24- whee, it’s been a wild ride

If by wild ride you mean hot, humid, and expensive. Then, yes, yes it has.

Our air conditioner died on Tuesday night. In North Carolina. In high summer.

This week has not been fun, easy, or cheap.

I specifically took two days off to relieve the pressure on my PTO balance, which was closer to the max than I was comfortable with. My summer class was over and I was just going to read and relax.

The universe said nope, no you’re not.

I had been building a new bookcase in the living room, listening to music when my husband came home from work and asked why it was so hot in the house?

By hot, he meant 80.

Huh.

I guess I was the proverbial frog in a cooking pot, blithely working away while I was being boiled.

Cue an awful night. But I was not going to call the emergency number to have someone out there to look at the unit in the middle of the night.

Long story short, we replaced the HVAC unit, and, as a bonus, updated the electrical panel.

With the electrical panel, the electricity had to be turned off for about 6 hours; no electricity, no fans, which was how we were keeping sane.

We spent the night at a hotel.

The crew worked through some hellacious conditions: up in a summer attic, through some of the wettest weather we’ve seen all summer, and with the quirks of this house. Seriously, no room in this house is a square box, they all have interesting cut-out windows, or extra walls, or, suddenly, a column!

They are getting the best review!

Yeah, so that’s where I’ve been since Wednesday. Spending money like it’s my job.

Oh, and since I am incapable of having workers at the house and not working myself, I’ve been keeping myself busy with mindless tasks. I reorganized the pantry, worked on the garage, kept the kitchen clean.

It’s been exhausting.

Gravity tolls for everyone

Summer means being outside frolicking. Biking, skateboarding, skating, walking the dog, playing outside with the kids, yard work…

The list is endless.

As are the ways that these activities can injure the human body. Injure in ways that need surgical interventions.

You name it, I’ve seen it.

Fractures of all sorts from the tips of your toes to your facebones.

Lacerations of all sorts everywhere there is skin. A laceration is a cut or an owie as we medical professionals call it.

Infected bug bites that subsequently need to be drained or otherwise surgically treated.

Random infections sometimes from the lacerations.

Summer has many ways to hurt people.

Most of them start with gravity exerting its will on people.

Word the wise, babies bounce but adults thud.

And with a fall and it’s sudden stop at the end, things can happen to the human body.

No one can escape gravity. And bubble wrap suits would be expensive, not very sustainable, and hot. Can you imagine the sweat?

Yep, gravity has everyone’s number. It is just a matter of time before you feel the impact of gravity.

No one is getting away from it.

In fact, gravity is in the room with you right now!

Tuesday Top of Mind 7/23/24- It’s the pay parity, stupid!

This was not the Tuesday Top of Mind that I was going to write. And then I saw a report that male nurses make more than female nurses.

Yeah. Women are STILL making less money than men. Even in healthcare. A report from July 11, based on the 2024 Nurse Salary and Work-Life Report from Nurse.com, shows that male nurses make approximately $6,000 more per year than female nurses.

I’ll let that sink in.

Women have been banging on the glass ceiling of the gender pay gap for over 60 years. Well, forever actually, but there was the Equal Pay Act of 1967.

The latest 2022 numbers were that women earn 82% of what men earn.

I’ve heard all the “reasons” men need to make more. The men have families. News flash, so do women. The X job is more dangerous so OF COURSE we have to pay men more. Because they are willing to do the dangerous jobs.

Give me a break!

A bigger news flash you can see from outer space- Healthcare work is dangerous!

Why should a man make more than me because he has an extra appendage? Do I not bleed for the hospital too? On an almost daily basis?

Women don’t negotiate is another reason given. Bitch, women have been negotiating. The point is that men in the C-suite aren’t listening or are gaslighting women into accepting less.

Women take time off to have children. This is true. But what about those of us who don’t have children? Or the ones who have to rush back to work because no structure allows them to take time off for their newborn? Like, I don’t know, guaranteed maternity leave?

Men just need it more for their families. Again, says who?

According to the article, the recommendations for the pay gap are education, discussions, regular audits, and meetings. Also mentioned is promoting career growth for female nurses.

Sigh.

Same verse.

But, Kate, at least it has improved since 2002. Yeah, in 2002, it was 80%. In 22 years the gap has shrunk by 2%.

Oh, boy. I’ll take that in small bills.

Granted, the gender pay gap started at 40% in 1960. 40% in 60 years is tremendous.

But it is not enough.

School Me Saturday 7/20/24- continuing education crucible

What if you don’t want a degree?

What then?

I believe it is everyone’s right to decide whether or not to continue their education post high school graduation. If they don’t want to have more education, no one is forcing them.

Except maybe the job market. But even that is getting a little thin to demand a degree. I’m sure we’ve all seen the meme of a company asking for 10 years of experience in a new field, with a master’s degree and only paying $25K a year.

And the goods market. How are they going to pay for the lifestyle they grew up accustomed to?

This is not knocking trade school. Trade schools are very important and teach valuable skills that can be used to get a high-paying job. For example, plumbing. There may be colleges to teach plumbing. However, it is often learned on the job through an apprenticeship program.

Then, the student also has to know enough not to get scammed. Or how to do their taxes.

Yes, they are adults.

But this is the price of living in our society.

The economy is a crucible that heats you up and spits you out.

Post-high school college and trade schools are a kind of armor to protect people.

Goodness knows no one is lining up to protect anyone.

It is a way to protect yourself and maybe learn what you really want to do.

Best Kept Secrets of the OR, part 2- Howling at the Moon T

This is the second part of the Best Kept Secrets of the OR.

This is not the post I was going to write. But I will keep that one half written and release it next week. I was just about done with it when I happened to look up and see the big bright nearly full moon.

I know a lot has already been written about full moons and healthcare. How we hate the full moon. How we fear the full moon.

True. All of them.

I know that Atul Gawande covered the statistical lack of the full moon craziness in his book Complications. Until he worked a full moon, he would have no idea.

The full moon brings out the crazies.

And it is not just the ER that feels the impact.

But I don’t think it gets enough attention.

Yes, the crazies howl at the moon.

There is more light available at the full moon that may lead people to do things they wouldn’t normally do because it feels kind of naughty. Until they step into a hole they can’t see fully and break an ankle.

There are also atmospheric pressure changes, kind of like a low-pressure front.

I mean the full moon also has an impact on labor and delivery. After all, the amniotic fluid is technically a body of water.

I mean I guess it isn’t only the OR’s best-kept secret.

But I hate working a full moon.

Not only are the patients feral, so are the surgeons.

Tuesday Top of Mind 7/16/24- Fifth verse, same as the first

Yes, the post title is meant to reference the song”I’m Henry the VIII, I Am” by Herman’s Hermits.

What the post title is referencing is that this is the FIFTH covid summer. 2020, 2021, 2022, 2023, 2024.

Not as bad, but still lethal. Masks have been legislated against or banned in many cities and states. You know, the masks that have kept some of us safe through this entire time.

It is illegal to wear a mask in some states if you are committing a crime.

Since when is the desire not to get covid a crime? Depends on who you ask. Are you asking the ones who don’t believe in covid, who think it’s a boogeyman dreamed up by those with public health in mind? To scare the stock market? To get people to buy into Big Pharma? To want to care for others, no matter their age, sex, religion, and orientation?

Yeah, those people. The ones who excuse the death of over one million Americans (the exact data is hard to come by). According to the CDC tracking database, there have been 1-9 covid deaths in North Carolina in the last week. However, the previous week’s numbers that allow comparison and percentages are not available. Ask yourself what they don’t want you to know or even acknowledge to themselves.

I am keeping a close eye on the infection rate at the hospital. We went from 1 admitted case to more than 5 times in a couple of weeks. ooh, five more patients? Yes, and these are just the ones that got admitted. Or came in. These are definitely the ones who are quarantining because they are in the hospital.

I have not resumed mask-wearing as a general rule. I have some in my car. However, I shop early or late or not at all. I don’t go places where there are a lot of people. On purpose, but then I’ve always kinda done that. Who knew being an introvert could help? Just every introvert known to man.

I have no idea how many covid posts this makes. My record-keeping has been spotty. And incomplete. And my mind has been busy with other things.

As always, it doesn’t matter if you don’t believe in covid; it believes in you.

Post-it Sunday 7/14/24-Details will save your ass

The gown card reads “Take credit for what you do. All documentation is important.”

This can be thought of in at least two ways.

Yes, write down everything you do during a surgical case. This is important. The OR documentation is a shell, it is up to you to fill in the details.

ALL the details.

This is to protect you when there is a complication.

All the positioning aids are important to note. It is also important to note what position the patient is in during the surgery. If you have to fudge the lithotomy a bit because of their body limitations, write that. Be as detailed as you can.

I don’t care if you’ve done this case 2000 times, document everything you’ve done.

All the medications are important to note. How will the pharmacy and nurses and doctors who take care of the patient AFTER they leave the OR know the details of what medication was given? Be detailed, not only in the medication dispensed to the field, but the total of the medication delivered to the patient. Don’t forget to include the route. Remember the 5 rules of giving medication to a patient from nursing school? Yeah, right patient, right time, right dose, right medication, right route. I would add another right; the right indication for use. If this medication is being used in a way that is unusual, write it down. Give justification as to why. If there are antibiotics added to bone cement, explain that.

All the dressing details are important, even if they can’t be seen without deconstructing the dressing. An addition of an antibiotic or non-adherent film is important to note. Because the nurse or doctor who will be taking down the dressing has to make sure they have all the pieces. Because some of that turns transparent against a wound.

All the people in the room are important. Not only is it up to the circulator to control the traffic in the room and keep the crowd down to necessary people only, but times are important. People I often see not listed on the chart as being present are the correct product representatives or x-ray techs. The times all the people in the room are present may be useful in the future. Not only for productivity tracking.

All the details of the equipment used are important. This is so we can track the equipment used and also aids in tracking down instrumentation if there is an issue with a later patient where the same equipment is used. It is often necessary to note when the equipment is used on patients.

All the supplies are important. In so many ways. This is important on the back end for ordering and correct billing.

Be as detailed as you want to be while charting. But remember, your charting might save your ass in a deposition during a lawsuit in 5 years, 18 if it involves an infant, or until age of maturity if it involves a child.

Tuesday Top of Mind 7/9/24-their plan, yes, that awful, horrible, no good plan

I took yesterday completely off after doing all the research into Project 2025 and Agenda 47. I did not want to sully the day with this filth.

A couple of years ago, I heard rumblings about the “conservative game plan” for after the 2024 election. You know, the one that is November 5, 2024.Call it Project 2025, the 900-page conservative wishlist. Call it Agenda 47, which is what Trump wants to do if he is reelected. And he’s got a whole lot of hurt planned for those he perceives who have wronged him.

I call it bullshit.

All of their horrible, misogynistic, misanthropist, nightmare wishing, end of the rainbow, white christian nationalist ideas. All of it is bunk.

Call a spade a spade.

They wouldn’t because a spade is a black card.

This is how far they have slid down the white christian nationalist shit pile.

Did you see the masked, khaki pant wearing, beige baseball hat wearing, blue polo shirted assholes that came pouring out of rented U-haul trucks to stalk the streets of Nashville, waving their upside down flags, and their confederate flags, and their 13 starred flags? Yeah these are a what I can surmise is an offshoot of the Proud Boy movement that call themselves the Patriot Front. They look like all the brotastic podcast boys, put the women in their place wannabes. Riding in the back of the probably sweltering U-haul trucks in disregard to ANY safety laws.

Ugh. I need a shower after digging through that muck.

I’ve done a pretty deep dive into the mess. The 900 pages of the Project 2025, the hate speech of Agenda 47 which, again, calls patriots traitors for daring to stand up to the great one. I’ve listened to podcasts, and I’ve watched videos, and I’ve read article after article after article about it.

Kevin Roberts, the head of the Heritage Foundation, believes that we are in the middle of another civil war and you know what side he is on. He also believes that this can be bloodless if the left allows it to be. Yeah, no. I don’t think so. Who gave him the covenant to declare that? Himself.

But I have a pretty good bead on what it all means.

There is a part of the introduction that says that they want to “live well”. Well, that’s up to interpretation. My well is to have dominion over my own body and voting rights for those who are citizens. To some of these people, living well is holding their feet/knees/weapon against the neck of others they deem less than themselves.

It all boils down to three things. All 900 pages of the vitriol. Of all the weaponizing of our own tools against us with the takeover of the DOJ and the firing of all the civil servants who are there as a constant. The Agenda 47 on 45’s own website.

$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$
I don’t like it because it is not like me, therefore no one should have it. Doesn’t matter what it is, gender affirming care (but Cialis and Viagra are still okay), rights of people to have dominion over their own body, rights of people to love who they love, regardless of gender, to be who they are at the core regardless of gender
We fear women

That’s it, that’s their entire platform.

Why would you believe a known liar? They are telegraphing who they are and straight out telling us who they are and then lying about it when they claim that they are not. Why should we believe the known liars? I will not pretty up their actions and words by calling it “Falsely accused without evidence.” It is lies.

Call them for what they are- liars and wanna be big men.

I call them creepy and gross who see bogeymen in the shadows that look and act a lot like their secret desires.

These are beyond scary times. This election isn’t about red v blue, Trump v Biden; it is about not allowing the very bones of Democracy be picked over by the corporate ghouls who want you to live as they DEEM you should. Personal freedom goes out with the bathwater. As I just wrote, money, fear of women, and fear of the unknown is at the root of it.

We should be alert but resolved.

I am.

Both as a woman and a patriot. Just not their definition of the word. Because of the whole woman thing.

I am going to take another shower now, just writing this. And set fire to my browsing history.