I got a text today from the college.

Even though I had set up a payment plan so that I would not be in arrears before the scholarship money was dispersed and I had already paid $800.

I did not do it properly.

Today’s text was that I would be dropped from my classes for the semester unless I ponied up the entire amount.

I have scholarship money but it is hard to access.

I do not want any further delays in my MSN.

So I paid.

I asked my contact at the college what was up.

She’s the one who told me that I didn’t do it properly.

She had nothing to say about the scholarship money.

Or about the $2000 from a student loan that went missing after I tried to apply it to Spring semester tuition bill.

Um, why is it difficult.

Do you like torturing students?

Ugh,

Again with the weekend cases with the tech that I don’t care for.

To amuse myself, and to keep a civil tongue in my head, I began listing, also in my head, all the adjectives that embody this guy.

For no apparent reason I started with O.

Obstinate.

Obstructive.

Only out for his own sake.

Obstreperous.

I could go on.

This amused me and let me finish the case without blowing my top.

Especially after he put his dirty specimen cups and culture swabs on the metal table next to the “chart”. Without waiting for stickers, without care for the hand-off process that keeps the patient safe.

Obdurate *swear word*.

TedX is coming to my city.

This is a branch of the TED talk.

Today was the last day for submissions.

To challenge myself I submitted an application about shared governance and engaging nursing.

I have not told my employer.

I have not told the others on the council.

This may not work.

But what if it does

Today a nurse came to me and told me, proudly, that he’d built the flat top table with the help of the day charge. Because his doctor would need it for his tibial plateau fracture, his last case.

I had already written the instrument list and I knew that there was a case that required the fracture table that he’d just taken apart. And it was the case before his tibial plateau case.

The nurse’s face fell a bit when I told him the fracture table would have to be rebuilt. Because the hip pinning required it.

Then his face cleared.

“That way you can watch me build the fracture table to make sure I did it right.”

He didn’t want any prompting.

I told him I was there to lend a hand.

He did great.

That tech that drives me crazy?

Pretty much drives everyone crazy.

Good to know that I am not alone.

I know that he is actively working on the new weekend call tech.

Telling her that they can absolutely switch shifts.

That she can work Wed, Thur.

And he will work Fri, Sat, Sun.

Only one thing wrong with that, sunshine.

Those are two different shifts.

Which I told  you when you asked.

There is no guarantee you would get a third day during the week.

Because the weekend tech has to ask for extra shifts.

And the surgeons whose rooms you’ve been kicked out of?

They are on call those weekends too.

How is that going to work?

And don’t tell me you will call the call tech to cover those cases.

No.

Just no.

You cannot arrange the whole universe to suit you.

And, there would be no one to make sure that you were doing your job on the weekend.

I’ll make a case against this.

I will make it succinct and persuasive.

I just hope it works.

Care before Computers in my new mantra.

They updated the electronic health record for the system this week.

Sunday went fine.

Monday and today, not so much.

They are still finding things that are broken.

Today endo was in a tizzy because they couldn’t pull the patient in to their prep room and they wasted ninety minutes trying to figure it out.

I told them to just do the case on downtime.

Because what was important was the patient getting the care they needed.

The charting could be done at a later date.

The case needed to be done now.

And then I spent ninety more minutes on the phone with support trying to get them back to being able to chart in real time.

I did this so they could do the case and make the patient feel better.

Would do it again.

As I alluded to yesterday I have two rules.

These are rules that I abide by.

These are rules that I would like my coworkers to abide by.

These are rules that I would like my bosses to abide by.

The first is be fair.

This was a rule that was given to me by the leader who gave me the job of the staff schedule.

I was to be fair.

I added that rule to my internal rule book.

And I adapted it as a leader myself.

Be fair.

You’d think the second rule would be a no brainer, I certainly did.

I was wrong.

Don’t lie.

Always tell the truth.

Sometimes the truth hurts.

If  you get found out in a lie it will rebound on you so fast.

And, also, lying makes you untrustworthy.

There is a meme I have on my Pinterest account. On my this is me board.

The meme says “Expect blunt, honest answers. If you don’t want the truth, don’t ask”.

This is so, so, so very true.

If you ask I will tell the truth.

And I expect you to as well.

Now I will e-mail my boss about what transpired yesterday, now that I’ve blogged about it and calmed down some.

Now that I am no longer in a towering rage I can calmly discuss what happened today.

The number one thing is to be fair.

Number two is don’t lie.

Today, I had to call my tech with 15 minutes left until go time with our case.

This happens frequently.

Yes, it is the same tech.

He lied to me.

He told me he was on his way.

He had had a flat tire.

On the exit that is 5 miles from the hospital.

FIVE.

He did not call when he got the “flat tire”.

It hadn’t occurred to him.

When I say right the sarcasm is evident, correct?

The highway was clear of accidents.

He was supposedly five miles away.

I called him at 0942.

He was allegedly five miles away.

He didn’t show up to the hospital for our case until 1015.

Uh, huh.

Right.

“Flat tire” five miles away.

In that time I had interviewed the patient and set up his table.

Which, in retrospect, was a mistake.

As it gave him time to interfere with my job.

I am so close to refusing to take weekend call just for this reason.

Two things will be my saving grace.

1. The weekend tech, who he’s been trying to warn off, starts her weekends in six weeks.
2. The rest of the weekends’ call shifts have been scooped up by another tech.

But don’t lie to me.

Okay. Time for a haunting story.

No, it isn’t scary.

It’s just something I think about.

A lot.

Be careful when discussing care in front of an awake patient.

The surgery was going to be a big one for our little hospital that could.

We were doing a lung lobectomy for cancer.

In the five years I worked there this was the first one I was going to participate in.

This is a BIG set-up.

The anesthesiologist was preparing to put the patient to sleep and I walked in to relieve the nurse for lunch and also to count as it was expected to go past 1500.

I picked up the chart and looked at the consent. There was no mention of laterality on the consent. It just said on the top line of the consent lung lobectomy.

I asked the nurse I was relieving about the laterality.

The room fell quiet.

The anesthesiologist hissed at me, It’s the left lower lobe.

The word stupid was implied.

I remembered the patient was still awake.

This was no time to inspire fear in him that we didn’t even know what we were doing.

And I spied it.

An itty-bitty notation two lines away from the bulk of the consent writing: left lower lobe.

This was duly initialed by the surgeon and the patient and the nurse who was correcting the consent.

But the patient still heard us discuss in the room the laterality.

He must’ve been so scared.

Now I am careful about the level of consciousness when I ask clarifying questions.

Tonight as my tech and I were setting up for yet another ectopic my favoritest OR song in the world came on the radio.

Play that Funky Music, White Boy by Wild Cherry.

It brought me back to my first days in the OR.

We would play that song, LOUD, at 0630 to get us hyped up for the day.

It always worked too.

I was telling my tech about it as we were grooving around the room opening the supplies and preparing the bed.

She said that no place had ever played music to get ready for the day.

I think it was because it was such a small place.

And to slow it down in the afternoon, as we wrapped up the day.

We played Over the Rainbow by Iz.

It was the perfect song to play for closing.

It makes me want to start doing that here.