1. Paradisi, Julianna RN, OCN


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Hostility among nurses is a well-documented topic of discussion, a phenomenon studied by both academics and hospital administrators wanting to create functional teams. Perhaps the remedy for healthy nurse-coworker relationships isn't found by studying dysfunctional relationships but by observing the successful ones.


I was lucky to have one.


I excelled as a student, even with balancing the role of nursing student with the role of mother to a preschool-age daughter.


However, academic success and my talent for multitasking did not prepare me for the reality shock of a new-grad nurse.


Thrown into the deep end. There was a nursing shortage. I was hired to work on a pediatric unit before graduation, skipping the two years of adult medical-surgical nursing that was customary for new grads at the time. I began my first job, pending successfully passing state boards, with an interim permit.


It was an era before nurse residencies or comprehensive orientations. My orientation consisted of accompanying a day-shift nurse while she managed her patients.


After two weeks, I began night shift on a 30-bed pediatric unit during the height of the respiratory infection season.


Night shifts were staffed with up to three RNs overseeing CNAs. Often the CNAs came from agencies, possessing varying amounts of skill. As a new grad overseeing CNAs, I was anxiously aware of the potential for errors.


Because it was a bad respiratory infection year, RNs were calling in sick. It was not unusual for me to cover 30 patients with another RN, or by myself, and two or three CNAs.


Several weeks later, I was assigned the role of charge nurse.


Am I the only new grad nurse who became nauseous pulling into the hospital parking lot before a shift?


My IV skills improved rapidly, but occasionally I missed administering a medication, or read an infusion order wrong. None of my mistakes caused patient harm, but it felt as though I arrived each shift to find a note from a day-shift nurse telling me of an error. I'd had an instructor who said she'd never made a medication error. Ever. I was convinced I'd made a horrible decision becoming a nurse, and contemplated quitting. It did not occur to me that the job expectations were unreasonable.


Pearls on a necklace. She floated to our unit from the PICU instead of being canceled for her scheduled shift. Her reputation as a rock star preceded her. The outgoing day shift was abuzz: She's coming to work peds!Have you met Moira? You'll love her. You're so lucky to work with her tonight!


"Great," I thought, "another nurse to embarrass myself in front of."


We were the only two RNs on that particular shift. Instead of dividing the patients between us, however, Moira suggested we take on the unit as a team, delegating what we could to the CNAs and dividing the assessments and IV medications for each patient, halving the time in every room.


Moira strung nursing tasks together as if they were pearls on a necklace. There was a natural rhythm to her work that made sense to me. I soon adapted it to my patient care.


It was the first of many shifts we worked together. Moira became one of my best friends-and my mentor.


'Let me tell you about errors.' One shift, I confided in her the doubts I had about staying in nursing.


"What are you talking about, Julip?" She called me Julip. When we worked together, I was Julip.


I told her about the missed meds, and the instructor who never made a med error.


"You're so crazy, Julip! Those aren't med errors. Let me tell you about med errors." Moira, the rock star, then proceeded to recite a litany of errors she'd made during her career, and what she had learned from them.


Eventually, I returned the favor by floating to the PICU when Moira's shift was short-staffed, and our unit was canceling nurses. Moira asked for me. My peds colleagues dreaded floating and welcomed my willingness to go.


In the PICU I learned that my personality and skills were suited to the detailed care of one or two critically ill patients, rather than to scattering my attention among 30. I thrived in the intensive care environment under Moira's watchful eyes.


A generous mentor. I floated to the PICU often. Moira taught me to draw blood from arterial lines, manage complex drips, and interpret blood gas results. Eventually, she asked me to transfer to the PICU. Because I wasn't six months out of nursing school, our manager had doubts. She said no. Moira would not accept her answer. She countered with a plan I'd never heard of before, nor since: She told our manager she would work my schedule, every shift, for a full year. She took responsibility for my training, the safety of our patients, and our licenses.


She was successful. I will never forget the time I called the PICU attending at home (we didn't have cell phones then), and his wife said, "Oh, you're not bothering us. He always says he rests easy when you and Moira are on. He calls you the A-Team."


Moira and I worked several years together in the PICU, until I moved away. We kept in touch for a while, but eventually I lost track of her. I think of Moira often, but particularly this Nurses Week. I'm not sure I'd have stayed in nursing if not for her.


She truly was one in 4 million.