I have packed in a lot of education, face time, and networking here in NOLA.

The best thing about conferences is the renewed sense of belonging you get from your fellow nurses. And the actual meeting of people you’ve only met through the computer screen for 2 years.

The ten-day excitement is only half over. Today is the last in-person day. But there is still much to do.

All the sessions that I could not get to have been recorded and must be watched and CEUs retrieved by June. But that is not why the excitement won’t end until Sunday.

I have the drive home to look forward to.

And I’m back on shift on Thursday night at 2100

And Friday I have an all-day webinar around sterile processing. I’ve been deep diving into their education and honestly, for a 20-year OR veteran I have learned a lot. But wait, there’s more. I have a Broadway show to look forward to with my sister.

Saturday will be my husband’s first day back at work from vacation. He will be going to the office. And I will be doing more education; half the day on OR stuff (still stuff to learn) and the rest of the day on corporate education that must be completed by month’s end.

I’m still early by my reckoning.

Monday was a cocktail party. I’m not one for drinking, or very loud music. You know what happens when you have nurses let their collective hair down? Dancing, drinking, laughing, general hullaballoo.

Tuesday night I got calls and texts about the tornado that devastated part of New Orleans. The worst thing that happened to us was the flickering of lights and the on and off problem with the internet. Traveling in Spring is like a box of chocolate; to quote Forrest Gump, you never know what you are going to get.

The worst thing about conferences is the strange bed. And the next worse thing is the distinct lack of cats in the room. Time to pack the car at 1100 for checkout. And back to the conference for the final delegate meeting.

I will be writing up my conference report on Friday. My goal is to submit it by end of month.

Lots of things

First the drive home.

And then, things to learn.

We are in New Orleans at a nursing conference. This is a treat long denied as the conference had to be virtual for 2 years. Alas, I don’t have any PI project to present that I haven’t already done a poster on or any traction on my current project.

I did participate as a panel presenter and spoke about shared governance and its importance for the hospital as a whole. I highlighted some things our council has done, including the covid car.

There are prominent signs everywhere to wear a mask. It is posted at our hotel. It was included in the paperwork from AORN. But virtually no one is masked. At the opening event, less than 30 of us were masked.

I know that these people were just excited to be mask free, especially since the mask mandates in places have started falling. But there are some of us who are not convinced.

It is very difficult to get current data. Any sort of current data. Some states stopped collecting it. Some states stopped submitting it. Some states only submit once a week, which is a different day every week.

I don’t want to be right that this is lull. However, I feel that I am. After all society is staring down at 1 million dead. As of right now the United States is only 34,000 away.

I think the US will hit this very grim marker sooner than later. But we won’t know, will we?

The post-it reads ‘why is their first thing to accuse? Be it pressure sores, falls, CLABSIs?’

Point of knowledge- a CLABSI is a central line associated blood stream infection. There was a central line that went into one of the big veins that lead straight into the heart. And an infection that could have gone straight to the heart. That’s what makes them dangerous. This is what is commonly referred to a healthcare acquired infection or HAI. We put the hole into the skin that round the bout led straight to the heart. There are many reasons for this line, all of them dire.

Hello.

You’ve lived through one of the worst periods in the history of nursing.

But we have notes to how you could have handled it better.

Yes, yes, it was a terrible time.

But if you could go back in time and learn from the mistakes that you made while trying to save the life of your patients.

In the midst of people dying, and not taking the time to learn how to protect themselves. Or refusing that knowledge because it infringes on their ‘freedom’.

But it is nursing’s fault.

Of course.

They want to blame the nurses.

Do nurses care that you have a nasty, possibly life limiting infection? Yes, yes we do. And we learn from each infection. Maybe the skin was cleaned in a counterclockwise not clockwise manner. Maybe that is why.

Maybe don’t leave the banana peel in the middle of the room to lead to patient’s falling.

Maybe gown up to re-position at patient who can’t move themselves every 2 hours. Don’t forget the two masks, the face shield, and the gloves.

Gown up and take care of a patient’s needs, knowing that the other room’s call lights are going off. Or if the patient is unable to press the call light, they are next on the list for re-positioning. Rinse, repeat. Along with phone calls. And new doctor’s orders. And family to be updated. And new lab results that lead to more order changes.

All done to save the patient’s life. Or make their death more comfortable.

What, you already do?

Scandalous.

However, too often the immediate knee jerk response is to blame nursing.

We need to stop that cycle.

In the last two years nursing has been stretched to the breaking point. And beyond. To care for patients who are there for life saving care.

Because of a pandemic.

Cool it on blame the nurse.

We just want to survive and let our patients survive and thrive.

And to say that is has been difficult is asking Mrs. Lincoln about the play.

Yesterday should have been day 1 but we were delayed by a crazy storm 3 hours into the day. Atlanta weather does not play.

This led to me missing the eChapter meet and greet from 1730-1830. We got into town at 1900.

And pickup stopped at 1700. Okay, I can pick up in the morning.

Today is a different day.

I was able to get my packet just in time for the session that I really wanted to go to. The session was about self-care. The importance of it and how you should engage in it. The best take home words from that session was ‘reconciliation takes two people but forgiveness only takes 1.’

This is a powerful sentiment.

And then a session on IRB. Institutional Review Board. Or the there is no risk to the participants of the study. Or there is risk and these are the steps taken to review and mitigate them. This is terrifying. This means that I must do it. I’ll look into joining the committee when I get back to work.

There is another session momentarily.

And then lunch.

And the welcome and keynote speaker at 1500

I wonder if I have time for a nap.

I am convinced there is a hive mind that directs our stomachs.

I read that every society on earth has done a fried food. And some sort of alcohol. Because if you take honey water and wait long enough, it ferments.

I am pretty sure that the same is with the cookie of the week.

I know them as fudgey cocoa no bakes.

They contain peanut butter and oatmeal and chocolate.

Other people tell me about eating them in the cafeteria in elementary school. A lunch lady special that she made if you were good.

My mother made them as well.

It is a simple no bake recipe.

Application of heat to butter, milk, sugar, cocoa and stirred to boiling. Let boil one minute, add peanut butter and oatmeal.

And portion out on waxed paper and wait impatiently for them to dry.

I’ve not tried them immediately after the no bake. (looks shiftily about). Why? What have you heard?

To many it is a good representation of our childhood.

I like to mess with a recipe. You all know this.

I’ve added unsweetened coconut to the mix. They were yummy, like a Mounds Bar.

But this month is all about comfort.

This recipe is easily in the top five of requested cookies.

Because nostalgia is real.

And if you never had them growing up, I’ll give you the recipe. Because this is a cookie that deserves to remembered kindly.

For edification purposes, Cassandra was cursed by the gods to always tell the truth. The kicker was that no one would believe her.

I recognize that the last two years have been difficult. No more so than for healthcare workers. And parents.

And the world at large.

But I am watching the new variant. In Germany, in China, in the UK.

And I am concerned.

I fear that the relief of freedom has blinded us to peril.

However, if I mention it, I am disparaged as a hysteric.

Don’t I know that covid is over? That we are safe now?

No to both of those questions.

Covid is very much out there. Replicating and morphing into yet another variant.

Which variant will be the one that morphs covid back into a killer? One that laughs at the vaccines. And infects and kills people indiscriminately.

We are not safe until everyone who is eligible is vaccinated

The vaccine works to decrease the incidence of hospitalization. Of death.

Of course, to mix Greek messages, the thing left in the box after Pandara opened it, was hope.

I am hopeful that there is a way out from Covid.

But I fear that we are moving too far. Too fast.

In case anyone is wondering, the new variate, BA.2 subvariant comprises 23.1% of cases from last week. This is according to the CDC.

AORN is in person this year.

In New Orleans!

I’d been to this one in March of 2005. My mom, two of my sisters, my niece, and I rented an 2 bedroom, 1 bath apartment for a week in the French Quarter.

There is no better way to do New Orleans.

Loud with frat boys.

But up close and personal in all of the action.

I was a new nurse.

I was a new OR nurse and keen to learn all the things.

This was before I decided to start my education journey.

Through BSN, MSN, and now staring down the barrel of a PhD.

I’ve put in to do some paid focus groups.

I always enjoy those.

I haven’t heard anything yet.

I will be on a panel though.

Speaking to the nurse educators special assembly about Shared Governance.

I think the slides are due in two days.

My husband, though, has not been present for a conference yet.

This will be interesting.

I’m afraid he will be bored.

Because I have lots of things to do and my days will be jam packed.

There is a welcome party by my chapter.

There is voting to be done via forums.

There is the panel.

There is the expo.

We are going to to the kick off party on Saturday. I bought him a ticket.

So much to do.

Not all fun.

We will be shoe horn in some sight seeing.

And restaurants.

Can’t forget the food.

And, despite gas prices, we are driving.

Because my husband is not yet ready to fly with people who will not be masked.

And two plane tickets is more than the 2 tanks of gas it will cost us to go.

It will be a raucous good time.

No beads though.

The post-it says “the other side of the coin with the need? For an abg right before incision and the crush that follows, including ologist handing off the specimen with NO label to someone in black scrubs.’

The universe saw the post-it from 2/27/22 and decided to up the ante.

The CRNA, the scrub tech, the surgeon, and the anesthesiologist needed something at the exact busiest time of the case.

The incision.

This one pushed my skills to the test.

The ologist and the surgeon agreed they needed a baseline ABG.

And decided that the time to request it was right then.

Immediately before incision.

There is much to do immediately before the incision.

The pre-incision pause has been done.

Lines including suction and bovie are being handed off.

The surgeon’s step is being put in place.

You remind the room at large that you are the only person in the room that is free and they will have to wait their turn.

The bovie and the suction are the immediate concerns.

Once the incision has been made, which is happening right now, the need for electrocautery and for suction is high.

Especially on a big belly case.

Where you don’t know exactly what you are getting into.

Of course there is no one in the department.

It’s a call case.

Why would there be?

The ologist bleats again, while you are tending to the possibility of bleeding, about the ABG.

You tell him to put the order in himself.

And you will print the sticker after the suction and the cautery are connected and starting to suck up blood and control the blood because the incision has been made.

And once the pressure of the skin is released the intestinal contents spill out like a trick can of snakes.

Which leads to more immediate requests from the table.

Once those are taken care of, you sign in, again, to the EHR.

While you are doing that you call the supervisor and ask for the respiratory therapist to come to the PACU to pick up the ABG.

You go in search of the blood tube for the ABG, which is not in the room.

Why?

This is the critical case room.

The ologist is sitting there frustrated.

You have no time to re-sign into the electronic health record and print the labels.

It has been 3 minutes.

Haven’t you finished getting the case started yet?

What are you doing?

The CRNA finds the blood tube and draws the ABG blood from the central line.

The phone alerts that the respiratory therapist is in PACU to get the blood sample.

The EHR has timed out AGAIN.

In a moment of calm, when the field and the CRNA are both content, you sign back into the EHR and try to print the labels.

Which do not populate to your to-do list.

You check the ologist’s work.

The order is not in correctly.

You correct that, and go get the printed label.

It has now been 5 minutes.

When you ask where the blood tube is, the ologist calmly tells you that he gave it to someone who knocked on the sub-sterile door.

Someone he didn’t know.

In black scrubs.

Wall, meet head.

The ologist allowed a specimen to go out of the room.

Hell, out of the department, without a specimen sticker.

There are so many ways that could go wrong.

You don’t have time to yell at the ologist.

Much.

But, wait, the sterile field needs you before you can cause bodily harm to the ologist.

Don’t tell me Murphy doesn’t live in the OR.

I know we are all tired of covid.

And we want our lives back.

“I just want to get back to normal!”

Is the refrain I hear over, and over, and over.

And over.

We should not go back to ‘normal’.

It is a fallacy anyways.

The last two years have changed us as a society.

As nurses.

As patients.

There is no going back.

There is only adjusting to what is now.

Many of the ideas need to come along.

Wash your hands.

Don’t touch your face.

Judge the person next to you for still wearing a mask.

Don’t do the last.

You never know what they are dealing with in their lives.

There is no return to normal.

As a society, America is 35,000 deaths away from 1,000,000.

One MILLION.

Should be shocking.

But is probably is a massive undercount.

Covid case numbers are declining.

For the first time since testing began, there is no patients in my hospital with active infection.

A few persons under investigation whose test results have not come in yet.

But no patient with active covid infection.

Don’t let your guard down too much.

Being from California they warn you about the undertow at the beach.

They warn less about the sneaker waves.

Both need to be on our radar.

This is the next normal.

As a society, we can not go back.

Only forward.

Comfort month continues.

I intended to bake Syrniki, a Ukranian cheese pancake.

And I could not find the farmer’s cheese that is integral to the recipe.

And this week has me on the ropes.

I’ve only slept 2 hours at a time, due to cases.

Two hours before and 2 hours during the day.

I’m tired.

I found a recipe to make farmer’s cheese but even that can’t hold my attention.

Cue double-cream cheese from Petaluma, CA, that my brothers-in-law sent us for Christmas.

I shredded the cheese that was part of their amazing gift.

And used it to make Syrniki inspired baked cheese cookies.

I had a cookie straight from the oven.

It was a little… lacking.

Inspiration struck in my pantry.

I brought toppings for the little cheese cookies.

A sour cherry jam, a triple pepper jam, and raspberry jam.

I had a triple pepper jam topped cookie as I was dropping them off.

Transcendent.

I wanted to do my little part, because my husband won’t let me go volunteer in Ukraine.

Making these gave me comfort during a hideous week.

Comfort cookie #2 of the month.

Ukranian Syniki inspired cheese cookies.

A humble little cookie.

Made of cheese, egg, and a little flour.

With toppings.

Good wishes and best thoughts to those fighting in Ukraine.

There are no words.