I have decided the word stupid as a descriptor is, well, stupid.

It doesn’t sound right.

And my managers are no longer listening when I say something is stupid.

See the new day shift “charge” layer that overlaps with my shift by 2 hours.

But that is a story for another day.

I am transitioning to using the word silly instead.

And it means the same as when I use the word stupid.

It means the idea is laughable.

It means the idea is absurd.

In fact if the word silly doesn’t make my point, I will start to use the word absurd.

Yes, I know it is only Tuesday but I had an idea.

I love post-it notes.

Love them.

I stick them on the back of my badge to make myself notes.

Sometimes it is a post idea.

Sometimes it is add on information.

Sometimes it is both.

I have easily a box full of these.

Because I am incapable of throwing away paper.

I’m going to start addressing the post ideas on the back of the post-it notes.

Ha, do you see what I did there?

I think Sunday would be a good day to start.

I will have to find a real juicy one to start with.

Why do I do this to myself?

A surgeon paged me last night with a request.

He wanted to go at 0700.

I told him I was told that I could no longer give out 0700 time slots, even if there is nothing in that room until later.

He asked for 0630.

I said yes.

I am going to go to work, clock in as call back, pick the case, open the case, get the patient, prep the patient, call the anesthesia team, think about calling the scrub tech, realize that someone will be here at 0600, probably the scrub tech on call.

Start the case.

Be relieved.

Come back home and go back to bed.

I will probably be asked about why I let this happen.

I will tell them I think their rules for not adding on early morning cases are silly and a surgeon disatisfier.

In March the hospital leadership were casting around for socially distanced ideas for nurse’s week/hospital week.

Curses on whoever decided those weeks should overlap.

I had heard about a covid pinata at an educational seminar and found the idea hilarious.

I brought that up to the meeting.

And the OR administration assistant was riffing ideas with us and together we came up with beating up a derelict car.

This was also hilarious.

But there were a LOT of hurdles to overcome.

The hospital had to find the car.

Had to get permission from the corporation.

Had to get an insurance rider.

Had to assemble the implements of mass destruction.

Had to make the car safe for destruction.

Had to arrange for delivery of the de-fluided/de-engined/de-glassed car to the hospital.

The stars aligned and it all happened.

We had TWO covid pinatas.

We had one car that we got to beat up on.

We had to arrange a five hour time during hospital week to beat up on the car, so that all who wanted to could beat up on the car.

IT WAS AMAZING!

Very cathartic.

Implements of destruction included the three different sizes of sledge hammers, two aluminum bats, one wooden bat, a crowbar, a crowhammer, and an bed IV pole that had been bent out of usefulness.

Participants got to choose their weapon.

I used the medium sized sledge hammer and took several might thwacks to the poor beat up car.

Someone had attached covid decals to the paint job: some sneering, some with an expression of horror.

I wanted a piece of the car to take home and frame but I did not get my wish.

I have pictures though.

As I was parking, I had a thought.

Some people hadn’t wanted to beat up on the car because they didn’t want to get hurt.

Water balloons would have been wonderful.

I wonder if we can incorporate them into next year?

This is the third week of the chocolate chip cookie month.

This is by far the most requested cookie of all the cookie Thursdays.

The OG jalapeno chocolate chip cookie.

Apparently making last week’s cookie made a doc forget about his “no sugar” month.

And this week was his favorite.

Oops.

I also started the sour dough for next week’s cookie.

Apparently I need to start to use the extra starter that I’m supposed to throw out.

I am collecting recipes.

Here we go again.

Last night, while some of the staff were writing the board (yes, this is a daily task) an emergency case came in.

There are very few true emergencies.

Bleeding.

Blocked ureters leading to urosepsis.

Fournier’s gangrene (if you’ve smelt it you know).

Compartment syndrome.

Volvulus of all sorts that are threatening the integrity of the bowel.

All of these cases are life threatening.

Last night’s was the volvulus.

It is 1810, people are starting to think about going home.

One of the CRNAs certainly was.

Dr. C called about a cecal volvulus, a true emergency.

I had a case due to come off the table in 45 minutes.

And a spare team.

And what I thought was a spare CRNA.

I stopped the CRNA on their way out the door and told them there was an emergency and I would need them to stay and start said emergency while the charge CRNA was finishing up the case.

They went to the room and asked how much longer that first case was going to take and then proceeded to come tell me they would be off the table in 30 minutes (lie) and they were going home.

I could not stop them.

eye roll and a heavy sigh (internal, of course)

Next I turned to the two staff members at the desk and asked them to please pick the case that had just been added on.

The case card was on the printer.

I turned back to the phone and called the pre-op and told them there would be an incoming case and they needed to be prepped with all due haste.

I went back to scheduling the case.

The staff I had asked to pick the case said they needed a preference card, because the one that had printed was blank.

I stared dumbfounded at them and repeated “You need a card to pick an ex lap?”

One of the knife and fork cases that EVERYONE needs to know how to pick.

The reply I got was “well, yeah. this card is blank.”

They were not kidding me.

Deep cleansing breath.

I quickly attached a card and reprinted the case before they got on the elevator to go pick the case.

I scheduled the case, got off the computer and went to fetch the patient.

Because this is an emergency, damn it!

I wanted to scream that they needed to stop being so married to the cards that they can’t make a step without them.

But I did not.

I went to get the patient.

I fully expect to be called to the office about this.

To be told that other nurses are not me and I should not expect them to be.

Um, I don’t.

I do expect them to be able to pick a basic case without a card.

I will be creating an education around this for the staff.

I will take them down to the case make up area, tell them they have 3 minutes to pick an ex lap.

On your mark, get set, go.

Not normally something I would post about.

But finished the taxes today.

They are due tomorrow.

Husband insisted I finish them tonight.

So we could get our payment in before midnight.

A day early?

Not going to lie.

It hurt.

It hurt a lot.

Bear in mind we have no children, no dependents, only cats.

And they are not write-off-able.

And I worked a lot this last pandemic year.

Alot, a lot.

Because, you know, pandemic.

Hospital needs must be met.

And it showed in my take home pay.

And it showed in how much was taken out for taxes.

We paid the taxman many thousands of dollars.

Because it is just being good citizens.

However, what about healthcare workers sacrifices over the past year?

The hours in the N-95 masks, covered in another mask because there is a shortage.

The hours in the coveralls, and boots, and faceshields.

The worry we might bring covid home to our families.

The double shifts.

The volunteer shifts.

The must go to work every day spirit.

Even though the pandemic is crushing our spirits.

The anxiety.

The depression.

The bitten down fingernails.

Oh, that last one might just be me.

Is it any wonder I began carrying an emotional support stuffed animal in my bag recently?

Is it any wonder healthcare workers are leaving the field?

26-29% in the cursory search I did.

At least that in my department.

Another nurse announced his retirement on Friday.

I wonder why.

This past week the CDC came out with the recommendation that if you are fully vaccinated, you do not have to wear a mask in public or social distance.

My state jumped on it and rescinded the state mask mandate.

Many businesses did as well: Walmart, Trader Joe’s, Publix.

I went to Trader Joe’s this morning.

And there were very limited people who were not wearing a mask.

I counted 2.

I am fully vaccinated, have been since January, and you bet I was wearing a mask.

Remember, they stopped the mask mandate, if you are fully vaccinated.

There is no way to check the vaccination status of customers, unless you ask.

It is putting the burden on the stores.

Because of people who will lie, obfuscate, fib.

And I am wondering if cases are going to go up within 3 weeks because people are stupid.

As Darth Vader says in return of the Empire Strikes Back, “Search your feelings, you know it to be true.”

I have two evening techs who split the week.

One works 3 evenings, the other 2.

The one who works 2 had surgery last week.

Yay for her (this was a long anticipated surgery).

Boo for me and the evening shift.

She will be out for 12 weeks.

Okay. I make the schedule and I have 15 other techs to rotate through her shifts.

I made a rotation, and scheduled people with it.

It was fair and equitable.

And if one of the day techs works an evening shift, they are schedule off the next day.

Same way it has always been done.

But day shift complained.

“It is too much.”

Um, it is only one shift a month.

They may have missed the fairness part of it.

It works out to ONLY one shift a month.

Schedule got posted on Sunday, to start in 2 weeks.

Wednesday, my assistant nurse manager pulls me into her office and said that some of the day shift techs had an idea.

They wanted to do their evening shifts on call.

ON CALL!

And they only want to be in the department if there is a case.

This means that I would be alone in the department.

I would do all of the evening shift chores: pulling cases if any left, pulling instruments if not done, cleaning rooms, stocking rooms, setting up any OR except for our call room.

By myself.

Plus all of my own charge nurse chores.

And if a case comes in I have to call them in, at a premium, to come do the case that I have scheduled, pulled, opened, and sometimes prepped the patient myself.

cool, cool.

On one hand I can be assured the work is done completely, and well.

On the other, I will not have to shepherd staff through the evening shift chores.

On another, I find this incredibly insulting to the tech out on leave, de-valuing her work like this.

On another, I will not have to find them work to do, because they are incapable of thinking/seeing what needs to be done and doing it without being told.

On yet another, I find this incredibly insulting to all the evening shift workers.

Again, this is not how it is to be valued.

I have to wonder, if this is a way to get rid of the shift all together.

Or of seeing how much I am willing to put up with before I leave.

Day shift wins again with their shitty ideas that leaves them without doing the tedious work.

Again.

This has been the oddest week.

On Monday, I agreed to serve as the regional shared governance market chair.

It is a role I have had before.

I will be in it for 7 months, long enough to prepare the next chair for service next year.

It is needed because of the nurses stepping down or leaving the region because of the pandemic.

My department and hospital is having its share of these losses as well.

Now my chair elect and myself have to figure out how to get nurses excited about shared governance.

The shared governance group had been speaking at new employee orientation to introduce new nurses to the concept of shard governance.

This part has been deleted with the pandemic and the retooling education did for orientation.

I have encouraged the CNO of the region to bring it back.

Tuesday was astoundingly busy.

Appy, appy, dislocated hip, appy.

Wednesday night was the same, but only with 2 appendixes, not three.

Wednesday was also the day that a good nurse friend of mine, who had cheerleaded me through my masters, told me her role was changing and she was going to work for the other region.

I have not done shared governance without her.

I hope I can rise to the challenge.

Today, which is Thursday, was like slogging through cement.