After the events of 1968, the author Joan Didion was flummoxed by the tumultuous events of that year.

So many things happened then

Kind of like now.

She had a hard time concentrating and writing was hard.

She said, “We tell ourselves stories in order to live.”

I imagine she found herself floundering a bit.

Kind of like we are today.

Historic things were happening.

Kind of like today.

She wrote the book “White Album” in that year. I imagine the title inspired by the Beatles’ White Album. It is about race and tumultuous times that threatened to rip our nation asunder.

However, she did not have a deadly pandemic at the same time.

Lucky us.

I have been floundering a bit these past few weeks.

All I seem to do it work, be on call, write my blog, occasionally feed my husband.

When I am not doing those things, I doom scroll, watching for news.

I stare into the middle distance when I am not even doing that.

This is not me.

I am a go-getter, someone with a thousand things to do and a hundred things always going on

All of my meetings, which is one way I engage with other nurses, have been cancelled because this nation is in the grips of another surge.

I feel we are on the brink of another quarantine.

I feel as if elective cases may be paused soon.

I feel tired watching all the people running around without masks and hugging and going out to dinner and going to birthday parties.

And I want to scream.

Mostly I feel tired.

This past year has been very grinding on the healthcare system as a whole.

I hope we get a grip on it before we are ground away to nothing.

As we, as a nation, are on the brink of 400,000 dead, it is hard to grasp it.

I find her words comforting.

We are all just stories after all.

I heard something profoundly disturbing this week.

Our tech population is down.

This means we are short on techs.

But the newbie isn’t even a tech.

Isn’t a nurse.

The newbie is an orderly.

Someone who cleans and stocks the ORs.

I love our orderlies.

They work very, very hard.

We as so much of them.

And of the three we have on staff one left and one had surgery.

Leaving only one.

And that one took the day shift spot.

Leaving evenings with no one.

I did not think that was very fair and I lambasted the managers.

We run too may rooms and too many cases after 1500 to be cleaner-less.

As it stood I was the acting orderly, going from room to room, turning over rooms, opening rooms while still doing my evening shift charge duties of answering the phone, adding on cases and getting people out on time.

And sometimes I was in a room myself.

It made for some endless, endless days,

We have a brand new orderly.

Evening shift welcomed her.

Day shift couldn’t wait to tell her to watch out for one of the evening shift techs.

Dudes, can she not even get in the door?

This is going to be hard enough on her, to learn a new department and new duties, without terrifying her because of the tech that works the hardest in the department.

Sure, she’s a bit outspoken, but so am I.

And quick to point out inconsistencies in policies and how other staff are treated, but so am I.

This may be why we get along so well.

She is also the only one who will come in when there is a crisis, to help out.

She is also the one who makes sure we have certain supplies, cough, suture.

When I heard this, I was so mad. I’m not sure what I am going to ask management about this, but I will.

This is not right, to throw a fellow coworker under the bus.

And. Don’t frighten the newbie they are just arriving.

I have had a week, let me tell you.

Not the 2nd vaccine shot, despite rumors to the opposite.

Sunday night I got called in at 0400 and worked until 0700.

My 2nd vaccine shot was at 0945.

Yeah, I could take a bit of a nap before I had to drive in rush hour traffic, or at least what amounted to rush hour traffic during a pandemic.

I overslept. I was going to wake up at 0830, shower and head to the main hospital.

I woke up at 0911. With a twenty minute drive.

I got up, brushed my teeth and drove down to the appointment, getting there in the nick of time.

I received my second Pfizer shot and I am very grateful that I did.

I was home by 1115.

I was back in bed by 1130 and up at 1345.

I caffeined it up and went to my normal shift.

Temperature normal, no pain, no nausea, no dizziness.

I worked my normal shift and went home.

After killing undead for twenty minutes I though it best that I go to bed so I did.

I was in bed by 0010.

My injection site had begun to ache a bit.

My pager went off at 0150.

Ugh.

Incarcerated ventral hernia, new doc.

Here we go.

I was at the OR until 0708.

Temperature still normal, some pain at injection site, slight dizziness that could be put to sleep deprivation.

I drove home and was in bed by 0745.

I woke up at 1130.

It confuses the cats when I am in bed after 1000.

No fever, minimal pain at injection site, no dizziness. I am tired but nothing else.

Some people at work who have been getting their second shots and suffering I am sorry.

For those still to get their second shots I have two pieces of advice.

1. power of positive thinking. If you put it out to the universe that it is going to be hell you have just invited in the bad juju.
2. peasant bloodline for the win!

Anyone else not in my household having sleeping problems?

Okay, just us then.

Likely not.

Last night I had a doozy of a work dream.

I remember I woke up a little at 0755 and my husband said it was too early, go back to sleep.

So I did.

Right into a dream about doing a laparoscopic cholecystectomy (gallbladder removal) in OR 2.

The woman was generously large. It took me 2 chloraprep sticks to prep her abdomen.

I secured her to the bed with a safety strap and foot boards.

As we were doing the pause before incision the consent, that I had looked at before, now read laparoscopic cholecystectomy and intra-operative cholangiogram. I looked at AB the surgeon and he said that it had been added because there was something hinky with her common bile duct.

I spent the rest of the dream fetching the c-arm and the supplies needed for the IOC.

I also called the radiology tech where the phone rang and rang and rang. Although, this is what happens every day.

Some of the supplies were in the basement which was the same basement as my CA hospital.

Some of the supplies were on the roof, where they were giving out vaccines.

I finally made it back to my patient and my case in time for the surgeon to say he didn’t need all that stuff and her anatomy wasn’t as bad as all that and he was done anyway.

He does not talk like this.

We woke the patient up and were taking her to the recovery room, which had been chopped into 2500 different rooms.

Because of the flood, you know.

Flood? What flood?

I woke up right after giving report to the PACU nurse.

Odd, odd, odd dream.

And it was 0845.

I saw that somewhere and I completely agree and feel the sentiment.

This has been the longest week.

Warning: contains political talk.

First we had the elections in Georgia.

Nail biter, that one.

My husband woke up very early, for him, on Tuesday and was doom scrolling his phone. He said he couldn’t sleep.

I asked him if it was because of the existential dread of the elections.

He paused and said, ‘Maybe.’

And both democrats pulled it out. Thank goodness. This wasn’t decided or announced until Wednesday, around lunch time.

Wednesday was the day the Senate and House were to certify Biden’s win.

Already there had been several senators and house members who were going to object.

It is your right to object if it is what you need to do.

Please do not object to get face time with future voters, say 2024 voters.

Please do not object to kowtow to strange political bases.

Okay, good. Time to go to work.

Off I went to work and about an hour in people came rushing to the desk, talking about the mob in DC and the presence of armed so called protestors in the capital.

The rest of the night I admit I spent doom scrolling, unable to look away.

And now we have fall out from that.

This is not good.

Our covid patient per bed capacity is not good.

By my calculations, we are 33% covid patient to hospital bed.

The ICU has been averaging 90% covid for over a week.

The step down unit has been averaging 75% covid for over a week.

And, I still firmly believe, this has all been fallout from Thanksgiving.

God help us when Christmas and New Year’s cases hit.

I figure we will be decreasing our elective cases soon.

Or, at the very least, going to outpatient only cases.

But then there are the cancer cases, who by the very nature of their surgery, must be admitted.

To a hospital where 1/3 beds has a covid patient in it, and that is not even counting the ED overflow hold patients.

Please wear your mask.

Please wash your hands.

No kidding, this last year has been hard.

For the people who have to shelter in place.

For the kids who have to do online school.

For the front line workers who are continually dragged into the healthcare machine.

I have a secret weapon.

I’ve played a video game, for YEARS.

I play Diablo III.

I played the original game on my husband’s OG Playstation, over 20 years ago.

And when Diablo II came out, I played that on my desktop computer. Again for years.

And Diablo III came out several years ago, my husband and I played it on our desktops, often partying together (this means we played on 2 separate computers, often in the same office and our characters went on raids together).

After beating the game several times over I put it away again, for a time.

When I decided 5 years ago to go back to school I needed a stress reliever.

I had a new computer, but the game and my characters were waiting for me in the cloud.

Excellent.

I created new characters, kicked some undead ass and kept grinding at work and life.

Earlier this year I discovered that the game had gone on without me.

They had developed what they called ‘Seasons’.

This was a way to portion off a new character, from scratch. And play the game.

I discovered seasons at number 18. They are now on 22.

The seasons last from 2-4 months.

Game play is the same.

It allows me to explore different character classes.

It allows me to kick the same undead ass as the other.

So, nearly every night I play when I get home from work.

I never play very long.

A girl has got to sleep.

But if I miss a night, I get antsy.

This game that is years old and my husband really wishes I’d find something new (cough, cough, the man played EVE for 20+ years).

It is my comfort video game.

I do Facebook and I dabble in Instagram.

But I prefer to kick undead ass as a stress reliever.

If you need me, right now I’m in Season 22, playing a necromancer: Level 70, Paragon level 342, Chapter 4 of the Season.

And kicking some undead ass.

Today was a sobering day.

As I watched the death count tick closer to 350,000, my husband and I reflected what that means.

He posited that because I was in the OR and not in the wards that burnout could not be real for me.

Um, tell that to my fingernails.

Or to my eating habits.

Or to my work nightmares that are getting worse.

I know these are stress dreams, where I can’t find my patients to give them their pills and it is suddenly 1400.

Or I am somehow circulating a case from my house, on an un-anesthetized patient.

Or I am the patient.

They haven’t yet paused elective cases in my OR.

OR cases that are to be admitted.

The first is because all surgical patients are tested 48-92 hours before their case.

I am waiting for the second.

I believe we have just finished the Thanksgiving bump in infected patients. It seems to be at the peak 3-4 weeks after an event, be it 4th of July, Labor Day, or Halloween.

Now, we wait for the Christmas and New Year’s Day bump.

Heaven help us.

It is New Year’s Eve and I sit here waiting for my husband to finish his game to join me in mine.

When 2020 began I was looking forward to starting my final year in graduate school, with only four months left until I was graduating.

In December 2019, I had heard of a virus in a province of China called Wuhan that seemed to be deadly and spreading fast.

It is now New Year’s Day.

In March I was told that I had to finish my clinical hours online, either doing education or participating in it.

In March our elective cases were all cancelled. However, evening cases are RARELY elective. And no one wants to work my shift.

In April, graduation was cancelled.

In May I received my diploma through the mail and elective cases resumed.

There is a testing strategy for elective cases. See above how most evening cases are not elective.

Many, many N-95 masks.

The year in the OR got busier and busier and busier.

I worked more and more hours, more and more call.

Sigh.

May 2021 be kinder and gentler to us.

This is my hope.

This has been a ball buster of a year.

I hope this year does not repeat.

I have hope that next year will be better.

For all of us.