This was a cookie that one of my best friends had been begging for.
For a while.
She wanted anything blueberry.
I showed her the recipe I was thinking of.
Nope, not the right one.
I pulled out a lemon blueberry white chocolate recipe and made it.
Many people stopped me to say how good it was.
This month’s theme is Baker’s Choice.
And today I chose to make the lemon blueberry white chocolate cookie.
Sometimes it is worth a choice to make a friend smile.
It seems that all I’ve done with week has been talking through my disappointment with the call only tech on Wednesday and Friday.
I mean, a lot.
A lot.
Of course I teared up. I was so intensely frustrated.
It all started when the ANM noticed that we were going to have three rooms running past 1700 and only two techs.
I reminded them, gently, not nearly at the top of my lungs, that this was an unintended consequence of only having the call techs cover the Wednesday and Friday from 1900-2300.
That they were leaving evening understaffed, on purpose, twice a week.
And I also mentioned that I was a wee bit upset at doing all the work myself.
Which is what I was told.
That the techs would only come in if there was a case.
I was told by them this was the case.
I had printed out my blog post from that day, the one I was so incensed about, sat the ANM down and made them read it. Because when I am upset words are sometimes hard.
“Oh, no, no, no”, they backtracked, fast. “If you need them, call them in.”
I reminded them this was not the story I got when they informed me about this weeks ago.
And so I had been doing all the evening work myself.
And seething with resentment.
I also pointed out that this whole construct that they made was helping with productivity.
Because 12 hours a week was not being staffed.
“Oh, no, no, no,” they insisted. “That is not the case.”
Forgive me if I don’t believe you.
This weekend was rough for the general surgeon.
He said that he felt like he had whiplash, starting on Friday.
Starting with the quick prep and case for the ubiquitous appy on Friday.
Through to Saturday, waiting around for his emergent septic case.
Unbeknownst to me he had been waiting to get this case started for awhile.
The Saturday night septic patient case with me as his circulator.
To his Sunday morning case that took forever to get started.
He and I had a conversation that although I can sympathize with his feeling like there are two speeds for the weekend versus evening speed, I have no power to do anything.
For that, he would need to take it up with the manager.
And he did!
He said he didn’t understand why and how there seemed to be two different speeds for add on cases.
And then he said the kiss of death, “Kate can do it, why can’t they?”
Facepalm.
Dude.
I have enough trouble with these people thinking that I expect others to work at my gear, which is high.
How many times have I been told that “Kate, they aren’t like you. You shouldn’t expect them to stretch for that.”
Um, why?
Can’t sleep again.
It hasn’t been this bad since last spring.
Case in point, last night I got to bed around 0113.
I woke up from a very strange dream at 0420.
The dream was so strange I had to get up and note down the details.
Because writer, you know.
I got back in bed at about 0440.
And slept until the pager went off at 0700.
I go off of call at 0700.
I texted the day nurse about the page and went back to sleep until 0715 when she texted me back.
Whelp.
That’s another night’s sleep ruined.
According to my sleep log that I keep, because data is power, I haven’t had any night’s sleep over 5.5-6 hours in about two weeks.
All I want to do is sleep.
Pager, be good.
Please.
Last week I got an email that the poster I had submitted to AORN this year was accepted.
I had two accepted last year.
And then COVID.
This year I knocked together a proposal for the long-term flashing project that I have been running in the OR.
Long-term meaning 6+ years.
Flashing is the immediate use steam sterilization of instruments or implants.
This usually means that something has dropped to the floor, or there is a to follow case, but more than likely it has hit the floor.
Flashing is bad.
It has taken 6-plus years to get a 12 month span with no flashing.
Many things had to happen in order for this to be successful.
In 2014, there were at least 25 flashes in the OR.
in 2020, there was 1.
In January.
Fingers crossed, spit, knock on wood, whatever you have to do.
The poster proposal was titled Flash this! How 1 OR systematically decreased IUSS to near 0.
I am going to keep it at near 0.
For the Murphy.
Because Murphy loves the OR.
Best laid plans and all that.
Whatever can go wrong will.
This poster got accepted.
Yay!
I have to design, get it printed and submitted for judging by July 12th.
And go to Orlando in August to the AORN conference.
I’m gonna melt!
Another thing I was kicking around as a better use of my MSN is establishing a writing career.
As a side gig.
I am reading and writing and learning about this.
I was thinking the AORN conference might be an opportunity to connect with other writers.
And one of the best ways for that used to be the business card.
I designed a card and submitted it for printing.
Double sided:
Regardless, I ordered them to have with me at the conference.
Will it work?
Who knows.
But I will be ready.
I was going to search for the perfect post-it note to encapsulate the entire experience of evening shift.
But then there was a stack of post-its and gown cards next to the computer and I picked the first one off the top.
At the top of the post-it are the words “don’t ask to be celebrated for doing your job”.
And this is very, very true.
Sometimes people come up to me and tell me this is their 5th call shift in a week.
And I pause and reflect and absolutely do not say the first thing that comes in my head.
Which would be “Child, please, I routinely do 9 a week, every weeknight and both weekend days”.
But I don’t.
That would be counterproductive.
So I don’t say the second thing that comes in my head.
Which would be “But you are the one who signed yourself up for this”.
Again, that would garner nothing but a huff from the person “confessing” to me.
And a talking to by management.
And I prefer to avoid those.
I usually say “Good for you. I bet the people you took call from are thankful”.
Don’t complain when you give yourself extra work and then have to work extra.
That is, in fact, how call functions.
This week was the last Cookie Thursday is a Thing for May.
10 days ago I began a starter for sourdough.
I’ve made these before.
Then: they were cakey and dense and overall one of my favorite cookies.
Now: The day was very warm so I decided to bring the butter up to room temperature in the sun, on the porch, in my favorite Pyrex bowl.
Coming back inside, I took 1 egg out of the refrigerator and placed it to the side so it, too, could come to room temperature.
I gathered the rest of the ingredients and went to get the now softened butter.
The butter on the porch worked BEAUTIFULLY.
I proceeded to make the cookies and had the first batch out of the oven when I turned around and noticed that I had not put the egg that I’d carefully placed out of harm’s way into the batter.
I have no excuse.
Other that I am tired.
Surprisingly the cookies baked up great.
I was afraid that the cookies would not be cohesive because the egg is a binder.
Nope.
Now I have a starter that I will continue to nurture and use the discards off every other day.
At least until I get tired of it.
But the softening the butter on the porch in the sun.
Definitely going to keep that one.
I have decided the word stupid as a descriptor is, well, stupid.
It doesn’t sound right.
And my managers are no longer listening when I say something is stupid.
See the new day shift “charge” layer that overlaps with my shift by 2 hours.
But that is a story for another day.
I am transitioning to using the word silly instead.
And it means the same as when I use the word stupid.
It means the idea is laughable.
It means the idea is absurd.
In fact if the word silly doesn’t make my point, I will start to use the word absurd.
Yes, I know it is only Tuesday but I had an idea.
I love post-it notes.
Love them.
I stick them on the back of my badge to make myself notes.
Sometimes it is a post idea.
Sometimes it is add on information.
Sometimes it is both.
I have easily a box full of these.
Because I am incapable of throwing away paper.
I’m going to start addressing the post ideas on the back of the post-it notes.
Ha, do you see what I did there?
I think Sunday would be a good day to start.
I will have to find a real juicy one to start with.
Why do I do this to myself?
A surgeon paged me last night with a request.
He wanted to go at 0700.
I told him I was told that I could no longer give out 0700 time slots, even if there is nothing in that room until later.
He asked for 0630.
I said yes.
I am going to go to work, clock in as call back, pick the case, open the case, get the patient, prep the patient, call the anesthesia team, think about calling the scrub tech, realize that someone will be here at 0600, probably the scrub tech on call.
Start the case.
Be relieved.
Come back home and go back to bed.
I will probably be asked about why I let this happen.
I will tell them I think their rules for not adding on early morning cases are silly and a surgeon disatisfier.
Dispatches from the Evening Shift 