Julianna Paradisi, RN, OCN, Author at Off the Charts

Whose Child Is This?

And I would do it again, but set down
This set down
This: were we led all that way for
Birth or Death? There was a Birth, certainly,
We had evidence and no doubt. I had seen birth and death . . .

—Excerpt from “The Journey of the Magi,” by T. S. Eliot

Painting: Untitled. Oil on Linen, 10″ x 8″ by Julianna Paradisi 2012-2013

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology. The illustration of this post is by the author.

There is a nurse who loves running for exercise through a downtown park. And lo, it came to pass, one very cold day last year in December, that she came upon a host of people gathered around an unconscious man as he lay in the cold, wet grass.

Among them, three Wise Men were on their cell phones, calling 911.

These are my criteria for lending nursing skills to strangers:

▪ I witness the accident

▪ I’m the first one on the scene of an accident

▪ Others are first on the scene of the accident, but they don’t know what to do or are doing it wrong

This unfortunate man’s […]

Julianna Paradisi, RN, OCN2016-11-21T13:05:52-05:00December 11th, 2013|career, nursing perspective|7 Comments

Giving Thanks for Meaning in a Nonclinical Setting

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology. The illustration of this post is by the author.

Some Thanksgiving seasons, it feels like the only specific nursing thing to be thankful for is the overstocked larder of the staff lounge, marking the advent of The Season of Eating.

I’m being facetious. Actually, there’s lots to be thankful for in nursing, including a regular paycheck, which is not taken for granted. However, most nursing units remain understaffed, despite hoards of nursing school graduates desperately seeking jobs—creating a no-net gain on the gratitude side of the ledger.

Ethical issues and long hours also make finding gratitude a challenge. It’s not the gifts from patients of flavored popcorn and boxes of chocolates in the staff lounge that warm a nurse’s heart so much as the handwritten cards accompanying them, thanking us for their care. For nurses, finding meaning in what we do goes hand in hand with gratitude.

This season, however, I was surprised by an opportunity to find meaning as a nurse outside of a clinical setting, and I want to share the experience.

One afternoon, a neighbor came to my door asking for help. She is the mother of two small children, and her toddler had accidentally burnt his hand in the kitchen. She’d taken him to the emergency […]

Julianna Paradisi, RN, OCN2018-03-28T10:27:41-04:00November 25th, 2013|career, nursing perspective|6 Comments

Guess Who’s Wearing Housekeeping Garb Now? Surprise! It’s Your Nurse

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

Catch-all: noun [usu. as modifier]

a term or category that includes a variety of different possibilities: ex. the stigmatizing catch-all term “schizophrenia”

American Hospital/by J. Paradisi

The first thought that came to mind after I heard that Vanderbilt University Medical Center had laid off its housekeeping staff and assigned cleaning patient rooms to nursing was this: Has anyone from the hospital’s administration ever looked inside the nursing staff’s refrigerators, microwaves, or sinks?

Universally, nurses’ staff lounge kitchens nearly rank biohazard status. In every unit a single nurse, but often it’s the unit secretary, martyrs herself (or himself) by emptying these refrigerators of forgotten food. She washes the moldy containers and places them on a nearby countertop, with this message scrawled in Sharpie:

CONTAINERS NOT TAKEN HOME BY WEDNESDAY WILL BE THROWN OUT! (Caps intended)

Another sign commonly posted above the staff lounge sink or microwave by this same nurse or unit secretary reads:

CLEAN UP AFTER YOURSELF! YOUR MOTHER DOESN’T LIVE HERE!

Fact: Nurses know a lot about infection control, but this does not automatically make us good housekeepers. Besides, nurses already have a job: keeping hospitalized patients safe while assessing their needs and administering their care.

While Vanderbilt’s decision to lay off its housekeeping […]

Julianna Paradisi, RN, OCN2018-03-28T10:28:19-04:00October 28th, 2013|career, nursing perspective|15 Comments

Do EHRs Rob Nurses of Voice and Oversimplify Description of Patient Care?

Julianna Paradisi, RN, OCN, writes a monthly post for this blog and works as an infusion nurse in outpatient oncology. Editor’s note: this post has been slightly revised for clarity since its initial publication a day ago.

Heroines of Nursing, mixed media collage by julianna paradisi, 2013. Text by Florence Nightingale

Previously I’ve written that I have a new employer. Part of this transition is relearning how to use the electronic health record (EHR). Fortunately, this new employer uses the same program as my last. However, that version was EHR-lite compared to the one we use now.

For instance, the new system contains an abundance of “smart phrases” that are used to lessen time spent writing nursing notes. If you are unfamiliar with smart phrases, an uncomplicated explanation is that they are preconstructed phrases chosen from those commonly found in charting, such as “The patient arrived ambulatory for IV infusion.” Instead of typing in this phrase, nurses can click on it from a computer screen menu, and voilà! The entire phrase is electronically inserted into the notes.

Smart phrases, like […]

Julianna Paradisi, RN, OCN2016-11-21T13:06:30-05:00September 23rd, 2013|digital health, nursing perspective|7 Comments

Differentiating Nurse Burnout From Boredom

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

Nurses frequently discuss burnout. Sometimes it’s called compassion fatigue. Regardless of which term, nurses are at risk because our work requires complex technical skills, an expanding knowledge base, physical endurance, and critical thinking, since a patient’s symptoms often do not present in a manner described in the textbooks studied in nursing school.

Above and beyond this, nurses are expected to display warmth and caring towards their patients, even ones who are rude and argumentative. This alone requires character and self-discipline. Add inadequate staffing ratios to the mix, and it’s easy to understand that at some point, a nurse may become susceptible to burnout or compassion fatigue.

Nursing school graduation and passing NCLEX don’t make you a nurse. These milestones earn you a place at the starting gate. It’s up to the individual nurse to navigate her or his career towards growth and longevity. I clearly remember, several years into my practice, recognizing that I’d reached a point of expertise in which I might not know exactly what to do in any emergency, but whatever intervention I chose would be safe and maintain a patient until the doctor or code team arrived. This was around the same time I stopped feeling nauseous every […]

Julianna Paradisi, RN, OCN2016-11-21T13:06:45-05:00August 22nd, 2013|career, nursing perspective|6 Comments

About Julianna Paradisi, RN, OCN

Whose Child Is This?

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Giving Thanks for Meaning in a Nonclinical Setting

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Guess Who’s Wearing Housekeeping Garb Now? Surprise! It’s Your Nurse

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Do EHRs Rob Nurses of Voice and Oversimplify Description of Patient Care?

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Differentiating Nurse Burnout From Boredom

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