Covid infections are down.

Not to pre-Omicron levels.

But they are down.

Deaths are not.

As has been seen in all the different variants thus far, deaths lag behind infections.

Which is logical.

Because a person has to get sick.

And sicker.

And seek the hospital.

And get vented.

And linger.

Or not.

They could die at home because they didn’t think they were sick enough for the hospital.

And people go to the hospital to die.

Not every patient, but enough.

But for a country who just hit 900,000 dead a week ago on February 4, the US is still averaging nearly 3000 deaths a day.

And the newest death toll number from yesterday is 915,000.

That is 15,000 dead.

In six days.

Yes, covid infections are down.

Although the US fully vaccinated rate is 64%.

And the partially vaccinated rate is 76%.

And there may be an under 5 vaccine announced soon.

States are racing to drop mask restrictions.

Except where there is a high transmission rate.

I know because I follow the news where the high transmission rate areas are.

But I don’t think the average person would.

But they are happy and eager to drop the mask wearing.

We will only have ourselves to blame if cases go back up.

Because we were greedy for this to be at an end.

Let us not celebrate prematurely and it bite us in the ass.

Again.

Dead is dead.

Fayta.

Fehta.

Same cheese.

Same amazing taste.

Salty and creamy.

Surprisingly non melty.

And spinach because feta needs a foil.

Something to play against.

This is the second week of cheese Cookie Thursday is a Thing month.

I’ve baked these before.

And they were well received.

A sconelet is a small scone.

One of my tricks to stretch a batch to feed many.

But today, I made a second, gluten free batch.

Some I will send to my sister, who doesn’t eat gluten.

I will keep a half dozen mixed.

Because I said so.

And I will give the rest to the ED.

They’ve had a rough, rough, rough go of it.

Especially lately with Omicron.

And the usual falls with fracture.

Appedicitises?

Appendicitees?

Appendix patients.

And holding patients waiting for a bed.

I’ve already had 4.

Good thing they are small.

Zoom is amazing.

I get to engage in hospital meetings without leaving my house.

I get to stay in my pajamas.

I don’t have to clear the ice from my windshield.

Zoom is the worst.

There just is not a lot of engagement at the hospital, regional or corporate level.

Take the group meeting I led to today.

Our hospital has Med Surg I, Med Surg II, ICU, IMCU, ED, Women’s (L&D and post partum), OR, Cath Lab, Infusion Services, and Interventional Radiology.

That is 10 departments.

In the past we had a much more robust shared governance council.

There were representatives from 7 of the departments.

Sometimes 8.

There was more multidisciplinary participation as well.

Pharmacy updates and conversation.

Housekeeping updates and conversation.

Engineering updates and conversation.

Public safety updates and conversation.

Electronic health records updates and conversation.

Patient satisfaction updates and conversation.

We helped them, they helped us.

Those are also fading a lot.

Today we only had two.

An EHR representative for a brief 6 minute presentation.

And the patient satisfaction updates.

Shared governance is about leading from the bottom of the hierarchy.

If not leading, then it is about being heard from the bottom of the hierarchy.

What else do we talk about?

Safety of patients and staff and data from those efforts.

And quality of patient care and work life and data from those efforts.

I believe in the value of shared governance.

Very much so.

So much that I am leading these meetings and participating in these conversations inside of my salary.

No longer do I get paid hourly for the hours that I put in.

Today there were 4 people in the meeting.

OR, Women’s, and ED.

Our Magnet coordinator was also in the meeting.

These are the the same 4 people who have been the most consistent for the last six months.

Really great information was shared today in our efforts to elevate staff.

And some things to focus our efforts on.

Both will be discussed at unit meetings.

At least in the ED, OR, and Women’s.

And anyone else I can get to listen to us.

I can’t make nurses care about what the council does.

I can, and do, point out the good that has come out of the councils.

Things like improved lighting in the employee parking lot.

Better signage inside and outside the hospital to indicate to patients where they need to go.

Increased clinical ladder participation.

It is frustrating.

And demoralizing.

But at least the four of us care.

Healthcare is hard right now.

So very, very, very hard.

Nurses are leaving for more money.

Leaving the rest of us to shoulder the load.

And I would rather keep engaging in the conversation.

Than let it die.

And this is the part of zoom that I hate.

The silence.

Are the shared governance faithful screaming into the void?

I’m very much a consumer of the CEU.

I use them for renewing my nursing license every 2 years in my state.

I use them for renewing my CNOR every 5 years.

I use them for maintaining my clinical ladder.

But, I also really enjoy learning.

And teaching to others.

One of my most frequent question is where to find CEUs for any of these purposes.

And every year I compile a list for nurses, departments, and professional practice binders that we use in our hospital units.

I get the list from a variety of sources:

1. Conferences
2. Online modules/seminars
3. Board of nursing in my state
4. Offerings from the various organizations I belong to- AORN, ANA, my state nursing council, the organization I work for
5. The honor society I belong to- Sigma Theta Tau
6. My current favorite is the Beyond Clean offerings about the sterile processing department

Kind of like the clampy project.

CEUs are everywhere.

Or, to horribly misquote Cole Sear from the Sixth Sense, “I see CEUs everywhere. Hanging around in the the internet, from accredited sources, they won’t be counted until they are found and watched or tested.”

I have got to re-watch that movie.

Right after the CITI training module I am on.

You know the one, about research ethics that are required for the research council. and various shared governance councils.

Okay.

Just me then.

If you want a 2022 updated CEU list, reach out to me and I will send it to you.

There is a legislative movement afoot to wage cap travel nursing.

In many states.

And many urging the federal government to move in the same direction.

This is an example of the free market.

And we all had to take economics in high school and many in college.

Oh, your school didn’t require it.

And you didn’t think you’d need it.

There is a meme that is going around attributed to nurselex.

A nurse in full PPE is embracing/supporting a clearly suffering patient.

The text underneath read

“If a lawyer can make $300/hour to defend violent criminals

and therapists can charge $250/hour for their work

and housecleaners can charge $100/hour

and tattoo artists can charge $150/hour

Then some nurses** making $100/hour should not be a concern of CONGRESS”

Nurses number 4 million in the US.

And we are expensive.

And a big part of hospital payroll.

Because the hospital is staffed 24 hours a day, 7 days a week.

In case you need us.

We’ve been at the hospital throughout this ENTIRE pandemic.

Tending to the dying.

Cheering those who are getting better.

Taking care of those who cannot wait.

And if nurses want to leave to get a slice of something they think is better…

I’ve worked enough places to know that the grass is not greener on the other hospital.

And it is free market to pay nurses what they can get.

And now people in power are clutching their pearls and bleating out ‘wait! that’s too expensive’.

I know of managers who used to tell staff if they didn’t like the changes to go ahead and leave for another job.

I’ve heard from friends that this kind of behavior is still going on.

From hospitals big and small.

I’ve worked for a barely scraping by hospital and I’ve worked for a big corporation.

The poor hospital will have a problem with this.

Several poor hospitals in parts of the country have closed during the pandemic and before.

Because they could no longer afford to stay open.

That is another side of the economics discussion.

Instead of a blanket cap that will never fly because, as a group, we are not willing to be pushed around.

There can absolutely be a conversation about why you feel the need to take such steps.

And can we also talk about your salary?

And by you, I mean the executives, the lawyers, and the legislatures.

And safety?

Of the nurses who have too many patients to handle and care for during their shifts.

Of the patients who have overburdened nurses.

Of the rest of the sick people who need care.

Is this a conversation you are willing to have?

I thought so.

The post-it reads ‘crushing management’s ideas by telling the truth. Would not recommend.’

Can anyone else hear Jack Nicholson’s character in a Few Good Men screaming on the stand?

You can’t handle the truth.

Management used to ask me questions about different matters that came up in the department.

Why?

Because I would always tell the truth.

But sometimes the truth is not what they are looking for.

I don’t care if they don’t want the truth.

I will not sugarcoat my response.

If I think an idea is terrible or has been done many times before and abandoned, I will say so.

That is the problem with being long lived in a department.

And having a good memory.

This kind of response is not very popular.

And, I imagine, gets me a debbie downer reputation.

You want to try the bright shiny idea that has been done before?

Oh, so many times?

Because maybe it will be different this time?

Knock yourself out.

However, you have to be careful of crushing their ideals too many times.

They will stop inviting you to the table for discussion.

And do the terrible thing anyways.

And when it fails, replace it.

Not with the non-terrible idea that came before.

But by something else that is even more terrible.

And non-sustainable.

You’ve heard the adage the road to Hell is paved with good intentions.

Similarly the road to not-happy employees is paved with bad ideas with good intentions.

Because someone did not think it through.

Or ask if there could be any downsides.

Or asking if there could be any downsides in their echo chamber.

No, no, don’t ask her.

She’ll say no.

What could go wrong?

According to the Johns Hopkins Coronavirus Resource Center, my go to for information covid information, the world had crossed 10 billion vaccines administered.

It is not nearly enough.

But it is so very exciting.

The world has come so far in so little time that it is mindboggling.

But, those of us who are living this in the real world, and watching the hospital numbers go up.

And the deaths go up up up.

This is a relief.

It is not nearly enough.

But it is a start.

Welcome to the first Cookie Thursday is a Thing for February 2022.

The theme for the month is cheese.

One of the most highly requested savory cookie is the cheddar penny.

This is a very simple recipe and bake.

There are several ways to add interest to such a humble cookie.

Sometimes I add red pepper flakes.

Sometimes I had a triple pepper jelly thumbprint.

Sometimes I eat them plain.

Kind of like cheezits.

The recipe is cheddar, flour, and butter.

Very simple but underrated.

Kind of like a ‘simple” surgery.

I hear that all the time.

It’s a simple surgery, it will take 10 minutes.

Until it doesn’t and there is now blood everywhere and anesthesia is telling you to hurry it along.

There can be beauty in simplicity.

It’s just a carpal tunnel.

Yeah, just surgery on the second most complicated part of your body.

Keep thinking that it is simple.

Looming deadlines.

The University of South Carolina application deadline is February 15.

I have such a block on completing this.

Or really even starting this.

I do not know why.

The university of North Carolina- Greensboro is looking for me to finish my application.

Only 2 of the 3 people the university has reached out to for a reference has responded.

And transcipts?

Are hard.

Especially when the first one is from 1995.

And then 2001.

And Chamberlain College of Nursing is online.

There are several brick and mortar schools.

But I did not attend them.

I am certain that the University can access them faster than me.

And Queens University of Charlotte was only 2 years ago.

Apparently I have to reach out to them.

I hope the Creighton and Napa Valley College transcripts are online.

Because I certainly don’t have a hard copy.

Come on, man, it was nearly 30 years ago.

Beginning the applications so late.

That’s all on me.

And, I repeat, I don’t know why.

It has been a minute since I did a covid round up.

I wrote an Omicron Math post on January 21.

That day there were 864,142 American dead.

On January 15th there were 850,000 dead.

16 days, 40,516.

The trend is accelerating.

However, we’ve heard over and over.

Hospitalizations go up.

Hospitalizations go down.

Deaths are on a lag.

Hospitalizations are still up.

There are still hospitals struggling.

Hell, my hospital is struggling.

Today is the first day there is a room available for admission.

Of course, that room will be gone by morning.

I’d ask to take bets when America will cross the 900,000 threshold.

But I’m too tired.

I no longer look at the number of cases.

I just assume they’ve gone up.

I do look at the screaming red line and where we are in the surge.

Do I still wear a mask in stores?

Absolutely.

Do I alcohol the pump handles when I get gas?

Yup.

Do I alcohol my hands when an alcohol dispenser is available in stores.

Yes.

Do I stay at least 6 feet away when I am speaking to someone I don’t live with or who isn’t in my four person bubble?

Yes.

Do I mind being thought a person who is taking this too seriously?

Absolutely not.

I would ask if they’re not taking this seriously enough.

Still.