1. Hunt, Loretta

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A hand releases a cobalt blue bird that soars above a vibrant world bursting with the wonders of life.


"When I saw this picture, I saw the story of nursing, especially the story of nursing on our particular unit. You see the hand, that's the hand of compassion; the stethoscope, that's the science of nursing; the underwater life, it's creation. Every little area reminded me of all the things that we do as nurses."


It was 2003. Belkis Ramirez had just returned to her unit from a conference held by the American Association of Critical-Care Nurses. She had been especially moved by the keynote address, entitled "Rising Above," which was delivered by the association's president, Dorrie Fontaine, as well as a painting with the same title that had been commissioned by the organization to illustrate the conference's theme. So inspired was Ramirez by the painting that she was carrying a copy of it with her.


Ramirez, a nurse on the medical intensive care unit (MICU) at St. Joseph's Regional Medical Center in Paterson, New Jersey, suggested that Rising Above be recreated in mosaic form as a MICU art project. The unit had already produced two mosaics, one called The Holy Family, created in honor of the hospital's Catholic roots, and the other a memorial to the victims of the terrorist attacks of September 11, 2001.

FIGURE. Pictured (fr... - Click to enlarge in new windowFIGURE. Pictured (from left) are nurses Belkis Ramirez, Jocelyn Espejo, and Gwen Dransfield, posing with the mosaic made by MICU nurses at St. Joseph's Regional Medical Center, using IV medication caps. Espejo created the template, which was left on a table in the unit, and MICU staff worked on the mosaic whenever they had time.

MICU nurse Jocelyn Espejo, who had planned to become an architect before she found nursing, sketched the painting onto canvas. It was Espejo's idea to use the colorful IV medication caps that are often tossed in the garbage after opening. But the caps only came in 10 colors.


Advanced practice nurse Janice Wojcik, who helped oversee the efforts, says, "We had to actually 'rise above' to figure out how we were going to get this particular art project accomplished. We couldn't do the artwork justice using what we had used in the past." So the nurses incorporated multicolored beads to instill depth and texture in the more intricate areas of the piece.


For two months, it was commonplace to see groups of nurses cutting the caps on their lunch breaks or gluing pieces together at the nurses' station during downtime. Sometimes nurses took parts of the project home with them; others would stay after their shifts to finish a section. As the nurses worked, they spoke about what Rising Above meant to them, the symbolism behind the images, the difficulties they encountered daily in the tense environment of critical care, and how they could look for new solutions to the challenges they faced in practice.


For each nurse, the opportunity to contribute to the project held a different significance. Cindy Schmidt found the assignment a relaxing icebreaker that brought her closer to her new colleagues. "When the project started, it was exciting because everyone was just going in and out," she says. "If they had a minute they'd stop. Everybody, I think, had a spirit of being one doing that work." Nurse Arturo Eijansantos got involved because he felt a deep pride for his unit that he wanted to transfer to artwork.


In February 2004-more than 3,000 medication caps later-the mosaic was completed. Wojcik estimates that more than 35 nurses contributed to the project, which is now displayed on the wall at the entrance to the MICU, serving not only as a greeting to visitors but as a reminder of the nursing team's accomplishment.


Of even greater value, says Wojcik, the project stimulated a cultural shift she hadn't seen before. "Now, when you go on to the unit, you'll often see two of the RNs in the room together working with a patient. It's not so much my patients as it is our patients. They want to deliver excellent care, and they've come to realize they work much better together than they do individually."


Remembering Edith 'Pat' Lewis

Influential editor and mentor to many.

Edith Patton Lewis, Pat to her friends, died in February at her home in Connecticut at the age of 90. Pat was a watchful critic and champion of nursing well into her last few months. We offer the following remembrances from former colleagues and friends as a tribute to this woman described as intellectual, eloquent, insightful, strong, and feisty.


Thelma M. Schorr, BSN, RN, FAAN, worked with Pat for many years. The following is an adaptation of an obituary she wrote about Pat, which was issued as a press release by Diana Mason, editor-in-chief of AJN, on February 25.

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Pat began her editorial career when she joined the editorial staff of A JN in 1945. She went on to become editor of AJN and Nursing Outlook and the founding managing editor of Nursing Research during the 35 years she was associated with the AJN Company. Aside from writing trenchant editorials, she would mentor new staff from all of the company's six journals when they were sent to her to learn to edit. "Remember," she would say, "never overestimate the readers' experience or underestimate their intelligence."


Pat retired in 1980 but continued her professional watchfulness, sending affectionate but pointed letters to the editors of several nursing journals and providing brief essays about pretentious prose or issues she felt strongly about. The following is from a piece she wrote for Image: The Journal of Nursing Scholarship that appeared in its Spring 1986 issue:


Having finally accessed Image's pages, printwise, this writer is behooved to prioritize her objectives so that the conceptualizations contained herein will be translucently articulated and the parameters of the discourse strictly delimited in order to maximally impact the parameters.


And if you lasted all the way through that sentence, you are to be commended, congratulation-wise, for your patience and fortitude. If you saw nothing wrong with it and had no trouble understanding it, I worry about you.


Actually, my only conceptualization is to say, "Isn't that an awful way to write." And my only objective is to plead with you, in the name of all editors and readers, "Please don't write like that."


Barbara Stevens Barnum, PhD, RN, FAAN. Pat was incapable of writing a dull editorial. Most of them, if they are read today, sound completely contemporary. Perhaps that means that nursing is too slow to solve its problems. But I think it has something to do with the fact that Pat's vision was futuristic, wise, and fresh. Outside of her family, Pat's main love was nursing. For years, she relished nursing conventions and the chance-no, not to compare ideas-but to fight them out, especially outside of the meetings with a few good friends, preferably in a smoke-filled lounge.


Pat had a thing about penguins. They were everywhere- on the door of her apartment, on her stationery, on her Christmas cards. I thought it sad that her chosen totem was one of the few birds that cannot fly. But I discovered later that they can literally jump out of the water, always landing on their feet. I knew then that Pat had picked just the right animal totem after all. She had her feet planted solidly on the earth but she could take bold leaps when she wanted to.


In Memoriam

Nell Watts, MSN, RN, FAAN, 79, died February 28 in Indianapolis after a long illness. For more than two decades, Watts was the executive director of Sigma Theta Tau International, the honor society of nursing. Under her leadership, the society expanded from a national entity of 50 chapters into an international organization of 324 chapters and moved its headquarters from a two-room office to a 33,000-sq. ft. one, the International Center for Nursing Scholarship, located on the campus of the Indiana University School of Nursing, her alma mater. Memorial contributions in her name can be made to the Nell Watts Fund for International Scholarship at Sigma Theta Tau International Foundation for Nursing, 550 W. North Street, Indianapolis, IN 46202, or to the Fisher Center for Alzheimer's Research Foundation, 1 Intrepid Square, W. 46th Street and 12th Avenue, New York, NY 10036.

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