The OR is very specific when it comes to the type of power strips that can be used.

Otherwise they are a fire hazard.

It has taken years to get them out of the ORs.

YEARS.

Imagine my surprise when I go to a room to help them turn over and there is a power strip.

An unauthorized power strip.

Behind the back table.

Used to power the flexible sigmoidoscope.

That the MD said he didn’t need power for.

Cool.

The nurse went to the desk and got a power strip from under the secretary’s desk.

And used it.

It just goes to show that everything can be a teaching moment.

And anything is an opportunity for quality improvement.

I educated the nurse that these power strips are carefully regulated because they are a fire risk.

She didn’t care.

I also retrieved one of the 3 long power cords, which are allowed.

And I will be giving it to the secretary to put it under her desk.

After I tell her not to give out the other one.

Two weeks ago I read an article about pistachio cream.

And I was intrigued.

Apparently it can be used savory or sweet.

Since then I am have had pizza with pistachio cream as the sauce (so good!)

Twice.

I knew I had to order some and incorporate it into Cookie Thursday.

After a search of Whole Foods, Trader Joes, Cost Plus, Sur la Table, Williams Sonoma, I admitted defeat and ordered it off Amazon.

My goal was to make a thumbprint cookie with pistachio cream and raspberry jam.

And I did.

The jar of pistachio cream that I got was kinda sweet.

I will be making it in my kitchen with pistachios and olive oil.

And taking my pistachio/raspberry jam cookies to the OR.

I was helping a room move a patient to the bed as the case was done.

When I noticed that the positioner was in a clamp that was, in a word, janky.

It was an ill fitting rusted clamp.

That was on upside down.

I asked the room why this clamp.

Why this clamp that I was pretty sure had been thrown away.

Someone had obviously saved it.

The nurse in the room laughed and said she could not find any other clamps.

I looked at her incredulously.

No other clamps, I repeated.

Um.

I can find 20 clamps in 5 minutes.

No one believed me.

The nurse and the tech trailed behind me as I went to the desk and labeled 6 pieces of paper with the numbers 1-6.

I looked at the nurse who could not find any other clamps and told her to time me.

I went through all of the OR rooms in four minutes and 32 seconds.

I did not find 20 clamps.

I found 30.

At the end, I explained to them the best hiding in plain sight that clamps do.

Time is irrelevant.

Is there a meaning to time?

Time is finite, yes.

However, in the last 18 months time often feels as it is standing still.

Or rushing.

Never just time.

Is anyone else feeling this way?

Today I told my mom that my older cat was 10.

I was TWO entire years off!

She’s twelve.

I’m sure I knew the correct answer.

Before this entire Pandemic thingy started.

But, as time is irrelevant, I was wrong.

I have also heard people refer to 1990s as twenty years ago.

Um, no.

I know that time is out there.

How do we capture it?

Case by case?

Shift by shift?

Add on by add on?

The note from this post-it is very long.

‘I definitely feel punked or gaslit.

The call sheet and the board with the call assignments did not match.

So I asked the guy whose name was on the board and he told me, no, it wasn’t him, must’ve been an error, one person was taking the first part of the call and the person on the call sheet was taking the latter portion.

Fast forward a bunch of hours to the middle of the night and I am fruitlessly calling the call sheet person.

After six phone calls, plus the supervisor calling he finally answered and said that he wasn’t on call.

Huh.

I started calling around and no one would answer.

Bear in mind this is 0200.

I called the guy whose name was on the board and he answered.

He also said that he told me that the call was him earlier and the woman who filled out the sheet did it wrong.

I have to say this puts a bad feeling in the pit of my stomach.’

This is where the note on the front and the back of the post-it ended.

This was several days ago and I still have a horrible feeling about the entire situation.

Do I think he lied to me outright?

Yes.

Do I think that he think he was being funny?

Yes.

He has a reputation of a bit a jokester.

But I do not find it funny.

You see, I asked him point blank about it.

And he denied it.

The only reason that came to light was the fact that we have a middle of the night case.

I told our assistant nurse manager about being punked or gaslit by this.

Nothing will come of it.

Which is the worst feeling of all.

I’ve been threatening to write my welcome to call at my hospital letter a long time.

I was persuaded against it by my boss and possible call changes coming.

So I desisted.

But recent tom-foolery around call has prompted me to start the letter anew.

In a fit of pique, I finished the letter.

The next day I read it again, to make sure that my anger and disgust didn’t come across on the page.

Good, it didn’t.

In the letter, to be given to new doctors and PAs, as well as existing ones.

I lay out explicitly things the department wants people to know.

1. the hours of operation
2. the hours of call
3. the phone numbers
4. some helpful hints about calling in the call team, such as there is a 30 minute response time, and then the create the case, pick the case, get the patient, prep the patient before the case even starts time
5. the fact that #4 may take upwards and beyond an hour
6. the fact that if their case is in need of a set that doesn’t live at the hospital the wait time for preparing instruments that are brought in from the outside
7. The fact that #5 may take 3-4 hours from the time the set hits the sterile processing department

My boss read the letter and agreed to give it out at the surgical committee meeting in July.

I told my boss I wanted it given to any new MD as well.

I told my boss I also wanted it laminated and placed at all the nursing stations.

To quote Miracle Max and Valerie from the Princess Bride:

Valerie, “Think it’ll work?”

Miracle Max, “It’ll take a miracle.”

Yup.

This is a problem of your own making.

Let me get this straight.

You told me to step back from doing my job as soon as I get in and let the day charge continue to run the desk until they left.

Whenever that would be.

Because you let them craft their own schedule.

While denying me anything less than 5 8s.

Cool.

I did as you ask and let them run the board until the end of their shift.

And it was chaos.

AND you decided to fix it.

But you didn’t solicit ideas of how to fix it.

Or tell me there was a problem in the first place.

Or ask.

You added an additional complication of a second charge nurse that will take care of the new chaos that you created at 1500 by not letting me do my job.

Because of the chaos that you created by having someone who isn’t really committed to the board run the board.

Instead of, you know, letting me do my job.

And you cloaked it in the all the other kids are doing it stock phrase.

Cool.

You should have left well enough alone.

I am more than capable of taking the board over at 1500.

Calmly.

Concisely.

Fairly.

As I’ve been doing for 6 years now.

Instead now I do not take up my charge duties until 1700.

Cool.

And I do not get any say in how the after 1700 rooms should be staffed?

I’ll be on the floor; moving patient, cleaning rooms and hauling trash.

Because there isn’t a consistent ORA after 1500.

Until it is time for the new level of day charge to allow me to take over.

When they want to go home.

Super cool

Today’s Cookie Thursday is a Thing cookie was a cookies and cream cookie.

Confession: I do not care for ice cream. Never really have.

But lately I am crushing cookies and cream by the local grocery store.

And in this month of Baker’s Choice I decided to see if I could put Oreos into another cookie.

You can!

I also added cream cheese because my friend asked me to do a cream cheese cookie as she was out of town when there was a cream cheese chocolate chip cookie.

As I was looking to the past posts I noticed I was remiss in doing a Cookie Thursday post last week for June 11.

Last week I made home made pretzels.

They are super labor intensive.

You have to make the dough, rest the dough, roll and cut out the dough, rest the dough, boil the dough in baking soda water, bake the dough.

Last time I made these, several years ago, I offered a plain with mustard pretzel, and a cinnamon and sugar one. And people went gaga for the mustard pretzel and ignored the cinnamon and sugar one.

This year I made slightly more plain with mustard and everyone scarfed down the cinnamon and sugar pretzel.

Oh, well.

That is a stark headline.

And it is meant to be.

600,000 dead from COVID in the US.

Yes, the rate of death is slowing.

Yes, most of the patients who are hospitalized are unvaccinated.

Yes, not everyone can be vaccinated.

Half that number would have been too many.

And the US reached that number December 13-14, 2020.

Let us tease apart what that means.

According to news sites, the first COVID death occurred in February 2020.

The US reached 100,000 deaths at the end of May 2020.

3 months.

300,000 deaths were reached in December 2020 .

6 months.

The US reached 600,000 deaths June 15, 2021.

6 months.

Yes, January and February were grim.

Yet, the numbers are still mind numbing.

I am sure I am not the only one who thinks that the COVID death rate was way undercounted.

In every country.

Including our own.

We may never have an accurate accounting of the COVID deaths.

That is not okay.

Healthcare workers are not okay.

Businesses are not okay.

There has been an unwanted and unwelcome schism in the political parties over this.

I don’t care what you believe.

I care if you are vaccinated.

And I feel for the ones who cannot be.

Who must stand by and watch people say they are not getting vaccinated because X, Y, Z.

COVID doesn’t care.

I have been fully vaccinated since January 25.

My husband has been fully vaccinated since May 14.

This means 2 weeks after our second shots.

I’ve taken my shot.

How about you?

Newsflash, I’m tired.

Regardless, I had an interesting conversation with a patient I was prepping for surgery last night.

It was so very late.

He was having a surgery that he obviously didn’t want to think about.

So he asked me about how the pandemic had been treating the hospital.

And specifically, how the pandemic had been treating me.

He said that he had been so relived when he got his second shot.

In fact, he had signed up for his first and received it the very first day that his age group was eligible.

I told him that I had never been so excited when my husband got his second shot in the end of April, although I had been vaccinated since January.

While waiting for the rest of the team we talked about many things.

Just not the surgery he was having.

I allayed his fears.

I comforted him.

I laughed with him.

He talked about being excited to get home in time to take the dogs out for their morning walk.

I talked about how exciting it had been to serve as a vaccination nurse.

And he showed me pictures of his dogs.

When the double doors opened, heralding the surgeon come to sign the consent, he turned to me and said that he could never be a nurse.

I smiled, with my eyes of course, and asked why.

He said that he was too much of an introvert.

After the surgeon came and signed the consent, I leaned in close and confessed that I was a huge introvert.

That people are hard for me.

That I fake it.

But everyone needs care.

He smiled at me, with his eyes and said well you do a good job.