Two months into this experiment.

I am now 8 months into salary life.

2 months in to working 2100-0700 call only.

The problem with ceasing to work all the hours, is that you cease to make all the money.

For my entire nursing career my self-worth has been linked to how much money I make.

I am certain this is similar to lots of adults.

And how much I can work.

Can work, not will work.

Because I’ve never met a shift I didn’t want to pick up.

But I am trying to reform my workaholic ways.

It’s a bit of an uphill slog.

I had grand plans when I started my shift.

I was going to organize the closets.

I was going to get rid of things.

To date, after Christmas, my biggest accomplishment has been tacking tee shirt mountain in our bedroom.

I love tee shirts and would routinely wear them under my scrubs.

Today I went through tee shirt mountain.

First, I separated them into types.

This pile is jammies.

This pile I wear out in public.

This pile I wear to work.

But I’m not working 5 days a week anymore.

I took the work pile and further separated them out.

This pile is the science ones.

This pile is the introvert ones.

This pile is the reading ones.

This pile is the Star Wars ones.

I have a lot of tee shirts.

Of course, I used to work a lot of hours.

I think I am going to rotate piles.

And all my funny/cool tee shirts get a turn.

To be worn when I go to work or out and about.

Or to class when I get to my next steps.

Now, which to take to conference with me.

I think I will take the kitten holding up the world, like Atlas in Green mythology, saying ‘I’m fine, everything is fine.’

And the educated, vaccinated, caffeinated, dedicated tee.

Basically, the entirety of the science pile.

What should I tackle next?

Book mountain, I think.

I definitely do not need to buy tee shirts for the foreseeable future.

The gown card reads, ‘They are welcome to chew me out. They won’t find me very tasty. I’m bitter.’

Many of my post-it notes are written on cards that are attached to sterile gowns to allow the sterile person to stay completely sterile and to close the back of the gown.

I wonder if Dianne Von Furstenberg saw one when she was putting her spin on the wrap dress in the 1970s.

A surgical gown has it all, wrap closure, long sleeves.

But I digress.

In organizing the library, which has been sorely neglected for years, I found a treasure trove of gown cards.

Many circulators keep the gown cards when they have finished tying up a person to be sterile during the operation.

These cards are perforated at the top and are 2.5 inches x 5 inches and are blank on one side.

This is the side that is perfect for jotting notes, numbers, the list goes on and on.

They also fit in the top of pocket in scrubs.

I have been collecting for years.

I have hundreds if not thousands.

I also use these to jot down ideas.

Because sometimes a post-it note is not available.

This this particular gown card is kind of bitter.

I know for a fact that it was written years ago.

But the sentiment is true today.

Some people who try to belittle me, or chew me out, find that I can be factual when I take them down.

People hate that.

Or, if you are bitter to me, I am capable of being bitter back.

However, this is especially true in this healthcare environment we find ourselves in.

The moral of the story, don’t be mean to us when we are trying to help you.

Healthcare workers the world over are tired.

In his book ‘This is Going to Hurt’ published in 2017, Adam Kay wrote that “night shift is a different time zone to the rest of the hospital.”

Any hospital shift that is not the standard 0700-1500 or 0700-1900 is an off shift.

And I believe that this quote applies to all of them.

It is different to be slightly off step with the rest of the hospital.

Information flows differently.

Emails are treated differently.

Staff is treated differently.

As a person who has worked off shift for 16 of my 21 years as a nurse I can attest this is true.

Day shift seemingly gets all the perks.

The fresh potluck offerings.

The tickets that HR sends out in an email back when that was a thing right at 0900.

The freshest food in the cafeteria.

It all happens on day shift.

Of course, a straight day shifter means that the management is around in full force.

Um, no thank you.

I do better work off shift.

I’ve done many different iterations of off shift.

2230-0700- night shift CNA in a nursing home

1500-2300- evening shift telemetry tech/unit secretary

1500-2300- evening shift CNA in the hospital

1500-2300- evening shift RN in the hospital

0700-1900- day shift RN on the floor in the hospital

0700-1500- day shift OR RN

call 1500-0700- night call in my first hospital

0630-1900-12 hour day shift RN in an orthopedic OR

0630-1700- 10 hour day shift RN in an orthopedic OR- they made me switch to 4 days a week after I became a service line coordinator

I handled 3 different service lines: pediatric, hand, and trauma- with only $1 an hour more. I should have held out for $3/hr.

2100-0700 call OR RN

0700-0700 weekend call OR RN

1030-2300- 12 hour evening shift OR RN

1230-2300- 10 hour evening shift OR RN

1430-2300- 8 hour evening shift charge OR RN

All iterations of call imaginable.

Having down this for 21 years, I can unequivocally say that the off shift and, I include evenings and night shift march, to the beat of our drummer.

And that’s okay.

We have to be nimble and able to hand disasters on our feet.

But props to the managers that take care of us and save us plates from potlucks and celebratory day shift meals.

Thank you.

You know who I am talking about.

Booze month continues on Cookie Thursday is a Thing.

I was tempted to do a rose cookie but then I found a recipe for a red wine double chocolate cookie.

Of course I added to the recipe.

How could I not?

I was afraid that the flavor the red wine would not come through when I added the 1/2 cup the recipe called for.

Definitely not enough.

I decided to make a red wine syrup instead.

I added a bit of sugar to two cups of red wine and reduced it on the stove until it was reduced by 50%.

The cookie dough continued.

And then, in the middle of a meeting for the hospital, I mistakenly set the oven to 275 degrees, not 375.

And I wondered why the cookies were taking longer to bake.

And when they were done they were the consistency of fudge.

Am I a clumsy genius?

We’ll see if anyone notices the difference between the 2 cookies.

As always, Cookie Thursday is a Thing is about experimentation.

I am very much a believer in healthcare.

I should be.

I’ve worked in healthcare in some capacity since I graduated high school, many moons ago.

I’ve been a registered nurse for nearly 21 years.

I believe in exercising and eating right.

I understand fully that this may be difficult for some people.

Or impossible.

I also believe in health maintenance through regular checkups and mammograms if you are old enough.

But there seems to be a disconnect with my health care provider around my yearly mammogram.

I missed the employee day in October of 2021.

Because of pandemic and case volume reasons.

And because I was in CA during employee day.

Since then, I’ve called and utilized their call me back function on the scheduling phone.

Three times.

I’ve gone on the website to schedule it myself through the health app that the corporation supports.

No dice, I am told to call and schedule.

I’ve gone through the corporation website.

Same result.

This is the same system that “lost” me for six months trying to get me to come re-do my scans.

I work for the company.

Trust me, they know where to find me.

But they had the wrong number.

They reached out to my primary care doctor who reached out to me via email.

This is the first I’d heard of it because of the wrong number they had.

All of these entities know that I work for the corporation, and they know my number and my email.

Personal, or corporate email, it does not matter.

Wall, meet head.

Repeatedly.

Now I am on hold with the scheduler system.

I listen to the same 10 bars of classical music and then a voice breaks in to remind me that I can get this scheduled.

On-line.

Or in person.

Or wait for a call back.

No to all of the above, thank you.

I will stay on the phone until I speak to a real live person.

The same 10 bars starts again.

Remind me not to go postal on the poor person who answer the phone.

They don’t know about the frustrations I have been going through.

If I, a medical professional, have issues getting through to the scheduler I can’ imagine what others have to go through.

Egad.

My mom called me on the way home from her travel job today.

And during our conversation, I could hear the traffic on the freeway on the drive.

During one conversational lull, I could hear a car with a big engine rack up the tachs.

That means the car, probably driven by a man, impatiently revved his engine and passed my mom on the right.

This is legal in our state.

And probably because mom was driving with the speed of traffic, no more, no less.

I’ve seen her drive my entire life.

I remarked upon the sudden, aggressive sound, and she laughed.

And said that there was no real place to go for him, but the car could go on with its bad self.

And then she said something that struck me as the core of what a circulator does.

The circulator is the RN in the room who is outside of the sterile field but watches to make sure that all is happening according to plan, and to plan for when it is not.

Mom said, “You know I watch what everyone else is doing…”

And I finished, “Because they certainly don’t.”

She was talking about other drivers.

Which is one of the reasons that I don’t worry about her driving in ice and snow.

However, truer words were never spoken about the circulator role.

We watch what everyone else in the room is doing: keeping an eye on time, on the suction amount, on the anesthesia team and how they are reacting or not reacting to the vitals, on the field to make sure there are no needs.

The circulator does many things.

But mostly, they watch so that the others in the room don’t have to.

This is why the circulator is the boss of the room.

But the driver is still an asshole.

Have you ever played canasta?

It is a card game, best with more than two people.

2 will do in a pinch.

Especially if it is the long summer between 8th and 9th grades and no one has a driver’s license and all the adults are at work.

And your best friend has come over for a visit.

This is a time when it was long distance to call the town over, where he lived.

Yeah, a long time ago.

That summer, in Glen Ellen, CA, I played a lot of canasta.

And I was ruthless.

Ruthless I say.

In canasta if you can hold all the cards in your hand and silently build your entire meld.

And put them all down at once.

And win.

Because you get more points for doing so.

I did this at least 3 times a day while we played canasta.

On the hot summer between 8th and 9th grades.

Oh, he would get so mad.

And fall for it the very next hand.

Good times.

I am not sure why that memory popped up today.

The characters in the book I was reading were playing canasta.

But that is not the important part of the story.

The important part is the holding of all the cards so that I could play them all at once.

I am sure I had opportunities to play cards before that, to engage more fully in game play.

It was more important that I get one over on my friend.

Thankfully I grew out of that one sided upmanship.

However, not everyone has.

And they hold information about doctor preference cards and wants and desires close to their chest.

They can reveal what they know in the exact moment that the case seems lost and the doctor is getting mad.

And they can be seen as the savior of the case.

This does no one any favors.

Least of all the patient.

I share freely what I know.

I no longer hoard cards.

And I definitely do not hoard knowledge.

And I think that makes me a better nurse.

The post-it reads, “When you go ‘above and beyond’, don’t forget that when you take that away, it will be missed and resented.”

Some days it doesn’t pay to do above and beyond.

Above and beyond means achieving past your job responsibilities.

How the higher ups respond is interesting.

Sometimes they just fold the above and beyond into your normal job responsibilities.

Sometimes they rewrite the job responsibilities to reflect the new job nuances you really weren’t away you were signing yourself up for.

For you only.

Naturally.

Without extra pay or acknowledgement.

And sometimes that is okay.

Some people want to work extra and take extra job roles.

It is in our nature.

But what about the others who don’t have that particular quirk.

There can be resentment on both sides.

Manager’s pet jibe anyone?

Slacker jibe, anyone?

And if the above and beyond isn’t really sustainable and you quit.

It is resented.

That someone, namely you, are not lightening the load of others by going above and beyond.

It is frustrating.

It is a quagmire.

And it makes the ones who go above and beyond tired.

I finished setting up my calendar for the year.

It is a very involved process.

But less involved this year as I do not need to keep up with call shifts.

I love a good calendar.

Yes, yes, I’m three weeks tardy setting it up.

No, I do not have any excuses.

As I like to be organized.

And the spaces in a calendar are not big enough for everything I do.

I jerry rig my own calendar.

And it fits all the various portions of my life.

Work meetings.

Call shifts.

Blogging.

School.

Education.

Work.

Exercise.

I want a calendar that has sections for each.

I make my own using monthly sheets.

5 each, one for each section.

And an ARC notebook from Staples.

They are my favorite notebook set of all time.

Now I just have to fill in all the different squares that I’ve got.

And plan the rest of it.

Nothing like 3 weeks into a new year to be behind.

But I’m doing it now and that is what matters.

2 vaccines.

plus booster

plus the Omicron variant

equals mild infection

I have heard from many of my family members.

And my coworkers.

That being fully vaccinated and boostered made Omicron covid infection that much easier to bear.

But please stop comparing it to a flu.

This gives other people false hope that their unvaccinated asses will be fine.

2 vaccines

no booster

plus the Omicron variant

equals more serious infection

I have some friends in this group as well.

Their symptoms are more severe.

The length of illness is longer.

There may be more sequelae.

That means they may be short of breath or tire more easily.

Even after they are feeling better.

no vaccnines

no booster

plus the Omicron variant

or plus the Delta variant, which is still hanging about causing deaths

equals serious infection

These are the people who are flooding the hospitals.

And the ICUs.

And the morgues.

The best way outcome using this covid math is

2 vaccines

plus booster

minus any variant

equals no illness

But those of us who are in the very last section are still masking and handwashing and social distancing.

Don’t get caught up in the math problem.