I followed a surgeon to the door after a case.

Three of the biggest anti-vaxxers in the department had been speaking over him and the other surgeon.

They were talking about all the people who lost their jobs.

They were talking about all the people who no longer could get religious exemptions.

And places not giving out exemptions at all.

They were talking about all the places around the country who were lightening mask mandates.

They were talking about where they were going to be going on vacation next.

And hoped there would be no masks required.

One of them mentioned alternative treatments for covid that their cousin’s uncle’s wife had.

And lived.

They were not taking about vaccinating their kids.

They were not talking about vaccinating other kids.

They were not talking about the stupendous loss of life.

These conversations were being had in the open.

In front of two of the biggest vaccine proponents on staff.

The two vaccine proponents who had been told to modulate their tones while talking to anti-vaxxers.

I was telling the truth when I followed the MD to the door.

I admire their restraint.

The post-it reads ‘to the new to evenings CRNA, you’re in the endgame now.’

We have had a crop of new CRNAs who work until 1900 or are the call CRNA.

It is always interesting when a new CRNA looks around and sees how busy we are.

It is as if they don’t understand why we are still doing cases in the nighttime.

The OR takes all cases and does them at all times.

Whatever the patient needs, we do.

I am a huge Marvel fan.

Have been since I was a child.

I have many boxes full of comic books.

This is an Infinity War part 2 reference.

Dr. Strange tells Iron Man that they are in the endgame now.

Meaning it is the one chance to defeat Thanos.

Evening shift is not at war with anyone.

But I love this quote.

Because to me it means that there is work still left to do and we have patients to take care.

Until the shift ends, or the call team comes in.

Whichever happens first.

P.S. my favorite Avenger is Hawkeye, who fights even when he is hopelessly outnumbered with his skill.

Kind of like the OR.

Except we take them on one case at a time.

700,248 dead since the beginning of the pandemic.

18 months.

The US hit 676,000 on 9/21/21.

9 days to add 24,000 deaths.

Are there words?

I am not sure there are words.

Take a shot.

Any shot.

Please.

Healthcare workers are begging you.

This nurse is begging you.

Literary month concludes with a recipe inspired by Roald Dahl’s Charlie and the Chocolate Factory.

The fizzy lifting drink that Grandpa Joe and Charlie surreptitiously drink and nearly die in the ceiling rotators?

Turns out there is not a lot of consensus about what the drink tastes like.

Or how to turn it in to a cookie.

I used miniature marshmallows in a standard cookie batter.

Tragically I was out of/couldn’t find my vanilla.

I used watermelon flavoring instead.

It added a certain sweetness, which, when coupled with the marshmallows, made the cookies light.

Almost lifting worthy.

The very first experimental cookie I ever made was to add miniature marshmallows to a cookie recipe.

I was in middle school.

It is awesome.

They turn all caramel-ly and chewy and disappeared because they melted.

But it is the substitution of the watermelon flavoring for vanilla flavoring that is my take-home lesson for today.

In baking, such as in the OR, sometimes substitutions need to be made.

The tray #1 is needed for a case and there are no more tray #1s on the rack.

A nurse with an imagination and a nimble mind would know that tray #8 is just a tray #1 with additional retractors.

Give the doc a tray #8 and keep mum about the substitution.

And they would never know.

Do you know what happens when you get a group of nurses together?

They come up with bright ideas.

Ideas about all sorts of things.

Things that need to be fixed.

And how to fix them.

Things that need to be retired.

And how to replace them.

Things that cheer others up.

And how to do them.

There is something relaxing and freeing when you get a group a nurses together and give them time to talk while they are waiting for the the speaker who is running late.

It’s like talking to my mom.

But multiplied by 20 other nurses.

Today I shared my crochet group of nurses during such a discussion.

The Random Acts of Crochet Kindness that is on Facebook.

This is a British group that advocates creating little makes to make people smile.

Sometimes they are butterflies, or flowers, or little angels, or even post box toppers.

But the ones that I am going to start with are the worry worms.

The idea is that you take these little makes.

Bag them and add a little note that says ‘I am not lost, if I made you smile, take me home’.

Or words to that effect.

Apparently there are tons of You Tube videos that show you how to make them, step by step.

I haven’t crocheted in about 5 years.

It is time to get my hooks out of retirement.

By some frankly weird coincidence it has been 9 months yesterday since I was considered fully vaccinated. (Edited because math)

My first shot was in December.

My second shot was January 12.

The date I was considered fully vaccinated was January 26.

I received the Pfizer vaccines.

And the CDC recommends booster shots after 6 months.

There is a lot of data behind the timing, and the idea of booster shots.

The CDC also recommended booster shots for those over 65, those medically fragile, and those who work in healthcare.

I work in healthcare.

I have been fully vaccinated for 8 months.

Greater than the 6 months talked about.

I work in a hospital.

One that has covid patients.

One that has never been covid free.

We’ve had covid patients since the testing began last year.

The lowest the hospital’s patient volume went was 3.

I work in the evenings.

None of my ED patients, the ones who are unvaccinated, are tested.

There simply isn’t the time for the PCR test because they need surgery in a timely manner.

However, on the flip side, I am young and healthy.

Well, young-ish.

I believe in vaccination.

I believe it is the only way we are getting through this.

I believe that the goal numbers for herd immunity keep changing and rising the longer this plays out.

I may be denied when I schedule my booster shot, although I am a nurse and work in a hospital that has patients, and may have asymptomatic patients who need surgery.

Because of my age and my general good health.

Let’s find out.

The post-it reads ‘Med-surg training has fallen on the way side to the detriment of new nurses.

When I fought tooth and nail to become an OR nurse, over the objections of my teachers, I first had to do some time on the medical surgical floor.

This taught me many things.

How to keep a clean room.

How to keep a clean patient.

How to take orders off.

How to stand up to a doctor when they would not call back and the patient was writhing in pain.

Or the flap that the nurses were supposed to be assessing for blood flow turned darker and darker and the MD would not call us back.

How to approach a doctor when the patient needed something.

This was over 20 years ago.

I did my time on med-surg and I learned a lot.

I have noticed there is a trend these past few years.

There is no time spent on the med-surg floor.

There is no time learning how to be a nurse.

Besides nursing school, which does not teach you how to be a nurse.

It just shows you how to keep a patient alive.

6 hours twice a week, during the school year, is not enough.

Now nurses go straight into specialty roles; be it OR, or OB, or ED, or special care nursery.

And they have to be taught on the specialty floor all the skills they should have learned on a med-surg floor.

In addition to the specialty floor details and skills.

I do not think that is a good thing.

And it is setting the new nurses up to feel worthless.

Or to feel like they know it all and the senior nurses know nothing.

I am not sure what is worse.

I am sure that there are studies that say it is a good thing to go straight into specialty.

But I could see the pendulum swinging back the other way.

Did I like being a med-surg nurse?

No.

Did I learn very valuable skills?

Yes.

Do I still use those skills today?

Double yes.

It appears that the site has eaten my post-it note for today 9/26/21.

And I saved it.

And tried to publish it several times.

And I saved it in draft.

Only not to be seen.

Hmm.

Maybe if I shut everything completely down I can get it back.

If not I will recreate it.

There are lots of ‘it’ that this could be referring to.

When to call the end of the pandemic.

When to call the sinking ship.

When to call the end of a code.

When to call the search for something that the doctor must, must have and then doesn’t use.

When to call the association with a hospital.

When to call a career.

Too many of the nurses that I know are tired.

Too many of the nurses that I know have come to me and expressed regret with their current working conditions.

Too many of the nurses that I know have come to me and expressed anger at their manager.

Or their manager’s manager.

Too many of the nurses that I know are starting to look for other jobs.

Too many of the nurses that I know have left to go to other jobs.

A good friend of mine told me last week that her manager told her that she was delivering not good care.

And this on a floor.

During a patient boom brought on by the surge.

During a pandemic.

The nurse that has won awards for being a top nurse in the state.

No wonder she is contemplating her future with nursing, with the hospital, with the company.

This makes me so sad.

Nurses who have been there delivering care to the best of our delivery in circumstances that no nurse alive and working have ever seen in the US.

And we have kept people alive.

People who would spit on us.

People who have yelled at us.

People who do not believe in the science of vaccines but are still reaching out for help when they get ill with the same disease that the vaccine is designed to alleviate or prevent.

But, of course, they didn’t take the vaccine.

And now they are sick unto dying.

That is a deliberate reference.

But my fellow nurses and I keep showing up for work.

Keep working through surge after surge.

Keep taking care of people; be they patients, or family, or co-workers, or people on the street.

Because that is what we do.

And we are tired.

The state nursing association is holding their annual convention in a nearby town. .

I am a member of this association.

Last month, when they were debating whether or not to call the convention and put it completely online there was a poll.

I love polls, so I did it.

And the results were that 89% of the potential attendees are vaccinated.

And that the majority of them had indicated they would feel comfortable at a convention where safety protocols are in place.

Including me.

So I am here at the convention center for as long as I can be, masked.

You know, because I worked last night and I have to work again at 1430.

And I would LOVE a nap.

This is a hybrid convention with some sessions live and some sessions recorded.

Before this, with the AORN and Lippincott conventions I have already participated in, I had 54.8 continuing education hours.

And I should earn 18.5 hours for these two days, including the on-long portion.

Meaning 73.3 hours for the three conventions.

And I need 135 every five years for my CNOR.

Not too shabby.

And I’ve learned a TON.

Learning is the battle.

So what if I cried when they asked for anyone who had served in the armed forces to stand up and be acknowledged.

Apparently the blog post of the past week remains heavy on my head and heart.

Normally I would have remained in my seat.

But I stood.

Happy Friday.