You know that scene in Wrath of Khan, where Captain James T. Kirk is bellowing in anger and grief “KHAN!!!”? Yeah, that one. Today I went around yelling ENDO!!! No grief but plenty of rage.

There was an 0800 hemi-arthroplasty case for an on-call doctor. An endo doc called and asked if she could go at 0730. My reaction, that I bolstered with my assistant manager via text was no. We would have been going back to the room shortly after 0730, especially with this doctor. My phone would not stop ringing; a cancellation for Monday, a second add on that wanted to be done at 0930 which I scheduled for after the hemi at 1030, and a request to schedule an endo case at 0730. I spent half of my case on the phone, setting all the pieces together to form a Sunday.

And then the hemi cancelled. I scheduled the second case for 0930, and told endo that they could go at 0800. They called and asked to add a second case, I said only if they were done by 0930, as there was a case. They called again and asked to add a third case. I said no, no, no, no, hell no.

And then the hemi surgeon called and had a second hip fracture and wanted to go at 0800. I hated to disappoint him but I had filled that spot up. We settled on 1030.

When I arrived at the hospital at 0830 I went through my usual pre-case routine. Upon realizing that there was a 7 deep queue for the transporter, my tech and I went and fetched the patient from Med-Surg. I go in search of my CRNA, who was down to do the endo case. It was 0915 and they hadn’t even started yet. They didn’t even have a patient in their department yet. They had been waiting 45 minutes for transport. No, I don’t know why they didn’t go up themselves but that’s a story for another time.

The case I told them had to be finished at 0930, in order to complete our cascade of cases for the rest of the morning, didn’t even start until 0935. ARRGGGHHH!!!

Oh, and the orthopedic surgeon had arrived forty five minutes early. Of course.

The endo case finished at 1030, throwing off my entire morning. Instead of finishing at 1130, we finished at 1330.

ENDO!!!

The hardest part of my job as the evening shift charge nurse is getting other people to do their’s. People seem to want to go toward entropy and are willing only to do what they perceive to be their job. And they are forever looking at the other people working the shift. And they are only willing to do exactly what the other person has done/is doing/has been assigned to do.

Me, I do whatever anyone else doesn’t do. But I have work of my own to do, a lot of work of my own to do. So, I cannot do your job for you.

I will not assign you to do many task.

I will not assign you to do something that I am not willing to do myself.

And that list is vanishingly small.

Sorry.

I have several new techs and nurses on the evening shift. Some of them are new faces, some are old. The story will still be the same.

I wish that the bosses would tell people, when they ask to change their shift, that despite the rumors on day shift that persist, evening shift is no walk in the park. There are no excessive breaks, there are things that have to be done, every night. The most important thing is that there is NO ONE else!

There is no one to give you a break, we are all in rooms.

There is no one to go fetch that thing you think the doctor just has to have, we are all in rooms.

There is no one to take out the trash from your room, we are all in rooms.

There is no one to clean your room, we are all in rooms.

And do not come looking for praise for doing your job. You will not get it here.

Welcome to evening shift, you have to rely on yourself.

Because we are ALL IN ROOMS.

The holidays, a time of wonder and joy. The holidays are for children and old alike. With presents, and food, and parties.

Unless you work in an operating room. Then the holidays are a time of rushing, of working, of continual cases, of seventy hour weeks, not including on call hours.

Everyone and their brother have met their deductibles and need surgery, like, last week. So they can be off during the holidays, recuperating. While everyone around them works to make the holidays awesome and magical.

It is also a time of bigger cases, more complex cases. Oddly, it is a time of increased cancer cases, especially of the bowel.

It is also a time of heart breaking cases. Like the ectopic pregnancy that we had to remove at 0130 Christmas morning. I don’t have children, and I’m not unduly religious, but even I know that is plain wrong by the universe.

I’m not sure if it is because we are busy, busy, busy, but I have no love for December.

Sadly, I wrote this one year ago. And it is still true and he still is a douche.

Ladies, it has begun. This makes me so mad, so sad, and so determined to stand up for my coworkers and the everyday person who can’t stand up for themselves. I know that standing up for yourself as a nurse is easier said than done. But I will not and do not stand for it when I am being abused by a surgeon, or another staff member. That is one of the best things my mother taught me, that I have the ability to say no, this is not right

Tonight, a very long, very bloody case was ending and I went into the room to help them come off the table. As I was preparing to move the patient with the rest of the team, this blowhard dickhead who has been intolerable since Tuesday, starting mouthing off to the nurse in charge of the room. Since was a surgical tech, and the nurse had twenty years of experience on him. He was saying some very not kind things to her, impugning her abilities in the OR, heavily hinting that she wasn’t as experienced as him because she was a woman. I looked at him after one minute of this and I told him to stop, that that talk was unprofessional and would not be tolerated in this operating room. He blustered at me, saying that he was just giving her a hard time. I looked at the nurse and asked, point blank, if he’d been “giving” any of the men in the room a hard time. She said no. At that moment the patient was ready to be moved. We safely transferred the patient and got him to the recovery room. The tech didn’t say anything to me as he left. But, after prompting, the nurse told me about her day with him, about the slights and the jokes at her expense. And I was appalled. I reassured her that she did nothing wrong and that she had to right to tell the tech that he was inappropriate, just like I did.

But I knew that this was just the beginning. Now that his man had been elected, he was feeling free to act like his man in his place of employment. He was feeling free to make rude comments, although he stopped short of copping a feel, which would’ve gotten him fired. At least we have that small saving grace, that laying hands on people in a malicious manner is dealt with swiftly and with termination.

I am going to escalate this to the management. My boss and I will be having a little conversation about this.

I realize that in the OR people feel freer to talk about what is on their mind, to be a little crude. Hell, I swear like a sailor at work. But if you are the only woman in a room full of men and the others are making you uncomfortable you should be able to shut that kind of shit down and make it clear that you will not be tolerating it, without laying hands on the perpetrators.

Fuck that shit, I don’t care if the president elect got away with it.

Not in my OR.

There will be no excuse.

I disappoint people every day.

It is different every time.

Sometimes it is the doctor who wants to impossible 2nd room.

Sometimes it is the staff member who wants to go home early.

Sometimes it is my boss who wants me to tell her that we are fully staffed.

Sometimes it is myself when I do something against my own code.

Sometimes I care.

But mostly I don’t.

When I disappoint someone who unreasonable about not getting their 2nd room, or to go home early, or someone who has to work later because we are not fully staffed, or that the new tech has to go into a room at 1700 when she tells me she’s never done that kind of case at our hospital, but has at other hospitals, and I tell her there is no choice, welcome to evening shift. When I disappoint any of the above, I tell myself that I’ve made a friend.

Of course I am being sarcastic.

They weren’t interested in being my friend, just wanted something I couldn’t give.

That’s how you make friends on the evening shift when suddenly our volume has ballooned to December levels, and it’s only October.

I’ve been at Magnet since Tuesday. It is Friday. I prepared to go to Magnet for a week. I will be recovering from being at Magnet for a week, running around doing all the things I didn’t do for 4 days. 

But, Magnet was worth it! 

Magnet is nurse engagement, it is nurse led, it is nurses teaching nurses, it is research studies, it is products that nurses make themselves that make their shift a little easier. At Magnet, we are all that nurse. The nurse who makes the department better, the nurse who works tirelessly so that the patients are well taken care of, the nurse who works with leadership to make changes to make the nurse’s lives and the patient’s lives better.

 Magnet is amazing.

Magnet is also tiring. I’m an evening shift nurse and I had to be up every day before 0600 in order to get my homework done and prep for the day. The time change helped. 

Magnet is also over. Sitting at the airport with my luggage because I’m ready to be home. 

For tomorrow is Saturday. The night of the Great 100 Gala. And I’m a great 100 nurse. It means that I am one of the top 100 nurses in NC. I’m over the moon about the honor.

But there is a lot of work to do between now and then. 

The last two workdays, the ones that I had off, were awesome. I so very rarely get a full day off between working 5 days a week and weekend call days and I got THREE FULL DAYS OFF IN A ROW. Excuse me if I’m a little excited. This meant no hospital, no call, no phone answering. Okay, I cheated, I answered texts but I did not answer the phone. I’m proud of myself.

But these last two days were a rehearsal for the six days I will have off soon for the Magnet conference. I will be out of state so I can’t take call. I know my relief will do brilliantly. After all, she just got two days practice being the evening charge nurse.

Almost time for the curtain to rise on the Magnet Conference, t-eight days until I leave.