Travel nurses have always been a thing

Travel nursing has always been a thing.

They fill a need.

Think of them like the short term answer to a department’s problems.

The problems can be wide ranging.

A staff tech or nurse is having surgery.

A staff tech or nurse is having a baby.

A global pandemic hits and some workers who are parents must step back from their work because of caring for their children.

Or caring for family members.

Or they themselves are at greater risk because of pre-existing problems.

The healthcare workforce gets lionized by being on the front lines during this global health emergency.

A global pandemic stretches on and the workforce gets tired.

Tired of the never ending wave of patients.

Tired of parts of society that wants to now vilify nursing and other healthcare workers.

Because of course it is healthcare’s fault that society wants to go back to the way it used to be; without masks, without social distancing, without the constant threat of illness or death.

It can never be the fault of someone who doesn’t want to wear a mask, or take any precautions to decrease the chance that they will become sick, or spread the illness to others.

It can never be the fault of someone who denies science.

Not, never that.

Healthcare systems are in crisis.

Workers are leaving because they are tired and it is a job seekers’ paradise.

Workers are leaving because they didn’t get their exemption to the vaccine mandate and they are being forced (in their minds) to quit or have weekly tests.

Workers are leaving because of the child care system that is also struggling, and the problems caused by the pandemic are continuing.

And the pandemic itself is grinding on.

Still.

And travel nurses and techs are there to step up and fill the gaps so that the machinery that is the healthcare system can keep turning.

My mom, a travel nurse for the past 4 years, says that her company is inundated with the need for additional nurses and techs.

EVERYWHERE.

Yes, they may be paid more or in different ways.

That is not their fault.

That is demand economics.

And anyone else in their shoes would do the same.

Be nice to your travel workers.

They may be all that is standing in the way of limiting patient care and decreasing OR cases because there is no one to work them.

Post-it 11/28/21-Unreliable memory

The post-it reads ‘I get you out early, when you ask, 9/10 times, why do you only remember the 1?’

This is in reference to the 1 time that I got someone out 10 minutes past their time to go home and they complained to management.

No mention was made of the previous 9 times I had gotten them out early.

Nope, they just remember the 1 time that I didn’t

No yays were given on the 9 times.

Just a trail of dust where someone had been.

As they got out of there before I could change my mind.

Only a boo given on the 1 time.

It is enough to crash my head against a wall.

Apparently this is hard-wired into our primal memory.

A disappointing memory really sticks in the mind.

Because to our distant past selves recalling the illness we had after eating the purple fruit is kept top of mind to remind us not to eat anymore purple fruit.

It is a survival mechanism.

Because humans are dumb.

It is easier to link to something unpleasant, because sometimes avoiding the unpleasant stuff can save your life.

It just is hard on charge position holders.

Especially when they complain that you got them out 10 minutes late.

Sometimes MDs are slow to close or run into an unforeseen incident during surgery.

Which makes surgery time longer.

It is not the charge nurse ‘forgetting’ to get you out.

That happens very, very, very rarely.

But you wouldn’t know about it, judging by the number of complaints that are raised.

Give the people in charge a break, especially if this is not usual.

This just means that something outside of their control happened.

Omicron, aka, omigod I can’t believe this is still a thing

Omicron

Omigod I can’t believe this is still a thing.

And people are wringing their hands and bleating why, oh why?

You know why, you dumb bitches and assholes?

Because you won’t take two seconds out of your day to put on a mask.

Or wash your hands.

Or stay 6 feet apart from strangers.

Take a shot that has been proven to be effective against this very real threat.

Because YOUR rights supersede everyone else’s rights.

Or you don’t believe in “science”.

Or the “greater good”.

I am disgusted by the lot of us.

Many of us do believe in science.

And being put out a bit to help our neighbors.

Whoever, whatever those neighbors are.

So spare me the sputtering.

And the crocodile tears.

And the he said and she said.

I believe in science!

I believe we could have ended this a good bit ago.

The sputtering of ‘fer liberty’!

Yeah, right, for a good kick in the pants.

For you are skipping merrily down the road to non-existence.

And dragging all the rest of us with you.

In order to “own” the science believing dweebs.

Yeah, I don’t even know what that means.

I’ve tried to be nice.

I’ve tried to be understanding.

I’ve tried to listen to your blathering.

But I’ve had it.

So what if you have covid last year.

This is a different covid now.

This covid has taken off the gloves and is no longer playing nice.

As if it ever was.

So what if you had covid last year and all you had was fatigue and a sore throat.

It really wasn’t that bad, like a bad flu.

That’s nice, dear.

5.19 million worldwide had covid and now they are dead.

DEAD.

Omigod I can’t believe we are still having the same arguments as over a year ago.

Put on a mask.

Wash your hands.

Take the damned vaccine.

And, maybe, just maybe, no other variants will pop up.

That is a pipe dream, but it is worth a shot.

Because I’m tired of this.

Aren’t you?

Let’s start F.A.F.O. as a thing

I have a new favorite phrase.

Fuck Around, Find Out.

This should absolutely be an acronym that is started.

I use it nearly every day.

It can be used to explain consequences of actions.

Doesn’t matter what the consequences are.

Mostly bad.

Or unintended.

Doesn’t matter what the actions are.

Usually something that people feel powerless about.

Use it and let people feel confused when there are consequences to their actions.

And people have follow through reacting to the consequences.

FOFA.

It just rolls off the tongue.

And is something that I am feeling a lot lately.

Healthcare workers have a LOT of options these days.

An option was dangled in front of me.

I was unhappy.

And I took it.

Could it be a good option?

Time will tell.

Could it be a bad option?

Time will also tell.

Are there things that I can do if it turns out to be a bad option?

Absolutely.

Healthcare workers are exercising their options now.

But for now I am sad that I am leaving my shift and my current position.

And my coworkers.

It is my last evening charge shift.

And then a tectonic change.

Both for me and for the department.

We’ll see how it goes.

I’m excited.

Whatever happens, Cookie Thursday is a Thing will continue in my department.

Can soundtracks mirror events?

There is an end to the season at my job tomorrow/today/next week.

Technically Friday is my last evening charge shift.

And then I go on vacation.

I’m supposed to be in London.

Again.

Again I am not because of Covid numbers overseas.

And then I start my new shift.

I am very excited to be doing this change.

I have felt stale for awhile.

As I was working my way down the chore list, I began humming to myself.

The song that I was humming.

On this penultimate day in my current job?

One Day More.

From the Broadway musical Les Miserables.

And the lyrics hit a bit differently.

‘One day more, another day, another destiny.’

I chose this change for myself.

And my sanity.

‘One day to a new beginning, raise the flag of freedom high.’

And the last lines of the song, ‘one more dawn, one more day, one day more.’

I have always positioned this blog as communiques from the front lines to headquarters.

The front lines will still exist.

They will just be a bit different now.

And on the way home I had the Broadway musical Hamilton playing.

And another song struck me as appropriate.

The Story of Tonight.

This song also hits a little differently this week.

‘I’ve seen wonders great and small.’

I will continue to see those wonders.

Many of the past wonders that I can think of happened on call.

‘Raise a glass to freedom.’

‘Something they can never take away. No matter what they tell you.’

And the last line of the song.

‘I’ll see you on the other side of the war.’

Europe is entering another Covid wave

Europe is entering yet another Covid wave.

The news has been alarming from Western Europe for over a week now.

Is this the US future?

The news has been alarming from some of the Western US.

The news is that hospitals are struggling with Covid case volume.

Despite the vaccinations efforts.

Despite the booster efforts.

Despite the mask mandates still in existence for my state.

Despite everything.

There are still at least 1,000 deaths a day.

I know, because I am obsessive like that.

I read ALL the articles.

Foreign and domestic.

And I see everyone acting as if the pandemic is over.

Today’s sum total is 775,785.

We hit another milestone.

Boo.

I get the totals I monitor daily from the Johns Hopkins Covid-19 dashboard.

And I see everyone celebrating as if this is over.

It ain’t over until the fat lady sings.

Wash your hands, wear a mask, get vaccinated.

If not for yourself because of some misguided beliefs.

Then for your neighbors.

And their new baby.

Or their child who is immuno-compromised and is too young for the vaccine.

I can’t believe we are still having this conversation.

I’m so tired of having this conversation.

Aren’t you?

Cookie Wednesday 11/24/21-Happy Thanksgiving

Since Thanksgiving is on a Thursday, there will be no cookie Thursday this week.

In the spirit of giving, there is cookie Wednesday.

I usually stick closely to the theme for the month.

Because that is what a theme means.

Themes help me keep track of cookies.

And all the cookie requests.

Not too long ago, I saw a jalapeno sauce at Trader Joes.

Hmm.

I wonder if that could stand in for chopped fresh jalapenos.

The answer is it can.

And the sauce is more consistently spicy.

Which makes for a more consistently spicy cookie.

I am sure there is an OR lesson about consistency.

But this week has been a ball buster.

And I am too tired for puns.

It’s the final countdown

If you don’t hear synth horns, what have you been doing since the mid 80s?

Yeah, so, the universe is mad at me.

In the last two weeks I have worked my usual: 1430-2300 Monday through Friday.

Laser call Saturday/Sunday 0700-1900.

Night call Saturday/Sunday 1900-0700.

And night call Monday-Friday 2300-0700.

Plus assorted meetings.

This is all completely normal.

And is changing after Friday.

I’m a workaholic.

So what?

Ever since I agreed to change my job role to that of the night call nurse, the universe has been throwing some serious shade my way.

Sorry, whoever I happen to be working or on call with.

Sunday was no exception.

I had an unusual call case in the middle of the afternoon,

The normal weekend team was busy.

And this was an emergency.

4 hours later, I was home.

At then the tech and I were called in for a big belly case.

The usual: perforation somewhere, tanking blood pressure.

And then the universe threw us a dislocated body part that does not usually dislocate.

At 0400.

And me having a car appointment at 0700.

I could have cried.

I am pretty sure the CRNA did.

And after that I had a meeting at 1100.

Do you think the universe knows that my life is changing in 4 days?

I think she does.

And I think she is PISSED.

Sorry, universe.

Sometimes change is good, you know?

Post-it 11/21/21- married to the idea (thumbs down)

The post-it reads ‘don’t be married to their plans’.

As discussed previous, Murphy lives in the OR.

And lives to fuck plans up.

This is meant to be a post-it to management.

Too often they are married to their horrible ideas.

By that I mean that they will see their plans through without acknowledging new information that comes in and points out how bad the plans are.

A few years ago, AORN came out and said that OR personnel should only wear disposable hats.

I have twenty+ cloth hats.

There are reasons for wearing a cloth hat.

It weighs down my very fine hair so I don’t get flyaways.

The cloth hat controls the edges of the my hair so that I don’t like a dandelion while in a sterile environment with all the hairs escaping.

The cloth hat allows me to show a little personality.

The thing is they have to be washed, properly in hot water, after every use.

And no one wants to keep track of that.

Therefore an honor system was set up.

Washing was still not being done.

AORN threw their hands up and declared cloth hats were forbidden, because no one could be counted on to wash theirs.

And my OR banned cloth hats.

Yeah.

So many, many problems with paper hats.

Some people who have short spiky hair, the hair was protruding through the paper.

Some people, such as myself, have very fine hair and the paper hats could never hope to control that.

I would put up my mask and the hat would be near the back of my head, exposing the front half of my head.

And no one would tell me.

The hats were meant to be discarded after every shift.

You can bet that wasn’t happening.

Ew.

I set up a research project involving paper hats and hair spillage.

I took pictures every day of my coworkers.

At the beginning of the shift, when their hair was somewhat neatly contained.

And at the end of the shift, with hair half escaped the paper hats.

There were listening tours by management and they had to listen to us complain about the paper hats.

I talked about my research project before the research symposium.

There was an uptick in surgical infections.

A root cause analysis pointed at the paper hats.

AORN quietly put into place that cloth hats were okay, as long as they were washed regularly, and covered with a PAPER hat.

The hospital followed suit.

Same rules as before.

The point is don’t be married to terrible ideas.

You never know when new information will come out to disprove or disrupt the plan.

Or infections may go up through unintended consequences.

When many people tell management their idea is terrible, too often they double down.

And make the idea more terrible.

Striking-when not to do it

Every time we went to visit Dad in the hospital we had to pass striking workers.

Every time.

And every hour on the hour they would strike up horns, and drums, and fake sirens.

The rest of the time they would shout.

Um.

This is a hospital.

There are very very very sick people here.

People who do not need to hear that kind of commotion every hour.

Is organized labor a good thing?

Yes.

Everyone who ever enjoyed a weekend needs to thank a union.

Have I ever been willing to cross a picket line?

Also, yes.

Is is important that people get to exercise their union rights?

Yes.

But, my dudes, perhaps this isn’t the time or the circumstances.

Chanting, drums, and sirens, oh my.

We are in a pandemic.

Spreading droplets by yelling does not do anyone any good.

Keeping patients awake inside the hospital might even be detrimental.

And having to cross the picket line every time I want to see my dad in the ICU is disheartening.

Having to wait outside because only 1 family member is allowed in at a time and listening to the noise and the sirens and the yelling.

Kind of made me not want to be on your side.