This is the last day of our vacation.

My husband says he can’t wait to go into the office tomorrow.

This is our third staycation since the pandemic began.

And even for homebodies this is getting a bit stale.

Right now the Thursday Cookie is in the oven.

I say cookie, but in reality it is Chex mix.

Another fan favorite for the OR department.

So far this vacation I have NOT done much on my to do list.

I have cleaned our closet.

I did laundry.

I read.

A LOT.

Tomorrow is another chance at my giant to do list.

Tomorrow properly starts my new job as a call nurse.

Tomorrow I get the house to myself, for the first time in what seems like forever.

Certainly since last March when the office closed to in person for my husband.

And then at 2100 I go to the hospital.

I don’t clock in.

I go to finish out the evening shift, and do whatever needs to be done.

To set day shift up for a good Thursday.

There are no parameters on this.

I think I am going to wing it.

The hammer has dropped.

I am now officially only a call nurse.

This fall has been a time of thinking about this.

And overthinking about it.

But the existence of a call nurse meant that my very comfortable role as a workaholic was steady.

You need me to pick up call?

You’ve got it.

Someone called in sick and you need coverage?

You’ve got it.

Oh, shared governance is struggling and needs an experienced person at the helm?

You’ve got it.

I have been a yes woman for a long time.

And it has been lucrative.

I’ve earned lots of money.

And many, many hours have been worked.

Many hours.

Now those call hours would be disappearing to someone else.

Call is my favorite.

Over the summer, I began wondering if I was doing a disservice to the department.

You give a man a fish and he eats for one day, et cetera, et cetera.

I don’t want to have an entire department dependent on me.

And changes made by leadership were chafing.

And my role in the department was beginning to be taken for granted.

I was not allowed to complain.

And my complaints, when I felt strongly enough to speak up, went unheeded.

But others could complain about me.

Nitpicky shit about well that person got out early yesterday too. No I don’t want to leave early, I just want to complain.

Or I was on the computer when I arrived, again, no matter that I had just been in their room and nothing was needed.

You’ve got lots of time after the schedule is over to work on the computer.

Do I though?

And I would have to have a conversation with management about being aware of millennials tender, purple feelings and I needed to find a better way to tell them to do their job.

Crap like that.

There needed to be a change.

I am on the precipice of my new life.

Terrified.

Staring at the entire mountain of things I have let slide while I was at work.

Because that was what my mind was telling me was the priority.

Can I be a reformed workaholic?

Is that a thing?

Or will I just replace my workaholic shifts with other things?

Let’s get started.

The post-it reads ‘a month in a finger snap’.

This has literally been the fastest month of my life.

In my head I am still in San Francisco.

And poof.

It is December

And the 4 week notice I had to give my current job at my current hospital has expired.

And I start my new job at my current hospital.

Technically today.

But I am on vacation.

I am supposed to be in London.

Again.

But we demurred when the cases started to go back up in the UK in September.

Immediately before we bought our tickets.

Back to the flying month.

I had a lot I wanted to accomplish this month.

I wanted to set up the schedule so if they took it away from me it could be done on auto-pilot.

Nope, cases got in the way.

I wanted to flesh out the Call Preserver book so that people who have not taken call in a very long time could do so.

Somewhat.

I wanted to work as much extra call that I could before the hammer came down and I was no longer going to be taking extra call.

I have had 2 nights in the past 6.

Weird.

I wanted to have an idea of what I was going to be doing with all my new found time now that I was no longer working 1430-2300 and solely taking call.

I have some ideas?

I don’t know.

On vacation I was going to start some of the projects that I’ve been neglecting during covid.

I have cleaned our closet.

And did leaf eradication in the front yard.

yay, me.

I have three days left of vacation.

I start my new life on 12/8/21.

And, rightly so, I am terrified.

I can do this, right?

Why is that still a thing?

Colleges are dumping the SAT and ACT, what about the GRE?

I wasn’t going to take the GRE as some schools do not require it.

However, one of the schools I am very interested in does.

I sat the GRE on Friday afternoon.

The email that I was sent to remind me of my appointment.

That I paid money for.

At a testing center.

Told me to expect 5 hours.

Yeah, no.

And also the testing company sent me an email.

Today at 1100.

About the math portion.

Breaking it down.

In bite sized pieces.

The only problem is I had to leave the house to get to the testing center by 1415.

Sigh.

One of the hardest tests I’ve done.

Probably because it has been over 25 years since my last Geometry class.

And I swear there is new math in the test as well.

And I am unused to reading a paragraph or two that I need to parse and answer questions for on a computer screen.

I know first world problems.

Picture it.

A room with 6 computers, and 4 people before I got there.

Social distancing much?

No.

However, the waiver I signed asked if I had been exposed to people with active Covid infections.

I work in a hospital.

I presume I am exposed all the time.

Especially since we don’t test the patients from the ER.

The waiver, though.

Stated that healthcare professionals could ignore that part of the waiver.

Because, you know, we are exposed constantly.

Especially those of us who work in a hospital.

Back to the test.

The person on my immediate left.

Less than 3 feet away.

Was doing a different test.

An open book test.

He dropped the book at least twice.

During my essay portion of the test.

And jarred me from my thought process.

Joy.

The overall test did not take me 5 hours.

It took me three and a bit.

In the last segment my lower legs ached.

Probably because of the horribly hard chair.

This also distracted me.

Pro tip- when the test gives you a 60 second break between sections, stand up.

Get the blood moving.

I’ll be able to access my results within 14 days.

We’ll see how I did or didn’t do.

At least that is done.

I will see if my brain will let me not do well.

Often I sabotage myself and re-do tests.

A little frustration was the testing center was not well marked.

When I looked up the testing center in the directory on the wall, there was no details of what floor the center was on.

That was disappointed.

But, hey, it was in the same building as the NPR station I listen to.

That was fun.

I didn’t see anybody I recognized from promos though.

On to the next part- more applications.

The president of the hospital knows who I am.

We worked together at my previous local hospital.

He’s been president of this hospital for several years.

We’ve worked on different projects together.

Most recently the use of the enneagram to foster communication.

Like, real recently.

This is a project we’ve been working on for the 2 years.

And it keeps getting sidelined by the pandemic.

But that is another issue.

Yesterday we had the quarterly awards ceremony at the hospital.

Shared Governance hosts them.

And, after dodging it for years, OR is the keeper of the nominations.

That’s a lot a work in itself.

But not what I’m talking about today.

The president of the hospital was at the ceremony.

As the Chief Nursing Officer couldn’t make it.

And we were making small talk like you do.

When he asked me point blank about my new job.

On some level it makes sense.

The approval had to start somewhere.

He said it was going to be good to have someone strong on the call shift.

And then he referenced a problem with one of the call shifts when I was in San Francisco.

Um, what?

And then he said the call shift would relieve the staff.

Not as if they would not be taking call.

But that it would be a burden off their shoulders.

And something about how it could be expensive for the department.

Or less money out for the department because they no longer had to pay out call back.

I don’t know.

The entire winding story to point out that the president knows about the call position.

And that I took it.

Yikes.

This was such a fail.

I am embarrassed for this recipe.

I had such high hopes.

I could have made traditional latkes.

Savory is a precedent.

But I was wowed by a cookie recipe I found.

Y’all know that Cookie Thursday is a Thing is all about experimentation.

This is an experiment I will not redo.

I finished baking the batch and realize they were horrible.

Potato chips, butter, sweetened condensed milk, and an egg.

I thought it would be something caramelly.

But no.

It was horrid.

I binned the entire batch.

Straight into the trash bag.

And the Pinterest pin that gave me the idea.

Straight to the Pin Fail board.

I have standards.

Even around cookies.

This is the first time all year I’ve had to buy cookies for Cookie Thursday.

Next week there will be homemade cookies.

1 batch for the OR.

1 batch for the ER.

I am expanding Cookie Thursday to other departments.

Because other departments could use the morale lift too.

Imposter syndrome.

Nearly every nurse that I know has it.

Except the ones who should.

It is that feeling that you are not good enough.

That you will never do anything right.

For your patients.

For your families.

For yourself.

And it can often lead to a spiral.

You feel bad.

So you work harder.

You feel worse.

So you work harder.

and so on.

According to the American Psychological Association this is not just a female phenomenon.

It stems from being high achieving.

Like many of the best nurses I know.

In the 2013 article ‘Feel Like a Fraud?’ by Kirsten Weir, there are tips to overcome the feeling like you just don’t belong.

Talk to someone who can help.

Talk to your mentors.

Realize that although there is a long way to go, you’ve come so very far already.

And, my favorite, own your expertise.

Well, actually they said recognize your expertise.

But I say own it.

And above all recognize that no one is perfect.

Including yourself.

There is always going to be someone more prepared and liked better.

And that is okay.

Let them live their own life.

You have yours to live and thrive in.

I am writing about this today because I woke up feeling like I was getting away with something.

I am on vacation.

Next week I start my call job.

And that will be my life.

Call Sunday-Thursday 2100-0700.

I could look at it as if I have earned it in slogging through this past year.

And I absolutely have: putting in 5 days a week on shift and 6-7 days a week on call.

I am choosing to look at it as taking an opportunity that will afford me to explore other aspects of nursing.

While still working full time.

Just less time.

I’m gonna go back to school.

I’m gonna blog more.

I’m gonna write more, not necessarily nursing related.

I’m gonna volunteer more.

I’m gonna put my hat in the ring to be on a board.

I’m gonna coach nurses to obtaining their certification.

I’m gonna offer up my own expertise as a tutor.

I’m gonna get to do all the things that I never got to do while the rest of the world was in quarantine.

I’m gonna work the tips mentioned in the article on trying not to feel like an imposter.

Here goes nothing.

Without the sterile processing department the OR would be dead in the water.

The SPD maintains all the instruments that the OR needs.

The SPD washes and sterilizes all the instruments that the OR touches.

The SPD also racks them (puts them back) to where they are to be expected so that the OR doesn’t lose their minds looking for a set.

The sterilizers have a series of tests that need to be done daily to ensure that they are ready for battle.

Or for use.

Vendor trays come in daily and the SPD has to inspect the trays, wash the trays, wrap the trays, sterilize the trays, with the vendor tags indicating the surgeon, date, and surgery the trays are to be available for.

Vendor trays are also used daily and need to be washed and readied for pick up or to wait until a rep puts them back together.

An OR such as mine go through many, many instrument sets a day.

Every surgical case needs at least 1 tray.

Often more.

And orthopedic cases need the most.

Except for the robot cases.

There are cameras.

And sets.

And scopes.

oh, my.

The point is the SPD works 24 hours a day 5 days a week, with call on weekends.

Just to ensure the OR has what is needed for cases.

Every single damned day.

Every single damned case.

There is an SPD week when they are celebrated.

Usually the second week in October.

I hope they know and understand that they are so very necessary for the functioning of the department.

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.

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.