For the Mentally Ill in Crisis, Someone Safe to Call for Help

A troubling encounter.

by julianna paradisi

Although it happened over two months ago, I’m still haunted by the memory, particularly during this cold, harsh winter following on the heels of a politically tumultuous summer and fall.

I’ve run the same loop along the Willamette River in Portland, Oregon, for years. This particular morning, a young man walked some 20 feet ahead of me on the sidewalk. He carried by its neck a 1/2 gallon jug of apple juice. Unexpectedly, he tossed an opened box of granola bars, with several individually wrapped bars inside, to the ground and kept walking.

He stopped abruptly at the same time I stopped to wait on the curb for traffic to subside so I could cross to the other side of the street, which is what I routinely do on my route.

We were now six to eight feet apart. From my peripheral vision I noticed him turn and face me. Because we’re in the middle of a pandemic, I was wearing a mask; this and my proximity seemed to disturb him. I stepped away a few paces, giving him more space.

Over my shoulder he said, “You’re a bitch.” I ignored him. He stepped closer, and repeated more loudly, “You’re […]

2021-02-25T10:54:11-05:00February 25th, 2021|mental illness, mental illness|0 Comments
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Who’s Going to Smile at My Baby? When the Pandemic Comes to the NICU

From the doorway, I watched the mother gently stroke her newborn’s forehead. “I love you,” she whispered. “I’ll be back soon.”

As a resource parent in the neonatal intensive care unit (NICU) at a large children’s hospital, I am privileged with the task of offering support to families. This was a typical stop in one of many patient rooms. As I gingerly entered the room, the mother glanced up at me, tears welling in her eyes as she scrambled to adjust her mask.

“I’m sorry,” she stammered. “I didn’t want to cry.” A tear rolled down her cheek.

“Not at all,” I replied. “I understand. It’s hard being a mom in the NICU, now more than ever.”

I invited her to share her feelings, hoping to offer some help or comfort. Wiping her cheek with her sleeve, she explained that the pandemic visiting rules had made it difficult to be at her baby’s bedside.

“I have other children, and I need to go home to watch them. The hospital rules say I am the only person allowed to take off their mask in her room, but she needs to see faces for her development. Who is going to smile at my baby when I’m not here?”

Speaking from personal experience.

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2021-02-08T09:43:44-05:00February 8th, 2021|family experience, Nursing, Patients, pediatrics|0 Comments
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The Unsung Heroes of Hospice Are Family Caregivers

Nurses who find their vocation in hospice may be among the most understanding people on earth. As a nurse who has helped many, perhaps hundreds of patients transition into palliative care and hospice, I thought that I would be prepared to handle placing my father into home hospice after a stroke. At 90, my father had vascular dementia due to chronic infarctions. The call from his provider informing me that he had had an embolic stroke with a hemorrhagic component was not completely unexpected. After his anticoagulation was reversed, I knew that he was likely to have another stroke soon.

Walking the tightrope: daughter, nurse, caregiver.

I guess that’s the curse of the nurse. No false hope for me. As the nurse in the family, I walked the tightrope of caregiver, support person, and grieving daughter. The help from the hospice team was extraordinary, but the overall care and responsibility was placed on the family. It was a bit of a shock to me. I can’t imagine how families without members in health care manage.

My father did not pass his swallow test, and he had left-sided paralysis; however, he was initially able to communicate, with some effort. In fact, the priest who saw him on the first day was obviously curious as to […]

2021-01-14T11:15:10-05:00January 14th, 2021|family caregiving, family caregiving, Nursing|2 Comments
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A COVID-Era Telehealth Appointment Drives Home the Fragility and Strength of the Therapeutic Relationship

The Reflections essay in this month’s AJN is by LaRae Huyck, a psychiatric mental health NP. In this one-page story with a dramatic COVID-era twist, she explores her years accompanying a young counseling patient from suicidal depression during adolescence to joyful engagement with life as she heads out into the world on her own. Writes Huyck:

The time I spent with her seems so short, but in actuality it made up nearly a fourth of her life. We had traveled though the awkward adolescent years, the landmine of her parents’ divorce, the loss of a beloved grandmother, and a failed relationship that ended her dreams of a prom date.”

The healing power of a therapeutic relationship.

“The Importance of Time” adroitly summarizes this journey, revealing the author’s compassion for this young woman and her hopes for her as well. It’s a story of healing and growth that reveals the good that therapeutic relationships coupled with medication can do for some patients. […]

2021-01-11T13:47:05-05:00January 11th, 2021|mental illness, narratives, Nursing, Patients|0 Comments
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Hospital Visiting Policies in the Days of COVID-19

Last month, I watched a YouTube video with two physicians, ZdoggMD (Zubin Damania) and Vinay Prasad, both active on social media, discussing Prasad’s perspective that allowing patients “to die alone is a human rights violation.” He argued that clinicians should not accept blanket rules from administrators and believes there are ways around what seems to have been standard practice in hospitals during the COVID-19 pandemic.

So when we asked on AJN’s Facebook page (December 13), “Should hospitals allow patients with Covid-19 to have visitors?”, I was surprised that the comments were split. Many respondents supported the need for patients to be able to have loved ones with them, but many others felt visitors shouldn’t be allowed because PPE was scarce or because visitors didn’t follow rules and, as one commenter noted, “We don’t have time to be the PPE police.”

No one should die alone.

Nurses have been assisting patients to connect with family members by tablets or mobile phones, or in many cases filling in as surrogate family at the time of death. A colleague told me that in her ICU, nurses decided no one would die alone and made sure that one member of the staff was there with the patient. And while this was comforting to many families, I know from a […]

2021-01-08T09:49:53-05:00January 8th, 2021|family, family experience, Nursing, Patients|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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