I’m very much a consumer of the CEU.

I use them for renewing my nursing license every 2 years in my state.

I use them for renewing my CNOR every 5 years.

I use them for maintaining my clinical ladder.

But, I also really enjoy learning.

And teaching to others.

One of my most frequent question is where to find CEUs for any of these purposes.

And every year I compile a list for nurses, departments, and professional practice binders that we use in our hospital units.

I get the list from a variety of sources:

1. Conferences
2. Online modules/seminars
3. Board of nursing in my state
4. Offerings from the various organizations I belong to- AORN, ANA, my state nursing council, the organization I work for
5. The honor society I belong to- Sigma Theta Tau
6. My current favorite is the Beyond Clean offerings about the sterile processing department

Kind of like the clampy project.

CEUs are everywhere.

Or, to horribly misquote Cole Sear from the Sixth Sense, “I see CEUs everywhere. Hanging around in the the internet, from accredited sources, they won’t be counted until they are found and watched or tested.”

I have got to re-watch that movie.

Right after the CITI training module I am on.

You know the one, about research ethics that are required for the research council. and various shared governance councils.

Okay.

Just me then.

If you want a 2022 updated CEU list, reach out to me and I will send it to you.

There is a legislative movement afoot to wage cap travel nursing.

In many states.

And many urging the federal government to move in the same direction.

This is an example of the free market.

And we all had to take economics in high school and many in college.

Oh, your school didn’t require it.

And you didn’t think you’d need it.

There is a meme that is going around attributed to nurselex.

A nurse in full PPE is embracing/supporting a clearly suffering patient.

The text underneath read

“If a lawyer can make $300/hour to defend violent criminals

and therapists can charge $250/hour for their work

and housecleaners can charge $100/hour

and tattoo artists can charge $150/hour

Then some nurses** making $100/hour should not be a concern of CONGRESS”

Nurses number 4 million in the US.

And we are expensive.

And a big part of hospital payroll.

Because the hospital is staffed 24 hours a day, 7 days a week.

In case you need us.

We’ve been at the hospital throughout this ENTIRE pandemic.

Tending to the dying.

Cheering those who are getting better.

Taking care of those who cannot wait.

And if nurses want to leave to get a slice of something they think is better…

I’ve worked enough places to know that the grass is not greener on the other hospital.

And it is free market to pay nurses what they can get.

And now people in power are clutching their pearls and bleating out ‘wait! that’s too expensive’.

I know of managers who used to tell staff if they didn’t like the changes to go ahead and leave for another job.

I’ve heard from friends that this kind of behavior is still going on.

From hospitals big and small.

I’ve worked for a barely scraping by hospital and I’ve worked for a big corporation.

The poor hospital will have a problem with this.

Several poor hospitals in parts of the country have closed during the pandemic and before.

Because they could no longer afford to stay open.

That is another side of the economics discussion.

Instead of a blanket cap that will never fly because, as a group, we are not willing to be pushed around.

There can absolutely be a conversation about why you feel the need to take such steps.

And can we also talk about your salary?

And by you, I mean the executives, the lawyers, and the legislatures.

And safety?

Of the nurses who have too many patients to handle and care for during their shifts.

Of the patients who have overburdened nurses.

Of the rest of the sick people who need care.

Is this a conversation you are willing to have?

I thought so.

The post-it reads ‘crushing management’s ideas by telling the truth. Would not recommend.’

Can anyone else hear Jack Nicholson’s character in a Few Good Men screaming on the stand?

You can’t handle the truth.

Management used to ask me questions about different matters that came up in the department.

Why?

Because I would always tell the truth.

But sometimes the truth is not what they are looking for.

I don’t care if they don’t want the truth.

I will not sugarcoat my response.

If I think an idea is terrible or has been done many times before and abandoned, I will say so.

That is the problem with being long lived in a department.

And having a good memory.

This kind of response is not very popular.

And, I imagine, gets me a debbie downer reputation.

You want to try the bright shiny idea that has been done before?

Oh, so many times?

Because maybe it will be different this time?

Knock yourself out.

However, you have to be careful of crushing their ideals too many times.

They will stop inviting you to the table for discussion.

And do the terrible thing anyways.

And when it fails, replace it.

Not with the non-terrible idea that came before.

But by something else that is even more terrible.

And non-sustainable.

You’ve heard the adage the road to Hell is paved with good intentions.

Similarly the road to not-happy employees is paved with bad ideas with good intentions.

Because someone did not think it through.

Or ask if there could be any downsides.

Or asking if there could be any downsides in their echo chamber.

No, no, don’t ask her.

She’ll say no.

What could go wrong?

According to the Johns Hopkins Coronavirus Resource Center, my go to for information covid information, the world had crossed 10 billion vaccines administered.

It is not nearly enough.

But it is so very exciting.

The world has come so far in so little time that it is mindboggling.

But, those of us who are living this in the real world, and watching the hospital numbers go up.

And the deaths go up up up.

This is a relief.

It is not nearly enough.

But it is a start.

Welcome to the first Cookie Thursday is a Thing for February 2022.

The theme for the month is cheese.

One of the most highly requested savory cookie is the cheddar penny.

This is a very simple recipe and bake.

There are several ways to add interest to such a humble cookie.

Sometimes I add red pepper flakes.

Sometimes I had a triple pepper jelly thumbprint.

Sometimes I eat them plain.

Kind of like cheezits.

The recipe is cheddar, flour, and butter.

Very simple but underrated.

Kind of like a ‘simple” surgery.

I hear that all the time.

It’s a simple surgery, it will take 10 minutes.

Until it doesn’t and there is now blood everywhere and anesthesia is telling you to hurry it along.

There can be beauty in simplicity.

It’s just a carpal tunnel.

Yeah, just surgery on the second most complicated part of your body.

Keep thinking that it is simple.

Looming deadlines.

The University of South Carolina application deadline is February 15.

I have such a block on completing this.

Or really even starting this.

I do not know why.

The university of North Carolina- Greensboro is looking for me to finish my application.

Only 2 of the 3 people the university has reached out to for a reference has responded.

And transcipts?

Are hard.

Especially when the first one is from 1995.

And then 2001.

And Chamberlain College of Nursing is online.

There are several brick and mortar schools.

But I did not attend them.

I am certain that the University can access them faster than me.

And Queens University of Charlotte was only 2 years ago.

Apparently I have to reach out to them.

I hope the Creighton and Napa Valley College transcripts are online.

Because I certainly don’t have a hard copy.

Come on, man, it was nearly 30 years ago.

Beginning the applications so late.

That’s all on me.

And, I repeat, I don’t know why.

It has been a minute since I did a covid round up.

I wrote an Omicron Math post on January 21.

That day there were 864,142 American dead.

On January 15th there were 850,000 dead.

16 days, 40,516.

The trend is accelerating.

However, we’ve heard over and over.

Hospitalizations go up.

Hospitalizations go down.

Deaths are on a lag.

Hospitalizations are still up.

There are still hospitals struggling.

Hell, my hospital is struggling.

Today is the first day there is a room available for admission.

Of course, that room will be gone by morning.

I’d ask to take bets when America will cross the 900,000 threshold.

But I’m too tired.

I no longer look at the number of cases.

I just assume they’ve gone up.

I do look at the screaming red line and where we are in the surge.

Do I still wear a mask in stores?

Absolutely.

Do I alcohol the pump handles when I get gas?

Yup.

Do I alcohol my hands when an alcohol dispenser is available in stores.

Yes.

Do I stay at least 6 feet away when I am speaking to someone I don’t live with or who isn’t in my four person bubble?

Yes.

Do I mind being thought a person who is taking this too seriously?

Absolutely not.

I would ask if they’re not taking this seriously enough.

Still.

Two months into this experiment.

I am now 8 months into salary life.

2 months in to working 2100-0700 call only.

The problem with ceasing to work all the hours, is that you cease to make all the money.

For my entire nursing career my self-worth has been linked to how much money I make.

I am certain this is similar to lots of adults.

And how much I can work.

Can work, not will work.

Because I’ve never met a shift I didn’t want to pick up.

But I am trying to reform my workaholic ways.

It’s a bit of an uphill slog.

I had grand plans when I started my shift.

I was going to organize the closets.

I was going to get rid of things.

To date, after Christmas, my biggest accomplishment has been tacking tee shirt mountain in our bedroom.

I love tee shirts and would routinely wear them under my scrubs.

Today I went through tee shirt mountain.

First, I separated them into types.

This pile is jammies.

This pile I wear out in public.

This pile I wear to work.

But I’m not working 5 days a week anymore.

I took the work pile and further separated them out.

This pile is the science ones.

This pile is the introvert ones.

This pile is the reading ones.

This pile is the Star Wars ones.

I have a lot of tee shirts.

Of course, I used to work a lot of hours.

I think I am going to rotate piles.

And all my funny/cool tee shirts get a turn.

To be worn when I go to work or out and about.

Or to class when I get to my next steps.

Now, which to take to conference with me.

I think I will take the kitten holding up the world, like Atlas in Green mythology, saying ‘I’m fine, everything is fine.’

And the educated, vaccinated, caffeinated, dedicated tee.

Basically, the entirety of the science pile.

What should I tackle next?

Book mountain, I think.

I definitely do not need to buy tee shirts for the foreseeable future.

The gown card reads, ‘They are welcome to chew me out. They won’t find me very tasty. I’m bitter.’

Many of my post-it notes are written on cards that are attached to sterile gowns to allow the sterile person to stay completely sterile and to close the back of the gown.

I wonder if Dianne Von Furstenberg saw one when she was putting her spin on the wrap dress in the 1970s.

A surgical gown has it all, wrap closure, long sleeves.

But I digress.

In organizing the library, which has been sorely neglected for years, I found a treasure trove of gown cards.

Many circulators keep the gown cards when they have finished tying up a person to be sterile during the operation.

These cards are perforated at the top and are 2.5 inches x 5 inches and are blank on one side.

This is the side that is perfect for jotting notes, numbers, the list goes on and on.

They also fit in the top of pocket in scrubs.

I have been collecting for years.

I have hundreds if not thousands.

I also use these to jot down ideas.

Because sometimes a post-it note is not available.

This this particular gown card is kind of bitter.

I know for a fact that it was written years ago.

But the sentiment is true today.

Some people who try to belittle me, or chew me out, find that I can be factual when I take them down.

People hate that.

Or, if you are bitter to me, I am capable of being bitter back.

However, this is especially true in this healthcare environment we find ourselves in.

The moral of the story, don’t be mean to us when we are trying to help you.

Healthcare workers the world over are tired.

In his book ‘This is Going to Hurt’ published in 2017, Adam Kay wrote that “night shift is a different time zone to the rest of the hospital.”

Any hospital shift that is not the standard 0700-1500 or 0700-1900 is an off shift.

And I believe that this quote applies to all of them.

It is different to be slightly off step with the rest of the hospital.

Information flows differently.

Emails are treated differently.

Staff is treated differently.

As a person who has worked off shift for 16 of my 21 years as a nurse I can attest this is true.

Day shift seemingly gets all the perks.

The fresh potluck offerings.

The tickets that HR sends out in an email back when that was a thing right at 0900.

The freshest food in the cafeteria.

It all happens on day shift.

Of course, a straight day shifter means that the management is around in full force.

Um, no thank you.

I do better work off shift.

I’ve done many different iterations of off shift.

2230-0700- night shift CNA in a nursing home

1500-2300- evening shift telemetry tech/unit secretary

1500-2300- evening shift CNA in the hospital

1500-2300- evening shift RN in the hospital

0700-1900- day shift RN on the floor in the hospital

0700-1500- day shift OR RN

call 1500-0700- night call in my first hospital

0630-1900-12 hour day shift RN in an orthopedic OR

0630-1700- 10 hour day shift RN in an orthopedic OR- they made me switch to 4 days a week after I became a service line coordinator

I handled 3 different service lines: pediatric, hand, and trauma- with only $1 an hour more. I should have held out for $3/hr.

2100-0700 call OR RN

0700-0700 weekend call OR RN

1030-2300- 12 hour evening shift OR RN

1230-2300- 10 hour evening shift OR RN

1430-2300- 8 hour evening shift charge OR RN

All iterations of call imaginable.

Having down this for 21 years, I can unequivocally say that the off shift and, I include evenings and night shift march, to the beat of our drummer.

And that’s okay.

We have to be nimble and able to hand disasters on our feet.

But props to the managers that take care of us and save us plates from potlucks and celebratory day shift meals.

Thank you.

You know who I am talking about.