingCenter: Lisa Bonsall is a favorite nurse blogger.
- Stacy Nigliazzo: This is a website, not a blog, but if you are unfamiliar with Stacy’s poetry, you should stop by. Her poetry is informed by her nursing. We’ve had the honor of our work appearing together in two separate issues of the American Journal of Nursing.
- Art Stormer: Betsy Wills tells interesting stories while bringing the work of emerging artists to our attention.
- TheONC: An online community featuring blogs by some of the leading thought leaders in oncology nursing practice.
- SpiderHuggers.com: While not recently updated, this informative, and delightfully written blog charmingly illuminates the world of spiders.
Eleven Things About Me:
- If I wasn’t blogging about art and nursing, I’d blog about food, wine, and spirits.
- My life is influenced by the phrase, “People are more important than things.”
- I am left-handed.
- My last job before becoming a nurse was cocktail waitress.
- I don’t eat red meat.
- I hate mayonnaise.
- Although I got my driver’s license at 16, I didn’t really know how to drive until I was 23.
- I won my first art award for a charcoal drawing I made, and my mother secretly entered into a local contest.
- I don’t roller skate, skateboard, or ski. I don’t like slippy-sliddie sports. I like my feet close to the ground.
- Although I am uncomfortable with heights, I have parasailed, and loved it.
- I believe the secret of happiness is finding meaning daily in the experiences of our lives.
Eleven Questions From Joni
1. What is your most favorite blog post you’ve ever written?
I’m still trying to write it.
2. When you’re not blogging, what do you do for fun?
Running, it’s when I do my best thinking. Painting, writing, cooking, knitting, spending time with family, road trips.
3. What’s your favorite book of all time?
It’s a tie: To Kill a Mockingbird, and A Tale of Two Cities.
4. Pets or no pets?
Currently, no pets, but I’ve had everything: snakes, birds, fish, turtles, pollywogs, kitties, and puppies. The last pet was David’s, my nemesis, Lucas.
5. How many healthcare professionals do you have in your family?
Four. I’m the only nurse.
6. What’s your ideal weekend?
Relaxing with David, and spending time with the kids without time pressures.
7. What’s your best organization tip for work or life in general?
Choose your goals, then work backwards to find out what steps you’ll take to reach them. If you can’t figure out the steps, you haven’t spent enough time researching your goals.
8. As a child, what did you want to be when you grew up?
I had a hard time choosing. As a teenager, an artist and writer. My father encouraged me to get job first, so I’d have something to write about. I stumbled into nursing accidentally. It turns out to be an excellent fit.
9. What or who made you laugh today?
It’s always David.
10. If you could be friends with one literary character, who would it be?
Antoine De Saint-Exupery’s The Little Prince.
11. What joke makes you laugh every time you hear it?
This is sacrilegious, because I really believe Capt. Sullenberger and his crew are heroes, but I laugh every time I watch this Matt Damon clip from 30 Rock. “Where’s my ticket to the Grammy’s?” It kills me!
Eleven Questions for my Nominees:
- Who was your childhood hero?
- What book (s) have you read more than once?
- If you could do one thing in your life over, what would it be?
- In one sentence or less, how would you describe yourself?
- What is your favorite way to exercise?
- Name one person from any era, dead or alive, you would like to meet.
- What is your secret talent?
- Do you ever dance to music when no one is watching?
- What is your all-time favorite TV show?
- What TV show theme song you know by heart?
- What is one ability you wish you had, possible or not?