love Archives - Off the Charts

Caring with Intention: Palliative Care and the Human Family

Vivian Dee, APRN-BC, RN, lives in Texas. She works on a bone marrow transplant unit and is and a doctoral student in the DNP program at Walden University.

In 2008, our organization created a new palliative care wing. No one was certified yet or knew much about caring for palliative care patients. The leadership scrambled to put together learning instructions in the form of PowerPoints and seminars.

In the midst of this flux, our unit admitted a homeless man as one of our first patients. Larry was an alcoholic who’d been out on the streets for many years. His health had deteriorated, and he’d developed liver cirrhosis. Since he couldn’t afford medical care, he’d opted for palliative care.

Larry was unpretentious and polite, and he soon became one of my favorite patients. I met him at the initial team meeting, where we established goals of care. As the days passed, I got to know Larry and his wishes, dreams, and desires. He would talk about his family, his cousins, and his mother. How he longed to see them one more time. To ask forgiveness and to say goodbye.

Days soon turned into weeks, weeks into months. Larry became weaker. Soon it was apparent that it would only be days before Larry took his last breath. Knowing […]

Guest Author2018-03-22T08:25:34-04:00March 22nd, 2018|Nursing, Patients|0 Comments

The Afterlife of Trauma, Near and Far

Julianna Paradisi, RN, OCN, is an oncology nurse navigator and writes a monthly post for this blog.

Mixed media illustration by Julianna Paradisi

The alarm clock rang noisily. I wasn’t ready to surrender the cozy cocoon of my bed and venture into the emotional turbulence of this particular day: The 14th anniversary of 9/11.

The week leading up to it was rough. My stepfather had quadruple coronary bypass surgery in another city. Although it was successful, and his children were there to help and support my mother, I’ve felt guilty for not being there myself, because I’m the nurse in the family, and I feel responsible for every medical problem that arises for the ones I love—even if I’m not really needed.

Besides this, at work we’re in one of those cycles where every patient gets bad news: The cancer has invaded the borders of another organ, or the patient is incredibly young for the diagnosis that’s been received. Six months into my career as an oncology nurse navigator, I realize the emotional toll from secondary trauma is often more related to a previous job as a pediatric intensive care nurse than that of my more recent position as an oncology infusion nurse.

Because of all this, I decided to minimize my media exposure to the trauma of 9/11 this year. I stayed off of Facebook, and instead of watching the morning news I listened to Lyle Lovett croon the delightfully […]

Julianna Paradisi, RN, OCN2016-11-21T13:01:58-05:00September 28th, 2015|career, narratives, Nursing, nursing perspective, Patients|2 Comments

A Brief Meditation on Love, Loss, and Nursing

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology.

Manicure, by Julianna Paradisi, 2014

As a child, I remember being afraid to fall in love, because I didn’t want to experience the pain of losing people I loved when they died. I don’t know why I thought about this; I only know that I did.

Becoming a nurse has done absolutely nothing to alleviate this fear, but life experience has, to some degree.

Nursing is hard not only because we are there for the dying, but also because we are there for the illnesses and deaths of our own, the people we love, too. Making a living by caring for the sick and dying does not exempt us from personal loss. We grieve and mourn like everyone else.

Recently, I sat in a chair in an emergency department, noticing the sparkly red polish of a woman’s holiday manicure as she rolled past on a gurney. Clearly, she hadn’t anticipated an ER visit as part of her holiday celebrations either. On another gurney, next to my chair, lay my husband, getting an EKG, labs, and IV fluids. The prayer, “Please, don’t let it be a heart attack or a brain tumor,” wove silently through my thoughts.

We were lucky. There was no […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:03:11-05:00January 14th, 2015|Nursing, nursing perspective|4 Comments

The Kiss: Hope in the ICU

By Marcy Phipps, RN, a regular contributor to this blog. Her essay, “The Love Song of Frank,” was published in the May issue of AJN.

by limegreeen9, via flickr creative commons

I always look forward to interdisciplinary rounds. I’ve worked with most of the team members for years and enjoy the differing perspectives and collaboration. Today is no exception; I know my patient very well, as he’s been in the ICU for months. As the interdisciplinary team moves through the ICU like a small mingling mob, pausing at each room for a brief nursing report and lingering for discussion, I stand in anticipation, ready to present my patient’s case.

My report, though, is politely cut short by the medical director.

“What’s changed?” he wants to know.

And I feel pressed to produce some crumb of improvement.

“Well…” I say. “He kisses his wife. His GCS* remains eight, but he kisses his wife.”

A few people smile, and I hear a few chuckles.

“It’s a reflex!” I hear someone say as they move away.

I know, of course, how little the kisses mean from a medical standpoint. His initial injury was neurologic, and his neuro status is quite compromised, but stable. His cardiovascular, gastrointestinal, and genitourinary systems are stable, as well. It’s respiratory insufficiency that keeps him in the unit. Puckering his lips in response to his wife leaning towards him is not significant […]