This is the final Cookie Thursday is a Thing for 2021.

I had a poll on the board in the break room.

And people chose Chex mix over cheddar triple pepper thumbprints.

Okay.

It has been quite the year.

I made cookies for nearly every week.

Except for the week I was in CA.

Or one week I was on vacation.

Cookie Thursday is a Thing turns 7 next week.

I think, time is fluid.

I mean I just got married a couple of years ago.

Just kidding, it’s been 23 years.

Eek!

Seven years of nearly weekly cookies.

Hmm.

In the next year I will be expanding the Cookie Thursday is a Thing as a morale booster to other departments in the hospital.

Why and how?

Because I have 40+ hours to fill a week.

And after 7 years I think the department can share.

I think I will choose the emergency room as the first recipient of a Cookie Thursday is a Thing batch.

Since the beginning this was an afternoon/evening shift endeavor.

And so it will remain.

I hope to deliver the cookies by 1400 on Thursdays.

I probably should tell the managers what I am doing.

The theme months will continue.

And I began 2021 with a booze cookie month.

And since 2021 has been so awful I will begin 2022 the same way.

Hopefully a reset.

Because, according to my coworkers who are confused by the fact I don’t drink, booze makes it better.

And there are still so many alcohols to explore.

I want to do a rose wine cookie.

I hear the millenials loves rose.

I want to do a vodka cookie.

This one’s plan is secret.

I want to do a port cookie.

I should check the bar.

In September 2019 I fell in the OR.

I tripped over the c-arm cord.

I face-planted into a trash can.

This was a call case.

The only people present in the OR was the surgeon, the anesthesiologist, the CRNA and PACU was on their way in.

The patient was under 6.

I was not going to let a little fall stop me from giving care to this child.

Although all the others, all men, urged to me to sit down and take a break.

I looked at them, pointed at the child we had JUST put under general anesthesia and said there was no time.

Everyone turned to the patient and the case began after we all did the pre-incision pause.

The anesthesiologist went and got me an ice bag.

After the case the surgeon steri-stripped the small wound on my cheek.

Huh, apparently I was bleeding.

The take-aways were

1. I did not hit my head on the corner of the desk. This would have been infinitely worse and likely fatal.
2. I did not break my glasses
3. we were able to give this child a safe surgery, circulator injury not-withstanding.

After the case, the bruising was already evident on my cheek and on my neck.

Blood complies with gravity rules, after all.

Over the next 6 hours I developed a black, black bruise from my cheek where I had impacted the trash can to my clavicle.

It hurt.

Duh.

The cut that had been steri-stripped was a vertical slash just distal to the cheekbone.

See, I could have hit there and broken my face.

After the pain and the swelling and the employee health visits and the x-rays I was left with a stabbing pain in the left temporomandibular joint, an urge to scream when I sneezed, and a new dimple.

Exactly where the cut had been.

There was a palpable knot of tissue near my chin.

It’s still there.

I went back to employee health in December 2019 and asked them about the new dimple.

The employee health nurse said it was swelling and would go down.

I intended to follow up in three more months.

But we all know what started happening in January 2020 and February 2020 and so on.

I was not going to go back to employee health.

I am quite sure they had their hands full.

At my latest dental appointment I was informed that three fillings were breaking down, as they were old, and they would need to be replaced.

They were all on the left.

I decided to get all three done in a fail swoop.

Why wait?

In a marathon appointment that took 2 and a half hours the fillings were removed and replaced.

I was warned there may be some pain.

I can handle pain.

But two weeks later there is still pain.

My teeth don’t hurt.

The new fillings are fine.

My temporomandibular joint on that side is killing me.

Just like it did after I fell in September 2019.

It took months for that pain to go away.

And I had to be careful chewing.

Same.

I felt dismissed by employee health two years ago.

And I am sure the pandemic made it worse.

And we are in the Omicron wave now.

I am still going to email employee health and ask for guidance.

I’ll probably be told that the file has been open too long and they closed it.

What then?

It has been three weeks since I upended my life to start this call lark.

During the busiest month of the year.

Is it any wonder that I do not know what day is it?

I missed one of the meetings I am keeping.

Why?

Because I thought it was Monday.

Nope.

It’s Tuesday.

Sigh.

It has also been the run-up to Christmas.

And Christmas itself.

And my baby sister’s birthday.

In a three day span.

I am feasted out.

I am peopled out.

I am surrounded by all the work I wanted to have begun in this new call lark.

Yeah, no.

I have seen the week between Christmas and New Year described as a liminal week.

This truly is a transitional time.

I am bound to get my feet underneath me.

Sometime.

Right?

New plan.

Break down the big projects into littler ones.

Wednesday, 12/29 I will start my application to one of the schools am considering for my PhD.

Wednesday, 12/29 I will work on my LinkedIn page for this blog.

I am so used to shoe horning projects in around my work schedule, never mind call shifts.

No wonder I think I am floundering a bit.

So much free time.

Time to get serious.

The operating room is always pushed to move faster.

Faster turn overs.

From patient to patient.

Faster in room to incision times.

Faster finish times to out of room times.

Faster instrument turn over times.

Bad luck, this one is mostly static.

Faster.

Faster.

Faster.

…

Yes, OR time is money.

But so is patient safety.

And safety of patients is paramount.

And safety of staff is paramount.

Sometimes I hear of staff who are nudged to go faster when it is not in the patient’s interest to go faster.

Mistakes happen in faster.

The wrong implant is opened and charged to the patient because they did not follow the implant pass off procedure.

An entirely different surgery than planned happened because they did not follow the pause procedure.

That is where EVERYONE in the room stops and agrees that the patient, the procedure, the consent, the laterality, the antibiotic, and the availability of all needed instruments and supplies are correct.

These intentional pauses are there for a reason.

That is because yup, someone fucked up.

The wrong body part was operated on.

The wrong patient was operated on.

The wrong antibiotic was given.

The wrong procedure was performed.

The very needed this was not available and so there was a wait under anesthesia.

These all have one thing in common.

Faster.

Faster isn’t necessarily better.

The post-it reads ‘Don’t use JCAHO as the boogie man to introduce change.’

The Joint Commission, formerly known as JCAHO, is a triennial review of hospital quality and safety.

The Joint Commission wants to make sure that you, as a hospital system, are really doing what you said you are doing.

That’s it.

Not so scary.

I mean, they do have the power to yank Medicare payments, thereby effectively closing the hospital.

However, as long as you are doing what you said you are doing, it really shouldn’t be that bad.

But it sure gets the higher ups’ panties into a bunch.

Tightens some sphincters.

This can goad management to make changes, “because joint commission will be here soon.”

Sometimes these changes are good changes.

Made to make the survey easier.

But sometimes they are bad changes.

Used to make changes in the name of Joint Commission that will make hospital life easier for those people enacting them.

Or to justify a job for someone who has failed up.

Every healthcare worker knows at least two people that I am referring to.

The threat of a Joint Commission survey is not bad.

It just means that the hospital has to tighten up its game a little.

And actually do what we say we are doing.

Do not use the Joint Commission as the boogie man who hides under the bed.

This is just a step to ensure that the hospitals are providing good, quality care.

No more, no less.

Shame on you if you use the boogie man to effect changes that do not make sense in the realm of quality and safety.

Of course, there is always THAT surveyor who makes it their mission in life to nitpick over every, single, little thing.

If that is what you celebrate.

And to all a good night.

And a good rest to the pager.

Short and sweet post for this Thursday before Christmas.

My mom got into the act with her annual cookie platter today.

Two of them.

One for day shift and one for evening shift.

I decided to add coal.

For those naughty healthcare workers.

By coal I mean dark chocolate fudgy cocoa no-bake cookies.

By using a dark cocoa they turn very dark.

Almost like coal.

But yum.

I don’t find them as cloyingly sweet as regular no-bake cookies.

Just kidding on the naughty healthcare workers.

Mostly.

One year ago.

December 22, 2020.

I received my first vaccination shot.

I remember working until 0700 the morning of.

My appointment was at 0925.

I decided to take a small nap before I had to drive to the city and get the vaccination shot at the big hospital downtown.

I very nearly overslept!

I was driving hellbent for leather on the way down.

Thank goodness traffic wasn’t yet recovered.

I stood in line for 23 minutes.

Got my shot from a friend of mine.

And went back home to go back to bed.

I was home and back in bed by 1100.

Because I had to be back on shift at 1430.

But I was so very grateful that the vaccines had been developed,

And I was able to get mine within two weeks of them being released.

I was even more grateful when the vaccines opened up to the regular population.

Slight sore arm.

No fever.

No chills.

Got up and went back to work.

Like the good soldier I am.

All of a sudden I have 40+ hours of “free time”.

In my working life I have NEVER had such a thing.

I am certain I am not alone in wishing for more free time.

Time has been moving oddly during the pandemic.

Or I may just be more aware of it.

Healthcare workers do not have enough time to do all the care that is needed for our patients.

We often feel the lack.

A busy shift can go by in the blink of an eye.

A slow shift can dddrrrraaaagggg.

It is the same amount of time but our perception is different.

Often I feel like the white rabbit from Alice in Wonderland.

No time to say goodbye, hello, I’m late, I’m late, I’m late, I’m late.

I’m late for things I haven’t even thought of.

By contrast people who are impatiently waiting for the pandemic to end are bogged down by ennui.

That means boredom.

According to the Oxford dictionary ennui really means ‘a feeling of listlessness and dissatisfaction due to lack of occupation or excitement.’

I took this to mean that minds are not occupied.

Healthcare workers have concept of the lack of occupation or excitement.

Every minute of the shift is scheduled.

And when we are done, we crave doing nothing.

This is the much vaunted ‘free time’.

I think it is like a pendulum.

And, personally, when there is free time, such as the vast amount I now have, I feel nothing.

All I want to do is read.

And write.

But mostly read.

I can’t help the feeling that this is not healthy.

But this is what the pandemic has gifted to me.

The concept of free time is seductive.

And a liar.

I promised a career coach that I would work on my LinkedIn page.

Using her ideas, adding my own, as another avenue to get Dispatches from the Evening Shift noticed.

I will be giving myself a deadline of the end of the month.

December 31st.

I just have to ignore the siren’s call of my books.

Maybe a new scheduled day theme?

I’m trying it out.

I appreciate alliteration.

Today’s musings as I stare at the email confirmation for the tickets to London we just bought.

Knowing that there is another variant out there.

We had to use the money by the end of December.

Or forfeit it to the airline?

I think?

Regardless they would not give us our $11,000 back.

We bought tickets for August.

I really hope we get to go.

I have many plans if we get to go.

Including a train ride to Wales.

But let me slow my horses.

There is a lot of pandemic muck to wade through before then.

But, fingers crossed.

Another musing is that my first salary paycheck will be here on Friday.

I’m agog in suspense.

I knew going into this lark that I was going to be making less money.

Due to the no call or call back hours.

And I had a lot of those.

I soothe those fears by reminding myself that all the call and call back hours would be decreasing anyway when the shift got hired into.

Am I lying to myself when I say I’ve got this?

We’ll see.

As my mother-in law says now I am not working extra for the tax man.

It would be nice not to owe 4 digit tax bill every year.

Another musing is do I re-take the GRE?

I truly did not give it my best shot.

And I am 3 points away from the minimum that one of the colleges asks for.

I have an email to them regarding the acceptance of a lower score than desired.

After all, I already have a graduate degree.

Applications open for a couple of the schools that I am looking at January 1st.

I have to get cranking on those.

Apparently I need an idea of what I want to focus my research on prior to getting in.

I have no idea.

Surgery?

Enough musings, I’m making myself anxious over here.

I may have to re-think this theme.