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.

Post-it Sunday 9/22/24- how the hospital speaks and tells time

The post-it reads “Military time primer. Alphanumeric.”

I am aware that these are two entirely different things.

However, they are how every hospital that I’ve ever worked at communicates. All five of them. Plus the nursing home.

Military time is used so that there is no question as to what is meant by 2 o’clock. Is that morning or afternoon? And do I know that you think it is morning or afternoon?

Well, in military time, that would be 0200 for the morning. And 1400 for the afternoon.

Times in the hospital are mostly for important things like drug administration times. Or surgery times. Or visiting hours. It is important that we mean the same thing.

The best and easiest way to learn military time is to know that it is based on a 24-hour clock. Just like hours in a day. Midnight is 0000, and noon is 1200. What confuses people is anything after noon. All of a sudden we are adding 12 to the hour. 1 pm becomes 1300, 2 pm becomes 1400, 3 pm becomes 1500, and so forth.

The way I’ve taught many people to remember military time is that if it is after noon, just subtract 12 from the number and get the number they are most likely used to seeing. 13=12 is 1 in the afternoon, and 1600-12 is 4 in the afternoon.

I’ve used military time as far back as I can remember. It is second nature to me and how all of my clocks tell time.

Alphanumeric on the other hand is to ensure that a message is not misconstrued.

For example, if you are on the phone with a doctor and they tell you this important heart medication is TID and you heard BID, that can make a patient sick. TID means three times a day and BID means 2 times a day. How often does the patient need the med you begin to ask the doctor. And they’ve already hung up and will yell if you call them back.

The proper way to convey this information is three times a day versus two times a day.

Alphanumeric also is useful when spelling out names of medications or even names of staff or anyone for that matter. M and N sound a lot alike when you are mumbling them into a phone. As do B and T and D. Mike and November sound markedly different. As do Bravo, Tango, and Delta.

It is all about the easiest way to communicate with others in the hospital. Without the possibility of error.

I learned alphanumeric spelling in the Air Force. Because it is how to military communicates as well. Although they love their acronyms as an additional ease in communication too.

As does the hospital.

School Me Saturday 9/21/24- above all else, take care of your health

Being a student is hard.

Like, really hard.

I understand and am suffering along with you.

However…

That is no excuse for not doing the minimum to care for your health.

Eating, hydration, and exercise. Oh, and sleep.

I know that shrinkflation has hit the grocery stores hard and it is sometimes hard to find time to eat, but do your best.

Eat a salad a day, or at least a vegetable. Less fast food and more at-home eating is also key.

I get that fast and easy will win sometimes. Just not every time.

Hydration. Drink that water. Hydration can impact all of your systems. And I mean ALL of them. Make sure you drink water first thing in the morning and try to make it the last thing you drink at night.

Exercise. Go for a walk on the Pomodoro break. Or do desk exercises. There are a lot of really great desk exercise videos and books out there. Your bone density will thank you. And bone density will be important for all the years you plan on living.

Sleep. This is the one that is the easiest to slide on. Aim for seven hours of sleep a night at a minimum. I’m not going to say no screens before bed because I read myself to sleep every night but minimize the engagement with the screens.

After all, you only get one body. Make sure you take care of it.

Tuesday Top of Mind 9/17/24- On your marks, get ready…

I am not sure if you’ve heard but there is a critical election here in the United States on November 5, 2024.

So much is riding on this election I would hazard to say that it is the most important election of my life. And yours.

No, that is not hyperbolic. Or an exaggeration.

On one hand, you have women’s bodily autonomy.

On the other hand, you have the slide toward fascism. And I do not write that word lightly.

Choose wisely.

Today is National Voter Registration Day.

If you are not registered, please register.

If you are registered, please check your registration.

There are some foul shenanigans afoot that want to strip you of your constitutionally recognized and protected right to vote.

Let us say no.

No to fascism.

No to the odd idea that men know best about a woman’s body. Weird, right?

No to making the rich richer and leaving the less rich hanging out to dry.

Just no.

Post-it Sunday 9/15/24- Sour grapes

The gown card reads “Sour grapes, trashing nominations because they can.”

I have no idea if this is an actual thing.

However, I have my suspicions.

The nominations for the nursing awards that I am in charge of are down.

Like, a lot.

So much so that I made an announcement at the end of the last awards ceremony that we did in August that the nominations were down and please encourage people to nominate the hospital staff. If there is a position, we probably have an award for it.

The answer is to take the nominations online.

Sounds simple.

It is anything but.

Where would the nominations be housed? Is this mythical place easily accessible? And is it not able to be hacked?

These are the questions we as a council are reckoning with.

Also, where would someone access the nominations to nominate people?

Because not everyone is tech-savvy.

The corporate-level shared governance tried to do this a few years ago. The same problems came up then, too. Not everyone has access to the computer app. Not everyone has access to the nominations to collect them and collate them for consideration.

I am waiting for pushback about the cursive nominations. Because we have those too.

I’ll just keep collecting nominations, collating them with the massive assistance from the administrative assistant attached to the group, and tallying up the votes.

The only way out is through. This is why I am still in charge of this council because no one has stepped forward to take my place. And after shepherding it through the covid pandemic and keeping it alive with two other nurses, I will not let it die. It is too important to celebrate hospital staff.

And, frankly, we need all the wins we can take.

School Me Saturday 9/14/24- on line class dress code

There really isn’t a dress code for online classes. Especially the synchronous ones. For the asynchronous ones, no one cares because you are never on camera.

But the synchronous ones. That is another story.

I have heard stories of barely dressed students, smoking students, and clearly hungover students.

Remember, you are paying money to do this class. It is best to act like it.

The program I am in started every other week in person at the university. I wore a version of librarian casual. One of my nicer tee shirts, slacks, or a skirt. When I was working as a research assistant my dress was dressier. Nice sweater, slacks, or skirt. I never wore a graphic tee to do RA work. I was being paid to do the work and there I should dress the part.

However, for my online classes that meet every Friday, I make sure I am 1) wearing a bra, 2) wearing an inoffensive tee shirt, and 3) bottoms. In the hot months, the bottoms are either shorts or a skirt. In the colder months, then it is probably pajama bottoms.

This last one is the most important.

Some people do not wear bottoms. After all, the camera only shows from just under the clavicle and your head.

But what if there is an emergency and you are not wearing bottoms?

You will give your professor and your class something to talk about for sure.

Keep it covered. Keep it classy.

Be prepared for emergencies.

Or the doorbell.

Whichever comes first.

Whatever you are comfortable being seen in is best.

The day the world stood still

This post is not part of the Best Kept Secrets of the OR series. This is a remembrance of the day the world stood still.

September 11, 2001.

The day that the world stood still. If only for a moment in time.

It is strange to think that an event that changed our world has no reference for the latest generations.

Last year’s post for 9/11 was talking through it for the generation that watched the JFK assassination on television.

This year’s 9/11 post will be trying to explain what it was like for the younger generations.

The one’s who didn’t live through it.

Who have only learned of it through textbooks. And that is if their state hasn’t banned history textbooks.

But September 11, 2001 was a day that took us outside of ourselves.

It was a date that allowed us to come together as a society. Even if only for a moment.

The parallels are there for today as well.

9/11 was less than 10 months after George W. Bush took up residence in the White House as the 43rd president after a nail biter of an election.

Our elections haven’t gotten any easier. Or easier on the nails.

But for the moment and for months after 9/11 America spoke with one voice.

And that voice said “No.”

We would not disappear.

We would not bow to the pain of the the 2,977 dead.

2,753 people died at the World Trade Center Twin Towers collapse.

40 people died on a plane outside Shanksville, Pennsylvania.

343 people died at the Pentagon.

Many valuable lessons were learned that day.

We would learn that not everyone is a friend.

We would learn that not eveyrone is a foe.

We would learn the value of helping others through the darkness.

We would learn fear.

Many lessons were learned after the events that this attack unfolded. I won’t get into them here becasue this shouldn’t be political. It should be a remembrance of what and who we lost.

However…

We learned that we would endure.

Tuesday Top of Mind 9/10/27- World Suicide Prevention Day

This is not the post I was going to write. That post is mostly written and will wait until next week.

Today, September 10th is World Suicide Prevention Day.

This is a somber topic that happens to correspond with Tuesday Top of Mind.

Suicide and the death of hope touch us all. It does not matter how rich you are, or how poor, or what gender, how young or how old, suicide has touched your life in some matter.

We cannot know the thoughts that weigh on the minds of so many and the pain they are in. So much pain that the only way they see to stop the pain is to kill themselves.

Much has been written about the topic.

Much has not been written because the writer is no longer alive to write.

The United States has a suicide prevention and crisis lifeline. The number is 988. There are options for a phone call, or a chat, or American sign language, or a text.

Anyone using any of the options will be listened to.

All it takes is for the person who is hurting to reach out.

The phone call is free. No minutes will be used.

But let us unpack the service’s name: A Life Line. This phone number is meant for people to reach out and speak to someone, anyone who might understand. Or someone to listen.

When someone disappears or “dies suddenly” we are only left with questions. Sometimes it is a motor vehicle accident, too often it is an overdose, and sometimes no reason is given. Sometimes it is suicide because the inner demons and the private pain are too much.

I urge you to use the number if you need to.

I urge you to give out the number to everyone who is in need.

I urge you to put the number away “just in case”.

Because we don’t know what tomorrow brings.

But, if by advertising this number we can help someone have a tomorrow that would be a wonderful thing.

If you are having problems and need to speak to someone, email me at katedevine@dispatchesfromtheeveningshift.com

I will listen.

I will not offer any solutions.

I will just listen.

Post-it Sunday- You’re suffocating them! Packages need to breathe

The gown card reads “I’ll say it again and again, overstocking leads to compromised sterility.”

I’m not sure if you’ve gotten the memo yet but the OR is all about keeping the field, the instruments, and the back table as sterile as possible. I’m sure that nugget of truth has filtered down.

Where does the sterile stuff come from, Kate?

It comes from packages. All of our sterile bits and bobs come from packages. Packages that we then open in a sterile manner and place on the back table. The scrub tech then uses sterile technique to cleanse their hands, put on a sterile gown and gloves, and then prepare the back table and mayo stand.

However, the bits and bobs come from packages, as discussed.

Some people dislike being away from the OR room and proceed to overstuff their cabinets with the packages. These can be packages of gloves, dressing supply packages, sterilely packaged drains, sutures, syringes, and needles.

There are a lot of things that are needed for surgery.

And people overstuff their cabinets with everything they can think of and then the kitchen sink.

This leads to compromised packaging.

Which leads to a break in sterility if not recognized.

Because a micro tear is still just as big a break in sterility as a big tear.

Or licking your hand and touching everything on the back table without wearing gloves as the scrub tech stares at you in disbelief.

The easiest and best way to prevent this is to STOP OVERSTOCKING!

Maybe if we anthropomorphize the packaging and make the OR team care about them like kittens we can put an end to the overstocking.

After all, you don’t want to suffocate a cute little kitten or puppy.

Right?

There are 5 other operating rooms within 100 yards of the OR. The odds are very good one of them will have the 75th size 8 1/2 glove.

Maybe stop the overstocking and use your resources?

I promise your sterile packages will breathe a sigh of relief.

This will also decrease the breaking of sterile technique.

Win-win.

School Me Saturday 9/7/24- academia moves at a slow pace until it doesn’t

University/college has been underway for a few weeks, if not longer. Students are settling into their classes, doing their reading, and looking at the assignments that aren’t due yet.

Some of us are waiting for the internal processes to work through the delays and allow the long-awaited project to proceed.

Waiting is terrible.

As is the amount of work that awaits on the other side of the decision.

I have found that academia is like that.

It moves at a slow deliberate pace until a decision is made. Often this period of waiting has the student on tenterhooks as they await the decision. This feeling is agonizing.

And then the decision is made.

Then it’s off to the races. Have to get the project done in time to start the waiting game anew.

It’s a little exhausting.

Okay, a lot exhausting.

Playing the waiting game with yourself as you, well, wait.

There is nothing else to do but wait.

And, often, wait some more.

This is the time to make plans and also to make headway into the other projects.

The projects for other classes that are waiting on you.

The decision will be made, for good or ill.

Sometimes the decision events in chucking the entire project as planned and going in another direction.

Good thing academia is also patient.

They have to be.

They also know that academia processes move slowly.

Until it doesn’t.