A coworker and I were talking this week and she said she would no longer say WTF. Instead it would be WTAF.

The A is for actual.

I thought that was perfect and I, too, would be adopting the phrase.

This week on WTAF: work day after holiday BS.

Oh, there’s another acronym.

Today is the first day after a holiday.

I was on call last night. Yeah, I know.

And a surgeon called and asked for the 0800 slot in a room that was not slated to start until 1200.

I gave him the time slot. And, because I’m nice and thorough, I texted the day shift charge of the change.

Who informed me that he told an entire team to come in at 0930. Because their case wasn’t until 1200.

Let’s pause and let that sink in.

The day after a holiday, he told an entire team to come in at 0930.

There were two techs slated to be out. But not nurse.

An ENTIRE TEAM 0930.

Thud, went my head against the desktop.

Fine. I’ll come in an start the case until the nurse gets there. But I was not to do that either.

Oh, oh, oh. And he told the CRNA that there would only be two rooms after 1700.

I repeat, on the DAY after a holiday.

Sheesh.

There are many ways that politics is built into Nursing Practice.

You have to be political to your bosses.

I got stopped this week in the cafeteria on my way back to the OR while I was on a break.

The president of the hospital stopped me after I paid for my baked chicken tenders.

He wanted to introduce me to some muckety-muck he was squiring around.

He was with two men, one who he introduced me to right away. The first man was something in finance. And Matt said very nice things about me.

We waited, kind of awkwardly, while we waited for the second man to finish the conversation he was having with the family of a patient.

I am still clutching my chicken tenders.

I was introduced to the second man who was the new doctor in charge of the region. Matt said very nice things about me again.

He introduced me as the Shared Governance Queen, as a Great 100  nurse and a recent recipient of the Corporate Nurse of the Year award. And that I was a hell of a team player in the operating room. And that he had worked with me when I was at another regional hospital.

I am awkward and smiling and I shook his hand.

And bid them goodbye as I was sure there was more important people to meet and I had to get back to the OR.

Matt continued on with his tour with the finance man and the chief regional doctor. .

I can be political when it suits me. I like Matt, he’s done really good things at my hospital.

And, still clutching my now cold chicken fingers, I went back to work.

 

 

Wednesdays are going to be about doctors.

These can be medical doctors.

They can be dentists.

They can be DOs.

But doctor stories will abound.

Some of them will be nice.

Some will not.

 

About five or six years ago I was approached to do the staff schedule.

This means I would make the staff schedule. Most people worked 8 hours a day, but there were a few 12 hour people and the call had to be assigned.

I was hesitant but our scheduler, our manager, was accepting a position higher in the company and wanted a trustworthy person to hand it off to.

I said yes. Because why not? Someone has to do it.

Jules and I would have conversations about how to balance all the schedules and their personalities.

I took the scheduling software class.

I did the first schedule along with Jules.

And then one on my own, with her overlooking it.

And then I was off to the races.

Except for a six month period, when they gave the responsibility to the administrative assistant, I’ve done it ever since.

That’s a lot of schedules 6 weeks at a time.

I work very hard on balancing the schedule.

I no longer do the calls, because someone decided that the choice should be given back to the employees. But that’s another Tuesday.

There was only one rule that Jules gave me.

And that was to be fair.

Streak Day 2. by the skin of my teeth.

I started my nursing career as a CNA in a nursing home. I moved to a skilled nursing unit at my local hospital while I was planning my return to nursing school. I spent the next six years at this rural hospital in Northern California.

For six years I climbed my version of a career ladder.

I was a CNA in the SNU.

I was a student who did clinical there.

I became a telemetry tech on the Med Surg unit/unit secretary.

I worked my days off as a CNA on the Med Surg unit.

I continued in school and graduated from an ADN program.

I was a Interim Permit RN, which means I worked as an RN, while waiting to take my NCLEX.

I worked as an RN there, evening shift for ten months.

I went to my boss in tears because I had found a job in San Francisco and I would be afforded an opportunity to be an OR nurse in two years. I was so nervous. My boss said she didn’t want to lose me and talked to the OR manager and got me a job as an OR nurse. The hospital sent me to PeriOp 101 class in San Francisco.

I worked as an OR RN.

I became the day shift charge nurse.

I took over the orthopedic service.

I took over 50% of the call.

In these six year I was learning and climbing, the hospital was struggling financially.

There were rumors of closure every six months and monthly I would catch my breath, sure that this was the month it would close.

I know of hardship and working at a rural hospital whose daily census is dropping.

I know of pinching pennies and thinking twice before opening supplies.

I think that this has made me a better nurse.

And a more cost conscious one.

 

Streak Day 1

Tomorrow is the first day of July and I propose a little experiment.

It is also the month that my birthday falls in and I always try to challenge myself then.

My proposal is a writing streak.

I will write every day in July.

Some posts may be short.

Some posts may not be.

Proposed daily topics

Sunday- Patients and coworkers from my past

Monday- Budgetary matters- This is the class that I am taking this quarter

Tuesday- Scheduling

Wednesday- Surgeons, am I right?

Thursday- Political matters

Friday- They did what? A little humor to bring in the weekend

Saturday- Call matters- call stories

I will try.

Hello and welcome to your evening shift.

You will be relieving an 8 hour person.

And, lucky for you, we have the room where there was just a respiratory code.

But, no worries, the surgery must go on.

Such was the fun that I started my shift with last week.

Better judgement prevailed and the surgery was called.

Next was the disposition of the patient.

Oops, the ICU is full.

Oops, the higher level of care ICU is full.

You know this, and are trying to get the gaggle of anesthesia at the top of the table to pay attention.

As they are fluttering and giving life saving medications and crowd sourcing their next steps, you are working the phones arranging for a respiratory therapist, a vent, a PACU one on one nurse, simultaneously asking an orderly to fetch a physical bed, asking the nurse you are relieving to get you a foley with a urimeter, not just a bag, looking up the cardiologist on call.

AND informing the gaggle that there are no ICU beds, including at the sister hospital. And that the PACU will be adequate, until an ICU bed can be arranged.

Repeat the bed information.

Answer the phone with the ABG results. Write them down, with repeating the information back to the RT.

Hang up.

Call the gaggle’s attention to the board and the ABG results and the fact that PACU is ready for the patient.

Prepare to put in the Foley catheter.

Ask the gaggle to package the patient for transport to PACU.

Remind them again there are no ICU rooms and this is a temporary thing.

Yay! Another nurse in my OR is going back to the college I’m doing. She’s going for leadership.

She has questions.

I gave her the application that is due for 25% off tuition.

And the application for the scholarship that is due in the beginning of next year.

And the dates of both of these.

And told her I had most of the books and I was happy to lend them out.

Except for the Kindle ones.

She starts in September

I told her I would help in any way I could.

And so it is the end of the current quarter.

7 weeks, going into the 8th week of leadership.

But.

I have not looked at my graded work.

All of a sudden I am afraid to look.

I put this fear down to the C I got last summer.

The one that knocked me out of the program.

I got myself back in.

But now I am afraid to look at my progress.

How do I do this?

At my latest shared governance meeting, which I was not anticipating,  I shared my latest project with one of the other nurses.

And, to my surprise, she was interested and thought it would be useful for her coworkers who also don’t sleep on call.

So, I am developing it to share sooner than I thought.

And the call for poster abstracts went out this week and I have until September 27 to write up the Call Preserver for AORN next week.

Apparently I was wrong.

The presentation abstract and the poster abstract.

Two totally different things.

Which means that when I submitted last year for my RF project I only submitted for the presentation.

Not the poster.

Bother.

Now I am going to submit both projects.

Fingers crossed.

Wish me luck.