I am on vacation.

I’ll say it again to convince myself.

I am on vacation.

For a week.

I have grand plans.

I am going to be dealing with my I am missing out crap that I did have time to do during this last week.

I have a master list.

I have no schedule.

I will be picking off the master list and working on that particular item.

Right this moment I am listening to a fandom break-out room.

About writing.

And imposter syndrome.

So that is first.

Next will be the guest bedroom.

#221bcon

The cookie for April 8, 2021 is key lime cookie.

The citrus month is continuing.

This is a sugar cookie, not using the toll house recipe as a base.

Instead of vanilla, there is a whopping amount of key lime juice.

For added zing I added white chocolate chips.

They baked up pale, to be expected, with an excellent crisp to their bite.

This is not my story.

It was told to me about another hospital, and another surgeon, by a CRNA.

A patient was going to be having surgery on a central body part. After the consent was signed the surgeon added another body part. This body part, well, there is more than 1.

It doesn’t matter what body part.

It matters that the surgeon mark the correct body part.

Because mistakes happen.

And marking the correct body part is a way to not make a mistake.

Because we make the surgeons mark a body part when there are more than 1 for reasons.

To recap, there is a surgery. Surgeon wants to add on a smaller biopsy on a body part that is not singular. Surgeon needs to mark the correct side.

CRNA tells the surgeon that they cannot bring the patient back because the non singular body part is not marked.

The surgeon suggests they bring the patient back anyway.

The CRNA refuses.

The surgeon puffs himself up and gets to within 2 inches of the CRNA’s face, screaming that he’s not going to mark the *expletive deleted, use your imagination* side.

I am sure there are veins sticking out and the surgeon is red in the face, maybe sweating.

Spittle is definitely flying.

The CRNA refuses, which is the appropriate thing to do.

The surgeon continues to attack the CRNA verbally, threatening his job.

The CRNA walks away, calmly, to get the head CRNA involved.

The head CRNA tells the surgeon that he will have to mark the side.

The surgeon completely loses his shit and threatens everyone within the sound of his voice.

I am sure there is an audience now.

This exchange has been going on, in front of the patient and the entire pre-op area for 10 minutes.

The CRNA refuses.

The surgeon is irate and threatening.

The CRNA asks, again calmly, what the chief of surgery may think of this display.

The surgeon grabs the marking pen and, muttering deprecations under his breath.

The CRNA apologizes to the patient for the delay.

The CRNA explains that it is for the patient’s own safety.

The patient remarks the surgeon must be having a bad day (!).

The CRNA is relieved at this point as it is change of shift and it is best to add another CRNA to the case because the surgeon is still making threats.

The CRNA goes to the office to talk to the head CRNA and says they want to press charges against the surgeon.

I wasn’t there but I would have applauded.

I have my CNOR.

This is additional certification that I got by taking a very difficult test.

This is additional certification that I maintain by doing 125 CEUs every 5 years.

I have re-certed 2 times.

I am also interested in volunteering for the credentialing company.

Not only as volunteer hours for my clinical ladder.

But also as something to engage me with the operating room education.

I believe that all OR nurses should be certified.

It is also good for Magnet designation.

To that end I volunteer when I can.

I am doing two days of volunteering this week for the credentialing company.

Because if not me, then who.

Look, I get it.

These past 14 months have been HARD.

From layoffs.

To decreased case volume for months.

To our friends and family and community members getting sick.

To our coworkers getting sick.

And dying.

I get it.

But this is not the time to let our guards down.

People are still dying at a rapid clip.

Cases have begun to rise again.

More and more I see people out without masks.

More and more I see people challenging mask rules.

More and more I see governors relaxing the rules for their states.

And more and more I see the death that follows.

Just don’t

Yes the case count is down.

But testing is also down.

Yes the vaccines are going into arms at a rapid pace.

Yes we are almost through.

Almost through is not through.

Be safe.

Get the vaccine when you can.

Still mask and practice distance after vaccination.

The life you save may be your own.

This Thursday I made my first citrus cookie of the month.

There are 5 weeks this month.

That is a lot of different citrus cookies.

This week I made orange white chocolate.

Of course, it is as I type this that I remembered what was missing out of the cookie.

Cranberries!

I swear.

I use the toll house chocolate chip cookie recipe as a base for many of my cookies.

I am sure I have written about Cookie Thursday is a Thing but I was terrible about noting down when I wrote, or keeping to a schedule, or lots of things.

The Covid Pandemic has NOT made me pay attention to those things.

I have decided to be more intentional about blog posts.

I am now writing down blog post titles in my calendar and keeping track that way.

I am also writing down all the blog post titles down from my entire blogging life that has been a bit half assed.

I promise to do better.

However…

Cookie Thursday is a Thing began out of my desire to use and show off our brand new kitchen.

The new kitchen was put in, through a nine month process where they ignored our request for a kitchen, figured it after we inquired about it in week 4, lost a cabinet, couldn’t install until they remade that cabinet, the granite was backordered, and then templated and installed.

That is a LONG time to be without a truly functional kitchen.

I was definitely going to be showing it off.

And experimenting with baking.

Thus, Cookie Thursday is a Thing was born.

Created/started/bragged about.

Cookie Thursday is a Thing (yes I am married to the title) began six years ago in January of 2015.

At first there were a couple of other bakers who would take shifts and bake weekly.

And then they all petered off.

Until I was the last circulator standing. (this took about 4 months)

Six years of weekly cookies.

On Thursdays.

The tag line is Cookie Thursday is a Thing because it is not yet Friday and we are sad.

I only bake with quality ingredients: butter, real vanilla, good chocolate, King Arthur flour.

6 years is a lot of ingredients.

Relatively quickly I decided that the months had to be themed.

Not only does theming the months aid in finding recipes, it also gives a bit of structure to the entire enterprise.

Over the years I have settled some months onto months of the year and kept the theme consistent.

6 years of cookies is 312 weeks. That’s a lot of cookie types. That is why they are themed.

This month, March 2021,the theme was Greatest Hits. Over the years there have been cookies that were consistently asked for.

I baked jalapeno chocolate chip cookies, I want them to be called the hot chocolate chocolate chip cookies but no one is playing along.

I baked fudgy cocoa no bakes, the peanut butter oatmeal one.

I baked cookies with Lucky Charms marshmallows in them for St. Patrick’s Day.

This past week I baked triple pepper jelly thumbprint cookies. Sometimes I do savory and they are always a hit.

Except for the BBQ chip cookie. That was awful.

I experiment on my coworkers using Cookie Thursday is a Thing. Sometimes it works, sometimes it doesn’t.

April will be a citrus cookie month. Very springy. All 5 Thursdays.

Just now I decided to post my weekly Cookie Thursday is a Thing on here.

Just for another thing to keep consistent.

So check back on Thursday to see what citrus I decided on for this week.

Well.

That was a lovely case.

Not a lovely surgeon.

I was awakened at 0230 and the nursing supervisor asked me to please call a surgeon, because he had a case.

Let us call him Dr. W.

I called him immediately.

He told me that there was a patient who had a certain medical condition and needed to go to the OR first thing in the morning.

Me: There are no first time starts available as the OR is booked. The earliest time will be 1000.

Dr. W: His condition is such that he can not go later. He will have to go emergently.

Me, looking at the clock on the computer, which was 0240: Okay, we will try for 0345.

Dr. W: Okay.

Me, not ever having worked with this surgeon: Are you familiar with our hospital? Will you need help getting scrubs.

Dr. W: No, I’ve been there on call.

Me: Okay. We will see you then.

I then call the nursing supervisor and give her the details, and ask her to call the rest of the team. She asks if x-ray is needed. I said yes.

I get dressed and drive to the hospital and clock in.

Immediately after changing I turn on the bed so it can be warmed up, go to the front desk and schedule the case and arrange for transport.

I confer with the scrub tech and go to the PACU to await the patient’s arrival.

I pull consents and log into the computer.

I am at the computer, beginning the charting, when the double doors to the PACU open.

I turn my head, believing that it is the patient.

It is the surgeon.

Me: Oh, I thought you were the patient. He is on his way.

Dr. W: What?

Me: I thought you were the patient. He is on his way.

Dr. W: I do not care for your tone. You have been nothing but belligerent on the phone. I am sorry that this patient is need of surgery at this hour. This is my seventh case today, in three different hospitals.

Me, taken aback by this aggressive turn in the conversation: Okay. The patient is on his way.

Dr. W.: I know that you would rather be at home in bed.

At no time have I said this, or conveyed this.

He turns to go.

Me, thinking that he could fill out and sign the consent before he began the H&P: Will you sign the consent?

Dr. W.: I know you don’t want to be here, the patient needs surgery.

He stalks off.

Me, sitting at the computer desk, my mouth surely open under my mask, unsure of what just transpired. I say nothing further.

Transport still has not come.

I get up and go to the ED to pick up the patient.

I prep the patient.

We are in the room at 0350, 5 minutes late.

The entire case was surreal.

Dr. W. is a completely different person in the room. Friendly, open.

I get that he was projecting. He didn’t want to do this case, even if it was emergent. He wanted to be home in bed.

I was just caught off guard with the personal attacks when they were not warranted.

I didn’t even give him my spiel that I give to all the new doctors about the operating room hours and the phone numbers of the desk and the charge pager.

To date I have volunteered twice at a vaccine site.

I have done different things at the site.

Yesterday I screened patients. Which means I went through their paperwork for completeness and checked their health history for specific things. Such as history of blood thinners, current chemo regimen, and history of anaphylaxis to vaccines. All of which may not play as well with the vaccines.

For four hours I went through car after car after car.

Paperwork after paperwork after paperwork.

I was told that the expected vaccine appointments for the entire day was 490+.

I did not keep track of how many cars I cleared through my line.

Some of the cars had up to 4 people for vaccine appointments in them.

Today I was part of the after vaccine team.

We went along the cars, peering at the times on the windshield that indicated when they could leave.

We asked how each shot recipient was.

We counseled that they may experience flu like symptoms after 10-14 hours and that symptoms were NORMAL.

Heavy on the word MAY.

And advil, ibuprofen (yes, I know they are the same) and tylenol would be okay.

We encouraged fluids.

And rest.

Toward the end of the day, depending on the mood of the vehicle, I began to be a little more loose with them.

If there were more than one person to a car, I asked which one had been shot up.

I encouraged fluids, over the counter medication as need.

I had many conversations about how the symptoms they may experience would be normal.

That the symptoms are their body learning how to react to Covid.

I began prescribing naps, careful to tell them I was not a doctor, but that, as adults, we all had to be given permission to rest.

I said that if they had any push back from their families to tell the families that the Nurse Said So.

Only one person asked about the differences between the vaccine and how people react. I told him that I thought that going into the vaccination with a mindset of it would be okay could be helpful.

There were selfies, and a general atmosphere of joy, with some tears of relief.

Everyone I approached put their masks on in the privacy of their car.

As I told them they were free to go, I reminded them one more time to be kind to themselves.

And congratulations on getting both vaccine shots.

I have decided.

After working way to many late nights in the last two weeks.

Including bad bellies, and OB emergencies.

And an 0530 clock out last night.

I have decided that I am in the middle of a bad call patch.

This is when I work WAY too much overtime.

And my pager gets a workout.

I have angered the call gods.

Nah.

This happens sometimes.

If you pull at much call as I do there will be times when the calls seem to be never-ending.

And the cases are dragging on.

And on.

And on.

And on.

I hope this ends soon.

I would like some sleep.