No heat Thursday continues with healthy butterfingers.

In the spirit of the no heat month theme, I knew that I wanted a healthy cookie in there as well.

Well, I say cookie.

I saw this recipe for healthy butterfingers with 4 ingredients.

Today’s calendar was jam-packed with meetings. I knew this. I also knew that simple would be best.

You see, the sole in-person class of the semester is tomorrow. This will make my second 97-mile round-trip of the week. There is tons of reading for my three classes and I knew I wouldn’t have much brain space for a complicated make.

Enter the healthy butterfinger.

Mix together 3 c pulverized corn flakes, 1/3 c maple syrup. 1 c peanut butter.

Portion out onto a cookie sheet with parchment paper. In the recipe, they get all fancy with shapes. I definitely do not have the brain space for that, I used the smallest cookie scoop.

I scooped one and a half cookie sheets worth of small balls. Into the freezer to harden.

While this was happening, I was listening and engaging with not one but two meetings, one right after the other.

Oops, gotta leave to get the flowers for the awards ceremony.

Got the flowers, got to the awards ceremony, emceed the awards ceremony, gave out the four healthcare and nursing awards.

I told you my day was jam-packed.

But, Kate, what about the 4th ingredient in the butterfingers?

While driving home to bathe the now-frozen butterfingers in chocolate, I listened to yet another meeting. This one was about the hospital and was exciting. When I got home, I hurried inside to continue listening to the meeting, while jotting down what I remembered during my 10-minute drive home and taking notes on the rest of the meeting.

It isn’t even noon!

After the meeting, I dug out my double boiler and started melting chocolate chips for the aforementioned enrobing of the butterfingers. It was going swimmingly until I ran out of chocolate and added additional chocolate chips.

The chocolate promptly seized on me. I dumped that chocolate and started over.

Now I am out of chocolate chips (how did that happen?) and 90% of the butterfingers are covered.

I just put the naked ones into the container with the others. I am sure that someone will want them without chocolate. If not, I will retrieve them from the hospital because I will eat them out of the freezer as a treat.

This make is very fragile and does not like being at room temperature. I quickly made an “In Fridge” sign for the drawer.

That was my day.

Lessons learned- use candiquik to coat the butterfingers. Standing over a double boiler is HOT.

The healthy butterfingers are good, though.

Yes, I know there should be an article like the word the, but then it wouldn’t match the cadence with The Night the Lights Went Out in Georgia by Reba McIntyre.

As discussed in the Monday Musing on 8/14/23 hot enough for you, it is high summer here in North Carolina. Hot days and afternoons often spawn late-afternoon thunderstorms. You’d think this would cool off the temperature and bring down the humidity but you’d be wrong.

The hospital is an electrical power hog.

Think about it- all those rooms, all those corridors, all those automatic doors, all those lights, all the air conditioning, and don’t forget about all the equipment in the specialty areas like the laboratory and the operating rooms. All of it takes electricity.

What happens when the thunderstorm is so intense that it knocks out the power to the hospital? It doesn’t even have to be a close storm. The incident that knocks out the power to the hospital can be a car hitting a transformer. Or a squirrel getting frisky with the power lines as has happened in, well, everywhere. If you Google squirrel and power lines there are many stories from around the country and around the world.

My point is it doesn’t take much.

Luckily hospitals have generator backup. This is the very large generator that backs up specific electrical systems in the event of an outage. These are things such as the life-sustaining ventilators, minimal temperature controls, half-lights in the corridors and rooms, and are usually indicated by a red outlet. No generator is big enough to power everything the hospital usually uses the power for. If it was it would be ginormous and require vast amounts of gasoline to power it.

The operating goes on stand-by during generator use. This does a couple of things. It decreases the drain on the generator, and it maintains the patient safety while in surgery because they are not being operated on under generator power.

Because what would happen to the patient if the generator failed during surgery because the surgery was allowed to continue despite the loss of power and working solely under generator?

The room would turn completely black with no lights. The ventilator and anesthesia machine would not work, which means the patient would stop being ventilated and the anesthesia gases would no longer flow. The pyxis machine would not work, which means the CRNA could not get medication out of it to give to the patient. The OR spotlights would not work, which means the surgeon could not see what they were doing. The video tower would not work, which means the surgeon can no longer see what is going on during a laparoscopic case. The electrocautery machine would not work, which means any bleeding the patient has must be controlled with the old clamp-clamp, tie-tie, cut method of controlling bleeding. The robot must have consistent CO2 insufflation so that the patient is not endangered by the working elements or the trocars, which means sudden loss of generator power can lead to important abdomen things being punctured because insufflation cannot be consistent.

In a word, the OR would be fucked.

I do not use that word lightly.

There could be tears.

In my 22 years, the complete and utter loss of power has happened to me twice while in a surgical case. Both times the generator kicked in after what felt like forever, but was, in reality, less than 30 seconds. You can imagine the chaos.

No, Virginia, the operations that were not yet underway when the power failed and the generator kicked in CANNOT be allowed to go forward.

But, but, the patient took time off work, arranged a ride, and has been NPO for all that time? What am I going to tell them?

The hospital is very sorry but surgery has to be cancelled to KEEP you safe. Yes, the generator is supplying power to some systems.

FOR NOW!!! But what if it failed?

It is the operating room nurse’s job to imagine the possibilities. And one of those possibilities is the generator failing, perchance by running out of gasoline. If that happened at the wrong time, the patient would be in dire straights. Or dead because of what transpired in the paragraph that describes/supposes what would happen if the generator failed whilst doing a case under generator power.

Yes, it sucks, but would you like to toss the dice and continue for a chance to die?

No, I didn’t think so.

It’s hot. Damned hot!

There is a scene in Airplane when McCroskey back at the airport asks how hot the plane is running. And Ted Striker replies, and Elaine the stewardess relays, “It’s hot, damned hot.”

Or at least that is how I remember it. I remember the instrument panel and Striker relaying to Elaine, who then relays to the tower about the plane’s overall situation. I remember Striker saying that the plane was running hot, and the controls were a little sluggish.

There is a scene from Good Morning, Vietnam when Adrian Cronaur riffs that “It is hot! Damn hot!” when talking about the weather in Vietnam. There is more to the quote, but that is just Robin Williams (RIP) riffing on the heat

I always think of that quote at the tail end of summer here in North Carolina. Middle to tail end of summer.

It is hot!

Damn hot!

And humid!

I don’t dare make anything with frosting because it breaks for Cookie Thursday is a Thing. Frosting does that, you know.

It is hot! Currently, the ambient humidity in the state ranges from 63% in Asheville to 58% in Greensboro and 63% in Huntersville.

And 88 degrees Fahrenheit but only because the sun is going down.

I don’t think I should mow today.

Even in the shade and the cooling temperatures. I am going to practice common sense and not mow.

The western US is going through, and what the world is really going through, a heat crisis. There was an unconfirmed temperature in China of 126 degrees Fahrenheit in July. The Badwater Basin in Death’s Valley peaked at 128.6 degrees, cooling to 120 degrees overnight.

This is not sustainable and we may have already tipped over the precipice.

It’s only going to get worse. The saddest comment I’ve heard over and over again is that this may be the coolest summer of the rest of our lives.

I am very glad that opted for a lighter roof.

I am also very glad that we have done so much to make our home energy efficient. New windows. Completely new siding plus poly wrap where it did not exist. New vent covers that can be closed in the winter to keep the house warmer, or open in the summer to keep the house cooler in the summer. New doors as applicable, back door, including the insulated garage door. Caulking and new weather stripping where applicable. Energy-efficient curtains throughout. Attic fan to blow out hot air when the attic starts to heat up I am selective when I run the big appliances such as the dishwasher, the washer, and the dryer.

My next thing is to hang an energy-efficient curtain in our bathroom which gets blinding sun in the afternoon and heats up our bathroom about 15 degrees.

The kicker is that the house is only cooled to 76 degrees. That’s it, it goes no lower than that. There is an overhead fan on each level of the house. And a couple of stand-along fans too. Especially blowing straight onto the bed.

There is much that living in California taught me about surviving the heat. Too bad there weren’t any lessons about surviving the humidity.

If we are to survive this, we must change our ways.

Climate change is a problem of our own making and our own hubris. Our wings are melting.

The post-it reads “I’ve been an OR nurse long enough that the issues that we solved years ago are popping up again.”

Sigh.

I’ve been a nurse for 22 years, an OR nurse for 21 of them. Let me tell you, I’ve seen some shit.

I’ve also been on committees that solved the issues.

Do I know why I keep getting invited to committees? No, no I do not.

Probably because I am consistent in my support, and am focused when working on problems.

I am also less likely to go off on personality tangents and to work to settle old feuds.

For me, it is about the work and the best care we can provide.

I don’t care about the personalities, I only care how they can impact the care that we give.

I must be frustrating when I decline to engage in shenanigans that some people find life-changing and worthy of their attention. I am that nurse who just wants to work.

Period.

End of story.

However, I have noticed a decided upswing in the issues that we solved years ago and someone new deciding they were an issue again.

Much sturm and drang commences.

The department is in an uproar.

Things are switched and switched back again.

There is nothing wrong with confirmatory projects.

However, there is something wrong with causing the destruction of thousands and thousands of dollars in supplies because someone decided the old way must be wrong.

AND PROCEEDED TO MARK ON STERILE SUPPLIES WITH A BALLPOINT PEN!

This renders them unsterile and unsafe for patient use. A ballpoint pen can cause microtears in paper, and ink is a liquid that can seep into the previously sterile supply.

There are small stickers at the desk that have been used to track supplies.

Maybe ask next time. And don’t decide because a process is before your time it is useless.

Thank you.

The school year is barrelling down upon us.

I know at the university I go to this is move-in weekend. Classes start for the fall semester on Monday.

Your university may have a different schedule but the motions and the feelings are the same.

This time next week, many of the freshmen will be moved into the dorms.

Many tearful goodbyes will be had.

Many parents will leave their children behind to become adults as the parents drive away.

This can be a sad time for parents and students alike.

But…

The students are on the cusp of something new and exciting and adulthood.

The parents are also on the cusp of something new and exciting. They will be rediscovering who they are when they are not so and so’s mom or dad.

Be careful of the new student as they leave the chrysalis and try out the new adult wings.

But be careful of the parents who perceive that something is different as they drive home alone.

Change is good. It is time to acknowledge that change is hard as well.

My fall wish is that all the students will be able to adapt to their changed reality. An additional fall wish is the flip side of that coin. That all parents will be able to adapt to their changed reality.

It’s going to be okay.

If it is not, you have the tools to survive. So do the students, you’ve made sure of that.

The theme for the month continues to be no heat. As in, I don’t turn on my oven.

I always do an edible cookie dough week.

I usually bake the flour, because flour as is from the store is not cooked! There have been several incidences of e coli outbreaks from flours.

But…

I bake the flour. It is obnoxious and turns a light yellow and changes the consistency, making it cakey and kinda weird. Frankly, it takes forever. You have to bake the flour at 350 degrees Fahrenheit for 5 minutes or until it reaches 160 degrees. I always manage to spill it when transferring it back to a container.

Then I read a recipe about microwaving it.

I decided to try it.

I microwaved the flour in the bowl I was going to be mixing the cookie dough in for 30 seconds. It reached a temperature of 130 degrees Fahrenheit. Another 10 seconds and the dough was at 175 degrees.

It still made the flour rather stiff and it stuck to the bottom of the bowl in places. I just stirred it really well, paying close attention to the sticking places. After a good stir, it began to look and act more like regular flour. I added the butter, milk, vanilla and salt.

This has been heavy on my head for weeks.

I had three things I had to complete by July 31.

They were:

1. AORN poster abstract due for AORN Expo 2024
2. AORN Expo 2023 videos and posters
3. NCNA poster submitted

July 31 was the deadline.

Line in the sand.

I finished the poster abstract on July 20 and submitted it for consideration.

I finished the AORN Expo videos and posters and received my 50.6 CEUs on July 28th.

I was stuck on the NCNA poster. That is a lot of white space to fill. And, although I can write and speak about CTIAT, would it be interesting to have the entire story on a poster?

I started asking my coworkers about whether or not they thought Cookie Thursday is a Thing had morale potential and what was their favorite cookie on July 18.

I took 32 of the responses, and made a table answering the two questions. Next to the table I put the quotes that I didn’t ask for but got.

Following a template of sorts, I made different headings. Design, Method, Outcomes, Further Steps.

In the Further Steps section I explained that Cookie Thursday started before I started the back to school journey and that I realized that I did not do it properly in a research minded manner. But I have plans to do that in another department.

And this is the moment that I realize I didn’t add ANY pictures to the template. I can print them myself and add them to the poster later but what a rookie mistake! I also didn’t add any references.

The poster got submitted late. I submitted it last night August 6. I had emailed the person collecting the posters on July 31 after I realized that the posters were in reality due July 30. All I can plead is the summer cold that I was not enjoying at the time.

Not covid.

Myself and my husband were both sick sick sick. The poster was the furthest thing from my mind.

The person got back to me almost immediately and told me I could submit all the way through August 13.

It is submitted now.

References are not easy to find as it is such a different take on morale. You know, that isn’t pizza and is driven by a singular person, not by the hospital or the department.

But all three things are done.

There is still a week before classes start.

I count that as a win.

The gown card reads “I’d say we’re too smart to be on this shift, but that may be why we are on this shift.”

Different shifts require different levels of knowledge.

They also require different levels of imagination and weebles.

By that I mean that when you knock down a weeble, they don’t stay down.

A toy from the 1970?

When weebles wobble, they don’t fall down?

Different people gravitate to different shifts.

This may be because of the management mix on those shifts. This may be because of personality types on the other off-shifts.

This may because we are there to get the case/job/work done.

End of list.

Some shifts are there to put in their time before they get relieved.

Ahem, day shift.

Some shifts are there to do the work because they know they won’t get relieved.

To go back to what the gown card, shift types kind of tend to stick together.

The off-shift knows that there is no other option but them and work with it.

After all, there isn’t anyone to complain to.

Get in, do the case, get done.

It really can be as simple as that.

To put it simply, there is a patient who needs us. We have the skills. We have the knowledge. There is no one coming to save us.

We might as well save ourselves.

Does this make us smart?

No necessarily.

It does make us a cohesive group, with little in-fighting.

Because none of us are getting out of this shift, until the work is done.

Okay, school hasn’t started yet.

Depending on your school, it won’t for another week or three.

However, it is important to start thinking about school. About the classes that are going to be starting soon.

For some of us, this involves thinking about and procuring school supplies.

And not just for ourselves.

This time is one of my favorite times in the school year.

The school supply drive.

All the new books and papers and folders.

All the new possibilities to begin a school year well-supplied and in the right mindset.

Not everyone has that privilege. To that end, I have been involved in the school supply drive at my hospital for several years.

After all, we don’t have children to buy school supplies for, and there is only so much room at our house for new supplies.

Why not volunteer at a school supply drive this summer?

At the very least, chuck an extra pack of paper into the cart when you are buying yourself some school supplies.

It would help out so many people. I’m not saying the trunk of my car is full of school supplies, but I kind of am saying the trunk of my car is full of school supplies.

If I can help those who are struggling, why wouldn’t I?

Through the magic of podcasts, I discovered a British podcast called You, Me, and the Big C.

This was several years ago.

It was hosted by 3 women, two with breast cancer and 1 with colon cancer. The pod was about life with cancer, how to deal, how to get on with it. It won several awards. One of the presenters with breast cancer died, almost immediately after I found this podcast. It soldiered on with the now 2 women with cancer, and the widower of the third presented.

It was always life-affirming and wonderful to hear new podcasts.

You may remember last summer when Bowel Babe died. She was a Deborah James, an accidental influencer, teacher, pod-caster, wife, mother, and made a Dame by Prince William himself in her garden for her cancer fundraising.

I have always been a proponent of cancer screening. As soon as I turned 40, I scheduled my first mammogram and have gone every year. I knew I would do the same when I turned 50 and the colonoscopy.

Then they dropped the recommended age for screening colonoscopy to 45. During a pandemic. I will get on that, I promise.

Here’s the thing with cancer, it waits for no one. Grows quietly in the dark of ignorance.

After Spring Semester ended I scheduled my first screening colonoscopy. I didn’t care who would perform the procedure. My only caveat was that it had to be before Fall Semester started.

Guess what I have done for the last two days?

Yeah, prep and colonoscopy.

I always feel like I need to walk the walk, if I am going to talk the talk.

Truthfully, it wasn’t horrible. At least I got a nice propofol nap out of it. They do not lie, propofol burns when it is being injected. Most pain I had in the entire experience.

The screening was clear except for one bitty polyp that got removed. This means I don’t have to do it for another 7 years. Yay!

However, it is Cookie Thursday. Of Cookie Thursday is a Thing. You may have heard of it.

August is No Heat Month, where I don’t turn my oven on at all. Because it HOT.

I needed a cookie that is shelf stable because I made the batch on Wednesday. That didn’t involve the oven. Fudgy Cocoa No Bakes it was.

Any colonoscopy joke can sit on the side-line.

By decreasing the age of the first screening colonoscopy they are catching more cancers at an earlier stage.

At a more curable stage.

If you are above 45, ask your doctor today.