The post-it reads “Teaching and the ones who only want to do what they perceive themselves to be good at.”

This can be taken in a variety of ways.

I know, and you don’t, that it is about the preceptors who only want to teach one way, because that is the way they think is best.

Now you do.

And you probably have had teachers like that.

We all have.

This can be split into two ways.

The ones who only want to teach what they like.

General cases, for example, instead of orthopedic cases. I get that some OR people do not like orthopedic cases, and feel they shouldn’t have to teach it to new hires.

The truth is that the people who do genuinely like orthopedic cases are unavailable, and you are the only one available, and that is the only case that doesn’t have a student or a new hire. You have to go where the cases are. And you have to teach people about the case on the OR table.

I don’t care if you don’t like the case. I don’t like ectopics, but I precept about them.

Teachers, the vibe of the case that the NEW person is learning is up to you.

It is okay to say, ugh, total knee, I hate orthopedics. I’ll give you one. And then never mention it again while you are precepting and teaching.

This goes hand in hand with the preceptors who are only doing it for the money, and not to teach new people anything other than “THEIR” way. Because “THEIR” way is the only way, capisce?

No, forget I mentioned that, don’t do that.

Be open to instructing new grads, new nurses, students. You might find out that you like it. But try not to poison their minds against what you personally don’t like. It is about them, and their journey.

Because, the new ones, will be out of orientation one day, and you don’t want them to say that they don’t “DO” orthopedics.

I wonder where they learned that?

Often the first week of school is the first week of the year. But having New Year’s Day on a Sunday made that awkward. And most schools and universities delayed the back to school day by a week.

Which means that back to school week was last week.

And the first week is always the most difficult. New classes, new schedule, new teachers, new books.

It adds up to a lot of stress.

Be kind to the ones that are actively starting their semester. It will be hard to shake off the December holidays.

That’s it.

Just be aware that the students among us may be a little more stressed than usual.

As always, be kind. Buy someone’s lunch. Go out of your way to give a nice comment.

It is amazing how a word of kindness can relax a person. The person may be saying that they are not stressed. On some level they are.

Kindness is also a thing for new employees in new units. This is also a stressful time.

Be kind.

It doesn’t cost anything but it makes the world of difference.

Be kind.

That is what Mr. Fred Rogers would have wanted.

Ah, January.

A time of renewal and a time of finishing the Christmas foodstuff bounty.

And using the Christmas foodstuff bounty up.

And using the Christmas foodstuff bounty up.

And using up miscellaneous ingredients that have been a Cookie Thursday is a Thing make in the previous 12 months. Or are in the pantry.

In September I made pickle chips. And, after doing so, I had 2 half jars of pickles. Spoiler alert- not a big mover in this house.

In this second Cookie Thursday of the Leftover theme month, I decided to use them up.

And use up some of cheese clogging my cheese drawer.

Let us also contemplate suture boxes. They come from the central supply in their box. Each box may contain 8-30 suture packets. And some of my coworkers would rather tear into a fresh box, instead of using the box that is already opened.

It is SUTURE.

It does not get stale.

Or moldy.

Sometimes they do expire, because they’ve opened the box with the furthest out expiration date, instead of the one marked USE FIRST.

And the department is left with the suture that they can’t use because it’s expired. Because someone didn’t pay attention.

Pro tip- use up the soonest expiring leftovers. It is just like managing your refrigerator and food waste. Eat Sunday’s leftover pot roast before Wednesday’s leftover pizza.

Why? It just makes sense.

Engagement is the interaction with others beyond self.

In the hospital, it is interaction with other departments, with other staff, with the councils and committees that make this world run. And allows for those at the bedside not to be run over by the policies on the higher levels. It’s kind of like functioning as the little girl at the end of the Emperor’s New Clothes, and she is the only one willing to point out that the Emperor is, in fact, naked.

The wonderful nurses that I work with in Shared Government help drive the conversation and point out things that may be embarrassing now for the higher-ups, but would be infinitely worse if allowed to continue. We have no problem pointing out when the emperor is naked.

And others do not.

It is not that they do not see, or do not care.

It is that they are tired. It is all they can do to work their 12s and go home. Only to rinse off, sleep, eat, and get up to do it all again.

I understand that they are tired.

And beat down.

And can only care during their working hours.

Because who knows what else they are responsible for outside the hospital. Spouses, children, and other responsibilities that drag on them. And for some people, the hours at work are a respite. And for some the hours at home are a respite. And still others are caught, suspended between the two rocks of home and work. And frankly they don’t have the time or the energy to get involved.

And that is okay. Others will take up the mantle.

However, I can’t help but wonder if the fact that I’ve been very involved, very engaged within the shared governance world has actually contributed to my not being burned out. Much. I’m not burned out much. Just a little toasty around the edges.

Can I propose engagement with your department, your hospital, or anything beyond the hospital as a bandaid and needed support to the burnout that every nurse I know is feeling?

It doesn’t take much.

Sometimes just a helping hand to others will do. .

About a month ago I had the experience of teaching a newer nurse about call, call being something I know a lot about. I helped them optimize their screens in the electronic health record, showed them a bit about the EHR in the hospital, and explained the steps of how to get called in for a case, in effect everything that I wrote about in the What to do when you get called in series last spring. 

This is a nurse with less than 6 years of experience, who expressed interest in returning to school information, specifically going back to school to explore what else their nursing degree could do for them. Because the bedside was not where they wanted to be. I could not blame them, knowing that the last three years have been chaotic for a nurse, let alone a new nurse. And we already know that longevity is not in this generation’s DNA.

And a good percentage of new nurses leave the profession altogether in the first five years. I’ll give you a hint, what is 1 divided by 2?

Yeah.

Fifty percent.

17% in the first year alone.

And this is a problem. For the hospital, for the department, and for them and their family.

What makes a nurse who has gone through all the schooling, all the hours on the clinical floor, and all the hours in a specialty area want to leave?

How do we as the bedside nurses who remain, and the department, and the hospital make them want to stay?

On one hand, sure, go live your best life. 

On the other, why?

On the third, how are you going to figure out what you want to do?

All questions that these nurses should look within themselves to answer. 

I am loath to support a newish nurse leaving the profession, or at least the bedside. However, if a nurse is not committed to the wellness of others, why keep them?

The post-it reads ‘if you see a surgeon showing their ass and acting like a toddler, imagine them with a pacifier or, better yet, light up shoes so you’ll have a light show to entertain you when they stomp their little feet in pique.’

Surgeons, sometimes they act like toddlers.

Especially when they don’t get their way.

Or “their” team isn’t available.

Or “their” room is in use during an emergency.

Or “their” instrumentation that they always use, don’t you know, what are you, stupid? is in use by another surgeon.

Hey, I wrote that book! It was part of an operating room kiddie book series that were decidedly not for children.

I titled it “Dr. Alexander, and the very bad, horrible, no good day”.

Much went wrong for Dr. Alexander.

There was a tricycle in his parking spot.

His team was on vacation and he had to work with those other clowns.

His scissors had been swapped for safety scissors.

He had to perform surgery in the janitor’s closet.

His day went so very, very badly.

And then he woke up! Clutching his teddy bear on a stretcher, sucking his thumb.

It was all just a bad dream.

It is comforting to think of misbehaving surgeons and administrators as toddlers. Well, I think it is comforting anyway.

And, with the new imagery of light-up shoes that a friend told me about, highly entertaining.

Doctors, sometimes they are just toddlers. Too bad we don’t have the power to put them in a time-out and take away their online privileges.

It is fun to imagine.

Irate surgeons stamping their feet wearing the light-up shoes. Threatening to hold their breath until they get their way. Threatening to yank their cases until they are told that insurance wants the patient to have surgery at this hospital.

You know, life in the OR.

The pandemic forced a more rapid shift away from brick-and-mortar schools. And classes.

This had been happening.

My BSN was done completely online in 2015/2016.

And, except for the clinical hours, my MSN was also done completely online in 2017/2020.

And all of the education hours that I have taken since 2009 have been online.

There has been a plethora of online degree places and colleges and universities have caught up to the public’s want for online education.

After all online lends itself to an off-shifter such as myself, to access classes and further my education. On my own time, and I can fit it into my own schedule. And I didn’t even have to drive anywhere to do them.

This is what is referred to as asynchronous.

This means that the class participants’ watches don’t need to be synchronized and people can do their own thing. You do miss out on the social aspect of physical classes, as well as the need to look busy when the professor is droning on. Pro tip, always write something, at all times, even if it is your to do list. It makes you look engaged. Of course, you have to follow along in half of your brain, so that you can answer pointed questions from the instructor but I’m like a ninja with this. I’ve been doing it since I was in middle school.

A synchronous class is a class that you actually have to show up for.

I’ve been to plenty of those.

People shuffle in, clutching their caffeinated beverages, and drop their school bags before sitting down. They chatter excitedly about what they did on the weekend. Or they grunt acknowledgement of greetings and close their eyes, preparing to get a few more minutes of sleep.

And then there is me, who gets there early, pulls out the text book and paper, prepared to take notes.

I really do take notes. And work on my to do list. At the same time.

I’m talented like that.

Do I still take notes like this in a PhD program? No, because now I type my notes, and have handwritten back up of any graphs that are created.

A word to the wise, asynchronous requires discipline and the ability to work on your own. However it offers much more freedom.

It is really to each their own. How do you learn best?

Yeah, I know. I did Chex Mix like a month ago.

But.

Let me tell you about the theme for January 2023. This month’s theme is going to be leftovers. This is where I will take some ingredients from 2022, that I still have, and use them. Sometimes I will remake the entire recipe, sometimes it will be the almost exact same recipe, with a change.

This week’s make is Chex Mix. I have tweaked the liquid part of the recipe, what is poured on the cereal, and baked. Why? Because I had 4 boxes left over from December. Some of my coworkers were remarking that they had to make sure they took their water pill that evening. Because some people need to watch their sodium intake.

Hell, all the people need to watch their sodium intake.

And that means you.

Modern food is way too salty.

Why?

To make it taste good.

The same reason they put sugar in things you don’t think require sugar. Because it tastes better.

Restaurants do it too. They put butter, or what passes as butter, on everything.

I rarely add salt or seasoning salt or celery salt when I cook. Just ask my husband.

It is the one cook’s stand for healthyish eating.

We should all be a little kinder to our kidneys.

And our livers.

And our brains.

I am choosing to start small. With a change that I know I won’t even register.

But my kidneys will.

Every year I write this disclaimer. And add to it. And tweak it.

And if I knew how to pin it to the blog start page, I would.

I began writing the yearly disclaimer to be able to point to my posts and say, see nothing to give away the patient here. You know, HIPAA. In case the corporation, that I work for and discuss my blog openly in meetings etc., tries to tell me I cannot write this. Not that they have, but I can believe they would.

I believe in protecting patient’s and staff privacy.

I do not include details that make it clear or easy to figure out which patient or staff member I am talking about.

I do not use names.

And if I do, they are changed.

I change ages.

I change gender.

I change details such as which limb is fractured.

I change details such as which surgery is performed.

And the cases that I do talk about obliquely are changed in how time is perceived as well. The cases/people/staff may not be the same at the time of the surgery.

I definitely change aspects of time. By that I mean there is no relationship between the moment I write the post and the actual events that prompted it.

I change a lot.

So that, if you knew where I worked, you could not figure out who I am writing about.

I discuss issues that impact healthcare broadly.

And, after the events of the past year, issues that impact women’s health.

And covid. Can’t get away from covid.

I do swear sometimes.

But mainly to make an emphatic point.

Sorry, mom.

I’ve been saying since the pandemic began that time has become weird. Or perhaps it always has been.

Time, after all, is a human construct.

When we are little time seems to stretch and contract in rather predictable ways. Longed for things, such as birthdays or Christmas or the end of school, seemed to take forever to get here. And dreaded things, such as tests or doctor’s visits or the beginning of school, seemed to rush and get here so very fast.

Those kinds of time contraction or elongation happen as an adult as well.

Waiting for vacation, dreading tax season.

Waiting for the new baby, dreading when that child goes off to kindergarten.

Time. There always seems to be too much or too little of it. It comes too fast or comes too slow.

Its unpredictability is what makes it predictable. Expectable.

And then enter the pandemic.

Time has contracted or expanded in weird ways. Or just appeared out of nowhere. Out of time, as it were.

There was the wait for the vaccine. There was the end of the pandemic celebrations which, in hindsight, were premature. Now it is the wait for the newest variant. And the wait for the end of a pandemic that will probably end with a whimper.

I graduated with my MSN in 2020. That was nearly 3 years ago. I became a nurse in 2001. That was nearly 22 years ago. This year marks 30 years since I graduated from high school.

Why does it all feel like it happened yesterday?

Time, huh, what is it good for?

(apologies to Edwin Starr who wrote the song War)