This Halloween Teal and Blue are The New Orange for Parents of Children With Food Allergies, Autism 🎃

Autism and Food Allergies Awareness at Halloween

Blue Pumpkin Bucket with Teal Pumpkin watercolor and ink by Julianna Paradisi 2019

This Halloween, Teal and Blue are the new orange for parents of children with food allergies, and autism.

Recently, I learned of two newish movements that merit recognition for championing the health and happiness of children while trick or treating. Both choose pumpkins of different shades of blue to alert the public to their causes.

Teal Pumpkins Help Children with Food Allergies Participate in Halloween Fun

How difficult Halloween must be for parents of children with food allergies! Imagine taking your favorite Disney character or Marvel superhero trick or treating, only to remove almost the entire loot from their buckets or bags at home, because most trick or treat candies contain allergens like dairy products, peanuts, dyes, etc. It must be heartbreaking to have to explain to your child again why they can’t eat the same goodies other kids do.

The Teal Pumpkin Project offers an inclusive alternative for children with food allergies at Halloween. By placing a teal pumpkin outside your door, you signal to children with food allergies and their parents that you are giving out non-food items for treats. The website creates neighborhood maps of homes offering non-food item treats, and you can add your home. Or, simply paint a real pumpkin from a pumpkin patch or grocery store teal, and put it on your doorstep or windowsill.

Here’s a list of inexpensive non-food items from their website:

Glow sticks, bracelets, or necklaces
Pencils, pens, crayons or markers
Bubbles
Halloween erasers or pencil toppers
Mini Slinkies
Whistles, kazoos, or noisemakers
Bouncy balls
Finger puppets or novelty toys
Coins
Spider rings
Vampire fangs
Mini notepads
Playing cards
Bookmarks
Stickers
Stencils

They do caution that some modeling clay products may contain wheat, and avoid products with latex. Age appropriateness and avoiding choking hazards should also be considered.

Blue Halloween Pumpkin Buckets: Be considerate of children, teenagers, and young adults with Autism enjoying Halloween

This Halloween, you may notice children, teenagers, and young adults carrying blue plastic pumpkin buckets. This became a thing last year when a mother wrote a social media post that went viral, asking people to please not require her non-verbal three year-old to say, “Trick or Treat!” to receive candy. She went on to explain that Halloween can be an engaging social event for children, teenagers, or young adults with autism, so be considerate of those who don’t respond verbally, or appear to be a bit “old” for trick or treating. This is good advice even if a person isn’t carrying a blue Halloween pumpkin bucket, because by showing kindness to strangers some have entertained angels unawares.

Blue pumpkin candy buckets can be purchased online.

Celebrations are more enjoyable when no one is left out. I’m grateful for opportunities to make Halloween activities fun for all.

 

 

 

New Episode: It’s Not All Cute Print Scrubs and Bunny Blankets

 

The Adventures of Nurse Niki

The Adventures of Nurse Niki

It’s Not All Cute Print Scrubs and Bunny Blankets is this week’s episode of The Adventures of Nurse Niki. Niki ruminates about floating from PICU to pediatrics. If you’re new to the blog you may want to catch up by starting here, Chapter 1

Don’t forget to follow Nurse Niki on Twitter

@NurseNikiAdven and “Like” The Adventures of Nurse Niki on Facebook!

The Adventures of Nurse Niki Chapter 5: Dirty Dishes, Stress Dreams & Earthquake Preparedness

The Adventures of Nurse Niki
The Adventures of Nurse Niki

The Adventures of Nurse Niki Chapter 5 is posted. This week Niki navigates dirty dishes, a  stress dream, and earthquake preparedness. Sound familiar? You probably work night shift!

On her Facebook page, Niki posted a video of a song she was listening to on her CD player. Notice the shopping carts? You’ve probably read Chapter 4. Last week, Niki posted Simon’s recipe for Macaroni and Cheese with gluten-free substitutions. Anyone tried it yet? 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 blog, the retweets of  @NurseNikiAdven, and those who not only Like Nurse Niki’s Facebook Fan Page. The support is very much appreciated!

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?

Keeping Toddlers Safe in an Adult Only Home

Scarletti Confetti pencil and markers on paper 2011 by J.Paradisi

With the onset of late summer hot weather many local children are falling through the screens of open windows. (Another frequent danger to children during hot weather is drowning.  AJN editor-in-chief, Shawn Kennedy posted an excellent article on that subject for Off The Charts).

When I was a Pediatric nurse, the falling diagnosis was nicknamed failure to fly, but only if the child was admitted for nothing more serious than observation and a few bruises. Often the injuries are life threatening or worse, and in truth such an accident is no laughing matter. Perhaps this is why Sesame Street has never featured an episode titled Things That Don’t Fly, in which I imagine Elmo singing a list of things that don’t fly: rocks, books, and YOU!

Okay, that’s not funny either; it’s a poor attempt at humor stemming from recent anxiety while babysitting my favorite toddler, the sister of my favorite twelve year old. A decade has passed since I’ve babysat a toddler, and I worried over her potential for injury while in my care. I’m a nurse, and a former Pediatric Intensive Care nurse at that. It’s a lot of pressure. Of all the people in the world, she should be safe with me, but from the moment she entered my home I realized how dangerous the adult environment David and I share is for an active toddler, even after efforts of childproofing, which included taking all of our CDs out of their towering storage rack and laying it on its side so she couldn’t pull it down on herself, locking under the sink cabinets, installing socket covers, and removing from reach all small, swallowable objects. The balcony door was fastened the entire visit, and she was not allowed on the balcony, even with adult supervision. All windows were closed and locked. There would be no failure to fly on my shift.

Here’s some other tips gleaned from over fifteen years in pediatrics, the news, and personal experience. In no way is this list complete or infallible:

Grandma, What’s in Your Purse? I have no idea how many accidental poisonings occur because a small child finds prescription pills in an unattended handbag. It’s so common that I have removed my little bottle of ibuprofen, used for headaches at work, from my purse. It’s inconvenient; sometimes I have to mooch from my coworkers or walk over to the hospital pharmacy and purchase ibuprofen when a headache comes on at work, but that’s how it is.

 ABSOLUTELY KNOW WHERE THE CHILD IS BEFORE STARTING THE CAR’S ENGINE. This applies when there is more than one adult with the child. Too many children are run over by a car while it’s backed out of a garage or driveway. The driver of the car and the adult in the house each assumed the child was with the other. When I was fifteen years old in Drivers’ Ed, the instructor taught us to walk behind the car to see what might lurk there before getting into the driver’s seat. This is an especially good idea when small children are near.

Never Leave The Child Unattended With The Family Dog. Dogs that are not accustomed to children are unpredictable around them. Dogs that are accustomed to small children are unpredictable around them. I once heard a story of a loyal dog uncharacteristically attacking the family’s toddler. The family was so shocked that after the dog was put down, they had an autopsy performed and found the dog had a painful ear infection. When the toddler touched her ear, the dog attacked him in pain. A very sad story. Protect both the child and the pet by never leaving them together unattended.

Secure That Big Ass TV. Towers of CDs aren’t the only things children old enough to crawl can pull down on themselves. TV’s that are not secure on their bases or bases that are the least bit wobbly put children into ICU’s with crushing injuries every year.

Do Not Assume Any Device Installed For The Child’s Protection Will Work. I’ve seen children who got under impossibly heavy hot tub covers and drowned. Baby gates fail and lead to falls. Years ago, I put my daughter’s baby acetaminophen on top of our refrigerator, safely out of reach when she was small. When she became a teenager, she informed me that as a child, she had climbed the kitchen drawers onto the counter and ate one or two orange flavored acetaminophen at a time while I took a shower, demoralizing me the way only a teenager can demoralize a parent.

The Best Protection for Children is Your Presence. Let the housework and phone calls wait. You are not the kid’s parent, so you’ll have time to clean up after they leave. Getting to know these little people is one of life’s most satisfying experiences. This is your opportunity to influence a developing new life in a positive way. There is nothing in the world more important than their safety and your peace of mind. Enjoy it while it lasts. They grow up so fast.

How I Became a Nurse Part II: Gatekeepers

Gate Keepers by jparadisi 2011

“Jules, you need to quit wasting your talents working with Sister Sebastian up there on the Pediatric unit. I want you transfer to Pediatric Intensive Care so I can train you. You’re a natural,” said Roz, when we finished our shift.

Roz found a way for me to float to PICU at least once a week. Soon, I was caring for stable patients with her backup. It was complex work, and I had a lot to learn. I loved it. I wondered what it would take to become staff. Roz encouraged me to ask Barbara, who managed both pediatrics and the PICU.

Barbara worked her way into nursing administration first as a pediatric RN and then in PICU. She and Roz had worked side by side in both units before Barbara became manager. They were friends. Roz and I sat in her office, discussing my transfer.

“Roz can’t say enough good things about your nursing, Juli. I’m happy to hear you’re doing well and I’m grateful for your help in the PICU. I think you will make an excellent PICU nurse, however, I’m reluctant to transfer you there so soon after graduation. You’ve been a nurse for less than six months, and I’m afraid that getting in over your head is a real possibility. I will feel more comfortable with the idea after you gain more experience. I don’t mean to discourage you, but for now the answer is no. Let‘s talk about it again after you‘ve been here a year.”

I was already in over my head on the pediatric unit, but I understood Barbara’s concerns. Since I floated so often, I knew it wouldn’t be long before she changed her mind. I decided not to push for the transfer at present.

What I didn’t count on was interference from Sister Sebastian. One evening I checked in on Peds before floating to PICU when once again she stopped me at the nurse’s desk.  “I see they scheduled you in the PICU tonight, however, it is not fair for them to have favorites. You cannot always be the nurse who goes down there. I am keeping you here tonight and I have sent Leah down to them instead. I have told Roz no.” Her wimpled face radiated with satisfaction as she spoke. She found pleasure in the self-assigned role of gate keeper. Her personal disappointments compelled her to block the way of others pursuing happiness. Now I know life is full of such people.

I wanted to argue with her that the other Peds nurses hated floating to PICU, but I knew it wouldn’t help. I took report on my assignment, realizing I was going to stay a Peds nurse for a very long time. During my break in the staff lounge, Roz called from PICU. “This isn’t the end of it,” she said.

Three days later, Barbara called me back to her office. Roz was already there, seated. Barbara started the conversation.

“Juli, Roz requests I transfer you to PICU. I have already explained my concerns. I still feel the same, but Roz has agreed that if I transfer you, she will take responsibility for your training in the PICU. She has committed to working the same schedule as you every shift for a year, to make sure that both you and your patients are safe. Do you still want to transfer?

I couldn’t believe Roz would commit herself like that for me. I agreed to the transfer, resolute that she would not regret her choice. Years later, after mentoring many new nurses myself, I fully understand Roz’s gift.  Her generosity is more overwhelming than the nursing unit she rescued me from. Life should be full of such people.

I thrived as a nurse in the PICU. I learned rapidly in the fast paced environment. Roz gave me a Pediatric Intensive Care Nursing textbook. I studied it at home and on breaks.

Roz was well respected by the PICU intensivist. Eventually, he trusted my nursing judgment nearly as much as hers. I was proud when he nicknamed us “The A Team.” I was going to stay in nursing after all.

Next week: How I Became a Nurse Part III

The Tangled Mess of Art and Nursing

Rain on Sidewalk photo: jparadisi 2011

The rain outside comes down in buckets. The sun, hidden by thick, dark clouds, casts no shadows to clue me in to how rapidly the morning is passing. I am restless. I find it difficult to sit at my desk and write a post. These unfocused days used to distress me. I felt sure I had used up every viable idea I would ever have.  Older and slightly wiser, (one does not necessarily lead to the other) now I recognize these days as periods of germination, but they have nothing to do with gardening. They are days obscured by ideas and feelings tangled together like the debris-matted hair of a trauma patient on the white sheets of an ICU bed. It takes time to carefully pick free each idea, one at a time, like washing dried blood from snarled hair. It’s messy work.

Making art is messy. History shows that making great art is often painfully so. Making a mess is counter-intuitive to nursing training. Nurses spend their shifts fixing the messes of others, while artists demand the freedom to color outside of the lines. I am learning to navigate this duality, which is pretty much my life.

The rain has slowed to a rhythmic beat upon the roof and dreamily I’m lulled into a memory. I am in the pediatric intensive care unit, holding the head of an unconscious patient, while my coworker gently washes her soiled, matted hair. Up until now, she has been too unstable to do so. It is my job to make sure her endotracheal tube stays in place, so the ventilator can continue to breathe for her. She tolerates the hair washing without need of further sedation, and her nurse parts her hair into strands and expertly begins French-braiding it. The skill and dexterity of his fingers surprise me as I watch. I’m not as good at French-braiding as he is. A father, he tells me his wife taught him how so he could get their daughters off to school properly on the days she had to work. I am impressed. When he finishes, we replace the wet sheets under his patient with clean, dry ones. Then he helps me wash my patient’s hair and French braids it too. I know that when both sets of parents return in the morning to visit their children, they will be pleased that we took the time to do for them what they cannot do while the children are PICU patients. I imagine them talking about it in the parents’ waiting room. Even the day shift nurses are impressed by my coworker’s unexpected skill.

I sit at my desk, picking stories out of the tangled mess of my memories.

Let Me Tell You One More Thing You Already Know

Intubated (Baby with a Breathing Machine) mixed media on vellum by JParadisi

Maybe it happened because I was tired after working a string of long, busy shifts.

Maybe Mercury, the communication planet, went retrograde last week.

Last week I wasn’t as good of a communicator as I would like to be.

I am one of those nurses who learned something in the Therapeutic Communication module of nursing school. Before you judge me as the nerd I kinda am, I do not go around repeating, “What I hear you saying is…” Such phrases are not what someone wants regurgitated back at them. The phrase is a tool, not a mantra. Instead, I learned to carefully listen to the words a patient uses and watch for any mismatch of those words in their body language. Then I speak to the body language. As a visual artist I first think in images, then put the ideas represented by the images into words, like a songwriter fitting lyrics to a melody. For me, the pictures come first, then the words.

Here’s what happened:

A colleague introduced me to a nursing student whose next clinical rotation is pediatrics. She told her I was once a pediatric intensive care nurse, and the student asked if I had any pearls of wisdom to share. While I am not so vain to believe my words possess a cure for the deep wounds of a human soul, I am vain enough to believe I occasionally have something insightful to say. So I offered this advice:

  • Always consider the parent-child unit as your patient
  • Even if a parent doesn’t know pathophysiology, they know their child better than you do.
  • The smaller the patient, the more important it is that you get it right the first time.
  • If you are unsure of what you are doing, find a nurse who does know. Stick close to your preceptor.

I finished and saw the glazed look on the student’s face. Her shoulders already turned away from me. She didn’t really want my advice; she was only being polite. David tells me when he sees this look in the eyes of the pharmacy students he precepts, he adds, “Let me tell you one more thing you already know.” She was not my student, however, so I shrugged it off.

A few days later, I was starting an IV in a patient. I had started IV’s in this patient before, and this particular day, while I did so, she told me about a bad experience she had as a child when a nurse started her IV. As before, her body language was the picture of calm while she talked. I inserted the IV easily. As soon as the patient saw the blood flash, confirming the IV was in the vein, she passed out, just like that. I yelled for help, but by the time my coworkers arrived, she was already coming to. With the innocent expression of a child she looked up into my face, and said, “Oh, it’s you.”

I disappointed myself. Her words had not matched her body language, and I missed it. I didn’t know how much courage it took for her to come in for treatment. I gave her some juice, and a little time to herself. When it was clear that her inner child had safely returned to her soul’s play room, I told her I was sorry. She apologized for not telling me how she really felt. She didn’t want to be a difficult patient. We talked about her fear of needles, and came up with a plan. She decided to finish her IV treatment, and I learned one more thing I already knew.