The gown card reads “I’d say we’re too smart to be on this shift, but that may be why we are on this shift.”

Different shifts require different levels of knowledge.

They also require different levels of imagination and weebles.

By that I mean that when you knock down a weeble, they don’t stay down.

A toy from the 1970?

When weebles wobble, they don’t fall down?

Different people gravitate to different shifts.

This may be because of the management mix on those shifts. This may be because of personality types on the other off-shifts.

This may because we are there to get the case/job/work done.

End of list.

Some shifts are there to put in their time before they get relieved.

Ahem, day shift.

Some shifts are there to do the work because they know they won’t get relieved.

To go back to what the gown card, shift types kind of tend to stick together.

The off-shift knows that there is no other option but them and work with it.

After all, there isn’t anyone to complain to.

Get in, do the case, get done.

It really can be as simple as that.

To put it simply, there is a patient who needs us. We have the skills. We have the knowledge. There is no one coming to save us.

We might as well save ourselves.

Does this make us smart?

No necessarily.

It does make us a cohesive group, with little in-fighting.

Because none of us are getting out of this shift, until the work is done.

Okay, school hasn’t started yet.

Depending on your school, it won’t for another week or three.

However, it is important to start thinking about school. About the classes that are going to be starting soon.

For some of us, this involves thinking about and procuring school supplies.

And not just for ourselves.

This time is one of my favorite times in the school year.

The school supply drive.

All the new books and papers and folders.

All the new possibilities to begin a school year well-supplied and in the right mindset.

Not everyone has that privilege. To that end, I have been involved in the school supply drive at my hospital for several years.

After all, we don’t have children to buy school supplies for, and there is only so much room at our house for new supplies.

Why not volunteer at a school supply drive this summer?

At the very least, chuck an extra pack of paper into the cart when you are buying yourself some school supplies.

It would help out so many people. I’m not saying the trunk of my car is full of school supplies, but I kind of am saying the trunk of my car is full of school supplies.

If I can help those who are struggling, why wouldn’t I?

Through the magic of podcasts, I discovered a British podcast called You, Me, and the Big C.

This was several years ago.

It was hosted by 3 women, two with breast cancer and 1 with colon cancer. The pod was about life with cancer, how to deal, how to get on with it. It won several awards. One of the presenters with breast cancer died, almost immediately after I found this podcast. It soldiered on with the now 2 women with cancer, and the widower of the third presented.

It was always life-affirming and wonderful to hear new podcasts.

You may remember last summer when Bowel Babe died. She was a Deborah James, an accidental influencer, teacher, pod-caster, wife, mother, and made a Dame by Prince William himself in her garden for her cancer fundraising.

I have always been a proponent of cancer screening. As soon as I turned 40, I scheduled my first mammogram and have gone every year. I knew I would do the same when I turned 50 and the colonoscopy.

Then they dropped the recommended age for screening colonoscopy to 45. During a pandemic. I will get on that, I promise.

Here’s the thing with cancer, it waits for no one. Grows quietly in the dark of ignorance.

After Spring Semester ended I scheduled my first screening colonoscopy. I didn’t care who would perform the procedure. My only caveat was that it had to be before Fall Semester started.

Guess what I have done for the last two days?

Yeah, prep and colonoscopy.

I always feel like I need to walk the walk, if I am going to talk the talk.

Truthfully, it wasn’t horrible. At least I got a nice propofol nap out of it. They do not lie, propofol burns when it is being injected. Most pain I had in the entire experience.

The screening was clear except for one bitty polyp that got removed. This means I don’t have to do it for another 7 years. Yay!

However, it is Cookie Thursday. Of Cookie Thursday is a Thing. You may have heard of it.

August is No Heat Month, where I don’t turn my oven on at all. Because it HOT.

I needed a cookie that is shelf stable because I made the batch on Wednesday. That didn’t involve the oven. Fudgy Cocoa No Bakes it was.

Any colonoscopy joke can sit on the side-line.

By decreasing the age of the first screening colonoscopy they are catching more cancers at an earlier stage.

At a more curable stage.

If you are above 45, ask your doctor today.

I had another one of those phone calls.

Ring, ring.

Me- This is Kate. How can I help you?

MD- This is Dr. Z. I have a patient who needs urgent surgery. There is a lot of blood and they are still bleeding. How fast can we start?

Me, after getting details-It is 2310. I am heading in now and the scrub tech is my next call. I will shoot for patient on the table at midnight.

MD- Well, I hope they still stay stable. Do what you can. **click**

Come to find out the surgeon knew about the case a good thirty-sixty minutes before they called me. They were watching to make sure the patient remained stable.

They were doing this by not ordering the type and cross. This is where the patient’s blood type is tested for type and crossmatched to ascertain the most compatible blood to give them in case of a transfusion need.

These tests take 30 minutes at a minimum.

And the order should not be buried in the pre-op orders. The ER can absolutely and would absolutely start the clock on this. This is essential for making sure the patient has blood available if necessary. Especially if they are bleeding.

They were doing this by not ordering the oral medication that they decided the patient MUST have prior to surgery. Again, something the ER can absolutely do. Anesthesia does not like giving anything orally due to the pesky NPO, especially minutes before induction.

By responding, when this oversight on the type and crossmatch was noted just prior to surgery, and the lack of oral medication was also noted just prior to surgery and the surgeon was questioned about the need for these both to be done before the patient heads back to surgery, oh, just the oral medication then.

On a patient we know is bleeding?

This is what you want to do?

Okay.

Handing the patient 2 oral tablets and a scant amount of water (seriously, like 1/8 of a cup) to wash them down with.

That took a minute to have the orders, that were just released, acknowledged, and released by pharmacy. Added 5 minutes to our pre-op time.

By continuing to pace around and say that they were WAITING and what was taking SO LONG?

Deep breath.

Count to TEN.

At no point did I snap back that these could have, should have been ordered just a mite earlier so that the meds would be given, and the type and cross that you no longer want could be initiated.

But it was close.

Managing surgeon expectations is a big part of the call process. But they can help themselves out by not acting like an impatient fool and, you know, ordering things in a timely manner.

Patient is fine and did not require blood.

On to the next case.

As a woman, I know what weaponized misogyny means.

It means every time there is a shred of happiness for someone of the female persuasion, such as a movie, or a kitten (although kittens spread joy regardless), some asshole who thinks they are macho and butch and here to show the little lady who’s boss pops up in the comments

Oh, I know what misogyny is. 

It is fear. 

Fear that a woman might outgrow you. Fear that a woman might be better than you.

Fear that a woman might realize she doesn’t need you. 

For example, the TARDIS (Doctor Who’s time travel box) is traditionally blue. Panetone 2955C, to be precise. Someone made it pink in a field somewhere in Scotland.

For one day.

The comments on the picture ran the gamut of disgusting, from looks like Pepto Bismol (I know this is an American), to ugh, to NOO!!!

From the men. 

Some of them hide behind fake accounts. Probably so the women in their lives don’t find out. Or they are just three kids dressed up as an adult to get into an R-rated movie. (Yes, this is a Loony Toon’s reference)

The Secret London post “Walking through central London with a bunch of gals (and one Ken) all dressed head to toe in pink, with women constantly yelling “Hi, Barbie!” at us was a joyful experience.” First comment? 

Surprised no one called the cops.

Yup, a man. 

Women who like things outside of our “traditional” roles of maiden, mother, crone are shat upon verbally every time we open our mouths. Or by words by typing on the keyboard. Or dare to like something they don’t

The well-actuallys.

The man-splaining The a woman can’t understand this (whatever this is that the man is gatekeeping). 

If we take offense at something a man said, they were just joking!

It’s not funny.

It is not funny to laugh at what we find enjoyable good. Sorry that you don’t, but that is what makes everyone different. The ability to like or not like based on personal preference.

America Ferrara said it best in character as Gloria, the woman whose Barbie it was. It is exhausting being a woman

Find the speech, read the speech, find a video of the speech.

I know there are some out there.

This is why.

It is okay that I like different things.

It is also okay that I like the same things.

As long as it is legal, I don’t care what other people like and enjoy.

Why can’t everyone do the same?

Not even a post-it, a subsection of my covid & things that want to kill humans board on my Pinterest “No shit, it’s still trying to kill us”

Just when you thought COVID-19 was gone, had convinced yourself it was gone, had lied to yourself that it was gone, it pops up like an undesired guest at a baptism.

Okay, fine, that was a small Maleficient joke.

But, yeah, covid is still trying to kill us.

It isn’t gone.

The masks are mostly gone, beat down by peer pressure.

I noticed that where there had been zero covid patients in the hospital for a few weeks, all of a sudden there were 3.

And then 6.

And then 9.

A friend of mine asked about the possibility of a covid booster shot, out of concern for their family members who are vulnerable. The fact that the school year is approaching and at the beginning of the last school year, there had been 60% call-outs for students within 2 weeks of the start of school.

In other news, the vaccine companies have nearly completed work on this fall’s vaccine. Apparently, it is to be ready in September. Pending FDA approval.

The news reports began reporting that there was apparently a summer surge of covid, for the fourth year in a row.

The real tell?

The seeming shortage of at-home covid tests. I know I got the last one at the local drugstore, which I bought after noticing that the ones I had expired.

Definitely ‘no shit! it’s still trying to kill us’ indeed.

Good luck convincing others that this is happening.

I’m sure they’d rather keep their heads down, and the masks off.

It is that time of year again.

When the school drives start.

School starts, depending on where you live, in the not-too-distant future.

People are hurting due to inflation. All the strides that have been made in the last forever are being erased, well, eroded by the lapping of inflation. Don’t forget shrinkflation as well. Don’t get me started on that.

It is the time to donate to those who cannot supply the goods necessary for school.

My trunk is full of notebooks, and paper, and pens, and binders, ready to be donated to the hospital’s school drive.

Do I have children?

No, we do not.

That doesn’t mean we can’t help out those who are struggling. It is one of the privileges of those who can donate. Helping out those who are struggling is its own reward.

Donate to the school drive.

Any school drive.

You may be enabling the next scientist on their way to making discoveries that will reshape our world.

Yes, the cookie jar is empty today.

I’m on vacation. Well, stay-cation.

Could I have made cookies?

Yep.

Did I make cookies?

Nope.

I decided to take a week off at the end of July to give my PTO balance a little breathing room.

Wouldn’t do to max out and stop accruing.

The max is coming faster these days since the hospital system started giving us with more than 15 years of longevity in the company a total of 12 hours of PTO a pay period.

I’ll do the math for you.

That is 312 hours per year. (I multiplied 12 hours of PTO earned by 26 pay periods in a year).

As I work 10-hour shifts, that is 31.2 days a year.

Am I grateful that I now earn 12 hours a pay period? Absolutely.

Does this create a bit of a boondoggle for me? It could.

Which is why I took this week off.

The second reason is that school is starting in 3 weeks and I will have my hands full then.

Relaxing week off at home it is.

Have I fielded a phone call from a surgeon who wanted to add on a case for the next day?

Yes, and happy to do it.

It would take more time to explain to them why I couldn’t help them than to call the evening charge nurse and tell them to call the surgeon.

It is a good thing that they reached out to me and not the nursing supervisor.

That is a habit I’ve been trying to break them out of.

I wrote a memo about it and everything.

I don’t think the memo got circulated.

I tried.

No cookies today.

I will pick it up next week when No Heat month commences.

Hi, yes, I work at a Magnet-awarded hospital.

My current hospital has Magnet designation for another 5 days.

Then we lose it.

Because they changed the rules that disallow markets of hospitals to share the load of the sources of evidence. This means that ALL hospitals have to stand alone with all of the needed documentation and sources of evidence.

Can it be done?

Sure.

With the system’s backing. Which, after covid, I am sure we don’t have.

Sure, there are lesser designations.

But I have been hearing rumblings, some from my own coworkers, that Magnet is a money shell game.

Magnet is supposed to stand for nursing excellence.

Do we give excellent care in the hospital where I work?

Yes, the shared governance group and I monitor that closely.

Monthly.

Does the hospital where I work hit all the benchmarks for keeping patients safe?

Yes, this is another thing the shared governance monitors.

I guess I have to amend my resume and take off Magnet designation for the hospital.

Or, can we be like Prince and say the Hospital Formerly Magnet Designated?

But then that would bring up awkward conversations. Did we fail to renew the Magnet designation?

I don’t think so.

More like the goalposts were moved.

I get to bask in the knowledge that the market was able to climb that hill, and do all the sources of evidence.

For five more days.

Something popped into my head after movie and a dinner last night. And it won’t leave.

I was bullied as a child and a teenager. Always the new kid, always the smart kid, always the kid with glasses. But mostly because I was always the smart kid. The one who took attention away from other students when I was engaging with the teachers, often way above the other students’ heads. My hand was always up first, I always had something to contribute to the discussion.

Did I care? Nope. I was going to show how smart I was and how capable I was, even then, in pigtails.

Others did not take kindly to that. I definitely was a target of the “mean girls”. Those girls who looked down on everyone else because they had something none of the rest had, popularity and relevance. Dating the handsome jock. Having a dedicated escort to homecoming.

You know the type.

Did they ask if I cared? No. They just assumed I was jealous of what they had.

Hardly.

But what popped into my head last night as I was reading, yet again, about the bombastic, unhinged group who call themselves the “moms for liberty”. Who spout awful things, and try to exhort influence over whoever they see as inferior. The fact that they were just labeled an extremist group by a civil right’s group. A female-centered off-shoot of the things that come out of right-wing politicians’ mouths, even against women.

Especially against women.

I see you, Tiffany.

The thought that popped into my head was that the moms for liberty group is just the mean girls grown up.

In high school, there were only a few popular kids who thought that everyone wanted to be like them, but they couldn’t because of some flaw that the mean girls decided they were against.

Sound familiar to the moms for liberty group?

They say to know and name your fear is one of the first steps to conquering it.

Was I concerned about moms for liberty before yesterday? I was concerned with the hate and vitriol coming out of their platform poisoning other moms and vulnerable people.

Am I afraid of them? They don’t have power over me. I’m married, to a man, and we have no children. What they are doing is concerning. Yes.

But I see you, Tiffany.

I see you, Regina.

I see you, Karen.

I think you are going to be found to be a group of ridicule.

After all, you’re just grown-up mean girls who are afraid that their looks are fading and losing their grip on the school.

Well, high school is over, we are grown up, and we don’t have to listen to you.