Finally, I connected with a nearby shot clinic for volunteering.

They have four hour shifts; morning from 0800-1230 and afternoon 1230-1600.

Due to my regularly scheduled work hours I will be working this Friday from 0800-1230.

These hours are perfect.

I can do my volunteer thing AND make it to work on time.

They have Saturday shifts too.

I just have to give up my laser call from 0700-1300.

Who can I ask to take it?

Yesterday, when I was explaining sometimes you don’t get a lot of sleep on call.

And sometimes you have early morning meetings and the calls still come.

Last night.

I went to bed early.

I was in bed at 2345.

I wasn’t asleep, let’s not be hasty.

I was reading.

I drifted off to sleep probably at 0030.

Only to be rudely awakened at 0210 by the phone.

There was a bleeding patient and the doctor wanted to go now.

Okay.

I was at the hospital from 0228-0428.

I was home and back in bed at 0445.

At 0817 the phone rang and it was an inspector, coming to survey the new water heater.

And he would be at the house at 0835.

For those following along it was the exact scenario I wrote about last night before bed.

Lovely.

Apparently I’m psychic now.

Sometimes you are at the hospital all night.

Sometimes you are at the hospital some of the night.

Sometimes you don’t get to bed before say 0300.

Sometimes you have to be up at 0800 for a meeting.

Sometimes you nap after the 0800 meeting for an hour or so.

And you wake up feeling like death.

Because that nap?

Is a double edged sword.

Yes, it may feel amazing to stretch out and snooze before your shift at 1400.

When you wake up you may be more tired than when you laid down to nap.

And you are staring down the barrel of an 8 hour shift.

On minimal sleep.

And the schedule for the day?

Is packed.

You get dressed.

Grab some caffeine on the way in.

And hope there aren’t any add ons.

The OR has a new nurse.

This is exciting news.

They are nearly done with orientation, which means they need to be trained on call.

This is crucial information for a new to our OR nurse.

They will need to be able to work independently.

I train all the new nurses.

What to do when they get the call.

What to do when they get to the hospital.

How to put the case in if the surgeon hasn’t.

Why it is important to mark cases as add on when they are.

When to use transport and when to get the patient themselves.

Hint, depends if there is a hospital bed involved or a gurney.

How to call a needed rep for the case.

How to pick the case.

How to pick the instruments.

How to prep the patient.

How to trust the scrub tech to open the room.

How to balance setting the room up and prepping the patient.

The ins and outs of obtaining consent.

How to call in the PACU nurses.

WHEN to call in the PACU nurses.

What to do if the case finishes too early and you are with the CRNA before the PACU nurses arrive.

To that end, I created a binder.

I used to call it the Now What book.

It details processes that nurses need to do while charting or on call.

And how to do them.

I have rebranded the Now What book.

It is now titled the Call Preserver.

Kind of like a life preserver, for call.

I am irrationally enraged at the moment.

But maybe rationally enraged.

My husband suggested I write about it and was surprised I wrote about the 1 year Covid anniversary instead in my last post.

I have the misfortune to live in an HOA. This means a home owner’s association neighborhood.

I do not have children.

I do not use the tennis court.

I do not use the playground.

I have NEVER been in the pool.

I have mowed lawns on empty foreclosed houses.

I have talked to neighbors about their children.

I have listened to those children’s lung sounds and reassured the neighbors.

I try my best with upkeep.

I do mow my own lawn.

I try to keep up with the planting beds in front.

But this last year?

This pandemic year?

This year where I was at the hospital nearly every damned day?

And I could count the numbers of actual days off where I was not at the hospital on two hands?

Excuse me if I still need to mow the lawn from before Christmas and there are leaves.

Excuse me when I don’t get my trash containers inside on a timely basis.

Excuse me when I don’t have the mental bandwidth to worry about what all my other neighbors are doing, San Diego!

I received a cheery little passive aggressive email from the HOA this last week.

Informing me of the yearly inspection that will be done on April 15th, so please finish all the chores to the outside of the house and pressure wash the house and drive way. And plant flowers if we wanted to (heavy on the if we wanted to).

Basically pretty up the yard and house.

I’ve lived here 15 years. This is the FIRST time I have received such an email.

One the reps for the OR lives two streets away. I can literally see his house from mine. And he was shocked by the email. He also thought that it was directed at him.

And I saw RED!

I have had some not very fun times with the HOA in the past.

But this!

I am daring them to say something to me.

I will inform them that I am a working nurse.

I have been at the hospital pretty much non-stop since the pandemic began.

I have held people’s hands as they go under anesthesia.

I have comforted family.

I have ensured that the OR evening shift is run smoothly and if they needed help it would be available.

What I have not been doing is staying at home during lockdown.

Someone has to care for the patients.

Someone has to buy groceries.

I am looking at lawn signs to put up on the day of the “inspection.”

“Hero Nurse Lives Here!”

“I’m a Nurse What’s Your Superpower?”

Subtle don’t you think?

Beats taking the day off (snort of laughter here) and waiting for them to come by and accosting them. And informing them, probably at the top of my lungs, that I have had a hell of a year and I do not need their condescension, or cute little emails, or neighborhood spies (I’m looking at you, San Diego.)

And get off my lawn!

I will be buying a door mat that says “Keep Calm, I’m a Nurse”.

Hello.

And welcome to the one year anniversary of the Covid-19 pandemic.

A year.

Can you believe it has been a year?

Last year at this time I was in my last semester of graduate school.

Last year at this time I was looking forward to graduation. I chose a local college specifically for the graduation experience and having the professors be local.

Last year at this time I was working my normal shifts in the hospital.

Last year at this time my husband was still going in to the office.

Last year at this time I was…

Since last year at this time I graduated from graduate school with an MSN-E.

I have not had the time to study for my certification regarding education.

Graduation was cancelled, with promises of an in-person graduation in the fall, if we wanted to wait.

Fall graduation was cancelled, with promises of an in-person graduation in the spring.

So far, the spring in-person graduation is going on as scheduled, with less allowed guests and I have turned in my list of two.

Since last year at this time I have worked ALL of my shifts.

Yes, we had a slowdown due to the cancelling of all elective cases.

Yes, some of staff got lent to other departments as required.

Not me.

No one wants to cover my shifts.

And none of our ER patients are tested due to the constraints of the testing.

Since last year my husband, who has a pre-existing condition, has not gone in to the office.

He has been working from home.

This has increased our electrical bill and our heating bill.

The office is above the garage and is susceptible to wild swings in weather, being poorly insulated.

In the summer the office is unbearably hot. To make the temperature of the office comfortable the air conditioner in the house has to be run at a very low temperature. The entire house has to be cold, so that the office can’t be 85 degrees. My answer was a stand-along AC unit that only cools the office. But the HOA rules state we can’t have a window unit. Sigh. We now have a free standing 2×3 unit that vents out the window. Because that is allowed. The vent, not the unit. The next issue is going to be the 4 mini doors that lead to the under the eaves cubbies which are not well insulated. This is a theme for the house. I will be working on insulating and sealing these doors when on vacation in April. Wish me luck.

Since last year I feel that all I do is work and sleep and work some more.

I know this is a depressive behavior. That I do the minimum of house up keep on my off hours. That I sit and read for hours at a time.

I am trying to cope.

But I am fully vaccinated at this time. And my husband’s vaccine group will be opening up next week.

And next week I am going to start volunteering at a vaccine site during the mornings before work. They have a 0830-1230 shift which means I will be available for my shift at 1430.

I am stuck.

I mean, we are all stuck.

I mired in a quagmire of my own making.

I don’t want to cook.

I don’t want to clean.

I don’t want to do anything outside of work.

Read, I want to read.

I want to read all the things.

I don’t want to do anything outside of books and work.

I feel that a lot of my coworkers are in the same boat.

Or it might just be me.

(shrug)

I could do any of the things; cook, clean, read, not work.

But I cannot stir myself to do any of it.

I find myself doing the bare minimum to keep the house going, to keep us fed, and in clean laundry.

This is not like me.

I should mow, the front lawn looks unkempt.

I should put away the clean laundry.

I should clean the garage.

I should do more than I am.

I should.

Instead, I feel that I’ve been worn down.

With Covid.

With vaccine news.

With news hitting us from every side.

With the science deniers and the mask refusers.

I understand that we are all depressed.

It has been a LONG, HARD year.

I feel that I need to save what energy I can to actually go to work and do the work of the operating room.

Tomorrow.

I have a plan about tomorrow.

Tomorrow I will call the window installers and inquire about our missing screens we paid for.

Tomorrow I will fold and put away all the laundry.

Tomorrow I will act like a functioning adult, rather than an adult who only goes to the hospital and comes home to read my book.

I have lost my mojo.

Have you seen it?

It is a small thing.

That allows me to look past being tired, and frazzled, and did I mention tired?

I know, I know.

This is a state that a lot of healthcare workers are in.

We have always been praised for being resilient.

We are resilient.

We roll with the punches.

But this past year has been punch after kick after punch.

And I have lost the ability to go the extra mile.

Or, rather, I misplaced it.

I believe in shared governance.

I believe in the power of the bedside to raise concerns and work hand in hand with the corporation leaders.

For the patients.

For the coworkers.

And, for ourselves.

I had a meeting this morning, to create the agenda for the next hospital based coordinating council.

And never was I so happy when the chair from last year, this last year when we met so few times, when much of our working lives were consumed by the pandemic. She said she was absolutely fine continuing as the chair for this next year, so that she can get the full breadth of the experience.

And I will continue as the support, as the rising chair.

All I could do was sigh in relief.

This gives me time to find my mojo.

Maybe I should offer a reward.

I’m not sure about what they are teaching these days.

Over the last several weeks, I have watched a nurse leave the room during emergence from anesthesia.

AKA one of the most dangerous times of the case for the patient.

To fetch warm blankets.

I ask why.

The answer I get is “they’re shivering.”

Sigh.

It is not because they are cold.

It is part of the emergence from anesthesia.

Part of the anesthesia delirium.

Is it kind of painful to watch?

Yes.

Are they cold?

No.

Will they be aware that warm blankets were placed on them at the very moment they emerged from anesthesia?

No.

While their brain is still resetting?

Also, no.

Should a nurse be right by their side, in case of emergency?

Yes.

Delegate the fetching of blankets, if you must.

But do not leave the room while the patient is waking up.

I received an electronic copy of my performance review.

I’m still trying to process this.

It reads like it is two people.

She is willing to do all the jobs in the department: cleaner, circulator, scrub.

She does not go into the rooms enough. (while doing all the jobs in the department)

She is very helpful and willing to work extra to get the job done.

She does not offer a break after 1700. (all afternoon breaks are done before I get there)

She does not ensure that the late people (1900) get off on time. (I’m usually in a room myself.)

She catches problems for the next day and works to solve them.

She sits too much at the desk. (I am adding cases and working on getting things for the next day.)

I got the sense as I read this that my lunch, that I try to take at 1620 at the latest so I can be free to relieve someone at 1645, is not appreciated. It has been so hard to carve out a lunch time that does not interfere with the OR cases. And next to impossible to take a lunch or a break after 1900 when everyone leaves, which is what I think that they want. This leads me to going without.

Sometimes I have to give unsavory assignments and I try to be fair and not always have the same people do them.

Sometimes I take the unsavory assignment, especially if it is going to go past 1830, and leave the late people out to do the stuff I do. Unsurprisingly, this is not popular either. And can double my workload as I still do all the stuff after the case, or between cases.

One of our late OR assistants quit, someone has to take up the cleaning and moving slack.

Again.

If the writing is on the wall and I have to keep a nurse or a tech to finish at 1700 or 1900 (and I’m talking 15 minutes at most) I ask/tell early. This is not an everyday or even every week occasion. And if someone offers to stay because they also see the writing on the wall, I sometimes take them up on it. Only to hear them complaining the next day that I kept them late.

Say it with me now!

PEOPLE!