24- Sacred rule killer

The gown card reads “Girding your loins to address the elephant in the room. This is harder than it looks.”

This can be about many things. Today it will be about the so-called sacred animal in the OR. I know that I’ve written about this previously but this gown card brings it back full circle.

These are the sacred rules. Sometimes called a sacred cow and in today’s gown card is referred to as the elephant in the room.

These are the often nonsense rules that are followed. Just because they have been done for as long as there is memory.

There is no research behind them.

There is no common sense behind them.

One day someone just made up a rule to make it easier for them in that moment. And they foist this rule upon us forever and ever and ever.

Even if they don’t make sense.

What are these sacred animals?

Stand up and give your chair to the doctor is one. When I was a baby nurse, nearly 25 years ago, we had several older MDs who would demand our seats and our pens and the charts (back when we had paper charts) even if you were using them.

Wearing shoe covers on the shoes that live in the locker room. My hospital shoes live in the locker room if they are not on my feet in the OR. I do not wear them outside. This is me protecting the outside from the OR, and the OR from the outside. And is a very good practice. Anyways, shoe covers make me fall down. Mostly because they are made for men’s shoes and too big.

Or the elephant in the room can refer to treating the surgeons and other doctors like gods. It is okay to stand up to them. It is encouraged to talk back to them if you know that what they want to do is not right.

The patients are counting on us to be able to stand up for them. Because they can’t.

Before you develop the spine to speak up put my number in your phone and put me on speaker. I’ll tell them no for you.

Perfectionism does not belong in the OR

I know this might be more appropriate for School Me Saturday but is a valuable lesson for the free Wednesday where I talk about operating room things.

I’m taking a second summer session class about scholarly writing. And the Teams classes are Monday-Thursday. Today’s class has been about dismantling perfectionism in the academic space.

I am the only nurse/non-humanities person in the bunch. That’s okay, I’m used to it.

I took notes in my usual note-taking way. I read the assigned readings, and have little (***) offshoots where I react to the passage. This is also how I take lecture notes. But the lecture notes have an additional part. I can HIGHLIGHT my lecture notes. I have 14 different colors to choose from for the different parts I want to highlight to spark additional exploration on the theme on my own time or to emphasize a point so I can refer to it later. I have assigned each highlighter color to a different subset that I want to explore in Dispatches, explore for school, or that I want to remember because it is cool.

One of the lectures/discussions was about perfectionism that is ingrained in us as children and perpetuated through school, whatever level is attained. Acknowledging that we have all been programmed by schools/religious institutions/families to strive for perfection was the take-home. We were also tasked with thinking about ways we can break that down and dismantle it.

Granted this is an English class but I think there are applications in the operating room.

Surgeons are always striving for perfection. Always.

The cosmic joke is that they are working on imperfect bodies.

I think that surgeons can help alleviate symptoms and do amazing things through surgery, but they cannot make people perfect. I’ve read about blaming the surgeon for cancer margins that weren’t clear or not being able to “get everything”. Sometimes a human can’t fix everything.

It is foolish to think they can.

It is also foolish on their part to chase perfection and not accept that perfection is unattainable. I’ve written about how surgeons have ruined an adequate repair in the quest for the perfect repair.

We need to cut ourselves some slack. Yes, I am including surgeons in this pool.

Who said perfection was 1) attainable or 2) the ideal?

We should talk to them.

Tuesday Top of Mind 6/18/24-professors suing to fail girls who have had abortions

To set the scene, two professors in Austin Texas want to punish students for their actions outside of class. The action in this case is abortion. How would they know that there was an abortion is not mentioned. The second professor is suing to not hire teaching assistants who have had an abortion.

Again, how would they know?

In their lawsuit, they claim that girls who take time off of class to have an abortion should be failed. By them. For the egregious crime of becoming pregnant and not wanting to be. Does this mean they will fail all women who can’t come to class because they are sick or need surgery? Because, of course, if they are absent because they are sick they must have had an abortion. But boys who are sick or need care can have it no questions asked, no threat to their grades?

Are they also going to fail the boys who participated in the girls becoming pregnant?

No?

I just asked because if the girls are pregnant and desire an abortion because reasons, the acknowledgment that it takes two for a pregnancy would be useful.

Or does it go back to the judge who sentenced the Stanford rapist to 6 months because otherwise, it might hurt his career? I won’t write what I said then because there aren’t enough curse words. This was back in 2016, let me jog your memory. And when his dad piped in that it wasn’t worth ruining his life for an action that was 20 minutes. I think he forgot that the girl that his son assaulted has to live with that forever. She got a far harsher sentence than he did and she wasn’t even on trial. Because he was remorseful. Yeah, remorseful he got caught.

But to go back to the failing of women and girls because they couldn’t attend class because of an abortion, how would they know?

This comes from an open desire to control the actions of women and girls.

Again, it is all about control.

The men want it and therefore the women should give in.

I’d ask if that was what they want but I’m afraid I can’t stomach the response.

This entire “culture war” that they’ve created and railed on is all about control.

I have a new shirt, did I say?

An RBG tee shirt that says “I’ve heard enough from old white men”.

That says it all, right?

These men are afraid of losing the control they think they have over women.

School Me Saturday 6/15/24- Feed me, Seymour! AI and the student

A bit of a break from the Alice in Wonderland theme.

Today I am going to take inspiration from Little Shop of Horrors.

Fun fact, this was among Jack Nicholson’s first movies. This was 1960, far before it was turned into a musical.

It was a horror movie about a hapless florist clerk who finds and is bamboozled by a strange plant that demands blood as its source of energy. He goes to great lengths to feed the plant, including killing his boss and his crush’s abusive boyfriend.

There was a Broadway musical that spawned a movie musical that starred Rick Moranis as the hapless, helpless, murderous Seymour. And Steve Martin is the abusive boyfriend who is killed, not by Seymour, but by huffing nitrous oxide.

It remains one of my favorite movie musicals and I listen to the soundtrack while I do yardwork.

When ChatGPT ignited the AI craze in November 2022 everyone went nuts. It was AI this and AI that. In some aspects, it still is.

My classmates and I had discussions about the ethical use of AI in colleges and its applications for students. My professors had frank discussions with us about the possible use of AI and the definite downfalls of it. And rules that had to be rushed into being around the use of AI.

Here’s the thing about AI. I consider it a fancy search engine. Powered by many, many, many gigawatts. And many many internet searches and data that is already out there. Which is why we are feeding the AI. Like Seymour was feeding Audrey 2.

Is it an achievement? Yes.

Did they “teach” the AI by feeding it all the contents of the internet? Yes.

Did they “teach” the AI to be selective in what is used as the source material? No.

Like so many things, garbage in, garbage out.

It wasn’t long before there were reports of the AI “hallucinating” and having nonsense as its output. Which led to more places banning it, even while the mania was just getting underway.

Today the world is still manic for AI. With a large, large, large caveat. A caveat emptor, if you will.

Buyer beware.

There are some useful avenues of AI in the classroom and some programs are actively embracing it.

You just have to be careful of the output. You don’t really know if what AI wrote is nonsense. Sometimes it is. And the teachers know when you’ve used AI.

Especially if the output references something that doesn’t exist. It’s just the universe hallucinating.

But be careful.

And don’t let AI become so much of a crutch that the world ceases to think for itself.

Don’t let AI be the plant that devours creativity and humanity’s sense of self.

Or, like the dentist in Little Shop of Horrors, society might end up being fed to the AI who is ALWAYS hungry.

Cookie Thursday 6/13/24- fudgy cocoa no bakes, of course

The theme for June is Schools’ Out and the makes are basically afternoon snacks. These are the snacks that were waiting for you at home to tide you over until dinner. Last week I made fluffer nutter sandwiches. Next week? I haven’t decided yet. But the right after-school snack should be comforting and familiar.

These definitely are.

Today I started a summer session class on Scholarly Writing and I didn’t plan well enough in advance to, you know, actually bake something. Fudgy cocoa no bakes it is.

These are the quintessential after-school snacks. Peanut butter for protein, oats for fiber, and chocolate just because.

I have to lock these in my trunk for the trip to the hospital because they are that easy to have “just one more”.

I’ve made these a million times and I STILL need to look up the ratios. Every time. There is no shame in that. At least, I don’t feel any. I would rather look a billion times than get the ingredients wrong and end up with a gloppy mess. And waste the ingredients?

Heaven forefend.

Tuesday Top of Mind 6/11/24- the vote against the federal right to birth control

Again with this bullshit.

Okay. Back up.

Last week there was a Senate vote on protecting the federal right to birth control. And it failed with only 51 votes to 39. Reminder, The Senate needs 60 votes to pass legislation. That is a different top of mind. There were some Republican yeas (okay TWO) and a couple of Democratic nays and still more people voted by not voting.

But the important thing is that it did not pass.

Even though over 90% of Americans support birth control.

What was to be protected by the bill?

A person’s ability to obtain and use birth control. And a doctor’s ability to prescribe said birth control.

There are mealy-mouthed people who say that the right to birth control is not in danger.

OH REALLY?

Some people said that Roe was settled law. This was very, very recently at their Supreme Court nomination hearings. Remember them? I do.

The right to birth control was settled with the 1965 decision of Griswold v Connecticut. This ruling essentially meant that the Constitution protected marital privacy rights against state restrictions. This has been used for many things, including Roe v Wade. And interracial marriage. This has definitely been mentioned in the last two years, by Justice Clarence Thomas and Justice Samuel Alito.

You understand our concern.

Forgive me if I don’t believe them. Any of them.

This is about controlling women.

And controlling child-making.

Which was the reason for Dobbs.

But it is ALWAYS and FOREVER about controlling women.

This is your call to look up and see if your Senators in your state voted yea or nay. If they voted nay make a note on your calendar to call their office monthly to say how disappointed and angry you are. I mean, you are not one of their billionaire handlers but it will make you feel better.

I hope. Let me know if it works.

Post-it Sunday 6/9/24- Don’t be fooled

The gown card reads “Don’t act like you think I’m a moron and I won’t act like you think I’m a moron.”

Look the people who work in the OR and are nurses and doctors are very smart. They have to be. We deal with the intricate workings of the human body. We have to know every part of it, and the mechanism of action of each of it. Not only that, but we have to know all about medications and their actions on every portion of the body.

There is a reason for such a steep learning curve for new OR nurses and techs. There’s a lot to learn. Not only that, you have to learn to anticipate what the surgeon wants. There is a reason that I reassure lap appy patients that if the surgeon falls out (passes out) during surgery the tech and I could band together to finish their surgery while we wait for assistance. It makes them laugh and relax. I once told a surgeon that I tell people this and they laughed and said after 23 years they would hope so.

The point is don’t discount anyone’s intelligence. No one; from the orderly to the circulating nurse.

There is also a soupcon or even a heaping cup of misogyny in there.

There is a prevailing “wisdom” that nurses are nurses because they aren’t smart enough to be doctors. I usually don’t respond to that. Who else is going to carry out the orders and question them when they are inappropriate? Many a life has been saved by a nurse refusing an order as written. Many a license to practice medicine has been saved by the same thing.

Some of us don’t want to be medical doctors and never have wanted to be one. Someone has to watch out for the patients and protect them from everyone else.

Let’s make a deal, you and I.

Don’t act like you think I’m a moron, and I won’t act like I think you are one.

Okay?

I’m glad we’ve had this talk.

Oh, and leave the patronization at the door, will you.

It just clutters up the workspace.

School Me Saturday 6/8/24- Giving yourself advice

In the 1951 animated feature Alice in Wonderland, Alice gives herself a musical pep talk when she is lost in the wilderness that is Wonderland. She begins to sing to herself that she gives herself good advice, but never follows it. That her problem is that she is curious and impatient and knows that there will be consequences.

And she weeps. All the wildlife that has surrounded her to listen weep as well.

These tears flood the surroundings and she has to swim for it. She meets a friendly mouse along the way. All is not lost. But this scene is beautiful in the movie and speaks to the student in all of us.

You see when you are in college classes and there is so much going on, it is hard to keep things like assignment due dates, and even assignments themselves, and testing dates front and center in your brain. Things can be missed or turned in late for a penalty.

We know what we have to do, but, like Alice, it is often hard to take our own advice.

I know that I should be reviewing all I’ve learned over the past 2 years, and I do a fair amount of rereading, but I also want to read ALL the books.

As a known procrastinator, this is something that I work on daily.

To track due dates I have them written in

my calendar app
on my dining room wall
on a Post-it on my desk

Why three? Because I know myself and my ways and I will belt and suspender and belt this for all I’m worth.

Last week I wrote about the Blue Caterpillar and his very opening query of Alice. Who are you?

Through school you will get to know yourself intimately. All the vices and the virtues. Pay attention to them so you can turn things in on time.

And, like Alice, don’t be afraid to ask for help.

Alice never went alone in Wonderland. We don’t have to either.

It is okay to give ourselves advice. Just be careful to follow it, huh?

Cookie Thursday 6/6/24- Schools’ Out

Do you remember the first giddy days of summer? When the temperature was hot but still endurable? When you did not have to get up early to go to school? When you got to stay up as late as you want, 10 pm even?

There is no comparable time when you are an adult. Except, maybe, vacations or retirement.

The June theme for Cookie Thursday is a Thing is Schools’ Out. These are the after school delights that you ate until you got sick of them.

The first make of the month is the fluffernutter.

In my memory, I never had these growing up. It is peanut butter and marshmallow fluff on white bread. It is about as basic as can be. In fact, the entire back took me less than 15 minutes.

I mean, I could have gone full Elvis and made banana, bacon, peanut butter sandwiches. But I will save that one for another month.

Time to remember how it was to be a kid. And try not to feel jealous of having no responsibilities, no job, no bills. It’s funny how much we want to be grown-ups until we are.

These delicious little makes should spark nostalgia. At least, I hope.

There will be a companion theme for September. And I can’t wait for that one!