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).

Reluctant Heroes: When Men in Nursing Cry

Reluctant Hero / graphite, charcoal, and pastel on paper / by Julianna Paradisi 2017

I first learned the effect a man’s tears have on my emotions from the parents of my young patients when I was a pediatric intensive care nurse.

I am not unaffected by the tears of a woman, but in the PICU the tears of the mothers differed in nature from the tears of the fathers.

A mother with a hospitalized child will cry, and when overwhelmed, she will break down. But in the PICU, more often than not, she took a tissue from the box I handed her, wiped her eyes, breathed deeply, and then put on a brave face to protect her child from knowing her fear and concern over his welfare.

When the father cried, it was an admission of helplessness. His problem-solving toolbox was empty. The tears represented feelings of personal failure, powerlessness to protect his child and family from disease or trauma. His criteria for being a father, or a man, was eroded.

These displays of total soul-brokenness undid me every time. […]

2017-01-18T10:32:08-05:00January 17th, 2017|career, men in nursing, Nursing|6 Comments
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All Saints’ Day Blessing for Health Care Providers

Autumn Angel / photo by Julianna Paradisi 2016 Autumn Angel / photo by Julianna Paradisi 2016

November is the strangest of months. Its days are shorter, darker. It begins with All Saints’ Day, a day of remembering our dead, of loss and grief, followed late in the month by Thanksgiving, America’s celebration of abundance with gratitude.

This year on All Saints’ Day I attended a discussion of health care professionals. The audience included nurses, physicians, pharmacists, social workers, and hospital administrators. The conversation ultimately centered on the emotional difficulties of patient care.

It wasn’t a debriefing as much as collective acknowledgment that, rather than accepting help, some patients or their family members view us as the enemy, sometimes disrupting our best efforts in the name of misguided advocacy.

Nurses spoke of being labeled as “bad” and played against each other by angry patients or family members. Physicians related episodes of verbal abuse from patients or family members demanding inappropriate procedures, medications, or dosing. Some spoke of needing to take refuge to center their thoughts before ordering the appropriate care.

Like most nurses, I’ve experienced similar treatment at the hands of difficult patients, but physicians don’t generally discuss with us how they are treated. Nurses and physicians suffer silently, instead […]

2016-11-21T13:00:49-05:00November 10th, 2016|Nursing, Patients|1 Comment
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The Speed of Patience: Notes On Navigating Hospital Hallways

The Speed of Nurses

'She Observes,' ink on paper, 2005 by Julianna Paradisi ‘She Observes,’ ink on paper, 2005 by Julianna Paradisi

A while ago, my stepfather had surgery at the hospital where I work. After spending a long day in the waiting room, my husband and I left the post-surgery unit. As we walked down the narrow hallway towards the main lobby, a young man, his girlfriend trailing behind by the hand, came around a corner from the opposite direction too quickly. They headed towards the elevator. We narrowly avoided collision. Had either my husband or I been disabled, someone might have been injured.

As he pulled the young woman into the elevator, he sniped at us sarcastically, “I’m not rude!” Rude or not, he was obviously unfamiliar with the traffic flow of hospital hallways.

Hospital hallways accommodate two types of travelers: staff and patients/visitors. These groups travel at speeds established by urgency and limited by ability.

For nurses, getting to a patient’s room fast may mean saving a life, or simply providing an emesis basin to preserve a patient’s dignity. Among nurses, a lack of urgency (the inability to act fast) is viewed as a character flaw.

Although […]

2016-11-21T13:00:53-05:00October 27th, 2016|Nursing|0 Comments
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All Unhappy Patients Are Not Alike

illustration by the author illustration by the author

The first sentence from Leo Tolstoy’s novel Anna Karenina is one of the most famous in literature:

“All happy families are alike; each unhappy family is unhappy in its own way.”

It can easily be applied to patients. Happy patients tend to love their doctors, feel they received the best possible care, and consider their nurses invaluable.

Unhappy patients are unhappy in their own way. The challenge for busy nurses is resisting the temptation to turn a deaf ear or feign listening, in effect reducing patients’ concerns to “waa, waa, waa.”

A common thread among unhappy patients is unmet expectations.

Sometimes the patient’s expectations are unrealistic because they’re based on incorrect assumptions—but they do not know this. Responding requires a willingness to listen and the patience to tease out why a patient is unhappy with their care. Let patients tell their stories. Most bedside nurses have limited time; it’s okay to enlist help from a case manager, social worker, or nurse navigator if necessary. However, investing time up front to improve communication with a patient may pay off in dividends by smoothing the rest of your shift.

Begin by listening. Sometimes, I’ll take a seat, and write what the patient says while they talk. This simple […]

2016-11-21T13:00:58-05:00September 6th, 2016|Nursing, nursing perspective, patient engagement|0 Comments
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The Quandary of Scheduling Vacation Time for Nurses

Illustration by the author; all rights reserved Illustration by the author; all rights reserved

While shopping in a grocery store, I passed a display of craft brew beer that caught my eye. The sign read Hospice Beer! After a double take, I saw on closer inspection that the label actually read: Hop-Slice Beer.

I realized I was badly in need of a summer vacation. Fortunately, I already had one scheduled on the books.

Summer is a traditional time for vacations, but often not for nurses, for multiple reasons.

Paid time off benefits vary from organization to organization.

Some lump vacation hours and sick leave hours into the same bank, while others separate the two so that nurses accrue hours into each per pay period. Paid vacation time accrues slowly when it’s used for paid sick time.

Further, after accepting a new job, nurses may find that as the newbie they accrue vacation and sick leave hours at a rate lower than their colleagues hired earlier; this practice, called tiered employment, exists within many industries outside of health care, whether they’re union or not. The practice can foster division between the newly hired and existing staff within units. Newer hires accrue less benefits for the same amount of work as their peers. The practice […]

2016-11-21T13:01:03-05:00July 25th, 2016|career, Nursing, nursing perspective|0 Comments
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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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