Certified Nurses Day 2025

Many households, all alike in dignity. In the fair hospital (or outpatient), we lay our scene.

Yeah, that’s the beginning sentences to Shakespeare’s tragedy Romeo and Juliet.

Happy Certified Nurses Day 2025 to all who celebrate it.

Not all nursing specialties have certifications, but most do.

You take a band of nurses who all work in different areas of the hospital. This one works on med-surg, this one works on labor and delivery, this one works post partum, this one works in cath lab, this one works in the operating room, and this one works in the emergency room.

OB has beef with the OR. ICU has beef with med-surg. Everyone has beef with the ER.

Stop!

We are all nurses and healthcare professionals, just trying to do our best for the patients. And their families. And our work families. And our real life families. And our pets.

Whether you are interested and pursue certification is up to you and who you go home to at night.

Whether you are interested and pursue additional education is up to you and who you go home to at night.

Certified, not certified for whatever reason, we all passed the same NCLEX.

Which makes us sisters and brothers.

Ignore the bratty younger sister and brother. Also ignore the know it all older sibling.

You are enough.

Tuesday Top of Mind 3/18/25- Where’s Buttercup?

This post is about our current political situation and the greatest movie of all time “The Princess Bride”. If you haven’t seen it, stop reading and go find it. It is probably playing on tv somewhere. And then come back when you have an inkling of what I am referring to.

You know when Wesley is panicked after being dosed with Miracle Max’s pill and he is demanding answers to, among other things who are you, are we enemies, why am I am on this wall, where’s Buttercup, why won’t my arms move? And Inigo Montoya calmly responds “Let me explain…” and pauses and continues “No, there is too much. Let me sum up.”

That is the mood today.

There has been an entire stream of shit decision and shittier actions from this administration. A firehose stream. The intention is to drown us. Or to give us so much information and things to react to that we cease to react.

The hits keep coming.

There are hits to education that are the 50% reduction in force to “return the education to the states”. Well and good, but there are states that are struggling with what the government gives them. West Virginia, are you paying attention? West Virginia is frequently 50/50 states, and not in a good way, in education.

There are hits to the healthcare industry. Medicaid is on life support at the moment. Reminder, there are over 72 million Americans on Medicaid. This pays for elder care, nursing homes, the children that are under treatment for all sorts of things. You know, like the children that survive being born at 23 weeks that are heralded as miracles. Miracles that will most likely need care for their entire lives. Medicaid also provides healthcare for at least 37 million children. These are vaccinations and well child visits. To lose Medicaid would put a double whammy on the hospital systems that are already struggling.

There are hits to the National Parks system. Not only did 1000 workers lose their jobs, but some parks had to adjust hours and are no longer allowing overnight visits. There are 63 named National Parks but that does not come close to explaining the breadth of what they do.

There is an unelected person who bought the election running around with a group of under aged 25 boys pulling the pieces of the government apart. A la the neighborhood bullies torturing the neighborhood pets.

There is the megalomaniac despot wanna be running a smear and revenge campaign against anyone he thinks has ever wronged him. Someone needs to remind him that it is speak softly and carry a big stick, not scream and shout and use the stick against anyone he deems as lesser. Psst, that is everyone who has less than $1 billion dollars.

That is where we are now. At the mercy of the man child.

I love that for us.

We need a Dread Pirate Roberts. Or, at the very least, an Inigo Montoya. Or a Brute Squad Fezzik.

I’m not picky.

But we need a Miracle Max, not a Prince Humperdinck flailing about.

Sunday Post-it 3/16/25-LOL

The post-it reads “Alpha numeric spelling is just coding.”

This post-it got me thinking about coding in a couple of different ways. What is meant by coding? It is a communication style that seeks to with hold information that might be damaging or incomprehensible to the non speakers. For example the anesthesiologist can say that they need an ABG, CBC, BMP, PT/PTT, T&C and a lollipop, and I know that something bad is happening or has the potential to happen at the head of the table.

I was kidding about the lollipop.

This spate of orders makes me wonder if there is unanticipated bleeding and the patient is not doing well. In response, I would look at the suction canister to see if I can see what they are seeing, and I would offer to get the tube colors that they need as a way to confirm the colors that they need. I would also glance at the back table/mayo and offer the scrub tech additional lap sponges if I see they are down to one or two. I would nudge the red lined kick bucket to be more accessible for the scrub tech.

I would also ask if the patient needs a higher level of care. By that, I mean does the patient require ICU or a transfer to a tertiary hospital. This is code

My next step is to call the supervisor to request an additional set of hands or the ICU bed or to get the ball rolling on the EMTALA paperwork. Which is the Emergency Medical Treatment Act and Labor that allows the emergency treatment of patients.

All of that from the sudden request for lab tests. But, to be more specific, those lab tests. The 17 letters tell a story.

Yes, but… Talking in medical code, AKA the acronyms that you know are near and dear to the heart of all medical personnel, is also done to protect patients. After all, little pitchers have big ears. This means that there is always someone who is listening. And being human they often will take the worst inference of what was just said. AKA the patients will jump to conclusions that aren’t true. And panic.

Parents do this too. Parents can spell out a word that they know the child will react to. Such as B*A*T*H or I*C*E*C*R*E*A*M.

Pet owners do this as well. Such as spelling out the word R*I*D*E or V*E*T.

Both times it works until the kid or the pet can work out is being spelled.

Are we coding in these instances so that the kid or the pet doesn’t become too excited?

I am writing this post because I caught myself coding a social media post the other day. I didn’t care how other people perceived the post but I wanted to share the information for those who are also frustrated by the current atmosphere.

And there I go again! AARRGH!

I think I need a N*A*P.

School Me Saturday 3/15/25- Spring Break!

It is Spring Break.

You might be on break right now, or frantically cramming/writing before your next big test/big paper is due, or you might be going back into the thick of things. This is dependent on when the school schedules the break in the school calendar.

Time to not be in class.

Time to see your loved ones.

Time to hit the beach. I mean, Miami did tell people not to come last month. Time to not hit the beach or find a more accepting one.

Time to sleep.

Time to read the book that’s been on your list all year long.

You’re flexible. After all, you are in college now.

Just be sure to rest up before the push toward the end of the semester.

No matter your plans, be sure to hydrate.

And if you are pulling extra hours because of the break, I see you. I was you.

Take a nap; I won’t tell your boss. Or your professor.

FFS Friday 3/14/25- Full moon rising

I’ve written about full moons and the hospitals before.

It deserves a sweary post on FFS too!

Last night, March 13, 2025, there was a lunar eclipse that was visible from North Carolina. This is also known as the blood moon because it turns the moon red.

This nighttime solar galaxy gift was going to be from midnight-ish to full eclipse at 0226 to finishing at 0600.

My neighbors were having a quiet conversation around their grill yesterday evening and I stopped to talk to them. All of them said they hoped to be in their bed. I said I hoped to not be at the hospital doing cases. They know what I do and they sent me off with the same wishes as I went back inside to wait for the phone to ring.

And ring it did at 2156.

I kind of got my wish. I got home from a case at 2342 just before the dimming started.

I knew, I just knew, that there would be a case. Even if the moon wasn’t quite full. I was right. Like I knew, I just knew, that the OB department was going to fill up quickly. Yep, that happened.

The full moon can have its effects on all of the departments.

When I left last night there were 54 patients in the ER that only has 24 beds.

Every healthcare person that I know, when I mention casually that it is a full moon, looks up to the sky, even in broad daylight, and swears. Sometimes they kick the walls, wheels of the gurney, the OR table, whatever is close by and won’t object to the treatment.

In the before times they would look at me and offer up their call. Which I would take because, well, workaholic.

But last night was calm with no additional calls or cases.

Did I mention that it was nearly payday too? That has its own resonance and people acting out.

Cookie Thursday 3/13/25- Dreamies

No, not the kind that you have in bed while you are asleep.

Let me explain.

This is the second week of the Baking the Freezer theme for March. Where I delve into my freezer and make up cookies based on the ingredients.

I was in the kitchen freezer and I realized that there were two(!) frozen loaves of bread. Which created something of a quandary. I could make croutons but would people like them as a Cookie Thursday is a Thing offering? I also still have a boatload of cheese in the fridge. Perhaps another Why is There Still So Much Cheese month?

No, no, Kate, stop getting distracted.

Back to the recipe books. I saw this vintage recipe for itty bitty grilled cheese looking bites. They go by different names, depending on the era, but the earliest recipe I was able to find was from 1910.

Bread, cheese, butter, spices. What can go wrong?

The uniqueness of this recipe is that the cheese goes on the outside and the butter goes on the inside of the itty bitty sandwiches. And then they are baked. Kind of like a reverse grilled cheese. Interesting. Y’all know I like an interesting cookie. Even though this is a bake.

I think a dab of mustard powder in the butter mixture might set this one up well.

Hours later…

The Cookie Thursday is a Thing offering has been made at the hospital.

The best thing I can write about this is to trust the process.

The best advice that I can write is to bake it on a warm enough day so that the all the windows in the house can be opened.

Because this recipe? Is a smoky one. Not smoke as in “eek, there is a fire”. But smoky as in the ingredients gave off a lot of fragrant steam. Or I need to clean my oven. Or a combination of the two.

The taste is 10/10. Would absolutely do again, perhaps with a bit of Worcerstershire sauce.

I am off to clean my top oven.

Best Kept Secrets of the OR #23-the quiet ones are the ones propping up healthcare

Population studies are fascinating. Who we are and what makes us tick as a society is very interesting. There are the loud ones that suck up all the energy in a room. Who demand all the attention and woe to the ones who get in their way.

They might not be correct but damned if they aren’t sure that they are. Any attention to them is good attention. In today’s parlance, they are the “pick me” group. Often at the cost to other people. Especially at a cost to other people.

Think of Johnny in the movie Airplane!. Always there with a quip, always there to unplug the runway lights. Anything for a little attention.

I find this group exhausting. Thankfully, this is not the vast percentage of society. We would all be exhausted all the time.

There are the in-betweeners. The group that wants attention, but the right kind of attention is best. These are the ones who plod along and are okay if they are recognized sometimes. It doesn’t have to be all of the time.

It’s all good to them.

Then there is the third group.

The quiet ones.

AKA the overlooked ones.

The ones who work quietly in the background, hitting all their metrics, hitting all their targets. Caring for their patients, often skipping lunches without the bosses knowing because it was what was best at the time. After all, they can eat later. Sometimes in the car on the way home

The ones who volunteer for extra hours so that the loud one who has been complaining about not getting their fifth vacation of the year approved (and it’s only March). Not because they want to work the extra hours but just to shut the pick me one up.

The ones who are rarely recognized for being the team players that they are.

Yeah, them.

This is an under-estimated and under-understood segment of the OR and, really, all of healthcare.

The under the radar workers who might as well be screaming “Don’t notice me!”.

Them.

The ones who are never nominated for awards, not because they are not worthy of recognition but it bothers them to be in the spotlight. And so they just toil away in the background.

Until they don’t. Then the lack of their presence is noticed.

Big time.

And they are blamed because group 1 and group 1 feel the lack.

Do yourself a favor. Befriend one of them. Be nice to them.

It’s like the lab personnel. Be nice.

Maybe they won’t leave.

Because your department won’t feel or run the same without them.

Tuesday Top of Mind 3/11/2025-Happy Birthday, Covid-19.

Happy Birthday, Covid-19.

It was 5 years ago today that the World Health Organization declared Covid-19 a pandemic.

The post I wrote last year on this date was that I was at work. Of course I was at work. I wrote that lockdown and elective cases stoppage, masks were a few days away.

Listen.

The WHO and the CDC and Anthony Fauci did the best they could with the wildly gyrating situation that was wrestling with a very deadly, very real pandemic.

Most people don’t care about that.

Most people only care about how a situation impacts them. Until they or their family member is the one on the vent. Or can’t get a bed because there are literally no beds or no vents available.

Remember New York? And the thousands of people who were sick in late winter, early spring, all the way to summer 2020? Remember the refrigerator truck morgues waiting outside of hospitals? Remember the Of course you don’t.

But those of us in healthcare that were sidelined because of the pause in elective cases remember. Well, some of us do.

Some of us who worked on the front lines in those dark days remember. Even if it makes us sad.

There was just a spike in December/January. Not that the U.S. would know. The current death toll on the CDC website is 735 in the first week of March 2025. The total death toll is hard to find at the CDC site and I spent a lot of time poking around looking for it.

The global death rate for covid is 7,090,890. It is hard to get a current death toll for the U.S, but I did find a number on the Worldometer site. That number is one million, two hundred nineteen thousand, four hundred eighty-seven. Americans dead from covid in 5 years.

Spare me the explanation that some of those dead in the U.S. were illegal immigrants.

Remember that it is still sickening people and they are being hospitalized, sometimes on vents? Yes, even today.

Covid taught the world many lessons.

However, it also gave rise to rampant misinformation and death threats against the very people who were trying to help us survive.

Remember that?

So Happy Birthday, Covid-19. May the lessons that you tried to teach us about humanity and resilience sink in someday. Preferably before the next pandemic.

We are flying blind and, as a healthcare worker and registered nurse, these remain scary times. Not only because 75% of the population shrug and go on with their lives, but because the U.S. has left the WHO and the CDC is likewise hamstrung. Research dollars and research at the major research centers, such as universities, are being affected by what they can research and what they can’t. And that list is horrifyingly anti-women, anti-LGBTQIA, and anti-science.

Good times to be in research. (This is sarcasm. So much sarcasm.)

Post-it Sunday 3/9/25- 29 ways

The post-it reads “29 ways to make it to the hospital”.

This is, of course, in the reference to the Marc Cohn song 29 Ways to Make it to My Baby’s Door. Yes, the same Marc Cohn who sang Walking in Memphis. Both songs are from his debut album in 1991.

Marc Cohn was the first bar concert I ever saw. I want to say it was in 1996 and in a small bar in the college town near where I grew up. Between 1993-1996

In the song, the protagonist lists off the ways he can make it to his baby’s door. Near the end of the song he sings that if she needs him real bad, he can find two or three more.

I know that people already think that I have an unnatural attachment to the hospital. I don’t, I swear. I do have an unnatural attachment to work, though I am trying my best to overcome it.

But I was thinking of mass casualty events when I wrote this post-it. Probably after one of the hospital shootings we’ve had nationally for a lot of years. Or being the second runner up to Oklahoma City when I was at Creighton. If that is even true, we talked about it in clinical just after it happened.

However, if the hospital needed me in a hurry, and they have, I could get to it, at night, in less than 5 minutes. This depends on hitting the lights right and no traffic.

However, I thought about it and counted the many ways I know how to get to the hospital during the day. I counted at least 10. And I only live 3 miles from the hospital.

Those are the 10 that I have found. There is probably more.

It just depends on how badly they need me.

And the traffic lights.

International Womens Day March 8th

Much like declining to wish people a “Happy Veterans Day”, I will also be declining to wish women a “Happy International Women’s Day”. This is for many of the same reasons.

There is nothing happy about this.

Google and Apple took it off of their calendars.

In an obvious sop to more than half of the country, Google did incorporate 5 images into its search page. An atom, a double helix strand of DNA, an Erlenmeyer flask, a dinosaur skull, and an astronaut in full gear.

And that’s it.

It is up to us to decipher which scientist or woman matches up with each image.

The atom is a bit of a head thumper to start us off. I imagine that it is supposed to represent Marie Curie. I guess. One of her TWO Nobel prizes is in physics.

The double helix of DNA is much easier to parse. Rosalind Franklin was the woman who took Photo 51, the first x-ray picture that clearly showed the double strands. Her work was stolen by the heralded discoverers of DNA, without her permission. She was robbed of the Nobel prize when the two men who had taken her data did not credit her. Worse, they tried to cover up this fact by saying that she couldn’t grasp the concept of DNA.

Bitch, please.

The Erlenmeyer flask is meant to be the contributions of all women in chemistry? I guess. It’s not really clear. There have been a lot of women in chemistry, after all.

The dinosaur skull could represent Dorothy Garrod. She was the one who first explained that the First Mesozoic era encompassed the history of man. Or perhaps it is representing the first woman archeologist, Margaret Murray, who worked in the late nineteenth and early twentieth centuries. There have also been a lot of women in archeology.

The astronaut could be any number of women. The first woman in space was Valentina Tereshkova. She orbited the Earth for 3 days in June 1963.

If you click through the Google doodle, it is just a celebration of women in STEM. No woman is named specifically by name.

But we know or can guess at the inspiration for each doodle image.

Women in science and STEM is an international effort.

One that we have to give all respect for and homage to.

But it isn’t enough. What other woman has had her data stolen or was forced to give her work to a man for recognition? There remains a lot of work to do.

One thing that must be acknowledged is the contributions that are not STEM related. Because the entire world and all of its discoveries are not solely STEM related. To act as if it is devalues the woman writers and thinkers and philosophers who have fought and bled and died and were forgotten for their contribution to the current world.

Despite the men. Not because of them.

But we still have to recognize that all these women were once girls. And these girls had books.