Ode to a Pair of Nursing Clogs

This year I took a summer vacation, one of the joys of which was time painting in the studio.

I’ve migrated to three different studios over the years, but a single constant in each was my old pair of nursing clogs, converted to painting shoes.

My Nursing-Converted-to-Painting Clogs

My Nursing-Converted-to-Painting Clogs

In their earlier life, they spent ten years traipsing across a PICU, and even flew in a helicopter a time or two while transporting sick children in Oregon to Portland.

When I transitioned from PICU to adult oncology, they retired. In their new-found leisure, they started a second career as my painting shoes, where we continued to do good work together.

Anyway, over the weekend I returned to the studio and painted, changing out of my street shoes into the old, faithful clogs. They felt funny. In fact, one foot was suddenly closer to the floor than the other. I looked down, and entire sections of the right foot clog’s rubber sole had disintegrated and fallen off in chunks. As I moved about, the left foot clog did the same. I stared at them in disbelief.  I had not foreseen their imminent demise.

The Disintegrated Soles of My Nursing/Painting Clogs

The Disintegrated Soles of My Nursing/Painting Clogs

I did not have a second pair of studio shoes to change into, so I continued wearing them while painting, standing and walking, balancing on what remained of the core of their sole. We made one last painting together. I tried remembering the last patient I’d nursed while wearing these clogs, but could not.

When I finished painting for the day, I washed my brushes, and swept up the trail of black, crumbled rubber left behind on the studio floor. Removing the old, familiar clogs, I put on my street shoes, and placed the paint spattered, destroyed clogs into the garbage.

Move on. They’re just an old pair of clogs.

Besides, there’s another pair, retired when I left the infusion clinic for the oncology nurse navigator job, waiting in my closet at home to take their place in the studio.

 

 

 

You Can Find Me Here: AJN’s Blog Off The Charts

Nurses Day 2013 has come and gone. I had a particularly good one, which I wrote a blog post The Best Nurses Day Gift: Enough Time for Patients for Off The Charts, the blog of the American Journal of Nursing.

Illustrating this post is my painting, What’s Left Behind.

Why Nurses Need to Make Art

The first thing people usually say to me when they find out I’m an artist is, “Gosh, I can’t even draw a straight line.” My response to that statement is, “Nobody can. That’s what straight edges are for.”

Detail of oil painting by jparadisi

Detail of oil painting by jparadisi

When these same people discover I am also an oncology nurse, the second thing they say is, “Painting must be so therapeutic, after dealing with so much death.” My response to this statement is more complex than the first.

First, there’s not really “so much death” in oncology, as treatments improve and many cancers are managed as chronic conditions, which is great. There is still sad sorrow, however. Ironically, when I’m most engaged in a real life human drama, that’s when I find it the most difficult to unleash my creativity. On those days, I’m more likely to calm myself by going for a long run, or knitting, which I consider hobbies.

For me, the creative act of painting is often as uncomfortable as a difficult day of patient care. This is because, I believe the difference between art as therapy, and art as art, is that art as art usually begins with a question or inquiry, and most importantly, results in an insight. Art as therapy requires neither. However, if art as therapy results in an insight, it can also meet the status of art as art. Simply speaking, strong works of art, like strong nursing, involves critical thinking, not simply performing rote skills.

Attaining insight is the reason I believe it is so important for nurses to open up to creativity. Insight leads to an understanding of motivation, our own, and that of others. When we understand our motivations, we are better able to communicate with others. In this dynamic time of The Affordable Health Care Act, nurses need to publicly communicate our role in health care now more than ever.

For instance, the nurse blogosphere is full of posts championing Advanced Practice Nurses as primary care providers. Proponents focus on filling the gap created by a shortage of Family Practice physicians, and reducing the cost of care. While these goals are admirable, the time is now to take creative control of the Nurse Practitioner image by promoting the characteristics differentiating medical science from nursing science: an emphasis on preventive care, in-depth patient teaching, and patient-centered care, which are in some ways superior to that offered by medical science. By creating an image, or branding, if you will, for APRNs, they are appreciated as a unique profession, not as a watered down brand of medicine, or “doctor lite.”

Unflattering, and inaccurate images of nurses are created through tradition, novelists, and outside observers, but rarely by nurses themselves. In order to dispel the nursing stereotypes we despise, nurses will need to rise up and create new ones through visual art, novels, screenplays, and films of such quality that our vision of ourselves transcends into mainstream culture.

Note: This post originally appeared in March 14 2013 on RNFM Radio: Nursing Unleashed!

Pondering Dreams

Gate Keepers by jparadisi 2011

Gate Keepers by jparadisi 2011

People who deny themselves the privilege of dreaming are doomed to failure.

Oscar Hammerstein II

I met a twenty-something student who wants to become a doctor. He’s completed a GED and is taking art classes at a community college. For some reason, he enrolled in a science class and became enchanted by the organisms floating on a glass slide he viewed through a microscope. That’s how he decided to become a doctor. He asked for my opinion. Not wishing to throw doubt on the dreams of another, I pondered my response.

His question reminded me of the only writers’ workshop I’ve ever attended. Introductions were made around the library table where we gathered. At my turn, I introduced myself as an artist and writer developing a body of work from my experiences as a registered nurse. The eye rolling, and general lack of enthusiasm expressed by the group clearly implied my dream was ridiculous. During lunch break, a fellow participant actually told me, “You know, it takes an MFA to become either an artist or a writer.”

There’s a saying in poker: If you look around the table and can’t tell who the rube is, it’s probably you. At this table, surrounded by other wannabe writers, I was the rube.

A few weeks later, despite the dissuasion of the workshop participants, I submitted two stories, “Voyagers” and “Icarus Again,” to the publisher of an anthology of nurse stories. Both were published. Encouraged by kindly, professional editors, my writing and artwork have been published nationally many times since. My first art exhibition, fresh out of art school, was favorably reviewed by a local art critic, which is more difficult to do than it sounds.

I am an artist and writer developing a body of work from my experiences as a registered nurse.

So there.

I think about this a lot when hooking up chemotherapy infusions to patients with advanced, metastatic cancers. Their prognosis is terrible. Though it’s impossible to know what I’d choose unless actually facing similar circumstances, sometimes I think I’d choose sitting on a tropical beach staring at the ocean until the end, and not spend my last few weeks or months in an oncology clinic fighting the odds. That’s when I remind myself that any patient perhaps belongs to that small statistic of people who survive or go into remission, allowing them one more birthday, one more Christmas celebration, a family wedding, or a grandchild’s graduation.

If there is no hope, then why am I an oncology nurse? Have we nurses witnessed so much human crisis that we’ve limited our capacity for dreams? Where lies the division between dreams and realism?

What are your thoughts? Which is the larger transgression: offering overly optimistic hope or being a gatekeeper? How is this idea reconciled with diminishing healthcare resources?

 

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?

Ah Yes! Back in The Studio

I write so much about nursing and art that I sometimes forget I’m a painter. Low census yesterday meant I had a free day in the studio, with this result. I love the flexible hours of nursing!

Untitled (Woman Holding Baby Doll) oil on wood by jparadisi 2013

Untitled (Woman Holding Baby Doll) oil on wood by jparadisi 2013

Sometimes a Cigar Isn’t a Cigar

Dreaded Bathroom Mirror photo: jparadisi 2011

The painter Lucian Freud died last week at the age of 88. The grandson of Sigmund Freud, he was a portraitist, making images of friends, family, the famous and the not so much, splayed naked on ruined couches, chairs or ottomans; sometimes draped with animals, mostly dogs. I first learned of Freud in art school, during a figure painting class in which an instructor commented something to the effect of:

“He breaks a lot of rules of painting, but somehow it works.”

I like Freud’s portraits, and was a little shocked after he died to read that many art critics strongly dislike them. Jerry Saltz writes about Freud for NYMag:

“Which brings me to my personal taste. While I don’t particularly like Freud’s work (just last week I saw the Met’s current Freud show and thought, “Meh”). Yet then as now, I admire him greatly. I look at Freud’s intensely worked, eternally noodling oozey surfaces, the incessantly teeming little paint-brush strokes, the Morandi-like limited palette of flesh tones, and his claustrophobic vision of naked models forever posing in his famously dilapidated London studio, and am often struck by how the life of his art seems to drain away. Mostly what I see is nearly maniacal painterly control. Yet Freud is an important touchstone for the many of us who secretly fear that we are not naturally gifted; we who are not precocious geniuses, we non-Picassos who are always unsure that we even are what we say we are.”

Ouch! Those are some harsh words. Good thing I’m not thin skinned.

The opinion that best challenges my own comes from someone whose art critique I hold with regard. He wrote about Freud:

“I hated his work with a passion. Certainly, like everyone else, I could see the penetrating psychological deconstruction he was going for and nailing…his drab palette and ethos of anti-romanticism encapsulated everything I am against.”

(Note:  Romanticism refers to a philosophical movement within art history, not romance, as in sharing a good Oregon Pinot Noir and gourmet chocolates naked on the deck by moonlight…Hmmm. Hey, David.….?)

My friend’s words touched on something for me, and I’ll tell you what it is. I agree, Freud’s portraits are “penetrating, psychological deconstructions” of his subjects. They are disturbing because they coldly render the sitter into gobs of painted flesh, not pretty flesh, but swollen, loose, pale, sweaty flesh. Freud took months to a year to finish a portrait, literally “deconstructing” the sitter through the physically punishing act of posing for hours, days, weeks, and months.

Sometimes, he painted people we think we know, like pregnant super model, Kate Moss. I only know the painting is of her, because he told us it is. Through Lucian Freud’s eyes, I do not recognize her famous face. At times, his portraits remind me of the shock I feel seeing the reflection of my imperfect body emerge from the shower in the in the steamy bathroom mirror, or watching David’s unguarded face in the repose of sleep; in both instances wondering, “who is that person?” This feeling of astonished wonder, this anti-romanticism, is the price of intimacy.

Freud looked at people through the eyes of a clinician, reducing them to bluish veins under discolored flesh. I think that’s why I like his paintings. I am a nurse, and often, the first vision nurses have of a naked patient is similar to one of his portraits. The sensation brings a bit of shock to both nurse and patient. Part of nursing is gaining the ability to navigate within the intimate personal space of another human being. We use a clinician’s eye to assess problems readable in the naked flesh of our patients. However, it is inherent in nursing to turn off the clinical eye and relate to the person residing inside the ailing flesh, with the understanding that they come before us deconstructed by their disease process.

Our decaying flesh is the price we pay for being mortal.

Social Media is a Gateway Vice

 
 
 
 
 

Street Art, artist unknown. photo: JParadisi 2006

   The stories people tell have a way of taking care of them. If stories come to you, care for them. And learn to give them away when they are needed. Sometimes a person needs a story more than food to stay alive. That is why we put stories in each other’s memory. This is how people care for themselves.

B. Lopez

 

 

     I clicked publish on the dashboard and became the narrator of my life.

     As all such stories begin, it was innocent at first. I’d heard it was dangerous, but I thought I could handle myself. I had no understanding of what I had done. So began JParadisi RN’s Blog.

     My naiveté was the result of experiences with other social media platforms. I actually closed my Facebook account once, and Twitter is no more to me than an electronic business card. I use each to announce art shows or accomplishments, and keep up with the same information from my friends. But, blogging, oh blogging, forgive my human foible I am hooked.

     Like most initiates, in the beginning I checked stats obsessively throughout the day, lit by each new hit. Soon, hits weren’t doing it for me anymore. I craved comments and links. I needed to know someone was reading my posts. Like a neighborhood dealer, the Internet is happy to oblige. It makes me wait in anticipation, driving me to write more, write better, whatever it takes to get another link or comment. Ideas for new posts wake me up in the middle of the night. At work, I look for occurrences to divert into insightful posts. Often I see the ideas as images, so I started a second blog, Die Krankenschwester to handle the overflow.

     Of course, I exaggerate to some extent.  Occasionally I am able to shut down my computer for up to 24 hours at a time. Blogging isn’t an addiction. It is a medium of self-expression just like painting. Blogging is equivalent to exhibiting my paintings: a public voice. In one way, it’s superior to a traditional art show, because I don’t have to ask permission to publish my thoughts on a blog. In the art world, hanging paintings in a gallery requires the permission of the gallerist. As a writer, I ask permission from editors to publish my stories. In many areas of our society, the public expression of individual opinions requires someone’s permission. Not inherently bad, gallerists and editors are gatekeepers, deciding who gets in (I am joyful when they pick me).  Blogging bypasses the gatekeepers, allowing anyone to express him or herself freely, as long as they are willing to take on possible consequences.

     It’s no wonder that people homebound with chronic or life-threatening diseases use social media to find support. It’s not surprising so many nurses blog, often anonymously, telling the stories their friends and families often don’t have the stomach to listen to or the background to understand.  I remind myself at social gatherings to say only I am a nurse, when asked what I do for a living. No one wants to hear about critically ill children or oncology at a cocktail party.

     We are social creatures and our need to tell stories is strong.  I cherish the quiet solitude necessary for my creative process, but if meditation was all it’s cracked up to be, solitary confinement wouldn’t be a punishment.

JParadisi RN Launches New Blog: Die Krankenschwester

  “There is no use trying.” said Alice; “one can’t believe impossible things.” “I dare say you haven’t had much practice,” said the Queen. “When I was your age, I always did it for half an hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.” 

 

-Lewis Carroll  

   

  If you could hear this sentence, there would be a drum roll.   Die Krankenschwester is a blog exploring identity by combining blogging and visual in an experimental format. Kronkenschwester ( kron/ken/shwester) is German for nurse and translates literally to the sick sister.  Most of the art work will be created specifically for Die Krankenschwester over a not yet determined period of time. The images represent a visual exploration of nursing practice and identity through art and pop culture.  I don’t have more of a plan than that. So check in at Die Krankenschwester now and then and see what you think.  

     JParadisi RN’s Blog will continue as a separate from Die Krankenschwester.  

  

Die Krankenschwester blog header JParadisi 2010

Die Krankenschwester blog header JParadisi 2010

Making a Painting with Gertrude and Earnest in the Rabbit Hole

 
 

comission (2010) artist: JParadisi

It takes a lot of time to be a genius, you have to sit around so much doing nothing, really nothing.

 

Gertrude Stein

   

  I don’t know much about genius, but I do know about making a painting, and it does take time sitting around doing nothing sometimes. I hate those times. I try to welcome them. I am a doer. I like waking up every morning with a list of things I want to do. Nursing is a good fit for me in that sense: there is always something to do when I’m at my nursing job. The studio is not like that. I go to the studio thinking I have several hours to make a painting. I set up my tabouret (a fancy French word for a little table or stool) with paints and medium and brushes and rags. When I can I leave a painting at a moment when I know what my next brush stroke will be. Then, when I return to the studio I have a starting point to re-enter the painting. It’s a little trick I play on myself.  Hemingway used this device, stopping at a point in a story where he knew what he would write next.  Knowing where to start does not guarantee a painting will progress, however. How many times have I spent hours applying paint to a canvas and stepped back to look at my work, disappointed? Sometimes, knowing what to do next leads to an artificial and contrived feel to the painting that I cannot stand. So out comes the palette knife and rag and I scrape and rub away all that paint and hard work, leaving me clueless how to get back into the painting.  At that point, I am Alice down the rabbit hole, forced to sit back and do nothing, really nothing. It’s painful and frustrating. The nurse in me wants to complete her tasks and check them off her list. The artist in me knows that’s not how a work of art gets made, and she laughs at the nurse’s compulsion.