Author: dispatchesfromtheeveningshift

I am a 2nd generation nurse. I received my MSN in May 2020 and am now a PhD student. I am the night call nurse and these are the stories from my nursing career.

Cookie Thursday 12/26/24-candied? cranberries

Cookie Thursday is a Thing is taking the day off from delivery to the department. Because Christmas was yesterday and CTIAT is tired. Not to mention I am sure that the entire department overindulged and there will be leftover treats available on the lounge tables.

But I am not idle.

Today is my sister’s birthday and I have been making her birthday cake for YEARS.

She always asks for the same thing- a Tres Leches cake. The cake is more of a sponge that three milks are poured over and smothered with whipped cream. That is already chilling in the fridge.

However, what I wanted to write about and experiment with is the viral candied cranberries that are everywhere! A bag of cranberries is soaked in a liquid for 2-24 hours (or more if you just didn’t have the bandwidth to deal with it yesterday), dried, coated in powdered sugar, and baked at 250 degrees Fahrenheit. I thought ooh, an experiment.

I used Prosecco because that was the first recipe I saw but you can also soak the cranberries in Sprite or orange juice. Or you can go the Inception route and use cranberry juice like I just now thought of as I was typing. That would be funny.

I used Prosecco, which is another reason not to bring these to the hospital, because let me tell you, the resulting powdered sugar-coated cranberries pack a wallop. I can definitely taste the alcohol and I don’t think this would go over well at work. Would they be popular? Yes. Would people have to go back to work BuZzEd? Also yes. And I don’t want to contribute to that.

The department is just going to have to be satisfied with their own leftovers.

Next Thursday is a new month!

Cookie Thursday is a Thing turns TEN and I have exciting plans to celebrate.

Post-it Sunday 12/22/24- the daily 50

The post-it reads “Daily 50s- pushups, squats, lunches, wall sit, and plank.”

This is not a prank. I don’t do pranks.

This is a post-it that I wrote myself about fitness. And then it promptly turned December and everyone knows that calories don’t count in December.

I kid, I kid.

As a society, we should start thinking about moving our bodies more. Especially after the calorie-laden holidays and that second piece of pecan pie. Or the third helping of mashed potatoes.

I am not suggesting a gym. Not with all the other newbies out looking for a quick fix. Because this is not a quick fix.

This is just your reminder to move your body deliberately in the new year.

New Year’s resolutions? I am not a fan because I think they are too quickly forgotten in favor of the couch and doom-scrolling. I’m not saying we don’t have reason to sit on the couch and doom-scroll. What about taking 15 minutes every hour and moving your body in a deliberate and thoughtful way.

Me? My goal is to unearth the boxing dummy from the garage. I also have a stack of 15-minute exercises I am going to do while doing the Big Write. Including boxing but not exclusive of it.

Get out that aggression, you know?

School Me Saturday 12/21/24-adjusting expectations

This was a HIGH bar for me to clear.

My expectation was that I could move heaven and earth to graduate with a PhD in 3 years. Eminently doable, I smugly thought to myself as I signed up. Doing the program in 3 years means that I will graduate before I turn 50!

I’m not sure why that arbitrary number was important. After all, I will turn 50 with or without a PhD.

Also of importance was the fact that I wanted to clear the triple hurdle and get my third degree in 10 years. No matter that the world was on fire in 2020 and 2021. And I was a working hospital-based operating room nurse the entire time.

Who was I competing against?

Myself. That’s who I was competing against.

Because this will not set the nursing world on fire.

Oh, and yeah, 2024 was a horrible year health-wise for me. Horrible. Your forties are like a gift. This is heavy sarcasm.

Sometime in the past months, I came to the realization that the thesis will not be finished and defended by the graduate in May deadline of March 20th. There just isn’t enough time to do all the tasks.

Everything takes longer in academia. And I mean EVERYTHING. Through a series of pitfalls, and, yes the personal physical challenges, and the university challenges, it has taken me 6 months to start my pilot project and 2 months to complete it and finish the class. This process should have taken me 6 weeks to start the pilot project and 2 months to complete it and finish the class.

Okay. I’ve written before that age is just a number and time means nothing. Why was I so worried about the PhD being completed by a deadline I made up in my own head? I will finish this degree in my own time. I should just enjoy this dedicated writing time.

The take-home lesson is that plans may change. Some people might look at a change as the opportunity to drop the idea completely. They would not be wrong in doing so.

Their path is their own.

Your path is your own.

Paths may change. I know that my personal path has taken a few right turns and a couple of u-turns. And that is okay.

Whether you stay on the path or decide that it is not the path you want, the important thing is to keep learning. Being an adult learner is hard but remember the reasons you started on the path and the reasons to keep on the path. Even as it changes underfoot.

You might surprise yourself.

I hope you do.

FFS 12/20/24-Fatigue

Fatigue as in tired.

Women in this country are tired of listening to old white men who don’t know anything about women’s bodies but still, somehow, think they have control over us. I am definitely tired of this.

I am tired of picking up an emergency room patient who is having an active miscarriage and bleeding out and burdening them by asking them more questions as to where they want the clump of cells to go. Or, if the pregnancy is advanced enough, which funeral home they want to use. Because of the new abortion laws in our state, we have to ask these questions, and the hospital is no longer allowed to do much.

I am tired of the threat of legal action against women for trying to live a normal life. After all, an Ohio woman was arrested and charged with abuse of a corpse after she miscarried in her own bathroom. It is as if the old white men never realized that 25% of pregnancies end in miscarriage. They’ve been told, it just doesn’t register with them.

We cannot let being tired of this shit control our waking lives. We have to pay attention and pay tribute to those who have died because of their draconian laws. We have to pay attention to the mocked-up trials that are outrageous and designed to be outrageous so they reach the very very very very conservative Supreme Court in the hopes of the Court siding with them. Oops, there goes another right.

Tired or not, we have to demand action. We have to pay attention to the news, distasteful and hateful as it sometimes can be. We have to pay attention to the laws being passed in our states. We have to pay attention to the cases that the Supreme Court takes up.

We have to pay attention, even if we are tired. Because like the Weeping Angels of Doctor Who, when our eyes and attention are not on them, bad things happen. People disappear back to the past when they touch a human and our present-day energy is used to keep the Weeping Angels alive.

Put simply, we have to keep our eyes on the modern-day Weeping Angels and what they are doing so that we as women are not sent back to the past. You know, without rights or a voice. Right where they want us.

Keep watching, even if you are tired. I will be.

Cookie Thursday 12/19/24- glazed ricotta cookies

This cookie doesn’t really fit with the Holiday theme but there is a story behind it that is very Christmassy.

Once upon a time, a long, long time ago, in a galaxy far, far away, I was working as a CNA on a skilled nursing unit of a local hospital. There were all sorts of patients, short-timers, post-total hip or knee patients who would be going home after physical therapy, and even a long, long-timer who had been there for 10 years.

This was a unit that some patients came to after extensive surgery, often from other hospitals. This story is about Gertrude, not her name and I don’t normally add names to my posts but I felt that she needed a name.

Gertrude was from Northern Italy and she had had major abdominal surgery in San Francisco. She had been admitted to our unit to gain additional strength before she went home to her little bungalow.

She needed a lot of assistance when she first came to us, walking to the bathroom, repositioning in bed, and having her drains emptied twice a day. This was a task that was delegated to me.

Gertrude was admitted to the unit in September, with an eye to go home before Christmas. Step by step she became stronger. Step by step her drain was putting less and less fluid. As the months passed, she got stronger and stronger.

In late November she was given a discharge date of December 6th.

As the CNA on the unit, I spent a lot of time with her. She was a very educated woman who delighted in talking literature or the college classes she used to teach. I really enjoyed talking to her.

She would regale me with stories of growing up in Northern Italy as I walked with her to the bathroom and to physical therapy and she talked about her favorite ricotta cookies. I can’t describe the accent she put on ricotta but she swallowed the o sound and made the t’s sharp. She informed me that when she got home she was going to make me her favorite Christmas cookies. I told her she didn’t need to but she insisted she would return.

She was discharged home with her friends on December 6th. Unit life after she left was a little flatter without our daily talks. It was December and December sucks in the hospital. It just does.

Right before Christmas, she made a triumphant return. Her drains had been removed, she was dressed in street clothing and she was all smiles. She was also bearing a box of the ricotta Christmas cookies for the unit nursing staff. With sprinkles. To make them festive.

Those were the most meaningful Christmas cookies that we received that year. But even better was to see her looking happy and healthy as she returned to life outside of the hospital.

That is why I made these glazed ricotta cookies for the December theme.

No sprinkles though. I was out.

Best Kept Secrets of the OR #18- Find Your Why

I know this sounds more like a navel gazing exercise than a secret of the operating room. I bet if you polled the long-timers in the OR, those who have been in the role for years, every single why would be different. And every single why probably has something to do with the patient.

Because when it works and all cylinders are rocking and rolling, and every potential catastrophe is dealt with it is beautiful.

Here is mine.

‘This.

This is why we do what we do. This is why we work the impossible hours, away from our own loved ones. This is why we cheerfully (mostly) smile at our patients and our doctors and do our very best for them.

Because sometimes, it is a awe inspiring ballet of anesthesia, nursing, scrub techs and surgeons all knowing our job and how to help others do their jobs. Ordering labs during the case on the in room computer, putting in lines, getting patients from the ICU ourselves when it is necessary getting blood products, keeping one step ahead of the sterile team.

This saving of a life can be a thing of outstanding grace and beauty.

Because you go home at the end of the day, exhausted, exhilarated. And that patient is alive because of you and the incredible tango you have all just performed, just for them, to the beat of their heart monitors and their breaths.’

*

According to my notes, I wrote this on December 16th, 2013. Do I remember the particulars of that case or that patient? No, but I would bet cash money that the patient hemorrhaged. When a patient hemorrhages, it is all hands on deck. Heck, if you can beg, borrow, or steal other hands do so. The hands don’t even have to be OR hands; I’ve pulled in PACU people before.

The saving of a life can be a thing of outstanding grace and beauty.

Still is, more than 10 years later. Which is why I will never leave the OR. As long as I am capable, I am there.

Tuesday Top of Mind 12/17/24- Your grandparents would be rolling over in their graves if they knew!

I am not going to ask how we got here. It’s bad enough that we are here.

By that I mean the rampant feeling by some LOUD segment of the population that vaccines aren’t important. So unimportant that they don’t want them and, furthermore, their children don’t want them. Yes, I know that is grammatically incorrect.

They feel that the diseases that are currently being vaccinated against are a thing of the past. After all, THEY never heard of anyone getting whooping cough, or tetanus, or measles. And THEY certainly never had it themselves.

Now the anti-vaccinator himself, RFK Jr., has ingratiated himself into an essential job at the government level. He will be handed control of the Health and Human Services. This is a man who caused a fatal outbreak of measles in Samoa tby peddling his snake oil and misinformation about vaccines.

This man is not a doctor.

Like the yummy mummies on social media who are anti-vaxers and never expose their precious offspring to “chemicals” like di-hydrogen monoxide, that’s water, by the way. Until one of their children comes out with a PREVENTABLE disease, like influenza or measles, and dies. Then comes the rending of the clothes and the gnashing of the teeth and the wailing and fake tears. And the claims that no one told them that precious little Timmy-kins could die. After all, they just wanted to fit in with Tiffiny and Karin.

Spare me.

I’ve only read examples of death by tetanus. This is where your muscles lock up so tightly because of the toxin. The muscles are so rigid that bones break. Sounds horrible and not something I’d wish on my worst enemy. If I had any enemies, that is.

My great, great-aunt died of pertussis in the 1930s, even though a vaccine had been developed in 1914. The vaccine wasn’t widely used until the 1940s.

The DTP (diphtheria, pertussis, and tetanus) vaccine is a 3 vaccine for 1 shot deal. The caveat is that it only lasts for 10 years.

The flu shot is widely available, beginning in the fall. This is a yearly vaccine that everyone should get. After all, 28,000 people died of the flu in 2023 and the young, the old, and the immunocompromised are at risk, even with a vaccine.

Is this ringing a bell?

Same things we said about the covid vaccine and there were still millions of people who died worldwide. How many? We don’t know because they STOPPED collecting/reporting the data.

Your grandparents and great-grandparents lost children to what we can now prevent and would look at you in disappointment when you decide to listen to disgraced doctor Andrew Wakefield and his many, many, many, many times disproven paper that linked vaccines and autism.

Double spare me.

Better yet, spare your kids.

Post-it Sunday 12/15/24-Napoleon who?

The post-it reads “The shortest surgeons are the biggest assholes.”

That could be the complete post right there. It is truth. If we have all decided that this is truth, we have to unpack it a bit.

The question remains what level of asshole.

Because, yes Virginia, there are levels to asshole. It is nearly Christmas and that IS a Christmas reference. It refers to the 1897 editorial where Virginia’s question is answered.

There is the instrument-throwing asshole. These are the ones who decide that the instruments are not up to snuff and they are tired of complaining about it. Hence, the throwing of the instruments. This is also one of the angrier assholes.

There is the globe-trotting asshole. These are the ones who absolutely, positively need to add on a case and the case has to be done as soon as possible because they have a plane to catch. Do they really? Or is that a handy excuse.

There is the gotta make dinner with the spouse asshole. These are the ones who swan up an hour late and try to get finished with surgery in time to meet their spouse at a restaurant. This is a close cousin to the globe-trotting asshole.

There is the deity’s gift to surgery. These are the ones who decided that the rules do not apply to them and they can absolutely jump the add-on line. After all, do you not know who they are?

There is the my father will hear about this asshole. These are the ones who followed in daddy’s footsteps and became a surgeon. They are a short step away from deity’s gift to surgery type but there are enough of them I decided they needed their own subcategory.

There is the operate on holidays because they are a miserable bastard asshole. Yes, I’ve worked with one of these. They were not religious and called us out on every, single holiday, especially Christmas. And 4th of July. And Memorial Day. And Labor Day. And President’s Day (this is a real holiday in California). And Thanksgiving. And New Year’s Eve. And New Year’s Day. Why they were on call every danged holiday, I don’t know. At least we were guaranteed call-back pay.

There is the too smart for this room asshole. These are the ones who are convinced that they are the smartest one in the room. We’ve all worked with this one. They delight in the “Well, actually” put down and mansplain or womansplain or theysplain the ENTIRE case.

Of course, there are exceptions to every one of these categories. Sometimes a short surgeon isn’t an asshole, sometimes a surgeon really does need to catch that flight, sometimes the spouse will leave them if they are late one more time because they have been taking care of patients, but sometimes they are just assholes. No matter their height.

School Me Saturday 12/14/24- CV reminder

A CV is a curriculum vitae. It is beyond a resume, which may cover a portion of your working and school life. The CV covers all the amazing things that you got to do, not only in your working life, but in your schooling life.

Writing your CV is important. It shows the ways you’ve changed in your working or schooling life and it also shows ALL the things that you’ve done in those lives. These can be awards, committees that you are on, or organizations and certifications that you have.

If you are still at school ask the writing center for help crafting your CV. Do not raw dog it like I did.

Just like you have a current and up-to-date resume ready to go at all times just in case, you should also be looking at your CV and adding things that you’ve done.

I recommend doing this yearly. Or when someone asks for it. I have several saved on the cloud, each named with my name and the year. But, Kate, why keep the old ones? Sometimes you want to reminisce who you were before all the work.

Personally, I update both the resume and the CV every year after I submit and receive confirmation of the clinical ladder. Seven years I’ve been a level 5 at my hospital. That is an accomplishment that makes me proud.

I was polishing my CV for a project not related to school or work when I realized there is a big chunk missing. I was a subject matter expert when the hospital system I work for was building out their EPIC. This means that I gathered with a bunch of other OR people and we hashed out the bare bones of what the EPIC should look like. I went back to the training computers when the build was complete and EPIC ready to release the system’s version to us so I could train other nurses and be the superuser for the surgeons.

The surgeons have never forgotten that I am the point person in the department with EPIC issues. It’s been 13 years and I still field questions regularly.

This was no where on my CV. Of course I had to add it. I also added the part about the subject matter expert and I also updated the non Dispatches from the Evening Shift writing that I do.

The moral of today’s story is when you get invited to do amazing things don’t forget to put it on your CV. Doing so shows that you are willing to take risks and also be involved in the hospital’s affairs.

Today’s homework is to bring up your resume and read it for completeness. Also get started on your CV. Be aware that this may take several passes. But it is so worth it.

Even if the only person you amaze is yourself.