A Nurse’s Sketch Book

 

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Nearly a year ago, I wrote a post about mindfulness and found time for creativity, in which I described how I used downtime spent in waiting rooms to draw, or more accurately, for advanced doodling.

The practice continues. This year, I purchased an inexpensive set of crayons, which I keep in a desk drawer. During my lunch break, I take a minute or two to add a splash of color to the ballpoint pen ink drawings. None took longer than 15 minutes to sketch, usually much less.

These rough sketches don’t take the place of painting in my studio, but, there’s a certain satisfaction that comes with adapting to challenges of managing time, learning to juggle purpose and passion. Nursing provides purpose rooted in service, and passion (or a reasonable facsimile of art) blossoms from its branches. Like spring flowers following a severe winter, it will not be denied.

 

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.

 

 

 

Getting Crafty: Felted Bags

Little Gems & Apple Bite Felted Purses made by me

Little Gems & Apple Bite Felted Purses made by me

Starting a new job has kept me super busy the past three months, and carves into the time I have to paint, draw, and write.

So, I’m really grateful for the two felted knitting kits I received as Christmas gifts last year from my mother-in-law. To be honest, I probably wouldn’t have picked these for myself, but that’s what’s so great about a gift: you don’t always know it’s what you need or want until you use it. Turns out, making these little bags has filled my need for creativity, without having to do anything except follow directions. They were actually quite fun to make, although sewing all of those teeny-tiny beads to the apple bag was a little challenging at times.

Anyway, they’re pretty cute. Nora J. Bellows designed the kits, found at nonipatterns.com.

Book Review: Nursing From Within, a Fresh Approach to Putting Out Fires and Self Care Work Arounds

In her book, Nursing From Within, a Fresh Approach to Putting Out Fires and Self Care Work Arounds, Elizabeth Scala, MSN, MBA, RN takes on the chronic dissatisfaction most nurses experience at some juncture in their career. With change rapidly dominating the landscape of health care delivery, nurses are stretched to the breaking point in their ability to provide safe, patient centered care.

Nursing From Within, a Fresh Alternative to Putting Out Fires and Self Care Work Arounds by Elizabeth Scala, MSN, MBA, RN

Nursing From Within, a Fresh Alternative to Putting Out Fires and Self Care Work Arounds by Elizabeth Scala, MSN, MBA, RN

This problem is not new in nursing, according to Scala. In fact, it’s existed in some form or another for decades. Scala considers,

It is possible that nursing, the entire profession as we know it today, is stuck. Bogged down from the energy that is created with the funnel. Looking left and right, turning around or glancing above us-who do we see? What do we hear? Where do we go for answers?

We hear the same things, talk about the same things, and live the same things.

While nursing has come a very long way in terms of scientific skills and critical thinking, can we say the same thing for our own personal and professional evolvement as a whole? Are we developing in a way that will help us to thrive and move forward as a group? Or is the mindset of ‘this is how it’s always been done?’ keeping us stuck in the funnel of nursing limitation?

 In a conversational voice, Scala uses stories from her personal experiences to illustrate how she changed from a nurse on the brink of burnout into one with an expanded viewpoint of where an open mind and change from within can lead. The creative career solution she chose at the book’s ending surprised me. It validates the versatility of a nursing license, but I’m not sure it answers the question at the heart of the book’s premise.

However, this does not take away from the truth of Scala’s observations, or the value of the  tools she presents for self care. Scala’s openness and authenticity shine through. Her topic is important, demanding recognition and discussion among nurses. I found much of what she wrote inspirational.

Nursing from Within: A Fresh Alternative to Putting Out Fires and Self-Care Workarounds is available now. Get your copy today by visiting Elizabeth Scala’s website or purchase directly from Amazon

Nurses and Holiday Stress

Painting by jparadisi

Painting by jparadisi

Nursing potentiates normal holiday stressors. For many nurses, the beauty of the winter holidays is diminished by feelings of stress.

Staffing woes contribute: Who knows why every year during the holidays, patient census randomly explodes abundantly or trickles down to near nothing, resulting in too much overtime or hours-deficient paychecks?

We go home to enjoy the glow of Christmas tree lights knowing our patients spend their holidays in a hospital or hospice bed, their rooms lit by overhead fluorescent lights, and this knowledge dampens a nurse’s ability to fully enjoy celebrations of bounty. We may experience feelings of guilt that our income is dependent on the misfortune of others, in this case, illness or trauma.

Mismatched schedules, especially those of night-shift nurses, complicate holiday arrangements with family. Gift giving weighs heavily on sensitive souls: Instead of buying gifts, shouldn’t the money be given to those in need? Or are our expressions of love for family and friends, the creation of memories and traditions left after our own health fails, equally important? Someday, we will become the ones missing from the family dinner table of Christmas’s future.

Here are suggestions for handling holiday stress:

  • Reduce expectations. Holiday preparations and gifts are expressions of love, not declarations of wealth. Stay within your physical and fiscal boundaries.
  • Plan quick, easy, and low-calorie meals in between holiday parties. You’ll feel better.
  • Enlist the help of children with holiday baking and food preparation. This is an opportunity to teach them to cook while spending time together.
  • Lighten your housework load by asking children to help with age-appropriate tasks like dusting, folding clothes, drying dishes, etc. Work out a payment incentive with them. Encourage them to use the money for Christmas shopping, to buy a toy for a less fortunate child, or donate to a food bank.
  • Plan downtime and use it for activities with personal meaning. Don’t skip yoga class or your morning run. Take a break from wrapping gifts for a cup of fragrant hot tea or cocoa with marshmallows. Spend an hour at church, take a long walk, or meditate to regain your sense of grounding.
  • Remember the gifts you give. Nurses give to their patients throughout the year gifts that cannot be remunerated on a paycheck. Although we do not have magic wands to cure disease, taking time to listen and help patients with their needs goes a long way. The best way to feel better is to help someone else feel better. This is the gift of nursing.

Does your nursing job ever affect your ability to enjoy the holidays? What steps do you take to reduce holiday stress?

Vacation!

At The Pool photo by jparadisi 2013

At The Pool photo by jparadisi 2013

JParadisiRN is on vacation this week. I’ll write a new post soon from a refreshed perspective. Meanwhile, if you haven’t read my oncology blog for TheONC, or latest post for AJN Off The Charts, this is a good week to catch up.

Cheers!

Can Nurses Change Course? Thoughts on Inertia

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

Take One Daily by jparadisi

Take One Daily by jparadisi

 

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?

The Difference Between Nursing and Journalism

Nurse's Note by jparadisi

Nurse’s Note by jparadisi

On any given shift, nurses witness the drama of life and death. This aspect of our work is unlikely to change. We witness patients taking in the bad news of their diagnosis, holding basins up to their faces while they vomit, and transfusing blood products before they exsanguinate. Although oncology is not an actual war, nurses and patients alike use military terms to describe it, such as battling cancer, or attacking tumor cells. We see ourselves as comrades in the fight against this devastating enemy.

Louisa May Alcott, author of Little Women, was a nurse during the Civil War. In her memoir, Hospital Sketches, she describes witnessing the death of a young soldier in detail so vividly the scene rings true for any nurse who has attended the bedside of the dying.

Whether we record our experiences in words to share with others, or keep them to ourselves, as nurses we bear witness to the suffering of our patients. Sometimes this secondary trauma leads to compassion fatigue, if not real disease or injury.

Watching people suffer is difficult, but at least I am not watching helplessly. I am grateful to be an oncology nurse now, when advancements in cancer treatment and its side effects occur regularly. Armed with these tools, oncology nurses bring knowledge and skill to the care and comfort of their patients. For me the ability to give aid makes witnessing the suffering bearable. I think being a news journalist or photographer sent to bear witness of the stories of conflicts in the world would be more difficult. Or filming a devastating natural disaster while people perish. Journalism requires a story, and pictures. Granted, at their best, these stories and pictures alert the world to action, serving a valuable purpose. Still, emotional trauma occurs among journalists, as in nurses.

Even Alcott experienced trauma from her military service when she contracted typhoid fever. She suffered lifelong chronic pain, a side effect of the mercury-based medication used to treat her. This is not unlike secondary cancers suffered by oncology patients from the chemotherapy administered to save them from their primary cancer.

Have you ever felt helpless in a patient care setting? Do your nursing skills offset the emotional trauma you experience or have little impact? What tools do you use to prevent compassion fatigue for yourself?

Doubtful That Art Saves Lives? Evidence Indicates It May Heal

Art Saves Lives,” is a bumper sticker I occasionally see around town, and every time I do  I think, “Maybe, but in an emergency I’d prefer my rescuer know CPR than how to wield a paintbrush.” It’s a conundrum created “where science, humanity, and art converge.”

Girl With Pearl Earring, after Vermeer. watercolor by jparadisi 2012

Girl With Pearl Earring, after Vermeer. watercolor by jparadisi 2012

But what of art’s ability to heal? Most nurses know the benefits of art therapy: self-discovery, personal fulfillment, empowerment, relaxation, and symptom relief. However, can merely looking at art produce similar effects?

This question came to mind while rereading Vermeer in Bosnia¹, an written essay by Lawrence Weschler. Weschler interviewed Antonio Casse, then the presiding judge of the Yugoslav War Crimes Tribunal, during the trial of Dusko Tadic for crimes against humanity.

Weschler asked Judge Casse how he maintained his sanity while listening day after day to horrific accounts of torture, rape, and murder. Casse’s answer: “Ah, you see, as often as possible I make my way over to the Mauritshuis museum, in the center of town [in the Hague], so as to spend a little time with the Vermeers.”

Can looking at art — even a painting as beautiful as Girl With a Pearl Earring — reduce the effects of secondary trauma and compassion fatigue? If so, can nurses and patients benefit from this simplest form of art therapy?

A small study ² conducted by Dr. Marina de Tommaso, a neurologist, found that patients who gazed at and contemplated paintings they considered beautiful felt less pain when subjected to noxious stimuli. The New York Times has reported that museum visits help Alzheimer’s patients experience symptom improvement ³. The mechanism triggering these effects on the brain is not well understood.

Though the jury is out (pun intended) as to whether looking at art has therapeutic power, I think it’s worth a try for patients — and their nurses. Here are a few easy to implement suggestions.

  • Incorporate artwork into waiting rooms and hallways, but be mindful of the patient population. Art with jagged edges or mirrored surfaces (some types of sculpture, for instance) may evoke posttraumatic symptoms in patients who have disfiguring scars, surgical or otherwise.
  • Place something beautiful in the patient’s view from the hospital bed or the infusion clinic lounge chair.
  • Place books featuring artwork in waiting rooms instead of year-old magazines.
  • Hang a beautiful painting in the staff lounge instead of that big, messy corkboard cluttered with safety committee meeting minutes and medication recall notices.
 OK, that last one will never happen, so here are some suggestions to try at home:
  • Find a location with a beautiful view on your route home. Pull over, take a deep breath, and look. We live in a beautiful world.
  • Shop for art at a museum gift shop. Not every budget allows for buying original art. Gift shops offer an assortment of quality reproductions. Have less money to spend than that? Collecting postcards of works by famous painters is an inexpensive alternative. Buy frames from dollar stores or thrift shops, paint them white, and hang them in groups on a bright color- painted wall.
  • Create an art space in your home. I pinned my postcards to an old vanity. Once I added candles, it doubled as a place for meditation and reflection.

Do you think it’s the art or a meditative response to looking that provides relaxation and improves symptoms?

¹ Vermeer in Bosnia, Lawrence Weschler,The New Yorker, Nov. 20, 1995
² ITALY: Beautiful Art Eases Pain, Monica Dobie05 October 2008 Issue No:47
³ The Pablo Picasso Alzheimer’s Therapy, Randy Kennedy, October 30, 2005, The New York Times