About Julianna Paradisi, RN, OCN

Julianna Paradisi, RN, OCN, finds inspiration where science, humanity, and art converge, creating compelling images as both a writer and a painter. She is the author of https://jparadisirn.com/, and also blogs frequently for http://www.theonc.org/ and https://ajnoffthecharts.com/, the blog of the American Journal of Nursing (AJN).

Wabi-Sabi: Nursing and the Art of Brokenness

Wabi-Sabi (Kintsugi), watercolor and acrylic on paper, 2018 by Julianna Paradisi

Nursing is the art of healing, which ironically also makes it an art of brokenness. We pack and bind wounds. We administer medications to cure disease. We offer interventions for the side effects caused by the medication administered to cure.

We work in a health care system which, despite our best intentions, is broken: not enough resources, not enough staff or providers, not enough health care to go around for everyone.

Nurses have broken areas within ourselves too, but our work environments expect us to perform as perfectly as possible, amidst the brokenness of our patients, the brokenness of health care.

Patients, physicians, other departments, and hospital administrators expect nurses will fix problems, whatever they are, despite the brokenness.

A timely example this flu season is the paradoxical message: “Don’t come to work sick,” coupled with the implication, “Your sick call leaves us understaffed.”

The answer to brokenness is wholeheartedness.

The effort to fix the brokenness or imperfection of nursing and health care may be particularly exhausting for nurses because we are directly responsible for the safety of our patients.

The words of author David Whyte as he recounts a wise friend’s […]

2018-02-14T10:05:33-05:00February 14th, 2018|healthcare social media, Nursing, nursing perspective|0 Comments
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Comforting Our Patients: The Importance of Well-Chosen Words

‘What I Said,’ ink and crayon on paper, Julianna Paradisi 2018

Nurses and writers understand the importance of well-chosen words. Precision of language is important for both. But nurses learn the emotional impact of words, wisely or poorly chosen, on the job, directly from our patients. There’s seldom an opportunity to edit or revise on the floor of a nursing unit. Words cannot be unsaid.

As an oncology nurse navigator, my nursing practice is almost entirely based on words. My stethoscope, which rarely left my body when I was a PICU nurse, now rests coiled like a snake in a basket, nestled among the art supplies I used to illustrate this post.

Since patients rate my nursing skills by my words, the ability to pass the ‘bs test’ is more important than ever before in my career. As a navigator, I have impressed a patient or two (and helped them get proper care) by recognizing over the phone that the symptoms they described were cardiac related and not the side effects of cancer treatment. But for the most part, words are the tool I rely on to prove my value.

It’s the nature of nurses to want […]

2018-01-09T10:09:34-05:00January 9th, 2018|Nursing, nursing roles, patient experience|1 Comment
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How I Spent My Summer: Funding the Cost of a Nurse’s Education

Photo by Julianna Paradisi/2017

At a neighborhood grocery store, I picked up a few items for dinner, one of which was a preroasted chicken still warm and juicy from the heat lamp display.

After ringing up the total, the checker began bagging my purchases. Before placing the chicken in a bag, she put a rubber band around the container to prevent it from accidentally opening, and then wrapped it in a separate paper bag as a further precaution against leakage.

I thanked her for the extra care. No one waited behind me, so we exchanged a bit of small talk. It was a weekend, and she asked if I had plans. “No, my husband and I work in health care, and it’s his weekend on,” I said.

“What area of health care?” she asked. I told her I’m a nurse and work with cancer patients. Expecting the cringe I usually get from laypeople when I say this, I quickly added, “It sounds sad, but I really love my work.”

Her face lit up. “I’m a nursing student! I’m taking exams to become a CNA so I can work with patients while I finish my BSN.”

Her news delighted me. I have strong intuition, and I felt sure she would make a terrific […]

2017-08-22T15:07:48-04:00August 22nd, 2017|Nursing, nursing students|2 Comments
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The Limitations of Rating Nursing Care by Customer Surveys

Ink and collage on paper by Julianna Paradisi 2017

Either They Loved It or They Hated It

While toasting the same English muffin for the second time that morning and cursing that it would make me late for work, I conceded we need a new toaster. It doesn’t matter whether I set the darkness level on 1 or 4;  the muffin comes out barely tinged. Select 5 or beyond, the muffin is burnt, and sets off the smoke detector. It’s time to buy a new toaster.

I found one I liked, shopping online. It had been purchased by over 1,500 other people; 55% of them rated it 5 stars. The other 45% of ratings ranged between 1 and 4 stars. The comments, however, were evenly split, 50/50. People either loved it or hated it. There was no in-between.

This made me laugh.

As with Toasters, So with Nursing Care

Likewise, many hospitals, in an effort to improve care, send out satisfaction surveys asking patients to rate their nursing care. In my experience, the results are similar to the toaster’s ratings: about half the patients rave about their care. Some mention their nurses by name, elaborating on specific details about their experience.

The other half complain […]

2017-03-31T10:28:07-04:00March 31st, 2017|Nursing, nursing stories, patient experience|3 Comments
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An Oncology Nurse’s Perspective on the Health Insurance Situation

Money Bag/ by Julianna Paradisi/ all rights reserved

Costly Care

I was an oncology infusion nurse in a hospital-based ambulatory center for a number of years, many of them before the Affordable Care Act (ACA) was signed into law in 2010. Besides administering chemotherapy and blood products, I infused medications to patients with sickle cell anemia as well as chronic autoimmune disorders such as rheumatoid arthritis, lupus, and Crohn’s disease.

The common denominator among these diseases is the high cost of the medications used to treat them, at the time ranging from $3,000 to $10,000 per treatment. I know, because patients told me, their nurse.

I also know because uninsured patients were required to fill out paperwork declaring their lack of income, prior to receiving authorization for charitable treatment. If they were sick enough, they were admitted to the hospital for initial treatment, at more expense than outpatient infusion, until the paperwork was completed and approved.

These were particularly difficult times to be an infusion nurse.

Some patients lost their jobs during cancer treatment, because the cost of their cancer care increased their employer’s insurance coverage risk pool rates.

Other patients worked night shift before arriving, sleepless, for chemotherapy as soon […]

2017-02-22T14:53:49-05:00February 22nd, 2017|health care policy, Nursing, Public health|1 Comment
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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