25- This just in, a nursing degree (any kind) is not a professional degree

This is more of a Tuesday Top of Mind topic but the intersections with education cannot be ignored.

In a slap in the face heard around the country, the Department of Education dropped guidance that a list of degrees would no longer be considered professional. Do you know how many nurses, registered or not, working in healthcare or not, are in the United States?

4.7 MILLION, according to the American Association of the Colleges of Nursing.

Yeah, you done fucked up and insulted 4.7 million people.

The so called professional degrees that were listed

medicine
pharmacy
dentistry
optometry
podiatry
law
veterinary medicine
osteopathic medicin
clinical psychology

The so called non-professional degrees that were listed

NURSING
physicians assistants
physical therapists
social worker
speech therapy
architects
accountants
educators

I first read about this on Wednesday and the everyone else had read about it and were giving their reactions. I held onto my reactions until today. They are in three sections.

The first is that this downgrade means that there is less money for all of these professions to go to graduate school. The “professional” degrees (see above) can borrow up to $50,000 per year, with a cap of $200,000. The “non-professional” degrees (see above) are limited to $25,000 per year, with a cap of $65,000. Massive difference, right?

They do know there is a nursing shortage, right? And the shortage is exacerbated by the severe shortage of MSN and PhD prepared nurses to serve as nursing school instructors. I fear this would only deepen this shortage.

It’s like only rich people can obtain graduate degrees. I mean people have the option go into crippling private loan debt. Things to consider. I would not recommend private loans for school. I know too many nurses who have been destroyed by them.

The second is that the “non-professional” degrees are, with the exception of the architect, mandated reporters. Being a mandated reporter means that the social workers, the health-care professionals (including nursing, duh), the teachers, the child care providers, and law enforcement are mandates, by law, to report child abuse or neglect. This definition comes from the childwelfare.gov.

I know that most people love their children and would never abuse them, but there are always those that will. And, as a mandated reporter, I have to report it. This is to save children’s lives.

The third section is that the “non-professional” degree workers are mostly women. And those in power love nothing more than to treat women as less than. This has been happening more and more in the last few years.

If women can’t get loans to go to school and the cost is prohibitive, I guess they will have to stay home and have ALL THE BABIES. Even though nurse practitioners and physician assistants make up the bulk of the rural healthcare that is available. According to an interview I saw with Dr. Jennifer Mensik Kennedy, the president of the American Nurses Association (ANA), if there were no NPs or PAs a patient in need of care would have to drive 90 miles for care. Each way.

I am not less than. I am a professional working registered nurse. I am not a doctor or surgeon’s handmaiden.

Ew.

In 5 years we’ve gone from hero at the bedside during covid to non-professional.

I have called or written my representatives and the ANA has an online petition at RNaction.org. You better believe I signed that as soon as I heard about this travesty.

It’s like they want women in the home, having babies, and to cripple higher education. If only we were warned (this is heavy sarcasm)! Oh, wait, we were. This is all in Project 2025.

In simpler terms, to keep women dumb and in the homes so they can have all the babies. After which I guess we die?

Nice try and fuck all the way off!

FFS Friday 11/21/25- Fidelity

As I am sure you are aware, a group of 6 Democratic lawmakers, both Senators and Representatives alike, released a video on Tuesday (November 18, 2025) advising military and intelligence communities to defy illegal orders they are given. 2 Senators and 4 Representatives made up the group. All of them had served either in the military or in intelligence work. There were 2 Navy (Senator Mark Kelly, Representative Chris Deluzio), 1 Air Force (Representative Chrissy Houlahan), 1 Army Ranger (Congressman Jason Crow), and 2 intelligence officers (Senator Elissa Slotkin, CIA, Congresswomen Maggie Goodlander).

The message is brief and stark. It is a reminder to the intelligence officers and military members of all services that their first duty is to the American citizens, not the current president.

Illegal orders must be disobeyed.

Their fidelity is owed to the constitution, not the current administration. Not the current Secretary of Defense, now named the SECRETARY OF WAR.

The CONSTITUTION that they have all sworn to uphold.

Not the self styled monarch that is drenching OUR house, the White House, in tacky spray painted shit.

Not the foreign leaders that hold their leashes.

Not the billionaires who bought the election for them. Because their loyalty is not to the Constitution.

The current members of the military and intelligence community owe their loyalty to the CONSTITUTION.

Their fidelity.

As the Marine Corps saying goes “Semper Fidelis”.

Always Faithful to the ideals of America, not the wanna be strong man ruler and his cronies.

The fight will be hard. Hell, it already has been hard. I cannot imagine the pressure that all current members of these institutions are facing.

I’ve written about the Officer Oath that I took at 19 to the Air Force.

I did not swear to Bill Clinton, who was the president at the time. I swore to uphold the Constitution. Against all enemies, foreign and domestic.

And neither did the current and past members of the military and intelligence community. Including the 6 that gave this powerful and timely message.

The current occupant of 1600 Pennsylvania Avenue reacted, of course. Badly, like they always do. Like the big blowhard they are. And of course he reacted with the threat of treason. And death threats. Because that is the only play that they know.

His current press secretary came out with “All the president’s orders are legal.” Excuse me? The fuck they are.

And of course the members of the “right wing” media reacted as if they’d been scalded. Instead of sitting and thinking what the message of the 6 truly was.

Get the military off American streets. Stop threatening United States Citizens. Remember your oath to the Constitution.

And, for the love of America, put that back in your pants before you hurt yourself!

Cookie Thursday 11/20/2025- Pecan pie bark

Yes, another bark.

But this one went better.

Except…

I had purchased graham crackers that were going to serve as the base under the praline mixture. Like Christmas crack, minus the chocolate, plus toasted pecans.

But when I went to make the candy, the graham crackers were NO WHERE to be found. And I mean no where. It doesn’t help that the house is in an upheaval with the dining room light switches being intermittent. Of course, I trouble shot to the best of my ability. It wasn’t the bulbs. I had to empty out the dining room, which was on my list for the week, because we are hosting Thanksgiving next week. The night before the electrician was coming I thought that it might be the original light fixture itself and, wanting no delays in getting the light fixed, I purchased one the day they were coming.

As an aside, when the electrician was here he tried the light switch. And it WORKED! Way to make the electrician think I am crazy, house. The plot thickens after he pulled off the switch plate and found that it was badly put in. Of course it was. When I say that this house was badly made, I mean it.

Back to the candy.

The graham crackers were missing. Strum and Drang, indeed. This is in reference to the late mid 18 century when a romantic period in German literature happened. This period exalted nature and feeling and can be translated to storm and stress. I think of it like being dramatic for dramatics sake.

It was quite the hullaballoo when I couldn’t find the graham crackers. Well, I wasn’t about to drive to the store to purchase more. That is its own trek with the construction going on the only street out of our development.

What did I do?

Like any operating room nurse worth her salt, I made do.

I used Ritz crackers as the base of the praline.

Because Ritz crackers are not unlike well made pie pastry.

I made the praline and poured it over the crackers and baked it as directed for 10 minutes.

And what do you think I found after I pulled the candy out of the oven and placed it to cool? The graham crackers. Safe where I had put them.

Of course.

Call Secrets of the OR- The call team takes all comers

This is a reminder that the OR call team takes all cases.

All surgery types.

All surgeons.

All service lines.

We do it all.

But more than that.

We, the call team, take all the patients who require our help in the middle of the night.

Regardless of sex.

Regardless of circumstance.

Regardless of immigration status.

Regardless of age.

Regardless of what surgery is needed.

Regardless of how much money/clout they think they have.

Regardless of how little money/clout they think they have.

Regardless if the hospital leadership considers them a VIP. I hate to break it to the leaders, all are treated as if they are a VIP.

We take it all.

And we don’t care what other people think about that.

Because it is not the deniers who need to be on the OR table.

It is the patient in need.

You get my meaning

I hope.

Tuesday Top of Mind 11/18/25- Robin getting slapped by Batman for saying he needs antibiotics for a cold

Less than a century ago, common illnesses such as appendicitis or pneumonia, or even extremity abscesses were often lethal. That means the infection, that there was no way of stopping, killed the patient.

It was in 1928 that the miracle of the petri dish occurred. Well, some say miracle, I call sloppy lab control. The petri dishes weren’t cleaned before Dr. Alexander Fleming went on vacation. He got back to his lab and the dirty petri dishes to find the newly grown mold that had developed was keeping the bacteria from growing.

Penicillin enters the chat.

But penicillin would worked on many different bacteria. Today we call it broad spectrum.

Then they called it amazing. And wondered what other antibiotics could be found and developed. Sulfa medications soon followed. And then resistances to the antibiotics started appearing.

Really the march to where we are now is fascinating.

There is a really good article. “Antibiotics: past, present and future” by Matthew Hutchings, Andrew Truman, and Barrie Wilkinson. It has good graphs, tables, and illustrations. But it points out the present we are living in and the future we should all fear.

The present that we are all living in is the rise of antimicrobial resistance (AMR).

This is when the causative agents of the infections are no longer susceptible to the antibiotics used to treat them. This means that the drugs no longer work for that infection.

I am not kidding when I call that the scourge of the modern age.

Because when the antibiotics we have are not the right antibiotic to treat an infection we might as well be back where we were 100 years ago. Shit out of luck (SOL).

And dying from appendicitis.

But how did we get here?

From the free and loose prescribing of antibiotics for nearly 100 years.

I have a cold, try these antibiotics. They aren’t the medication for viruses, but hey, it might help.

I feel better, I think I will stop these antibiotics. Yeah, I’ve only taken them for 3 days and it is a 7 day course but I feel better now.

A new friend from another place, let me shake your hand and give you what I might have and pick up what you might have. From the casual contact.

Oh, is that a rescue animal. Can I pet it?

Germs are like people, they want to live. And to do so they mutate and learn to overcome the antibiotics. Worse, yet, they have the ability to learn from other germs that are nearby. Germ A learns to be resistant to antibiotic a because germ B taught it to be so.

It is a huge problem.

This week is Antibiotic Awareness Week, November 18-24. It is meant to raise awareness of appropriate antibiotic and antifungal use. (not for colds, jan!)

Because we are rapidly approaching the cliff where none of the antibiotics will work and limited new antibiotics in the pipeline.

Your mission:

Try rest and fluids for illness first, especially a cold
always finish the course of antibiotics
do not ask for antibiotics for a cold. The reason you feel better is the placebo effect
when your child needs antibiotics for a cold don’t give your leftover ones from last year
listen to the medical professionals about antibiotics

Governments and scientists are working on it. They were slow to wake up to it, and slow to get going, but everyone is aware that this is a problem.

And hope really hard that it is not too late.

FFS Friday 11/14/25- Frilly, ice is coming to town and all I can think about is sparkling ice capades costumes

The F word for the day is frilly.

As in rebranding immigration and customs enforcement as the ICE CAPADES!

Picture it. Loads of government goons, festooned in frilly ice (frozen water) dancing costumes.

This may be the rebrand that the department is needing. I mean, you can’t fear what you are laughing at.

The newest blue city to come under the frosty gaze of ice (do you see what I did there?) is Charlotte. This isn’t my city but I live nearby.

Why are they coming? No one knows.

There was the killing of an immigrant on the train by a under medicated and under watched individual with mental problems. But that was in August, practically last year in the fast pace of news.

According to the Charlotte-Mecklenburg Police Department, in the third quarter violent crimes were down 20%. A violent crime is defined as homicide, robbery, rape, and aggravated assault. In fact, since January, overall crime has decreased 8%.

Kind of like Chicago. Who had a 28% drop in violent crime. BEFORE ice came calling. This is according to a mayoral report.

So, what gives?

Charlotte is blue.

And the administration DOES NOT LIKE THAT.

I mean, they can try to actually help the average American with a net worth under 1 billion. But where is the fun in that?

It is much easier to rule with fear. This dovetails nicely in the Authoritarian plans.

What if we laugh instead?

Kind of deflating, isn’t it?

For them, I mean.

I will continue to consider this ice incursion into our blue city as the latest stop on their nationwide ice capades tour.

Think of the frilly costumes.

And resist.

On a more practical note, preparation is key.

Make sure your phone is fully charged. The better to take their pictures with or to stream video with.

My husband has reported that several of his coworkers will be working from home because of the color of their skin. Which led him to wonder if he should do the same. No matter that his mother’s family has been here for 200 years. The family originally came from Spain but, according to ice, they are the wrong color.

For the undocumented persons in Charlotte, it has been advised by a lawyer to carry all documentation of time in country, rent and utilities information, taxes (anything that has your name and address on it), green card application, signed G-28 form from your attorney, your attorney’s information, work permit if applicable, any sort of status such as DACA, and asylum proof.

Remain silent immediately upon detention. And copy the packet to the cloud.

Stay calm.

But also picture them in a frilly ice dancing dress.

If only for the smile it gives you. On the inside.

Think of the frilly costumes. Especially the sparkles.

Cookie Thursday 11/13/25- Caramel apple bark

You can stick just about anything in chocolate and call it a bark.

This one is chocolate, caramel, pretzel, and granny smith apple.

And it’s a bark!

Okay, I wrote that part last night and today I attempted said “bark”.

Remember when I said that this would be a bark? Yeah, no. The pretzels, although freshly purchased and freshly opened, were stale. Ick.

And the freshly cut apples were too juicy for the chocolate to set properly.

And the caramel, that went on the freshly cut apples, did not stick to the apples.

A mess really.

Won’t be doing that again and really calls into consideration next week’s planned bark. I may have to reconsider.

This is the second week of the Fall theme of November. Uninspired, I know. But there are only THREE CTIATs that count in November. The 4th is Thanksgiving and I will be delivering no cookies to the hospital on Thanksgiving. Sorry, folks on call.

I will make it up to them with the December theme, though.

Also tragedy struck my Pinterest account.

It was deleted. On purpose by the company. Despite my appeals.

Apparently I am too political. Funny other people can post wildly political things in the opposite direction. It was getting too corporatey there anyway.

I would have continued to save political stuff. Sorry, not sorry. I will continue to save political stuff, just not there.

But with it goes all 3200 CTIAT recipes I had saved. Some for future themes, some were favorites, some just looked cool.

That’s okay, I have a hell of a memory and can reconstruct most of it.

Because Pinterest is just a storage vault. And I was expecting something like this for awhile now.

I had been cross-saving some very special looking recipes to another type of vault.

Again, sorry, not sorry.

This won’t slow me down at all!

Probably not as they intended but oh well.

Good thing I have at least 20 cookie specific cookbooks I’ve been saving for a rainy day.

This also gives me permission to be more organized with my saving. CTIAT was organized and I had about 50 different subsections.

But I remember all the subsections and will use them to build CTIAT recipe repository 2.0.

I will rebuild, I have the technology and I can make it multi-level. I can make it better than it was.

Better, stronger faster.

The first bionic CTIAT repository.

Bonus points if you know where that is from.

And a gold star.

Peri-operative nurse’s week

But, but, mister, what does a peri-operative nurse do.

Well, I’m glad you asked that, Billy. Well, you see I don’t rightly know. When I went in for surgery there was a nurse and a tech and the doctor and anesthesia in the operating room. But there was another nurse before who helped me get ready and yet another nurse when I woke up. But hell if I know what they all do.

No one knows.

And we like it that way.

All jokes aside, a quick google search revealed conflicting answers.

To the Mayo Clinic, the peri-operative nurse works with patients prior to surgery, to complete paperwork, to help answer any questions and to calm the fears of patients.

To the National Institutes of Health, the key responsibility of the peri-operative nurse is to maintain a sterile environment for the patient and the surgical team. Before, during and after surgery.

To Johnson and Johnson the peri-operative nurse provides care and guidance to patients during their surgical journey by doing pre and post op assessments, managing post op pain and side effects, but they also have a specialized role in the intra-op phase.

See, clear as mud. And contradictory.

All of these examples are correct but they don’t tell the whole story.

I often tell patients that the circulator, one of the type of peri-operative nurses, is the wall that functions to protect the patient from everyone else. The surgeon, anesthesia, reps, disease causing germs… everyone and everything.

Yes, we do do it all.

And smile while doing it.

We’ll be there, by your side, every step of the operative journey.

It’s what we do.

Tuesday Top of Mind 11/11/25-Raise a glass to a veteran

It is Veteran’s Day in the United States.

Not Victory Day for World War I as a certain recent occupant of the White House wanted to rename it.

It is not just a day for World War 1.

It is not just a day for World War II.

It is not just a day for the Korean War.

It is not just a day for Vietnam.

It is not just a day for Operation Desert Storm.

It is not just a day for any American’s who served in the military.

It is not just a day for any I hope this is the pathway to American citizenship for those who have served as non-citizens of the U.S.

It is not just a day for any non-citizens who died or bled for the U.S.

It is the day for to remember their sacrifices, both in terms of youth and blood and sanity.

But also to remember the debt we owe ALL of them.

I continue to have conflicted feelings of whether or not I am a veteran. I certainly don’t feel like it. I was certainly ready to sacrifice for my country. I certainly recited the officer’s oath and I learned for 2 years as an ROTC cadet.

But that is me.

And there are a lot of former and current service members who are not getting the care they deserve for their sacrifice. No matter how small.

Raise a glass, sponsor a dinner for a veteran’s association, wear a remembrance poppy, thank a veteran.

Hell, do all of it.

Just remember what they gave and what we took from them.

And don’t let anyone take anything else from them.

Like their healthcare.

Like needed support because we threw them to the dogs and didn’t bother to care for them properly when they limped home.

School Me Saturday 11/8/25- Et tu, Cornell?

In another of “This is a real nice university, shame if something happened to it” shakedown of the flagship universities of the United States, Cornell has caved.

Remember, the government has been withholding research and other monies from the universities that it has singled out.

This is separate from the 8 universities there were asked to sign the pledge.

And it only cost Cornell $60,000,000 to restart the spigot of $250,000,000 in federal funding. $30,000,000 to be paid directly to the government with another $30,000,000 to be invested in U.S. Agricultural research.

Of course, the government says that this is in response to phantom antisemitic Title VI violations that they have not been found in violation of.

This makes me so angry.

Both that the university rolled over and showed it soft underbelly to the government for pennies. And that the university caved at all.

But don’t worry, in agreeing to this bullshit deal, Cornell is admitting to no wrong doing.

Except selling out which puts pressure on all the other universities to do the same thing.

All so that government and the Department of Education can use them as an example of “doing the right thing”.

Yeah, more like doing what the bullies tell you to do so the floggings and beatings stop.

They should be ashamed.

I would say that the government should be ashamed of running this shitshow but I imagine the opposite is true and they are proud of making the universities submit to the boot on their neck.

Shame on them for running the government like a 2 bit protection racket.