Europe is entering yet another Covid wave.

The news has been alarming from Western Europe for over a week now.

Is this the US future?

The news has been alarming from some of the Western US.

The news is that hospitals are struggling with Covid case volume.

Despite the vaccinations efforts.

Despite the booster efforts.

Despite the mask mandates still in existence for my state.

Despite everything.

There are still at least 1,000 deaths a day.

I know, because I am obsessive like that.

I read ALL the articles.

Foreign and domestic.

And I see everyone acting as if the pandemic is over.

Today’s sum total is 775,785.

We hit another milestone.

Boo.

I get the totals I monitor daily from the Johns Hopkins Covid-19 dashboard.

And I see everyone celebrating as if this is over.

It ain’t over until the fat lady sings.

Wash your hands, wear a mask, get vaccinated.

If not for yourself because of some misguided beliefs.

Then for your neighbors.

And their new baby.

Or their child who is immuno-compromised and is too young for the vaccine.

I can’t believe we are still having this conversation.

I’m so tired of having this conversation.

Aren’t you?

Since Thanksgiving is on a Thursday, there will be no cookie Thursday this week.

In the spirit of giving, there is cookie Wednesday.

I usually stick closely to the theme for the month.

Because that is what a theme means.

Themes help me keep track of cookies.

And all the cookie requests.

Not too long ago, I saw a jalapeno sauce at Trader Joes.

Hmm.

I wonder if that could stand in for chopped fresh jalapenos.

The answer is it can.

And the sauce is more consistently spicy.

Which makes for a more consistently spicy cookie.

I am sure there is an OR lesson about consistency.

But this week has been a ball buster.

And I am too tired for puns.

If you don’t hear synth horns, what have you been doing since the mid 80s?

Yeah, so, the universe is mad at me.

In the last two weeks I have worked my usual: 1430-2300 Monday through Friday.

Laser call Saturday/Sunday 0700-1900.

Night call Saturday/Sunday 1900-0700.

And night call Monday-Friday 2300-0700.

Plus assorted meetings.

This is all completely normal.

And is changing after Friday.

I’m a workaholic.

So what?

Ever since I agreed to change my job role to that of the night call nurse, the universe has been throwing some serious shade my way.

Sorry, whoever I happen to be working or on call with.

Sunday was no exception.

I had an unusual call case in the middle of the afternoon,

The normal weekend team was busy.

And this was an emergency.

4 hours later, I was home.

At then the tech and I were called in for a big belly case.

The usual: perforation somewhere, tanking blood pressure.

And then the universe threw us a dislocated body part that does not usually dislocate.

At 0400.

And me having a car appointment at 0700.

I could have cried.

I am pretty sure the CRNA did.

And after that I had a meeting at 1100.

Do you think the universe knows that my life is changing in 4 days?

I think she does.

And I think she is PISSED.

Sorry, universe.

Sometimes change is good, you know?

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

As discussed previous, Murphy lives in the OR.

And lives to fuck plans up.

This is meant to be a post-it to management.

Too often they are married to their horrible ideas.

By that I mean that they will see their plans through without acknowledging new information that comes in and points out how bad the plans are.

A few years ago, AORN came out and said that OR personnel should only wear disposable hats.

I have twenty+ cloth hats.

There are reasons for wearing a cloth hat.

It weighs down my very fine hair so I don’t get flyaways.

The cloth hat controls the edges of the my hair so that I don’t like a dandelion while in a sterile environment with all the hairs escaping.

The cloth hat allows me to show a little personality.

The thing is they have to be washed, properly in hot water, after every use.

And no one wants to keep track of that.

Therefore an honor system was set up.

Washing was still not being done.

AORN threw their hands up and declared cloth hats were forbidden, because no one could be counted on to wash theirs.

And my OR banned cloth hats.

Yeah.

So many, many problems with paper hats.

Some people who have short spiky hair, the hair was protruding through the paper.

Some people, such as myself, have very fine hair and the paper hats could never hope to control that.

I would put up my mask and the hat would be near the back of my head, exposing the front half of my head.

And no one would tell me.

The hats were meant to be discarded after every shift.

You can bet that wasn’t happening.

Ew.

I set up a research project involving paper hats and hair spillage.

I took pictures every day of my coworkers.

At the beginning of the shift, when their hair was somewhat neatly contained.

And at the end of the shift, with hair half escaped the paper hats.

There were listening tours by management and they had to listen to us complain about the paper hats.

I talked about my research project before the research symposium.

There was an uptick in surgical infections.

A root cause analysis pointed at the paper hats.

AORN quietly put into place that cloth hats were okay, as long as they were washed regularly, and covered with a PAPER hat.

The hospital followed suit.

Same rules as before.

The point is don’t be married to terrible ideas.

You never know when new information will come out to disprove or disrupt the plan.

Or infections may go up through unintended consequences.

When many people tell management their idea is terrible, too often they double down.

And make the idea more terrible.

Every time we went to visit Dad in the hospital we had to pass striking workers.

Every time.

And every hour on the hour they would strike up horns, and drums, and fake sirens.

The rest of the time they would shout.

Um.

This is a hospital.

There are very very very sick people here.

People who do not need to hear that kind of commotion every hour.

Is organized labor a good thing?

Yes.

Everyone who ever enjoyed a weekend needs to thank a union.

Have I ever been willing to cross a picket line?

Also, yes.

Is is important that people get to exercise their union rights?

Yes.

But, my dudes, perhaps this isn’t the time or the circumstances.

Chanting, drums, and sirens, oh my.

We are in a pandemic.

Spreading droplets by yelling does not do anyone any good.

Keeping patients awake inside the hospital might even be detrimental.

And having to cross the picket line every time I want to see my dad in the ICU is disheartening.

Having to wait outside because only 1 family member is allowed in at a time and listening to the noise and the sirens and the yelling.

Kind of made me not want to be on your side.

There is a song by the Canadian group the Fanatics.

That was on one of Doctor Demento’s albums.

And on his radio show in the 1980s.

It is called Ti Kwan Leep.

It is a comedy song.

And I would have put money down that it was John Belushi playing Ed Gruberman.

The song is about learning patience in the context of martial arts class.

That teaches the Ti Kwan Leep.

It is a technique using patience as a tenet of the martial art.

That the brutish bully must develop patience in learning.

And how impatience is a tool for your opponent.

Because anger is a tool for your opponent.

And anger comes from impatience.

There are so many ways that this song is part of my foundation for teaching and for learning and for waiting in line.

You have to have patience dealing with patients.

Ha!

I crack myself up.

You have to have patience in dealing with coworkers.

With surgeons.

With administration.

With families.

With every aspect of the OR.

And life, really.

I have had many people apologize for the wait when I am waiting in line, waiting for my order, or simply waiting.

I always reassure them that I am a nurse and that I am patient.

Because I am.

And being patient is a very, very valuable and underrated foundation skill.

Now, the Doctor Demento’s comic albums are also an underpinning for my life.

But that is a story for another time.

But some people do need to learn patience.

Or have a boot to the head.

I had announced my intention to make cinnamon cookies in the beginning of the week.

And so I did.

But I thought I had bought this cinnamon bun jam type thing.

To use especially in cookies.

Negatory.

Not in the baking pantry.

Not in the regular pantry.

Not in the fridge.

I had to go to plan b.

And use cinnamon syrup.

Because sometimes a plan has to change.

For various reasons.

I also changed the recipe.

Because it was supposed to make a skillet cookie.

Not enough cookies can be cut out of a large skillet cookie.

I tweaked the recipe by adding more flour and more cinnamon than it called fo.

Because OR nurses have to be flexible.

And not married to the plan above all else.

Because plans, like recipes, are subject to change.

Or is that deals on the internet?

Traditionally here in the South the OR case volume skyrockets in December.

You have to have surgery when you’ve reached your insurance deductible, you know.

The case volume in my hospital has been spotty.

Some days busy.

Some days not.

Not OB.

They are always busy.

There usually is an ever increasing incline of cases.

And later and later cases into the evenings.

The incline this year has been weird.

But today it is finally acting like it is the end of the year.

There were 36 cases.

Most in a day in over a year.

I went in to act as laser nurse at 0730-1030.

And then I went home to nap.

Because I’ve been at the hospital every day this week until 0300 on Monday and 0200 on Tuesday.

Shh, don’t tell Thursday.

I am tired and my feet hurt.

According to two of three schools I am interested in for my doctorate I need to have letters of recommendation.

Not just normal letters of recommendation.

No.

They have to be from another PhD nurse.

I know only 2.

And those 2 work for the same organization I do.

Asking them was easy.

I offered a series of conversations so that they could be comfortable writing me a letter.

But the third!

Oh, the third.

I was stymied.

I only know the 2 PhD nurses.

I know loads of doctors, surgeons and otherwise.

But a PhD nurse?

That was going to be a hard one.

As I had done when I was in high school and needed an Air Force officer active or former to interview for the scholarship I was applying for, I reached out to someone I know tangentially.

We’ve had conversations when I volunteered for the company.

We’ve had conversations when we met up at conferences.

I took a deep breath.

And reached out via the credentialing company site.

Did I mention this third PhD nurse was the CEO of the credentialing company with CNOR?

I did not have his email address and had no way of getting it.

I reached out through the credentialing company contact portion of the website.

Stating that I was an MSN nurse who needed a third letter of recommendation from a PhD nurse.

He emailed me back the next day and asked for clarification.

I gave him as much clarification as I could.

Today he emailed me and asked for my CV and the dates I had volunteered with the company.

I will email those to him tonight when I get home.

Was it scary?

Yep.

I am not an outgoing person.

I am very shy.

But I did it.

And now I have a line to the 3rd PhD nurse.

I don’t want to get ahead of myself.

But.

Maybe.

After all, the former Air Force officer that interviewed me in 1992?

It wasn’t until 2009 that I saw him on television, of all things.

3000 miles away from where I had talked with him.

It was Chesley Sullenberger and he had just saved a lot of people on a flight Charlotte.

You may have heard of it.

The Miracle on the Hudson.

The post-it reads ‘are we doing the 2 step.’

This one requires explanation.

My father was in intensive care in California recently.

And the ENTIRE experience made me appreciate what families have been going through in the last 18 months.

To get into the hospital your temperature had to be taken.

Answer the reason for the visit today.

And then you had to present your covid vaccination card at the desk.

Wait for them to ring up to the floor to inform them of a visitor.

Give up your driver’s license.

Wait for approval of the floor.

Wait for the visitor sticker to be printed.

Wait for the sibling or mother who was visiting ahead of you to come down.

Get your visitor badge that they would place on you.

Get your driver’s license and covid card back.

And then be allowed to the elevator.

At the correct floor you had to present your badge and yourself to the security outside of the elevator.

To be told to go down to the hallway T and turn left.

Pick up the phone.

Speak to whoever picked up the phone.

And then be granted entrance.

See your dad.

But don’t visit too long.

He gets tired easily.

And there is someone else waiting for you to come down so they could go up.

But the 2 step on the post-it refers to their frankly inconsistent visiting rules.

On day A- 2 people could go up.

On day B part 1-1 person could go up.

On day B part 2- a second person got to go up.

To be challenged by the charge nurse as to why there were 2 visitors.

Um, your desk okayed it.

On day B part 3-1 person could go up.

All the parts on Day B happened in a thirty minute time frame.

The rest of the family, and there were 4 sometime 6 sometimes 7 of us.

Had to wait on the corner.

Or in the car at the parking garage that we had to pay for.

On any given day of the 4 days I was there the answer was never the same twice.

Of all the family I was the one best equipped to understand the stress that the nurses are under.

And I had a hard time with it sometimes.

If I, someone who has been working nearly every day for the past 18 months, couldn’t get it, then a family member who is also under immense stress would no chance of understanding the inconsistent rules and harsh tone that some of the nurses/security guards/management/doctors took with us.

And when informed that I am a nurse, my mom is a nurse, and my sister is a doctor you could almost see their eyes rolling.

Yeah, sure you are honey.