Spooky Cookie month continues on Cookie Thursday is a Thing. Today’s make is bloody bandages.

These are operating room folks, and it is hard to gross them out.

No ick matter here!

Bloody Bandages

Sugar wafer cookies, the ones with the cream filling between thin crispy wafers.

white chocolate Candiquik. This is meltable chocolate that comes in a variety of flavors and colors and here in the United States it goes by that unfortunately spelled name, or some craft stores carry it for candy making. It melts fast in the microwave and smoothly.

toppings- for effect I used a combination of green sprinkles, and freeze-dried raspberries

I had to experiment a bit with technique. The first tray I laid the wafers out, melted the chocolate, tried to make a square of chocolate with a spoon, put the toppings on

This works but it gets messy as the chocolate begins to dry.

The second tray I had the wafer cookies in a stack, picked them up, spread the chocolate using a knife, added toppings. This worked much better and I was able to get a more uniform square of chocolate

What makes these bloody bandages is the rectangular shape of the wafer cookies, and the hopefully white square of chocolate. And the raspberry “blood”.

On some I added green sprinkles to simulate infection.

I think they are adorable, and they were very fast to make. I barely got through NPR morning edition podcast, which is about 15 minutes long. Seriously one of the fastest makes yet.

Silly post incoming.

Dot is our 9 year old cat.

She is a brat.

And deeply bonded to me.

Oh, so deeply.

Her favorite thing to do when she is not sleeping is to sit in touching distance.

And STARE.

I’m not sure what she thinks I am going to do.

When I drive up from a call case, not matter the time, her little head is in the window.

And when I start up the stairs she meows at me. I’m not sure what she’s saying, she’s still inside, and I can’t hear her. And she’s a cat. Probably something along the lines of “where have you been, lady!”

I unlock the door and head inside. And she meows at me, and does that cute little ankle rub that all cats do. She accompanies while I lock down the house for the night and turn off the lights. She heads to the bathroom at the same time when I am brushing my teeth and getting ready for bed. And drinks water out of her cup that lives in the bathtub. The cup used to live on the counter but she kept knocking it over when they drank it down to half full. Because she’s a brat.

Sometimes she sleeps with us, most of the time she sleeps in the office distraction chair.

She does this no matter what time I get home: 2300, 0000, 0200, 0400, 0600, 0800.

But she started doing something obnoxious since I’ve worked the call job. I’m not sure if it is because I am home more, or what.

No matter what time I head to bed, even if it is after morning feeding time, she has to wake me up by 1100. Usually by applying her whiskers to my face in whisker torture.

Every damn morning.

As soon as she sees that I am awake, she curls up in a ball next to me and goes to sleep.

Why 1100?

Don’t know.

And she loves Zoom, especially the camera. I have to warn members of the zoom meeting I am on that they may see a white cat and her name is Dot and she has zero zoom chill.

Right now she is sitting at the top of the stairs, waiting for me to go downstairs.

Again, I have no idea why.

I mention it because she did it again this morning, even after I got to bed at 0500. And now I am tired.

I certainly hope that everyone knows about the neo-natal nurse in the UK who is on trial for killing babies. She has been accused of murder of 7 babies from 2015-2016, and the attempted murder of 10 more. Caught in the act of one of the attempteds she tried to backpedal, to blame the deterioration on being something that was actively happening.

But, Kate, why is this so different than the Radonda Vaught case in Tennessee. Because that death happened as a swiss cheese flaw in the system. The medication that was administered should not have been at that particular pyxis, available to be given in an unmonitored place in the hospital.

But this nurse. She has been accused of willfully causing the death of several babies who should have been safe in her care. She would inject air into IV lines, or poison them with insulin, which is very hard to detect by autopsy. She was the only nurse who had been present on the unit for all the deaths and codes. Yes, it is conceivable that someone could have snuck in, but unlikely. The NICU is an open ward, with little bays for the isolettes, warming beds, and cribs.

Please read up on the case, it is chilling.

But that is not what I wanted to talk about.

I want to talk about the mirror that must be held up to the profession. And why it can be a good thing.

Can it be annoying to be the ant under the spyglass? Yes.

Can it go to far, and lead to accusations that are not true? Yes.

We have to rise above that. These are vulnerable people. They are the ones in hospitals, and they are in the healthcare worker’s care. We are observed, our charting is minutely gone over for errors. All of this is to keep the patients safe.

It can be good when a mirror is held up, because someone should be watching. These are people’s lives that depend on us. We need to remember that.

And to not kill the patients.

No, not even for whatever twisted satisfaction it gives you, just don’t

The post-it reads ‘choose your vaults, AKA choose who you disclose to carefully’.

This is referring to the people in the department that lives to gossip and the one who loves to trot over to management and tattle. These might be the same people, or they may not be.

The importance is to know which is which.

The information disclosed may be as simple as ‘oops, I accidentally wasted a supply’ to ‘did you know teammate X did this or that’. No detail is too salacious for this group. They may even share their experiences with a similar situation.

With one group you might get commiseration/shock at the situation. And the discussion ends there.

With the other group you might get commiseration/shock at the situation, and someone who b-lines to the management to tell.

The operating room is hard; we work fast and are told to work faster, lives are on the line everyday in the rooms. Sometimes, people just want to bitch. They don’t intend to complain to management, or even to the charge nurse, they just want to get their rant off their chest. Often, they feel better after and can go blithely on their way. In this instance the person who got the information is now the keeper of the information. And the receiver can either simply acknowledge that they now have information and keep it to themselves, like a true vault, or share it with others.

It is vitally important to know who is the proper vault in the department. And who will share confidences with EVERYONE because it is just something to talk about. Or they feel it gets them brownie points with management.

I cannot stress this enough, know which is which. Because even if vault b (the one who cannot keep details to themselves) only discusses your information, no matter how small, with other members of the team and not management, they have proven themselves unworthy of more than basic keeping of information.

You want a true vault, the one in the department who keeps confidences and details to themselves. And does not share with anyone without your express permission.

Except when there is danger to the ranter to the patients, or their family, or the department/hospital. Or except when there is danger from the ranter to the patients, or their family or the department/hospital. All bets are off then.

It’s a fine line.

I feel attacked.

No, not really.

Yesterday at school they had a seminar on preparing for the exam that is to be done prior to starting a dissertation. And how to avoid procrastination.

My nearest and dearest will tell you I am a procrastinator. I’ve been one for a long time. And no matter the strategies I’ve learned about, and programs I’ve tried to self-teach to not be a procrastinator, it has been to no avail.

To do lists.

Masterfully crafted schedules.

Pomodoro timer technique, where every hour is chopped up in to 25-minute segments. And you are supposed to go on to something different after the segment. Until the work is all done. This works okay.

Minutely written howler lists that I write myself. A howler is a yelling device that Harry Potter utilizes to have the parents long distance yell at their kids. I use these as a way to prioritize what needs to be done.

Bupkis.

No idea why.

No idea how to train myself NOT to be a procrastinator.

Not much helps.

For example, this week I had a 1-page paper due in the Financial Longevity class I picked up last week, a 45-minute philosopher presentation that I had to give on Friday that needed a PowerPoint made to help deliver the remarks, and a statistics midterm that is due on Sunday.

I spent the week doing the reading for the philosopher presentation and witing the pilosopher script and PowerPoint. And the reading for my new class, including an outline for the paper due yesterday. And the studying for my statistics midterm. And blog writing, and outlining the major papers I have beginning in a month. And the philosophy midterm just dropped, a 20-page paper on four different philosophers and what was learned in class due next Sunday.

I am learning something and working every day.

So why do I feel like I am not doing enough?

And writing it down shows me that I am not behind. It just feels like I am.

As I joked to one of the PhD professors living through a pandemic, well, working through a pandemic on the front lines wrecked my brain. After all, when every day is do or die at the hospital, what is the point of a 20-page paper?

Nevertheless, I soldier on. Even if my brain feels sluggish.

I wonder how much of that is the pandemic fatigue that all nurses I know have, how much is recovering workaholic fatigue, and how much is true procrastination.

Hmm. Must ponder that.

There is a Gaelic saying that I printed up for my desk translated into English it means ‘Don’t Lose Heart’. And I’ve offered a copy to those in my cohort. As I feel we are all in the same boat.

There is a post-it on my laptop in my dining room desk that I wrote the same saying on. Right next to the post-it with my favorite reminder from Elyse Meyers, “I Just Do Things Scared.”

To go along with this month’s theme of Spooky cookies, I chose to make Candy Corn Cookies. I make these every year. And every year, people are surprised by how good they taste.

Because candy corn undergoes an amazing transformation when heat is applied. It turns to caramel.

Transfiguration through application of heat sounds familiar to anyone in healthcare.

We are under a tremendous amount of pressure from all sides- covid, flu barreling down on us, the increase of the RSV or respiratory syncytial virus. This is a virus of the respiratory track and mostly affects children.

All of that is still dangerous though. Wear a mask, wash your hands.

It is the sudden increase in pressure that creates the heat for healthcare workers.

I mean, the hits do keep coming. All of the above respiratory viruses, over full hospitals, chock full and holding emergency rooms, increase in the OR schedule and need for more and more from the OR.

And since we are humans living in this society there are other pressures as well, including inflation.

It is no wonder that there is a nursing shortage, and an overall healthcare shortage, and a teacher shortage, and nursing school instructor shortage.

The list goes on.

Like candy corn, we have no choice but to transform.

There is a flow of admissions to the hospital. In, get better, or not, and leave.

Hospitals in winter are usually full. And less so in the summer.

Same with the operating room schedule. Here in North Carolina, most people have an insurance deductible to meet before insurance really kicks in. Once the deductible and out of pocket max has been reached, in theory the rest of hospitalizations, and surgeries, are not on the insured’s bill, but the insurer’s bill. In theory.

This means that many, many people have reached or will reach their out of pocket max toward the end of the year. And can suddenly afford their surgery. This stresses the surgery schedule.

Happens every year. Like a tide.

Of course, the tide doesn’t drop until March. I have a theory for that too. Getting the out of pocket max over with in the first of the year means that the rest of the year will be paid for. This is what I would do.

Some, but not all, admitted patients are surgery patients.

Even the non-surgical patients typically follow a pattern of admission. Up in winter due to flu season and colds. Down in the last spring and summer due to kids being out of school and away from passing the cold around amongst themselves.

In years past, summer admissions decline.

But not during covid times.

My hospital has not had a lighter census (admitted patients) since 2020.

At all!

Hell, we’ve been full 99 times out of 100 all year long. And when the hospital is full the emergency room has to hold patients who otherwise would have a bed on one of the floors. Recently, the ED in my hospital had a hold number of 17, more than half of their total beds. Even with a new unit on the floor, the number of hospital beds available cannot keep up with the demand of patients.

This means that the staff in the ED and on the floors have had no time to rest, relax, or rejuvenate for nearly 3 years now.

I fear for the state of the hospital during the winter months with the certain increase of bed needs due to flu.

Compounding this is even if there was a place and a bed to place them in, there may not be people available to care for them. This I put the blame squarely on the continued covid pandemic. Because it’s not over, not even close.

No matter what you want to believe.

The post-it reads ‘there are only 6 or so distinct personalities in the OR, or a combination of them. These comprise your coworkers).

This is actually something I’ve been developing, for years, either to write as an article, or to develop into a book of fairy tales. Or both.

These are the 6 observed personalities of the OR, in no particular order.

1) The Pretty Pretty Princess. This is the one whose makeup is always perfect, their nails are manicured against policy, and they know JUST how to speak to management/surgeons to get what they want. And they ALWAYS get what they want or gets away with behavior that would get you fired. For a fairy tale trope this is the spoiled (sometimes misunderstood) brat.

2) The Call Dog. Also called the call whore in not nice places. This is the one who scoops up unwanted call from all comers. This may be because they love to work, see also Workaholic, or is in need of the money. Caution, this can be dangerous to the department when they are reassigned or leaved. If they leave, no one in the department knows how to function on call. For a fairy tale trope this is the worker bee.

3) The Old Timer. This is the person who has been around the department the longest. And they REMEMBER when X (whatever type 4 is proposing) was tried and it didn’t work! What works is the way we’ve been doing it ever since I got here. This may also be the one who is resistant to new technology or the Electronic Health Record. They want to know why they can’t they just have a paper and pen, for goodness sakes? For a fairy tale trope this is the stuck in the past person who is impeding progress. That progress may be positive, or negative.

4) The IN MY LAST HOSPITAL We Did it so Much Better, We Should do it that Way. This personality type is exhausting to the listener. They are unwilling to learn the ways of their new department and instead always daydreams out loud about the way it used to be in their old place. This may go 2 ways. They are the slow drip against the department mores so that they get their way. They are acknowledged and it is explained to them that this is a different place, with different surgeons, and that what they have been talking about has been tried and failed miserably. The alternative is the If You Liked it So Much Better There, Why Are You Here conversation. For a fairy tale trope this is the one who can’t let their past go and so are doomed to repeat the in my last place we did it so much better script. See also high school jocks still reliving the big game where they caught the game winning touchdown well into their 30s.

5) The lecturer who knows everything about everything and they want to tell you. Or they think they do, and they want to tell you, or correct you. Don’t get me wrong. Sometimes this is how information is distributed to the rest of the team. If there is someone in the department who is knowledgeable, acknowledge and take their knowledge for yourself. But this can be taken to extremes. For a fairy tale trope this is the overly helpful blowhard that may not be more of a hindrance than a help.

6) The Hoarder. This is the coworker who knows very well where the instrument that the doctor requires is but keep that knowledge for themselves. Sometimes this is done so they can swoop in and find it so that they can be praised. Sometimes they don’t tell you or “find” the thing because they are mad at you or the surgeon. Sometimes it is because no one asked if they knew where the thing was. For a fairy tale trope this is the one who has valuable information to give for the quest, but no one thinks to ask them.

These generalizations are mean, a bit. And you will definitely recognize all of them. And if you don’t? Maybe you are that number.

There are definitely more, or combinations of the types. That will be another post, or maybe discover them for yourself. Definitely report back.

Or if you think you are all 6, relax. You are not all 6, and if you identify with a personality type that is okay. The OR is hard to learn and function in and everyone struggles sometimes. Just don’t let the personality type be your WHOLE personality.

Hi, and welcome to the October university update. I promised I would only update on my personal university journey once a month. Here it is.

Class has been in session for 7 weeks now and we are about halfway through the semester. That must mean it is time for midterms. And the third class that is an online paper class began yesterday, 10/7/22.

As a recap this semester I am taking a statistics applications class, a philosophy knowledge development in nursing class (the Ph in PhD), and the class I just picked up is Financial Longevity. Let me break them down one by one.

This is my third statistics course, and while I am not struggling per se, it is not my favorite class. Yesterday, yes, only yesterday, it dawned on me that I hardwired my brain against statistics when I naively took economics and statistics in the same 6-week session during my BSN.

Dude, don’t ever do that. I have counseled against taking them together ever since. Did I pass? Yes. Were there tears? Oh yes.

Ever since my brain has rebelled against statistics. Well, this is statistical applications, which is different you say. Yes. And I have to learn an entirely new program, in addition to learning an entirely new email system, class platform, and new job as a graduate assistant. Don’t do that. It’s been a bit chaotic.

The midterm dropped this morning and I have to do the problems and turn it in NEXT Sunday. Who wants to use the cattle prod on my sense of urgency? I’m trying, I really am, I work on readings and practice problems almost every day.

Thank goodness I took the call job when I did and got my brain used to THAT before introducing this new chaos level madness. I’ll get by, I always do.

The philosophy course is similar to the one I had to take at Creighton. Except there is a presentation next Friday that I am working on my PowerPoint for now. I really enjoy this class; the teacher is awesome and fosters intellectual stimulation among myself and the cohort.

There are two papers due in this class. One about the Ways of Knowing, a 5-page exploration of the different ways there are to know things due in November. And a 20-page behemoth on Concept Application. What concept? And how do I apply it? I think that was discussed in the first class, which I missed because I was over the Atlantic Ocean on a plane returning home. i have emailed the instructor seeking guidance.

The new class on Financial Longevity may seem out of place. I chose it specifically. It had to a graduate level class, and maybe applicable to the thesis. I chose it because I am interested in the topic. Everyone should be, really. It behooves us to prepare for the future, even if retirement is not our scene (is it mine? probably not). This is the only class that I am taking that is online only, back to discussion posts and weekly papers. All right, something I am familiar with. Did you know that they call this asynchronous, where you don’t meet regularly for actual classes, doing all the work by yourself. Finally, a class that gets me.

Since this is a quarter class, not a semester, I anticipate the work will be truncated into the 7 weeks. Again, something I am familiar with. I’ve already done the task for yesterday, which was an introduction of who I am and why I am taking the class. I explained that my first hospital seemed to always be on the verge of closing. And since this was the only hospital in a “retirement” town it was important to be mindful of costs. This is a lesson I took to heart.

Outfitting the “office”, AKA enriching the office supply websites and stores.

1) Because I was spending entirely too much time in a chair, I bought a standing desk. The desk sits on top of the dining room table, and I can move it up and down at will. Yesterday was my first day of all day classes where I used it. I am already a fan.

2) A laptop stand. I do the bulk of my schoolwork in the dining room, because the husband was complaining about me being in the office when he was and I had a laptop, why was I using the desktop too? Short answer, because I can. But this way I can work and move to minimize distractions of him on the computer or watching television.

3) As I have been spending more time on the laptop in meetings and such, I was wanting more light. But not from the fixture in the room, although that is on a rheostat. And I anticipate having to do short videos for school. And maybe YouTube. IDK. Jokes on me, the glare from the ring light that I bought works great for brightness but makes a terrible glare on my glasses. On the positive side, the glare obliterates my fear of people seeing what websites I am on.

4) Shelving unit for the dining room. Future purchase as I am still deciding. In the dining room there are EIGHT chairs! Eight! And we are a house of 2 people, although I sometimes have family over for dinner and holidays. Right now, the extra chairs are horizontal places for school things. This will help that.

I have to get going, I have a midterm to continue to study for and a computer program to use for the midterm that I am still not proficient at.

Welcome to October!

The month of Halloween and the pause before the world plunges into the insanity that is the holiday season. The temperature is cooler, the leaves are turning colors and falling. It is time to tuck the garden into bed for the cold season.

Fall is my favorite season.

In years past I would go all out making homemade candy for the Thursday before Halloween. Only to have it rain that week and ruin my plans because some candies? Remain sticky when it is humid outside. And some things, like frosting, don’t work too well when it is 100% humidity. And water pilling on frosting is the WORST! Have I seen it? Absolutely and it sucks.

The Cookie Thursday is a Thing theme for this month is Spooky Cookie.

But basically, it is candies and treats I want to try. Sometimes because they are spooky. And sometimes because it a candy I have wanted to try my wooden spoon at.

Pumpkin spice has been derided as basic. A very low bar for fall cuisine. And have you been shopping? The stores are FULL of pumpkin spice this, and pumpkin flavored that.

This week’s make is a pumpkin spiced rice krispy treat. Was it something the world needed? No. Did I have fun and does it taste amazing? Yes.

But first I have to whip up some pumpkin pie spice. Instead of buying it, because sometimes it hard to find. And I have all the ingredients. Of course I do.

Pumpkin Pie Spice

2 tbs cinnamon

2 tsp ground ginger

2 tsp nutmeg

1 1/2 tsp all spice

1 1/2 tsp cloves

As with many spice recipes I wasn’t very strict on measuring. And although the phrase measure with your heart hasn’t been around for that long, I really like it. It feels Southern, but is it? Is it one of those backstabby comments that have two meanings like Bless Your Heart? I couldn’t find it in my readings. I infer it to mean whatever measurement that makes your heart happy. While still staying within the recipe’s lines.

I doubled the recipe as I anticipate putting this on everything- sweet potatoes, butternut squash, and I bet it would be great on coffee froth.