The Thirteen Days of the OR Christmas

Adapted from a Little OR picture book by the same name.

Once there was a snowy Christmas, cold and snowy, snowy and cold. Nothing would be better than staying home under the covers with a good book and a cup of tea. But, of course, the patients still made it to the hospital for their surgeries. J. Ashe, my charge nurse, assigned me to a different room each day. These are the my thirteen days of the OR Christmas.

Bah Humbug.

On the first day of Christmas, my charge nurse gave to me
a surgeon in a good mood.

(Dr. G. Mood declined to be pictured for this book or even named as he doesn’t want to ruin his reputation among the other surgeons)

On the second day of Christmas, my charge nurse gave to me
two shoulder scopes
and a surgeon in a good mood.

(get out the hip waders)

On the third day of Christmas, my charge nurse gave to me
three appys
two shoulder scopes
and a surgeon in a good mood.

(this is not looking good)

On the fourth day of Christmas, my charge nurse gave to me
four cataracts
three appys
two shoulder scopes
and a surgeon in a good mood.

(at least the eyes are quick)

On the fifth day of Christmas my charge nurse gave to me
FIVE C-Sections
four cataracts
three appys
two shoulder scopes
and a surgeon in a good mood.

(babies, hurray!)

On the sixth day of Christmas, my charge nurse gave to me
six bowel resections
FIVE C-Sections
four cataracts
three appys
two shoulder scopes
and a surgeon in a good mood.

(this is not trending well)

On the seventh day of Christmas, my charge nurse gave to me
seven hip revisions
6 bowel resections
FIVE C-Sections
4 cataracts
3 appys
two shoulder scopes
and a surgeon in a good mood.

(well, at least the surgeon is in a good mood)

On the eighth day of Christmas, my charge nurse gave to me
Eight Septoplasties
7 hip revisions
6 bowel resections
FIVE C-Sections
4 cataracts
3 appys
2 shoulder scopes
and a surgeon in a good mood.

(I must’ve been bad this year)

On the ninth day of Christmas, my charge nurse gave to me:
Nine bladder tumors
8 septoplasties
7 hip revisions
6 bowel resections
FIVE C-Sections
4 cataracts
3 appys
2 shoulder scopes
and a surgeon in a good mood.

(Santa, am I getting coal?)

On the tenth day of Christmas, my charge nurse gave to me:
ten fractured ankles
9 bladder tumors
8 septoplasties
7 hip revisions
6 bowel resections
FIVE C-Sections
4 cataracts
3 appys
2 shoulder scopes
and a surgeon in a good mood.

(Okay, who told Santa about that time at the holiday party?)

On the eleventh day of Christmas, my charge nurse gave to me:
Eleven breast reductions
10 fractured ankles
9 bladder tumors
8 septoplasties
7 hip revisions
6 bowel resections
FIVE C-sections
4 cataracts
3 appys
2 shoulder scopes
and a surgeon in a good mood.

(Or the time at the 4th of July picnic?)

On the twelfth day of Christmas, my charge nurse gave to me:
Twelve carpal tunnels
11 breast reductions
10 fractured ankles
9 bladder tumors
8 septoplasties
7 hip revisions
6 bowel resections
FIVE C-Sections
4 cataracts,        
3 appys
2 shoulder scopes
and a surgeon in a good mood.

(Make it stop!)

On the thirteenth day of Christmas, my charge nurse gave to me:
the day off. 

Yeah, right.

On the thirteenth day of Christmas, charge nurse Jack Ashe got from me:
my resignation
and a California birdie.

Tuesday Top of Mind 12/23/25- SC measles

Unless you’ve been living with your head in sand, or under the blankets, or under a rock, measles is running roughshod over Spartanburg, South Carolina.

Y’all, Spartanburg county is only 76 miles from the county I live in in North Carolina.

All the data has been gleaned from Department of Public Health South Carolina website.

As of the Friday Measles Update, there have been 9 new measles cases in upstate. This brings their total number for THIS outbreak to 144.

This just in (the website hasn’t been updated yet). The newest total that has been reported for this measles outbreak is 153 confirmed cases. This doesn’t count the 249 in

Some children are on their second round of 21 days of quarantine.

In this latest update of confirmed cases, 34 are children under the age of 5, 101 are 5-17 (so school-aged), and 12 are adults and older.

Measles is no joke. It is at the top of the contagious disease list.

The MMR vaccine, which contains the measles, is one of the safest and most reliable vaccines that is in the vaccination playbook. According to the CDC, the MMR vaccine is 97% effective. It remains one of the most effective vaccines for the MOST contagious disease that there is a vaccine for.

What is the disconnect? Never mind, forget I asked that.

The MMR is 2 doses for those over 1 years of age. There is also an MMRV vaccine that also covers chicken pox for children 1-12 years of age.

According to the DPH South Carolina website, there are no scheduled vaccination events in this county. But you can request a visit from the Mobile Health Unit for vaccination.

You know what is worse than the fear that is being mongered around vaccines? Listening to these monsters and deciding that you, as a parent, know best, disregarding the hundreds of years of experience that public health workers have, and not vaccinating your children or yourselves.

Worse than that is actually getting the disease with its risks of death and disability.

But what do I know, I’m just a nurse who cares deeply about other people and their children.

Perhaps I should write a parody about the 21 Days of the Measles Quarantine. That is a Christmas song I don’t want to write/parody.

Or do I? Stand by for that one.

Also your grandparents and your great-grandparents are rolling over in their graves at the thought that the vaccines that they would have killed for are being discounted by spoiled brats who think a social media influencer who just wants likes and clicks knows better than most of the public health nurses and doctors.

Maybe public health has been too effective.

FFS Friday 12/19/25- Flu increasing in NC, spreading like holiday music

This is your yearly December PSA. And a warning.

The best time to get your flu shot was 2 months ago in October.

The second best time to get your flu shot is today.

Come now, don’t tarry.

This is the warning part of the post.

If it seems that everyone is sick this holiday season, it is likely because they are.

The waste water monitoring data for North Carolina just increased. The NC level for the entire state is moderate. This is specific to flu A. But by the CDC map there are multiple areas of the state that are marked as very high and high levels of flu A in the wastewater.

This is well worn and timeless set of instructions.

Wash your hands.

Wear a mask

Cover your mouth when coughing.

Avoid crowded areas.

Avoid people who are actively coughing.

Drink your fluids.

Get plenty of rest.

And, for pete’s sake, get your flu vaccine!

If not, don’t come crying when you get the flu.

You are protecting not only yourself, but others in the community.

Just do it.

Cookie Thursday 12/18/25- 5 chips chocolate peanut clusters

The stove I ordered had to go back as it wasn’t the stove I thought I had ordered. I wanted dual fuel, gas on top, electric oven, and what was delivered was gas on top, gas oven.

I am not sure if you’ve ever baked with gas. Let’s just say it isn’t ideal.

Back to drawing board.

I picked out a new stove and they are supposed to keep the deliver/installation charge from the first stove.

Confused? Because the installation people are. I have a phone call in to them.

Guess what? The holidays are mucking up the timing.

New stove #2 will be delivered to my house on the Saturday after Christmas. It would be ideal if I could get the installation worked out before the end of the year.

Don’t worry, I will be calling them back.

So no new stove to try out for the last Cookie Thursday is a Thing of 2025. Instead I will hopefully be ringing in 2026 with a new oven.

Fingers crossed.

I mean, the airfryer is an airfryer/toaster oven combination so I am not totally in the weeds.

But still.

This left me cookieless on the last CTIAT of the year.

I pulled out a recipe that I’ve been wanting to do for No-Heat August for literal years.

It is 5 bags of chocolate chips, 2 containers of peanuts.

In hindsight, it makes entirely too much candy.

Like way too much.

Like who at the hospital can I give the excess to too much.

If I make this again, I will halve the recipe and use half bags of chips and 1 container of peanuts.

It is a good empty out the baking pantry recipe though.

The 5 bags were

  1. caramel chips
  2. semi-sweet chocolate chips
  3. white chocolate chips
  4. butterscotch chips
  5. milk chocolate chips.

I used the crockpot to melt the chips, added the peanuts, heated it some more and used my cookie scoop to portion out the candy. And portion out the candy. And portion out the candy.

I placed the candy scoops as close as I could on 3 parchment paper lined cookie sheets and I still ended up with 3 full to the bursting sheets of 5 chip peanut clusters.

Did I mention it was a lot?

I took an entirely full cookie containment device to the hospital. And portioned out 2 full smaller containers for the other at the 0700 meeting.

I still have an entirely full sheet of peanut candy.

I will be handing these out to other units.

But I really should’ve realized I was in trouble when the chips and the peanuts filled up my entire crockpot.

Call Secrets of the OR- Call shift is great until something wakes you up

I still call my job the coolest shift I’ve ever had.

There are a LOT of positives. And I’ve written about them. As well as some instructions on how to deal with them. And how to sleep on call.

Now let’s talk negatives.

The first negative is that you now have a hair trigger sleep habit. Because when the call comes, you have to be awake, dressed, and at the hospital within 30 minutes.

I live stupid close to the hospital (less than 3 miles) and it still sometimes takes me 20 minutes to get there.

Because of this hair trigger sleep habit you are especially aware of every little noise the pager or your phone makes. Because it might be a case. Or it might be a pager in need of a battery.

Or it might be a stupid political text at 0400 (four in the morning).

Or it might be the university that is 90 miles away that you are attending virtually anyway with a new announcement regarding the snow day. Or the hurricane. Or once, memorably, a car fire in the parking garage.

Or it might be a text alerting you that the delivery drivers/installers will be there sometime in the next 12 hours with whatever you ordered.

Ask me how I know…

Or it might be your brain going off. For no apparent reason except to get you of bed at 0300.

Regardless of the time the hair trigger has been pulled. You are now awake and there will be no more sleep tonight.

You could toss and turn and read on the Kindle and check your email. Or try all the myriad of things that past insomniac you used to do to get to sleep. I mean counting sheep is an option. So is sleep hypnosis. I use repetition of one particular number, just that number, until I am asleep.

But you know that it is useless and your brain is now engaged and awake.

So you get out of bed.

This makes the cat happy.

You brush your teeth and get dressed to start the day.

Who cares that the sun isn’t even up?

There’s a new crossword puzzle to do and emails to catch up on and a cat to feed and a sunrise to watch.

Don’t worry, there will be a nap in your future.

I hope that for you.

Now this negative doesn’t happen every night. No.

It is just often enough to be obnoxious.

I still wouldn’t change a thing and this remains the coolest shift I’ve ever done.

School Me Saturday 12/13/25- Winter-freaking finally-break!

I know this semester has been, well, odd.

Hell this entire year has been odder.

So many changes on the federal level, including new intrusive FAFSA questions.

Including the grinch swiping away what little student loan relief that the Biden administration was allowed to do by the courts.

I mean, we all know who the grinch is, right?

Put that aside.

Things will still be bat-shit-crazy in the new year and the new semester.

Take a deep breath now, and count the good things.

Finals are done and your grades most likely in by your instructors.

Winter graduations and hoodings for graduate students have occurred. Including two of my cohort. Congratulations, guys, well done.

I’m not jealous at all. No, really I’m not. This is a process and I am just not as far along as them.

It is too early to plan for Spring Semester.

Christmas is over 10 days away.

Now is the time to breathe. And maybe nap. In fact, I hope your sleep is as good as Dot’s on her warming pad and window perch.

My winter hope for you is that you rest well over Winter Break.

Think about school only if you want to but don’t obsess about it.

Read that book you’ve been meaning to get to.

Watch that hot new movie in the theater before it is pulled.

As an aside, Hamnet was one of the best movies I’ve ever seen.

Watch that television show that you’ve been saving up for the end of the semester.

Wrap your presents (if you do them), ready your travel plans (if you are going anywhere), but be safe.

The crazy things will be there after the first of the year.

Take this time to re-center yourself and remember who you are and why you are on this journey.

And have a happy, safe, and restful holidays.

Spring Semester is just a breath away.

FFS Friday- FDA, blink twice if you are in trouble

Actually, don’t bother blinking.

We in healthcare KNOW that you are in trouble. As you have a bad case of the know nothings in charge of you and your vaccines and your medications.

Some of the Senators could have helped you out but they were too busy bending the knee to a wannabe fascist who is hell bent on wringing all the money they can out of their shitty decisions and actions.

You see, they are in their villain phase.

Where the only thing that matters is the green.

Of course, I write of money, moola, dough, loot, and bucks.

They are too busy stealing from us that they think that making us sick by not extending Affordable Care Act credits for those who need help with the astronomically skyrocketing costs of insurance, shields what they are doing by providing cover fire.

Forget bread and circuses, this administration is about social media lies and villainy.

Why? Because to be the lowest level they can be feels GOOD. To them at least. I would have sent myself to bed without dinner if I acted like they do. Lives are not their playthings. Did no one teach them manners as children? Or even ever told them no?

Today’s latest bullshit is a waving of a “possible” black box warning on the covid vaccine.

Yeah, that one.

The one that has saved millions and millions and millions of lives.

Worldwide.

This black box warning will be slapped on the life saving, lung saving, world saving vaccine by the end of the year, according to reports from CNBC and Reuters and CNN and other news sites.

I think this is a distraction. Of course all the news is covering it.

Of course all the healthcare workers, MDs, RNs, LPNs, CNAs, PAs, and the like are decrying it.

If true, this is big black coal letters the size of Mt. Everest BAD.

This kind of bullshit pulls the wool over the eyes of the people who don’t know any better.

And makes them doubt ALL the vaccines.

Makes them doubt healthcare.

Makes them doubt medicine.

Takes us back to when we were smashing rocks against other rocks and against each other.

I am not sure of their endgame, besides confusion, and lining their own pockets and those of their billionaire handlers.

Or are they spoiled brats who are gleefully pulling the stuffing out of America?

After all, weakening us makes us prey.

Well, I don’t feel like acting like prey. Wanna see my teeth?

We tried to warn you but you didn’t listen.

Cookie Thursday 12/11/25- Triple mint chip cookies

So my oven must’ve heard us talking about replacing it. Because this was the worst performance by my oven in the nearly 12 years I’ve done Cookie Thursday is a Thing.

Each batch as they came out of the oven, was a bit different. Even with the same parameters of temperature, dough, and time.

The first batch was too done and so has not been included in the hospital’s box.

The next batch was crispy on the edges but the centers were cooked but not brown.

The next batch was perfect.

The last batch was back to crispy on the edges and the centers cooked but not brown.

I think my oven is trying to tell me something.

Three of the five burners do not work.

The top oven bleeds heat.

The bottom oven is rarely used an still functional.

I am saddened because this is the best stove I’ve ever had.

I get it, its tired. There have been thousands of cookies and hundreds of meals over its 20 year life.

It is time.

This is the last Cookie Thursday is a Thing that it will ever have to do.

I used the three half bags of mint in this week’s cookies.

Bailey’s Irish cream chips, Andes Mints chips, and peppermint bark chips.

They taste very good. Minty and crispy and chewy.

All at the same time.

Call secrets of the OR- Advocacy

The gown card that sparked this post is “you are the patient’s advocate. Yes, even in the middle of the night.”

Oooh, return of the gown card.

I wrote myself this gown card in the middle of a difficult middle of the night case.

The surgeon had been pushing to get the patient on the table, had been pushing to go home, had been pushing to start the next case.

It doesn’t matter why they were pushing, just that they were pushing you as the circulator to do something you weren’t okay with.

It is important to listen to your gut.

After all the patient can’t speak for themselves.

The family can’t speak for themselves or the patient.

It is up to you to speak for the patient.

Yes, even in the middle of the night when the surgeon is huffing and puffing and threatening.

Be like the Little Pig in the Brick House of Three Little Pig fame and stand firm.

You know what can and cannot be done. You know all the steps to make a surgery safe for the patient.

Know that you know and speak up for them.

They would do it for you, if they knew.

Tuesday Top of Mind 12/9/25- Empty stools in empty lab rooms

With apologies to Claude-Michel Schonberg, Herbert Kretzmer, and Cameron Mackintosh and the original singers of this adapted song.

I speak of course of Les Misérables.

All of the albums, the 1985 cast album, The 10th anniversary Dreamcast, and the 2012 movie soundtrack, have been on near repeat in my head and in my speakers since the first No Kings protests. I’ve written about it before but something about the failed revolution speaks to me in these WTF times.

My favorite song has always been Empty Chairs at Empty Tables when the survivor of the barricade, Marius, sings to the phantoms of his friends. It is hard to be a survivor of atrocities. I imagine it is harder yet to be among the survivors desperately trying to salvage what they can at the CDC. Because of the grant pulling and the firings and the August 20, 2025 attack on the CDC itself where a police officer died.

I was driving home from baking Christmas cookies with my mom when I started humming this song. I started changing the lyrics right then. I tried to stay true to the original cadence of the song and I changed some words.

Empty Stools in Empty Lab Rooms
There’s a rage that can’t be spoken
There’s a fear goes on and on
Empty stools in empty lab rooms
Now my friends are fired and gone

Here they talked of exploration
Of possibilities
Here they talked about diagnoses
And the diagnoses never came

From the laboratory in the hallway
They could see a germ defeated
And they rose crying Eureka
And I can see them now
The very science that they had worked
In the lonely lab at dawn

Oh, my friends, my friends, forgive me
That I work and you are gone
There’s a rage that can’t be spoken
There’s a fear that goes on and on

The lonely faces on the screen
Phantom shadows on the Zoom
Empty stools in empty lab rooms
Where my friends will work no more

Oh, my friends, my friends, forgive me
That I work and you are gone
There’s a rage that can’t be spoken
There’s a fear that goes on and on

What scientific advances won’t be made? What cancers will grow out of control because there is no one to stop them?

How people have to die because this is happening?