Monday Musings 1/23/23- zoom crickets

Zoom is a good thing. It allowed us to keep in touch with far-flung family members during the pandemic. It allowed for the rapid emergence of tele health. It allowed for children to keep up in school. It allowed for me to finish my MSN. It even started before that. My hospital system went to it in early 2019, shunning, oh, what was it?

Hold on, it will come to me.

Skype! That was it. A precursor to Zoom still in use.

Zoom, Skype, all of the platforms have this in common.

Crickets.

Dead air.

No one saying ANYTHING. Just a dog barking.

Maybe.

No one wants to say anything. In case they are wrong.

And the silence hangs there.

Any minute now.

I’ve forgotten the question.

Getting uncomfortable now, isnt it?

I’ve told my professors that if they ask a question to a group and there is silence, I will answer it.

I can’t stand the anticipatory silence

I mean, it’s just there waiting.

Four seconds is all it takes for silence to become awkward.

I know. I’ve broken enough silences.

Did you know that?

Post-Sunday 1/22/23-no one is looking at you

The post-it reads “Don’t worry, healthcare workers do not judge your body. We judge how difficult your particular body habitual will make our job.”

If I had a nickel for every time someone apologized for not shaving ‘down there’, I would be rich. Not retired, just rich.

If I had a dollar for every time someone asked for us to do liposuction while they are under anesthesia, I’d be rich.

I am not sure what it says about our society that patients who are ill, and coming for emergent surgery are so hung up on their appearances. And what we can do for that, or that we would be judging them for that.

Some patients, especially when sent over from the office to be admitted, go HOME. And shower, and change, and shave. Or let the dog out, or clean the kitchen, bent over in agony, in case their friends and family who are coming to take care of the children, or the dogs, or the cats judge them because a plate is left out or the coffee maker is not set-up for them. This is because they don’t want to be judged. Or they pack a bag, anticipating a hospital stay when most people go home from surgery.

Often this delays their care.

And delays other surgeries.

Not our job to be judges at a beauty contest. Our job is to take care of you.

We see scores of bodies weekly and do not judge any of them.

Please don’t delay your own care to go home and run around making sure that the people who are coming to take care of you are not inconvenienced.

Just come on in!

The rest will take care of itself.

School Me Saturday 1/21/23- cohort group texts

During my very, very, very long first day of in-person classes, the entire class cohort went out to lunch during the break between morning and afternoon classes. It was long because I had worked all night the night before and slept in the car while my husband drove me the 90 minutes to school. Made for a very long day. I should have taken a nap during the lunch break in my car, but I did not.

I felt it was important to go to lunch with the group, to be more open to learning more about these people. We are going to be together for our major classes after all. Even if some of us are on three-year tracks, and others on the 4-year track, our foundation classes will be the same.

During lunch, which was yummy, (the group had chosen a sushi restaurant, and I went along, knowing there would be something for me to eat that was not sushi; there was a tofu bento box), all the phones came out and we exchanged numbers. So we could commiserate and keep each other up to date with tips. and cheerleading as necessary.

Note to self, there is always a group mom. Yeah, we are all in our 30s, 40s, and 50s, but there will always be someone who is watching out for us. Bless her.

The group text has been remarkably useful. It has only been a week and there have been collaboration texts, memes, and confabbing on the sometimes remarkably vague instructions. And a picture of my cat sleeping on the distraction pillow I put on the dining room table.

To my surprise, the text stream has not devolved into more basic elementary or high school taunts and gatekeeping. I guess we all had to grow up sometime. And, really, is a group of nurses really that kind of people?

Strike that. I’ll rephrase, is a group of nurses who are actively educating themselves for the good of all nurses really that kind of people? No, no they are not. I have never felt as embraced by a class, or an institution of higher learning before. It is amazing. A bit bewildering, but amazing.

Today the text stream was about reading for next week’s theory class and how one article ties into the last set of articles in our philosophy class. Well played, curriculum, well played.

I already know my role in the texts. I will send a funny meme, no more than once a week, as a stress reliever. I can have restraint sometimes. And I only mentioned this blog once, to one member in her personal text. Again, restraint.

Cookie Thursday 1/19/23-crust cookies

Leftovers month continues. And this week is utilizing the leftover pie crust in the fridge from the holidays.

Crust cookies are one of those things that are popular and will disappear quickly.

You take extra pie crust, spread on melted butter, and top with cinnamon sugar. Bake at 350 degrees Fahrenheit until golden brown and cool before busting the crust into bite-sized pieces.

I did give in to the incessant holiday ads for a spice company and bought the cinnamon sugar topping, even though it is ridiculously easy to make.

This is one of those cookies that are kind of brainless and look oh so very simple to make. And they are. But there is the time involved in rolling out, topping, and baking.

Although this is one of the easiest makes for CTIAT, it still took me 2 and a half hours to bake all three cookie sheets full, cool, and break up.

I used the time wisely by reading a couple of the articles for tomorrow’s class.

Look at me, multi-tasking even while making the cookies!

That was a joke.

In reality, my mid-morning meeting cancelled.

That’s okay, there will be another meeting tomorrow. Or, rather, class all day tomorrow.

Let’s talk Magnet Designation

Magnet designation. This means that the hospital nurses are the best. It holds the hospitals that have it to a high bar of excellence. The majority of the nurses must be BSN prepared, if not higher. The majority of the nurses must be certified.

There are several more hoops that nurses and administration must jump through. Patient safety standards and incidence are held to the lens of the national numbers. And the goal is that the hospital’s numbers are lower than the national incidence of things like falls, or baby drops, of catheter-associated urinary tract infection (CAUTI), or central line-associated bloodstream infection (CLABSI) from a special IV.

Nursing research is to be done on behalf of the hospital. Often these are from projects that the nurses who are going for advanced degrees participate in.

It is a mark of honor that the hospital strives for. Shared governance councils encourage their member units to participate in all of it as well.

Magnet wants the hospitals to be the best they can be.

Nothing wrong with that.

However, changing the rules isn’t very sportsmanlike. The recent rule change that affects my hospital is that each hospital in the system has to be able to stand on its own. And tick all the boxes, including research.

Before, the four hospitals in my area were allowed to apply as a group. This lessened the amount of work that all the hospitals would have to do individually, while still participating and being able to call themselves Magnet certified.

As of two years ago, the rule changed to the one that all hospitals have to stand on their own.

This means that the hospital that I work at will be losing its magnet designation in August.

Bummer.

Because the hospital I work for has no hope of completing all of the magnet hoops to be able to stand on its own. And the corporation would not support us to apply for magnet designation if we could.

I get it. It is Magnet’s program and they can change the rules. And it is expensive to apply.

I did enjoy working for a magnet hospital for the 15 years that the system was given the designation. If I wanted to work at a Magnet hospital, I would have to leave the hospital I work for and go work at one of the hospitals that was allowed to apply for magnet status.

There is a lesser program called Pathways to Excellence.

And penciled into my overfull calendar is a notation to look into it. For the smaller hospitals in the system.

Maybe my hospital can be on the pathway instead.

But the word is getting out, and some nurses are crushed. Perhaps that can be our research project. The impact of losing magnet designation on nurses.

hmmm

Monday’s Musings 1/16/22-Blue Monday?

This was a phrase I had never heard before and then I read about it in two nurse articles.

Blue Monday refers to saddest Monday of them all, the 2nd Monday of the new year.

Or at least, it is what a British advertising agency wanted you to think. If they could convince you that you were sad after the holidays, maybe they could convince you to book a vacation to somewhere warm. Acknowledgment of a down period in someone’s life to sell them something. Seems like capitalism to me.

But.

They are not wholly wrong, are they?

In the Northern Hemisphere, it is cold, the days, although not as short as they have been just three weeks ago, are dark, it is after Christmas and there seems to be nothing to look forward to. Except for vacation at some time in the future. Maybe. If you can get the time off.

There is something to the letdown after Christmas. The pretty things are put away, there is no more anticipation of fun times. Just a dreary slog to more sunshine. I have seen more X days until the time change and the days getting longer posts this past week.

Depending on where you live, the weather is not cooperating either. It can be gray and overcast, and downright cold. Or, in the case of California, more rain than they’ve seen in years.

It is okay to feel blue after the excitement of Christmas.

It is okay to feel blue at the dreary, seemingly endless cold of this time of year.

It is important to remember that these days will end.

Not to be Pollyanna Puke on everyone but find something that makes you happy and embrace it. Get a mug of tea, a warm throw, and a block of time there aren’t any pressing matters, and give yourself the gift of personal time. There’s a reason that the idea of self-care has taken off in the last decade. You have to take care of yourself.

And for nurses it is doubly important. You have to take care of yourself. Because, if you fall, who is going to take care of the patients?

Some chocolate or other dietary treats. Some wine. A massage. The aforementioned gift of time to yourself.

Distraction. It’s not just for toddlers anymore.

Acknowledge that this may be a difficult time for a lot of people; more difficult than the holidays. And, going back to yesterday’s post-it post, be kind.

Be kind to others, because you don’t know what they are going through.

But, above all else, be kind to yourself.

Because we are all our own worst critic.

Post-it Sunday 1/15/23-Those who can’t teach

The post-it reads “Teaching and the ones who only want to do what they perceive themselves to be good at.”

This can be taken in a variety of ways.

I know, and you don’t, that it is about the preceptors who only want to teach one way, because that is the way they think is best.

Now you do.

And you probably have had teachers like that.

We all have.

This can be split into two ways.

The ones who only want to teach what they like.

General cases, for example, instead of orthopedic cases. I get that some OR people do not like orthopedic cases, and feel they shouldn’t have to teach it to new hires.

The truth is that the people who do genuinely like orthopedic cases are unavailable, and you are the only one available, and that is the only case that doesn’t have a student or a new hire. You have to go where the cases are. And you have to teach people about the case on the OR table.

I don’t care if you don’t like the case. I don’t like ectopics, but I precept about them.

Teachers, the vibe of the case that the NEW person is learning is up to you.

It is okay to say, ugh, total knee, I hate orthopedics. I’ll give you one. And then never mention it again while you are precepting and teaching.

This goes hand in hand with the preceptors who are only doing it for the money, and not to teach new people anything other than “THEIR” way. Because “THEIR” way is the only way, capisce?

No, forget I mentioned that, don’t do that.

Be open to instructing new grads, new nurses, students. You might find out that you like it. But try not to poison their minds against what you personally don’t like. It is about them, and their journey.

Because, the new ones, will be out of orientation one day, and you don’t want them to say that they don’t “DO” orthopedics.

I wonder where they learned that?

School Me Saturday 1/14/23- Back to school kindness

Often the first week of school is the first week of the year. But having New Year’s Day on a Sunday made that awkward. And most schools and universities delayed the back to school day by a week.

Which means that back to school week was last week.

And the first week is always the most difficult. New classes, new schedule, new teachers, new books.

It adds up to a lot of stress.

Be kind to the ones that are actively starting their semester. It will be hard to shake off the December holidays.

That’s it.

Just be aware that the students among us may be a little more stressed than usual.

As always, be kind. Buy someone’s lunch. Go out of your way to give a nice comment.

It is amazing how a word of kindness can relax a person. The person may be saying that they are not stressed. On some level they are.

Kindness is also a thing for new employees in new units. This is also a stressful time.

Be kind.

It doesn’t cost anything but it makes the world of difference.

Be kind.

That is what Mr. Fred Rogers would have wanted.

Cookie Thursday 1/12/22- January time of renewal and using up foodstuffs

Ah, January.

A time of renewal and a time of finishing the Christmas foodstuff bounty.

And using the Christmas foodstuff bounty up.

And using the Christmas foodstuff bounty up.

And using up miscellaneous ingredients that have been a Cookie Thursday is a Thing make in the previous 12 months. Or are in the pantry.

In September I made pickle chips. And, after doing so, I had 2 half jars of pickles. Spoiler alert- not a big mover in this house.

In this second Cookie Thursday of the Leftover theme month, I decided to use them up.

And use up some of cheese clogging my cheese drawer.

Let us also contemplate suture boxes. They come from the central supply in their box. Each box may contain 8-30 suture packets. And some of my coworkers would rather tear into a fresh box, instead of using the box that is already opened.

It is SUTURE.

It does not get stale.

Or moldy.

Sometimes they do expire, because they’ve opened the box with the furthest out expiration date, instead of the one marked USE FIRST.

And the department is left with the suture that they can’t use because it’s expired. Because someone didn’t pay attention.

Pro tip- use up the soonest expiring leftovers. It is just like managing your refrigerator and food waste. Eat Sunday’s leftover pot roast before Wednesday’s leftover pizza.

Why? It just makes sense.

Engagement helps with burnout

Engagement is the interaction with others beyond self.

In the hospital, it is interaction with other departments, with other staff, with the councils and committees that make this world run. And allows for those at the bedside not to be run over by the policies on the higher levels. It’s kind of like functioning as the little girl at the end of the Emperor’s New Clothes, and she is the only one willing to point out that the Emperor is, in fact, naked.

The wonderful nurses that I work with in Shared Government help drive the conversation and point out things that may be embarrassing now for the higher-ups, but would be infinitely worse if allowed to continue. We have no problem pointing out when the emperor is naked.

And others do not.

It is not that they do not see, or do not care.

It is that they are tired. It is all they can do to work their 12s and go home. Only to rinse off, sleep, eat, and get up to do it all again.

I understand that they are tired.

And beat down.

And can only care during their working hours.

Because who knows what else they are responsible for outside the hospital. Spouses, children, and other responsibilities that drag on them. And for some people, the hours at work are a respite. And for some the hours at home are a respite. And still others are caught, suspended between the two rocks of home and work. And frankly they don’t have the time or the energy to get involved.

And that is okay. Others will take up the mantle.

However, I can’t help but wonder if the fact that I’ve been very involved, very engaged within the shared governance world has actually contributed to my not being burned out. Much. I’m not burned out much. Just a little toasty around the edges.

Can I propose engagement with your department, your hospital, or anything beyond the hospital as a bandaid and needed support to the burnout that every nurse I know is feeling?

It doesn’t take much.

Sometimes just a helping hand to others will do. .