Diet As Tolerated

Posted on May 14, 2013 by jparadisirn

by jparadisi

Sitting in a trendy restaurant sipping a cocktail, I pick Marcona almonds from a small plate set between a blonde woman and myself. We are guests celebrating the birthday of a mutual friend. We grin self-consciously before introducing ourselves.

She asks, “What do you do for a living?”

Do all nurses dread this question at parties? Admitting I’m an oncology nurse is a buzz kill. The dread I anticipate appears in her eyes but not for the expected reason. She says her father is hospitalized in another city and “not doing well.” She can’t visit as often as she’d like.

She asks, “Do you like your patients? Is it hard taking care of them?”

I wonder, how much information can she tolerate? A few morsels or an entrée?

Cancer conjures images of wraiths drinking reconstituted chicken broth from Styrofoam cups or receiving nourishment through tubes. It would be untruthful to say this never happens, however, the social ambience of the clinic where I work surprises newcomers.

Instead of lounge chairs lining the walls of a single, cavernous space, our clinic has private rooms. Long-time patients have favorite ones. It’s not unusual to find Happy Birthday written in Sharpie on a piece of fax paper taped to the sliding glass door of a room of its “regular” occupant. Sometimes there’s birthday cake too. Cancer patients can eat birthday cake, like the rest of us. They eat “diet as tolerated.”

Patients with lengthy appointments are offered lunch, and some choose their infusion day based on the cafeteria’s soup du jour. Many choose to bring food from home, however.

Often, patients make their meals at the infusion clinic a special occasion by bringing utensils from home. I particularly admired a hand-thrown ceramic bowl brought by a special patient. Weekly, it was filled with something new: pillows of wonton, pea pods, and water chestnuts in broth, or brown rice with chicken. On rainy days, it cradled creamy macaroni and cheese, and an heirloom silver fork delivered each small bite to her awaiting mouth.

These meals are prepared with love. Families take pride in the accomplishment of feeding a loved one with cancer. The family table marches onto the foreign field of cancer proclaiming, “We will not surrender our loved one without a fight.”

Back in the restaurant, I see our hostess heading our way. The blonde woman has concerned eyes. There is only enough time to offer her with a small morsel of information.

I consider my answers to her questions, “Do you like your patients? Is working with cancer patients hard?”

“I love them,” I say. “Working with cancer patients is hard work but I can’t imagine a more rewarding job.” Her eyes relax. She takes a sip from her wine glass.

Like a fairy godmother, the birthday girl hugs me, kissing my cheek. Pouf! I am restored to a guest at her party, sipping a cocktail.

*This post was originally published on TheONC website.

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

Posted on January 1, 2013 by jparadisirn

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

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?

The Hostess With The Mostest

Posted on September 17, 2012 by jparadisirn

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.