I imagine these posts are pretty boring. I will continue them once a month as a grand wrap up of my progress toward PhD.

Yesterday, my husband finally asked the why question. To be fair I was asking this myself. What will a PhD do for me in my current job, healthcare system? Not much is the answer. All the degrees I’ve gotten have been a defensive move toward not being able to function as an OR nurse anymore.

He was surprised by the I want to write textbooks answer. I mean, have you met me?

Class does not start in September like I thought. The school year starts August 9. The reason I know this is I looked it up as part of the research assistant grant follow up. I was chosen. This means I am indebted to 10 hours of work for a professor per week. I hope the call job continues to enable me to say yes. I have to give them an answer by the end of week.

Being a research assistant will look good on my resume. It will also enable me to teach some classes, I think, and grade. I get to finally use my MSN in a constructive manner.

But what about the great white whale of a trip? For London. If school starts this is gonna be awkward? The short answer is that yes we are still going. I immediately emailed my advisor when I realized. She said I would be fine for the first in-person day of class. It is my online elective that I have not yet chosen or signed up for. I will have access in London, and I can make-up my first day of class. It will make a hell of a story to tell my classmates.

Even with the $10k stipend, I am still applying to scholarships like mad. I joined a clearinghouse of sorts, with my professional email address. I have not gotten any, but it has only been 2 days since I started applying there. I also am applying to all the other usual suspects: AORN, NCNA, the company that credentials my CNOR, the American Nurse’s Association. I imagine I will have to also do the FAFSA.

I am also in the process of upgrading my clothes for this new reality. Many of my clothes are tired after working on my body during the pandemic. Many of my clothes are not appropriate or professional. My husband is thrilled.

I did order a professional type bag off of Kickstarter. The pandemic weighing on shipping and manufacturing I have not yet received it. Maybe by school start. I know that the boxes of bags has left the port and is on their way because I get frequent updates.

I hope the progress in May will be the completion of two more rooms in the house. I would say 3 but I am stuck for progress. I would rather read, especially since part of the letter was a book suggestion before school even starts. I am waiting on availability at the library.

I had ever intention of making these myself. I had the coconut, I always have the flour, I always have the sweetened condensed milk, and I always have the flavorings. I even got up early to make the macaroons.

But real life intervened. As it so often does.

My husband fell down the steps last year. He did not seek out help from an orthopedist surgeon, despite me telling him to, for several months. Preferring to complain about it to me instead. He was diagnosed with a frozen shoulder in December, after FINALLY seeking care. An MRI on last year’s deductible, thank you, later and surgery was not indicated. Thankful for that. Physical therapy was.

The thing about shoulders is you have to be diligent about stretches, regardless of surgery. Spoiler alert, he was not. He is a grown man and I cannot, will not ‘make’ him do things. He was diligent about going to physical therapy though. But he was unhappy about his progress. Because he did not do his daily stretches. He wanted a quick fix, and there is nothing quick about rehabbing a shoulder. I know, I’ve had shoulder surgery twice, plus a rotator cuff strain from a car accident. There is no shirking your stretches.

Compounding this he fell after making fun of me when I tripped in New Orleans. And he fell hard. And declined x-rays at the hospital that I offered. He finally went back to the orthopedist after three weeks. And was diagnosed with a non-displaced hairline fracture of the proximal ulna. Which is already healing. That’s good.

His physical therapist told him of a new treatment for frozen shoulder. One that involved breaking the scar capsule after local injection, and lubricating the joint with steroid. They do this through a saline injection that will ‘pop’ the frozen shoulder capsule and stretches. All of this is done at the doctor’s office. He was told he could drive home today from his appointment. Traffic being what it is around here this is a 45 minute drive, at minimum. The appointment was carefully made to coincide with his Thursday physical therapy appointment.

I did not think driving himself would be useful or safe. I used my baking time to take him to both appointments.

I was browsing at the grocery store near the office. This is a new one on me, one that I had heard of. I saw they had bite-size coconut macaroons on offer. I grabbed two boxes and bought them.

This kind of goes against the home-made portion of Cookie Thursday is a Thing.

But it allowed me to be present and available for my husband today.

And it afforded me a nap when I got home from these errands because I had dropped off the bought cookies earlier at the hospital. I left them in keeping with my manager.

It will have to do.

During our 10 hour drive back from AORN in New Orleans, I started thinking about what the pandemic has stolen from all of us. Now that it is waning, and deaths are going down, although it is to be determined regarding hospitalizations.

The biggest thing that the pandemic has stolen from us is time. This is multi-layered because time itself has different meanings. I read an article this week about how the pandemic has skewed our sense of time. I feel this acutely. Two summers have come and gone and we are looking at our third summer under covid. I would have thought you lying if you said we would be here now. Two Christmases, two birthdays; the list is unending.

The following is a list of what the pandemic stole from me, personally. Everyone else’s list is different, but we should still be able to grieve over it.

1. MSN graduation in 2020. I was looking forward to this, it is why I chose a hyperlocal school. And I did not get to do any of it. The only graduation I went to was for my ADN, way back in 2001.
2. In-person work with my preceptor. In person education experiences had been cancelled. I was not allowed to teach for the end of MSN project. I had to finish the rest of 150 hours as a student online doing education. Not teaching, learning. And my preceptor left the organization during the last two years and I don’t know why or where she went.
3. Many, many hours of sleep. Again, this is not solely about me. I know that many people lost sleep during the very beginning of the pandemic due to fear.
4. There was a Sherlock Holmes traveling museum in South Carolina. I had tickets and plans to go. In March of 2020. No idea if this is still a thing, or even where it has landed.
5. There was a Sherlock Holmes convention in London. This was the original planned trip to London. It was going to be great to meet other fans. This was going to be in September 2020.
6. There was a Sherlock Holmes convention in Pennsylvania. This was a consolation prize because I could not get to the other two. Surely, the acute case of the pandemic would be over. No. This was going to be in November of 2020.
7. Poster presentation in March of 2020 and again in August of 2021 for AORN. These were different posters and although there was a poster portion of the online conference it is not the same.
8. I was going to take a year off and continue to pursue my PhD. This was going to be in September of 2021. As my husband says, the pandemic year did not count.
9. To finish my PhD by age 50, I had to start when I was 46. All of a sudden I will be 47 at the beginning of this program. I will probably be 51. I will be 51 regardless, but it is still a goal I had set in my brain.
10. In 2020, I was the chair of the professional nurse council for my organization. I was chair during 2020 but over Zoom, does this count? I didn’t have to travel to a far away hospital to be chair, that’s a win right?
11. Peace of mind regarding the leadership changes they rammed through. All of a sudden any autonomy I had was gone until 1700. And how is that working out for you?
12. My goal has always been to write. I was going to take the year off from school to polish up my fiction writing. And start sending query letters out. Instead, I worked insane hours at the hospital and training to do med-surg nursing so I could offer up hours to people who did not have a lot of hours because the elective cases had gone. Unsurprisingly no one took me up on the offer. Why would they want to work evening shift, if I was working all the hours? And taking all the call because they didn’t want to.
13. My over reaching goal for school has always been to write professionally. Articles, textbooks, I’ll do it all. Again, not a lot of movement there because I had been so overwhelmed being a working nurse during the pandemic.
14. I lost money on the London trip. This absolutely deserves its own line. It was completely planned and paid for. I had no hope of recouping everything. With the airline credit, I rebought us tickets for August. And they were $2000 less. I theoretically had a credit that carried over but had to be used by March 2022.
15. My sister was going to go with us to London for her 40th birthday present. I am sad that I don’t get to share London with her, as we are both anglophiles. I put that money toward a trip to San Francisco, including hotel. We will go to Twinings in her honor. And bring her back some tea to try.

This last one is a biggie and I felt deserved to come out of the queue. I have lost good faith in my fellow man. Whoever made the response to a pandemic political should be sentenced to serve hard time in the ICU watching people die. Instead of sensibly all striving to end the pandemic and get back to our new normal, some people decided to be assholes and whine about their freedoms and embrace other people’s deaths as just a cost of doing business for living their lives as they wanted. I still struggle with this, with rage and disbelief, and I also struggle to forgive.

The United States is over the acute phase of the pandemic for the most part. This is a list of what I personally lost. I think the biggest thing is the warping of time. but I know the biggest thing is knowing that some people don’t care about the dying that is still happening. That vulnerable people are at risk. That is hard to fathom and believe.

D. E. A. D.

This has been hanging on my mind for awhile. And our inability as a society to say it. To acknowledge it even.

According to the Merriam Webster dictionary it is someone who is no longer alive. That they have ceased to exist as the person you knew. It is a noun. It is an adjective, a description at times.

As a society we dress up the word in euphemisms. Passed is one. That person has passed. To some it may be a polite way of saying dead. To me it is stark reminder that as a society we do not deal well with death.

Oh, the patient in that room had a code blue. The patient coded. Also a euphemism for health care workers. That means the patient had a cessation of heartbeat and breathing. And we snatched them back from the maws of death. Or we didn’t, but we tried.

Even the famed M&M, or morbidity and mortality, conference that hospitals do to discuss less than ideal outcomes dresses up the word. Hell, at least they address it and how to make the system better.

Are we so afraid of death that we are unable to face the realities of it head on?

Death is not polite. It rarely comes knocking and you never know when it is your turn.

In hiding the word, society makes ourselves feel better. If we don’t say it, it is not happening. But it is. No need to dress up the word that happens to everybody. To quote Benjamin Franklin “nothing is certain except death and taxes.” None of us are getting out of this alive.

It is time to have more open conversations around the word dead. Because sometimes the used euphemism is misconstrued and misunderstanding takes place. And I cannot think of anything worse.

The post-it says ‘2 super I charge nurse memories this week. 1) telling an irate CRNA to calm down 2) chasing everyone away from the desk because I can’t hear on the phone with 5 conversations going on at once.’

Yeah, this was evening shift in a nut shell.

I had an irate CRNA, who is named in the post-it note, no I will not name them. They were going on and on and on and on. About an imagined slight from the surgeon. There was no time for hand-holding and there there-ing the CRNA. There was a case to begin. I took 5 minutes and sequestered the surgeon and the CRNA as the tech and I counted and told them to hash it out. There was a patient that needed our help and I was not interested in a blow by blow conversation discussing the issue. They would have to be adults and handle it like adults. There was no other choice.

Sometimes you have to be the kindergarten monitor. I stopped short of sending them to their rooms without supper. Because patient was waiting.

Within four minutes they had the conversation they needed to have. And we could get on with the business of helping the patient.

No time was lost on this interaction and the patient was able to have their surgery.

I swear the OR desk has magnets in it. Kind of like a kitchen in a home, everyone congregates at the OR desk. Some are goofing off, some are awaiting the elevator, some are trying to work. hi, yeah, that’s me.

The phone rings and it is someone that I need to talk too.

But I can’t hear them. Because of the 5 different cross conversations going on.

In this instance I have no compunction with excusing myself a moment, muting the phone, and getting everyone at the desk away. I quick assign evening tasks that they know already need to be done and go back to the conversation on hold. With a silent desk area.

Sometimes you have to assign tasks that need to be done and, again, all adults here.

Yeah, shift work is often about being the adult in the room and facilitating talking. Or not talking as the case may be.

Or, everything I learned about how to treat people at work came from kindergarten.

I was aghast, appalled, angry at what was revealed to us at the latest shared governance meeting. People are misleading travel nurses, or any nurse or tech they feel is infringing on THEIR department. This can even be a nurse or tech from the float pool.

They are withholding vital patient information, such as report, from people who are just there to help.

It was a tale of two hospitals as explained by one of the participants in our group.

At hospital A, the flagship hospital, report was withheld from the oncoming nurse. No one was there to greet the nurse when they arrived to, again, help by taking an assignment and patient load. It was as petty as not giving needed information such as parking, or cafeteria hours, or even how to get into the department. How do you think that nurse felt?

By contrast, at hospital B the same nurse had a vastly different experience. They were helped to find parking, that their badge worked to gain access to the department, where they were greeted by the charge nurse, who facilitated them getting report and generally helped them get their feet. Same nurse, different greeting. I can tell you the nurse felt way better about hospital B.

I said that what was described to us made me want to shake hospital A.

And shake the hand of hospital B.

Are we 5? Or toddlers? When has it become acceptable to gaslight, and mislead people who are just there to help us?

sigh

Don’t make me take it back to the golden rule. Treat others like you want to be treated.

No, scratch that. The platinum rule. This is a rule that states that people are to be treated the way they would treat others. This involves having a little empathy.

These techs and nurses are just there to help. And we should let them. Healthcare has been taking it in the shorts since before the start of the pandemic.

We should all be ashamed of treating helpers this way.

Mr. Rogers would be ashamed at some of you.

This is a brief side-step in coconut month. This week is Passover, and I found a recipe that sparked my interest.

The recipe is for matzo crack. I have made it before several times using different crackers. I have used Ritz crackers, saltines, but this is the first time that I used matzo crackers. I am not sure I had never had matzo crackers.

Being welcoming to other faiths is important. This is a skill and a mindset that needs to be ingrained.

And the other recipes I found were above my skill set.

Therefore, chocolate topped matzo toffee.

Because the world is better with butter.

And chocolate.

Covid is not gone.

Despite what politicians will tell you.

Despite what the man on the street will tell you.

Despite what your cousin’s mother’s auntie’s next door neighbor will tell you.

People are still dying. No one is writing it down. No one is keeping track of current infections. No one cares!

I get it.

A giant, broadway in lights covid is over… in neon.

Yeah, keep telling yourself that.

I get it.

It has been a long, hard two years. Because it has been over 2 years of this nonsense. Healthcare is tired. Nurses are tired. I am tired.

But wishful thinking doesn’t make it so.

And don’t wear a mask on an airplane if you don’t want to.

The air is only circulated with every exhalation for however many hours you are on the plane. But what if?

I will be continuing mask wearing when I see fit. No matter what people may say.

You think I care about what people say?

Or think?

Or talk about the crazy behind my back?

Don’t know me very well do you?

I don’t wear a mask for myself.

I wear it to protect others. And those people who cannot be vaccinated. Or the people whose vaccinations didn’t work. Or are too young for vaccination. This is who I chose to protect.

You do you.

I’ll be over here wearing a mask to protect others.

No matter who is against it. Because it is the right thing to do.

Can’t argue with the right thing to do. And if I get to fly to London in August. I will be wearing a mask during the flight.

Let us be honest. Sometimes a surgical case is not our cup of tea. Heck, the entire service is not our cup of tea. Every nurse I know has a case or body function they HATE.

Despise.

Abhor.

Nails on chalkboard would be more soothing.

Please don’t make me go in there; I’ll do anything.

For the most part this can be accommodated. Kind of. If you have the staff.

And the case aversion can be as varied as the human body. This nurse hates teeth. This tech hates feet. My own mother hates vomit, explains a lot about my childhood.

Me? I can’t stand phlegm. Lung butter. Ew. This has roots in training. My patient had a full beard, a raging upper respiratory infection, and green noxious phlegm everywhere. And the patient, not sound of mind, reveled in it. Makes my skin crawl just writing about it. Nightmares tonight.

Do you want to know WHY I did not pursue a CRNA, which means certified RN of anesthesia? For this alone.

Case aversions exist.

However, the body part/function in question is attached to a patient. Someone who needs our help. And we soldier on. This is what we are best at.

Through something we hate, despise, abhor, makes us want to run and hide.

Because someone needs us.

I have and I will continue to care for patients who exhibit my case aversion.

But I will wear gloves.

The post-it reads ‘don’t be married to the plans.’

This is something that the OR does particularly well. Plans change. Diagnoses change. Patient anatomy is not clear cut and pretty like it is in text books.

There can be a tentative plan. A structure in place, a general idea of how something will go. An over all plan.

Beware that overall plans can change. And do.

A does not lead to B cleanly. Sometimes there is a needed jaunt to Z. Don’t be surprised by it. Be flexible in plan changes.

You might surprise yourself.

This is hard lesson in nursing. Despite all of our preparations, plans can change.

And have contingency ideas in the back of your head for how this is going to go. For example, the anatomy is plain weird and there is no safe way to finish the planned procedure. E.g. a lap appy.

Okay. You will need larger sponges, even maybe some appy tapes (long, thin sponges that are x-ray detectable), different suture, and a few instruments.

I guess the lesson for today is not to be married to the plans, but have an alternate in mind for when the plan changes.