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22- bloody bandages

Spooky Cookie month continues on Cookie Thursday is a Thing. Today’s make is bloody bandages.

These are operating room folks, and it is hard to gross them out.

No ick matter here!

Bloody Bandages

Sugar wafer cookies, the ones with the cream filling between thin crispy wafers.

white chocolate Candiquik. This is meltable chocolate that comes in a variety of flavors and colors and here in the United States it goes by that unfortunately spelled name, or some craft stores carry it for candy making. It melts fast in the microwave and smoothly.

toppings- for effect I used a combination of green sprinkles, and freeze-dried raspberries

I had to experiment a bit with technique. The first tray I laid the wafers out, melted the chocolate, tried to make a square of chocolate with a spoon, put the toppings on

This works but it gets messy as the chocolate begins to dry.

The second tray I had the wafer cookies in a stack, picked them up, spread the chocolate using a knife, added toppings. This worked much better and I was able to get a more uniform square of chocolate

What makes these bloody bandages is the rectangular shape of the wafer cookies, and the hopefully white square of chocolate. And the raspberry “blood”.

On some I added green sprinkles to simulate infection.

I think they are adorable, and they were very fast to make. I barely got through NPR morning edition podcast, which is about 15 minutes long. Seriously one of the fastest makes yet.

School Me Saturday 5/11/24-semester’s over, relaxation time is now. Ask the Dormouse

Yay! You survived to the end of the semester.

As many of my classmates are fond of pointing out, C’s get degrees. Or B’s. Depending on the level of education you are striving for.

Enter the Dormouse to the Alice in Wonderland college/university conversation we are having.

The Dormouse is a character at the Mad-Tea Party. You know the one! The one who is asleep in the teapot. And on the chair. And on the table.

Something made the Dormouse tired.

It might have been life.

It might be his companions. Cough, cough…Mad Hatter, the March Hare.

Or, maybe, he just finished a semester of school.

Perhaps we should let him sleep.

As for you, it is okay to relax after the end of the semester.

Maybe you only have a week off. Maybe you have 12 weeks off.

Make the most of them.

Me? I am indulging in all the fiction I’ve not been able to read during the semester.

And it has been glorious!

I have an extensive To-Be-Read pile and it gets bigger as my favorite authors release books.

My aim this summer is to make a sizable dent into the pile.

What are you going to do?

Happy Nurse’s Week!

It is that time of year again.

Where everyone we’ve given free medical advice to in the past year thanks us.

Nah, I’m only kidding.

But it is Nurse’s week.

Congratulations to us for choosing the hardest schooling and working under the most extreme conditions. Especially in 2020. And 2021. And 2022.

All those years and months in an N-95 mask did was hone our skills and sharpen our dedication to the profession.

It’s not for nothing that I liken nursing to blue-collar work. Because it is hard.

I have been punched and hit and cussed out and peed on and pooped on and pinched. Once a former nursery school teacher, who had dementia, cornered me in the bathroom in the nursing home for 20 minutes. I couldn’t leave her, she could have fallen. All I could do was pull the emergency bathroom alarm and wait. And wait. And wait. Finally, someone came to help me help her back to bed.

Nursing. It’s not for sissies.

It is with some fondness that I remember working nights in the nursing home as a certified nursing assistant. It taught me a lot of things. Time management, how to budget because every other week my paycheck was a day short, how to talk to difficult patients, how to turn and change 32 patients every two hours every night. But the second best thing it ever taught me was how to lift. I lifted a 500-pound patient out of bed every morning, with her help. Well, I levered a 500-pound patient out of bed every morning so she could go visit her mom in another wing.

The best thing that it gave me was the desire to return to a nursing program and finish my RN. And so I did. Look at me now, a PhD student. Okay, it’s nearly 30 years later but it still counts.

Happy Nurse’s Week.

As I tell my fellow hospital nurses, find yourself a corporation to work for that wants to help you be the best nurse you want to be. If that is no longer the hospital, that is okay. If it is higher in the corporation, that is also okay. Weird flex but okay.

Happy Nurse’s Week.

Be the nurse you want to be.

Tuesday Top of Mind 5/7/24- Everything old is new again

History has much to teach us.

How to survive a pandemic. Such as the so-called Spanish Flu from 1918. Even though at best guess it started in Kansas.

Nope, never mind. Some people never learned about masking and taking steps to ensure that OTHER people are kept safe.

What’s next?

Students protesting against what they see as an unjust war. And them being fired upon by the Ohio National Guard. What they were protesting was the expansion from Vietnam into Cambodia. May 4th, Ohio National Guard fired upon the protestors, killing 4.

Oh, lookie, students are protesting again against what they see as the unfair treatment of the Palestinians in Gaza at the rockets of the Israelis. Yes, Hamas (the ruling party of Gaza) did kill 1269 Israelis without mercy on October 7, 2024, and kidnapped 240 people. Israel defended itself (their words) and have killed over 30,000 Palestinians in retaliation. They are searching for the Hamas leaders and killing women and children. And choking off much-needed humanitarian aid at ports and crossings and killing an aid convoy from World Central Kitchen. This is why the students are protesting. Last weekend police were violently (at times) dispersing the student encampments on multiple universities. You know, destroying the student’s First Amendment rights. Nothing to see here.

Another thing history tried to teach us, that no one is listening to. No students have died in the current times so perhaps those with guns learned their lesson. Probably not.

The Supreme Court showed its thumb firmly on the scale for the former president. But then it has never been apolitical.

What’s next?

Fifty years ago women were granted the right to privacy, outlined in the 14th Amendment. This was the Roe v Wade decision and was universally hated by those who wanted to control women and didn’t give a fig about their privacy. But I’ve written about that. A lot. And I am still incandescent with rage, nearly 2 years later as women’s rights are dripped down the drain, women die and some unborn are tortured. But that will be another Dispatch.

The same Supreme Court also ruled against privacy rights, which was what Roe v Wade was about, and handed abortion to the states. Who have all but danced around Roe’s body in response and finally get the chance to control women. Again, that will be another Dispatch. Or read the ones I’ve already written.

George Santanaya, a philosopher, wrote in 1905 “Those who don’t cannot remember the past are condemned to repeat it.” Winston Churchill also said “Those who fail to learn from history, are doomed to repeat it” in 1948. Take of that what you will.

History repeats itself because we do not listen. We are forced to relearn lessons that history has already tried to teach us.

Post-it Sunday 5/5/24- the OR is too hard on its toys

The gown card says “Remember when your sister dismembered your favorite Barbie doll.”

Boy, do I!

Let me set the scene. I had received the Loving You Barbie for a birthday, or it might have been Christmas. This Barbie was awesome! Red sweetheart bodice, sleeves AND skirt that were tulle-like with red velvet hearts on it. I’ve called it the Sweetheart Barbie for years but the doll apparently debuted in 1983. I would have been 7 or 8. She came with a little heart notepad and pencil. In my recollection, my favorite thing about this Barbie was that her hair wasn’t platinum blond, like the others. Instead, it was a warmer golden blonde. At least that’s what I remembered.

Not sure how old my sister was when she got her hands on Barbie. I definitely don’t remember her having access to scissors.

First, she scalped my favorite Barbie. I remember being pissed.

And then she tore its head off. Everyone knows you can replace the head but it is never the same after that.

Little sisters! Am I right?

About 20 years later, after I got married, my husband received a box from his parents. And in that box were the remnants of his Star Wars toys. And I mean REMNANTS. He had a fondness for blowing things up with firecrackers.

Kids. They just can’t have nice things.

This is also the way of the OR.

Every time I see plant engineering fixing a hole in the wall, or putting up hard plastic to protect our walls, or the corners of the walls.

Or environmental cleaning blood off the ceiling.

Or biomedical engineering replacing a piece of equipment that the OR has damaged.

Sorry to all of them.

The OR is hard on our toys.

But the ER? They are hard on the gurneys.

Makes sense when they have upwards of so many patients (hard to get an exact number on the fly). But extrapolated out, the OR is harder on its equipment, walls, instruments, etc.

Sorry.

School Me Saturday 5/4/24- party like the Mad Hatter is throwing a tea party

It has to be said. May the Fourth be with you.

That is the obligatory Star Wars reference. I am wearing one of my Star Wars tee shirts, the crystal fox from The Last Jedi.

However, that is neither here nor there.

Which is a typical Mad Hatter reference, I mean definitely something he would say.

And a very merry unBirthday to you. Remember, this was the song that the Mad Hatter and the March Hare sang to Alice at the tea party.

In this instance, I am referring to the end of the semester.

A very merry end of the semester to you.

You made it!

If you are not taking summer classes, this means you have a nice long break until Fall Semester begins in August. Use this time wisely.

I am not saying party like the Mad Hatter is throwing a tea party. However, do what you want to do. Read what you want to read. Watch what you want to watch. Gather with your friends and relax.

If you are an adult learner, take a breath. You probably have other responsibilities like family or work. It’s okay to let go of school for the summer. You’ve earned it.

Just don’t forget about the fall classes you signed up for.

Me, I’m going to hopefully take my preliminary exam and am definitely taking a Dissertation session. This means I will start working on the chapters of the Dissertation.

This is not a drill. This is the way I graduate in May of next year. Intentions mean a lot and I am putting that out into the universe.

But first! First I read.

For a week, maybe 2.

Dispatches from the Evening Shift end of semester impromptu vacation

The end of the semester can bring up many feelings.

Too often the weeks and days leading up to the end of the semester are busy, busy, busy.

Final projects.

Final papers.

Final presentations.

Yeah.

All of those.

I was gonna contradict myself and say that there were no presentations. But there was one.

I would say the majority of my feelings are exhaustion.

I don’t want to read for school, I want to read for pleasure.

I don’t want to write for school, I want to write for pleasure.

In the past few days, I’ve mostly been reading.

A lot.

Like a lot a lot.

The Women by Kristin Hannah was the first book I read. It is about the forgotten women in Vietnam, the nurses. Oh, so good.

Maddening and tear-jerking all at the same time.

This country did those women dirty.

Oh, and I worked a few shifts in there too.

After my last 10 hours as an RA.

And it occurred just now that I didn’t turn in my last time card.

Oh, dear.

Okay, that isn’t what I said. But drat!

And it was due today.

Bother.

I’ve got to get that in.

Oh, and I’m on my fourth and fifth antibiotic of the Spring. Can I use that as an excuse?

Too late, because I’m gonna.

Tomorrow I will write another Dispatch from Wonderland regarding school life.

I can’t wait to find out what I’m going to write about.

Time card first!

Post-it Sunday 4/28/24-no post-it today

No post-it today.

My last final is due tomorrow. And I have spent 2 days deeply mired in writing the darned thing.

There have been a multitude of texts. Of encouragement. Of possible solutions.

Because we got to talk about the problems, just warned not to turn in identical word documents.

One of my cohort called me Kathy.

Kathy!

The audacity.

Of course, I didn’t correct them.

They are stressed too.

No post-it today. Although technically I did finish a post-it that I keep my assignments on.

I had to get it done because tomorrow is my last research assistant day!

Until August.

Ooohhh, I’m gonna read all the books.

I can’t get too excited, I have to arrange for and take my preliminary exams. Hopefully in late May or June.

Oh, and the fridge died last week.

Well, I say died. The ice and water stopped functioning. And it is freezing things in the refrigerator itself. Definitely on its last legs.

The new one is coming Tuesday so I have to do the pre-delivery checklist. I already measured to make sure that it would fit in our oddly shaped downstairs. It will. And I will empty out the refrigerator, as requested, and disconnect the water line day off.

No post-it today because my brain is blank.

I had to work like the dickens to get my assignments done. Because I will be gone all day tomorrow.

I am okay with not doing post-it Sunday.

Now, which book should I read first?

School Me Saturday 4/27/24-Off with her head!

Reminder- this series is roughly based on Lewis Carroll’s Alice in Wonderland and Through the Looking Glass. In this series, Alice is the student and the other characters are actors in the student’s life.

Nope. It isn’t Alice’s head that needs to be lopped off. It is the Queen of Hearts.

In this post, we are going to pretend that the Queen of Hearts is the little whisper of self-doubt that all students have. Regardless of where they are in the college/university/degree journey.

ALL students have that little voice that whispers to them that they are not good enough.

That they are only in the program they are in because of pity.

That the next test/essay/research paper will be their last.

Because how can they last?

Do they really think they can finish?

Do they really think no one is laughing at them and their audacity for thinking they are on par with their classmates?

And, if they finish by the grace of the teachers, how do they think they will pass the next test? In nursing, this is the NCLEX, the national boards that assess a nurse’s readiness to practice safely.

It is insidious, that little voice in all students’ heads.

In the book, Alice draws the Vorpal sword, which allows her to defeat the Jabberwocky by cutting off its head and defeating the Jabberwocky allows her to defeat the Queen of Hearts.

The key to defeating the student’s Queen of Hearts little voice is to draw their own Vorpal sword.

This is gonna get a little metaphysical but bear with me.

The Queen of Hearts yells constant threats. Off with his head, off with her head. But no heads are actually lopped off except the Jabberwocky. She is all bluster and vim, but in the end, Alice proves her to be thin and unsubstantial. Because the Queen of Hearts is only a playing card. In naming her to be inconsequential Alice defeats her.

The little voice in students’ heads (and I am not immune) can be defeated in such a manner. It is about recognizing the voice and knowing that the voice is not telling the truth which allows the student to defeat the voice.

This is not an easy battle, (see me in my fourth degree program and still struggling at times with the voice), but naming the voice and recognizing that it is self-doubt at its heart allows us to ignore the voice. Ignoring the voice leads to its defeat, just like paying a lot of attention to the voice allows it to grow.

My best advice is to talk to other students and have conversations about defeating self-doubt. There is safety in numbers and when one student is having a bad day, the others can serve as a support system to buoy them up.

Above all, give yourself grace.

This is new. This is difficult. But there have been others before you.

Talk to them. Talk to your classmates. Find the voice and squash it like a little bug!

This is where I put in a mantra- the only way out is through.

Picking the surgical case is a personalized topic

I’ve been an OR nurse for over 20 years. My career has been in three hospitals, many different shifts, and many, many, many call shifts.

Call is my favorite, after all.

Call is my life now.

I’ve been picking cases, and this is getting case supplies together, for a long time. There have been thousands of cases that I’ve picked.

I like to pick cases and I think it is soothing.

Most people who I’ve talked to about picking cases have developed their own process.

This is mine.

I use the elevator to go to the case make-up area in the basement. This is where the supplies are kept. When we were designing the basement for case-picking I was adamant that the room had to be organized in terms of picking a case. This means you start in one corner of the room with the basics. These are the supplies that every case needs. A back table cover, drapes for the surgery (this is dependent on what kind of surgery you are picking for), gowns for the surgeon and scrub tech, and a basin set. This is the absolute bare minimum for a case.

I crank up Down with the Sickness by Disturbed and start in that corner.

These days or nights, I pick a LOT of general cases, a few ob-gyn cases, and very few orthopedic cases. But the process is the same.

Starting with the basics- back table cover, basin set that is appropriate for the surgery (there are 2 basin sets), gowns for the surgeon, and drapes for THIS surgery.

Next, I pick out gloves for the surgeon. This is the next area in the basement. This is also where I get the prep kit if this is an ob-gyn case.

And then it is time to select the bovie tips that are needed, if any, and the suction tips that are needed, if any. You see what I mean about being highly customizable? I refer to this section as the basic sharps- knife blades, syringes, extra sponges (raytex or lap), bovie tips, bovie grounding pad. These are all within 2 large shelving units. These are the end of the basics, the bare minimum for every case.

If you turn around, there are the dressings on another cart. These are highly case-specific.

Then you go to the particular section of the case make-up that is determined by the case you are picking for. Orthopedic stuff is with orthopedic stuff, laparoscopic stuff is with laparoscopic stuff, ob-gyn stuff is with ob-gyn stuff, and so on.

There is a section tacked on the end of the ob-gyn section that is the hot items. I don’t mean stolen, I mean electro-cautery items used for laparoscopic or open surgeries.

Here I pause to look at the exact card to see what I am missing. I do not go line by line with the card. There are many reasons, but mostly because what is on each line is not alphabetical like I told them would be good. Instead, supplies are listed by how where it is in the WAREHOUSE! Tell me, in what universe does that make sense?

But we adapt and move on.

It would surprise exactly no one when I say that surgeons have many opinions on the supplies. Some surgeons are really concerned with costs, some are not. Some surgeons, well, most surgeons, just want what they want. They will complain mightily if corporate does not want to buy them what they want and instead give them a comparable supply.

I head upstairs to the instrument room. It used to be next to the case make-up area but has since been moved back upstairs. I pull the instruments that are needed for the case.

End of story time.

Down with the Sickness is four minutes and thirty-nine seconds long. It never takes me the entire song, including elevator rides, to pick a call case. But I’ve done this a long time and I have most of the cards memorized.

I train a lot of people in my job, or, I did, and I offered to do a case-picking BootCamp, like the Call Bootcamp that I do. No go.

Everyone is going to develop their own style. But a grounding in the basics would have been useful to new people.