25-Preparing for a fall college fair

It’s been a minute since shared governance put on a college fair at the hospital.

There are a myriad of reasons so go ahead and pick one.

The pandemic. The four bulwark members were on zoom meeting for over a year.
Lack of interest by hospital members. We were too tired, too demoralized by watching the public ignore common sense protections. See reason 1.
The Great Resignation. This hurt the hospital in so many ways as people sought to make more and go to travel nursing or people left the profession all together because of, you guessed it, reason 1.

But now the units are bulking up their shared governance presence and interest. Even though some departments are still hurting for staffing they survive.

Seems like the perfect time to stage a comeback for the hospital college fair.

At one of the last college fairs we did, there was an overarching theme of “What if healthcare isn’t what I want to do for the rest of my life?” There were a few requests for colleges and trade schools that were not healthcare related.

Fair enough. Because not only do we have nurses and techs and CNAs who want to further their education, they also might have husbands and wives and children who want to do so as well.

I want to make this fall’s college fair at the hospital the most inclusive one yet.

Nursing schools will be represented.

But so will schools that have something other than nursing.

I have to start calling and emailing places soon.

Just as soon as we have a firm date. You know, other than “fall”.

Ideally it would be just before or in the of tuition reimbursement application window. Those dates I know.

Wish me luck. I already informed the president of the hospital that this was something shared governance was hoping to host in the fall. I also laid out the reasons for inviting not healthcare related school. They were fine with it although they would prefer that the team members stay at the hospital.

Again, fair. But we have to allow those team members who want to fly to fly.

You know?

Cookie Thursday 5/15/25- Too much of a good thing

I can sense that after 2 weeks of the non-stop treats and massages and food gifts there is little appetite for CTIAT. So I shall stay home and my oven will stay cold.

I must remember this for next year.

No need in carrying coals to Newcastle. This is a charming English idiom that points out a pointless action.

The cookie drawer will be empty today.

Don’t worry, there’s lots of treats in the hospitals.

Best kept secrets of the hospital #1- the explosion in patient armbands is giving the 80s and 90s Swatch trend

Yeah, so this is expanding to the entire hospital. Because what is involved happens to the entire hospital.

Once upon a time, at least 30 years ago, the Swatch watch was trending. Only we didn’t call it trending then, we called it cool.

The Swatch watch were colorful plastic watches that kids collected like hotcakes. Well, the cool kids with disposable income collected them. And then they wore ALL of them at once.

Like the stacking bangle trend of the 2010s.

Except they were watches. Some kids I went to high school with wore as many as 6, marching up their arm.

Of course the times were not synced. The extra cool kids synced the times to different major cities around the globe. So they would always know what time it was in New Delhi. Or London. Or Tokyo.

When I was a new nurse, the patients only wore one armband. The one with their name and their medical record number and their birthday on it. These were stamped using their patient admission card that every patient got at admission.

This was WAY pre-EHR.

And then it was thought that we needed to be able to recognize the patients who were DNR more readily. DNR means do not resuscitate. This is usually a personal decision by the patient not to seek CPR, or by the family. I imagine that somewhere a patient who desired to be DNR was not readily identified as a DNR and coded when their heart stopped. Because no one knew they were DNR.

They started putting DNR bracelets on the patients who were DNR and no CPR would be given to them. This is so you can tell at a glance that a patient is a DNR and CPR is not desired. For whatever reason.

And then it was thought that we needed to be able to recognize the patients who were a fall risk. This is so we could take measures to keep them safe. The patients who were labeled a fall risk had certain conditions that precluded them to a fall. These include orthopedic problem, stroke, and, believe it or not, post surgical.

Another bracelet was added to the stack of DNR, patient bracelet, and fall risk.

Again, this was so we could tell at a glance who didn’t want CPR, and who needed to be watched carefully to prevent a fall. As well as who the patient was.

And then some patients should not have an IV or a blood pressure taken on a certain arm. Or their leg had a DVT, which makes the SCD sleeve a contraindication. You guessed it, a bracelet was developed for that. This bracelet was to be worn on the affected side.

This makes 4 possible bracelets- patient identification, fall risk, DNR, and restricted limb.

Are you seeing the trend here?

In the last 4 months, there have been 2 additional possible arm bands added to the possibilities.

The first is for patients who use an insulin pump for administration of insulin. The armband is to alert the staff that this patient doesn’t need insulin and is used to decrease the chances of a hypoglycemic event.

The second is a timing armband for a specific medication that we use in the operating room. This is a long acting local medication. The idea is that no additional local medication should be given to a patient who already has this long acting local medication on board. Once you have seen a local medication toxicity seizure or reaction, you never want to see them again.

This makes 6 possible bracelets. On one arm.

I means it is possible to have the restricted limb bracelet on the other arm and the rest on the arm.

But it is giving the Swatch watch trend from the 80s and 90s.

Did I mention that all the bracelets are different colors to make them easy to identify a patient?

Yeah, you see it now, don’t you.

Google image search what I am talking about and you will never unsee it.

I am sure that there are still additional armbands out there at other facilities. And the information conveyed by the bracelets is good quality information that us healthcare workers need.

But it just seems a bit excessive.

Tuesday Top of Mind 5/13/25- Fluoride and why getting rid of it is a bad idea

There are a lot of dumb hills to pitch a fit over these days. My least favorite is the anti-fluoride movement.

Fluoride is important because it prevents cavities and strengthens teeth. As someone who has a complicated relationship to my dentist I am in favor of everything and anything that decreases my chances of additional tooth decay.

Fluoride has been shown in some shoddily done studies to “alter your gut microbiome and has suggested associations with thyroid disorders, weight gain and possibly decreased IQ”.

Note the important shoddily done study in question that indicates decreased IQ has been roundly criticized and recommended for retraction. Yes, it is that bad.

The measurements used to ascertain IQ decrease were 1) not validated, 2) used different testers, 3) done in multiple cities. It is the first point that is the most crucial. I can swear to you that the sky is pink, not blue. I can have other swear the same to you. But I won’t let you look at it to see for yourself that it is pink.

It is the same energy as the question that captivated the internet in 2015, is the dress blue or gold.

Bitch please, it depends on the lighting. True, sometimes the sky is pink, especially in the early morning as the sun is rising, or later in the day as it is setting.

For a sarcastic example: Yay, you proved that the sky was pink at 0635! Now prove it again and again and again. Also, prove it at noon.

I’ll wait.

Who are you going to believe? Me, or your lying eyes?

Ugh.

Nothing that the troglodytes and mouth breathers have brought up, none of the studies have been replicable. That means no one else has been able to do the same study, as outlined in the study, and gotten the same results. This is the major finding. This is the flaw in the study.

Trust me, I’ve taken many graduate level courses to make sure that the studies that I will create are able to be replicated. This is why what these people who are playing with fire drive me so insane with anger. They don’t know enough not to touch the hot stove. But they will blame the resulting burn on vaccines, don’t worry.

This is more bluster and nonsense coming from non-science believers.

There is a big story going around now that the Secretary that is pushing for this swam in feces contaminated water. Worse, he let his grandchildren swim in the same water. Gross.

Also, double ugh.

As someone who has spent thousands of dollars at the dentist in the last year, I will keep my fluoride toothpaste and my fluoridated water. Or is someone going to tell me that the hole in our bank account is a figment of my imagination or the pain that I’ve suffered through is in my head or is because I am overweight?

Triple ugh.

Post-it Sunday medical non-fiction series 5/11/2025- Happy Mother’s Day to the mother of most of modern science, The Immortal Life of Henrietta Lacks

Yes, yes, Happy Mother’s Day to all mothers, be your children human or not.

The non-fiction medical book for today is The Immortal Life of Henrietta Lacks by Rebecca Skloot. Henrietta Lacks (and the cells that were taken from her cervical cancer) is the mother of most of modern medicine. Until her, the cells that were to be used to medical research died. But hers did not.

And have not. Still.

Her cells have been to outer space, ridden on airplanes, or in cars, and even in the breast pockets of pilots as the cells were flown to additional hospitals/laboratories.

I first read this book shortly after it had been published in February of 2010. The cover is striking, a beaming black woman, hands on hips takes up the left side of the cover. The right side is the title “The Immortal Life of Henrietta Lacks” and the subtitle of ‘Doctors took her cells without asking. Those cells never died. They launched a medical revolution and a multimillion-dollar industry. More than twenty years later, her children found out. And their lives would never be the same.’ It is a striking cover with the background being, well, cells. Yellows and pinks against a red background with Henrietta Lacks in black and white with the colors bleeding over half of her.

Frankly, one of the reasons I probably picked up the book was the cover.

This is a tale of medical misadventure in the beginning of the medical marvels of the 1950s and on. Cancer treatments were developed using her cells, medication treatments were developed using her cells, the ability to keep other so called immortal cells alive was developed using her cells.

This book is the story of Henrietta Lacks. Her life was a quiet one, albeit a hard one. She was married at twenty to the father of her 2 children. He was her cousin. They went on to have three more children, moved away from their hometown to have a better life for them and the children.

Henrietta knew that something was wrong with her insides shortly after the birth of their fifth child, Joe.

This book is also the story of the explosive growth of medical innovation after the survival of Henrietta Lack’s immortal cells. It is the story of the man who first cultured the cells, of the callous way medicine used her cells but didn’t tell her family. It is the story of her family and how they survived after she died.

I don’t want to give away too much of the story but for me this is an absolute must read.

Every time I read it I notice different things. I re-read this recently and from what I know and understand now about HIPAA and medical consent as a PhD student I was struck anew of how important the story of Henrietta Lacks’ immortal cells are.

I will continue to recommend this book to all who want to learn more and those who want to know the wrong way to go about medical research. Because this book is a warning about getting it right. Not only for the family of the woman who died but for us all.

School Me Saturday 5/10/25- Teacher Appreciation Week

It is no wonder that 2 of the most influential professions, both mostly staffed by women, have their respective appreciation week right before Mother’s Day.

I am, of course, referring to nurses. And TEACHERS.

Women vastly outnumber the men in each of the professions. Teachers are 77% female to 23% male and nurses 88% female to 12% male.

Gender really doesn’t matter in either profession.

It is the quality of instructor. Even in the higher grades.

Looking back on my 40+ years of being a student I can count on one hand the number of male teachers that I’ve had, and 2 of those in the graduate school level.

No matter how you define it women are important to these very important gateways for students/patients.

It is time to celebrate them. It is time to thank them. And not with yet another coffee cup, although the caffeine does come in handy.

If you have had a teacher you really enjoyed in school, no matter the level, take some time to think fondly on them during this week. Thank them, even if it is silently. Better yet, if it is in the form of a handwritten note or card.

Because they don’t get appreciated enough.

Especially for all they do for us and the children in their classrooms.

FFS Friday 5/9/25- FINALLY

Finally the last outstanding race in North Carolina was called for Allison Riggs. She was elected to the state Supreme Court and has been serving as such since the November 2025 election.

I’ve written about this before.

Her opponent objected mightily to being bested by a woman and a Democrat and he pitched a well-funded fit. Where did the money come from to file these appeals and court cases? No one is telling.

But we can all guess.

He wanted to change the rules of the election AFTER the election.

Remember, I warned y’all that this was a test case for future tomfoolery around elections that the Republicans don’t win. And, boy, was I right. I hate it when I am right about this kind of bullshit.

Earlier in the week a federal court decision came out in favor of Riggs. (you know, the declared winner although those sore loser wouldn’t certify the race). Judge Myers wrote that to allow the rules to be changed after the election to suit one side that to allow the uprooting lawfully cast votes could lead to undermining of public opinion. He ordered the state to certify the election. Finally.

This was Monday.

So why did it take until Wednesday for Griffin, the one who wanted to throw out lawfully case votes and the party that backed him, to concede? Again I ask there the millions of dollars to fund this came from?

No need to ask it they will try again.

They will.

But for now Allison Riggs has retained her seat on the NC Supreme Court.

But we have to wary of this bs being pulled on other races in other states.

The country will be watching.

Cookie Thursday 5/8/25- Egg replacement brownie

Last month I decided to find the best egg replacement for cookies. Chocolate chip cookies to be precise.

And I found it. The best egg replacement was the banana egg and psyllium husk egg combo. These cookies were perfection. The banana added the moistness and the psyllium husk added the binding and the moisture retention properties needed.

Well, after four solid weeks of making the same chocolate chip cookies I decided I was sick of chocolate chip cookies. I wanted a change, is that too much to ask?

This month I decided to not continue with the egg replacement in chocolate chip cookie experiment and move on to baked goods with different egg replacement.

The recipe is one I had made before “Lunch lady brownies”. I made them this last September for that month’s lunch lady theme for back to school. It is a simple recipe with 5 ingredients. I just swapped out the four eggs for 4 egg replacements. I used 2 bananas and 2 psyllium husk eggs. To give the batter a fighting chance of rising, I added 1 tsp of baking soda to help with lift.

It was very promising and the brownies rose beautifully.

The brownies took a bit longer to cook and I used the time tested method of sticking a toothpick into the baked good and removing it to check for no batter left clinging to the toothpick. I prefer this method over timing for cakes and brownies, especially when browning can’t be trusted because of the chocolate.

I took the brownies out and left them to cool for 10 minutes. I was going to mix the frosting after this time.

And then I got called in. Cool, that’s what I do. I put the brownies in a cat secured place and went to the hospital.

One case turned into 2 and it was nearly 5 hours before I could get back to frost them. By then they had shrunk down quite a bit and I shrugged, thinking that it would make for a very fudgy brownie. It did.

My husband saw me frantically frosting the brownies after I got home from the hospital because I had a full night. He remarked, casually, “I didn’t think you liked making brownies.”

He has a point. I resisted making brownies for CTIAT for YEARS. I also don’t like making frosting.

I frosted the now very cool brownies and placed them in the refrigerator as the recipe ordered.

This morning I cut them into 2 inch x 1 inch slices and put them in the delivery device.

I would let the department weigh in on the egg replacements.

Me, I was just happy that the frosting set.

Happy Nurses Week 2025 5/7/25

It is Nurses’ Week once again.

Funny how that happens.

This is the week that nurses and nursing are being celebrated.

If 2020 was the Year of the Nurse and Midwife that marked 200 years since Florence Nightingale’s birth, then simple math makes this 205th year. You see what I did there.

There have been other notable nurses besides Florence Nightingale. Many, many, many. The nursing theorists whose work guide us. The original nurses who worked to provide us with structure.

Clara Barton and her work on the Civil War battlefield come to mind. As does her star achievement of the American Red Cross.

Dorothea Dix was a contemporary of Clara (can I call her that?) and advocated for mental healthcare of soldiers. She also was concerned with the mentally ill poor people and helped established mental hospitals.

Margaret Sanger who worked as a nurse in the tenements of New York and founded Planned Parenthood. She was also instrumental in the birth control pill development. She, too, was probably sick of women dying in childbirth.

Mary Seacole was a Jamaican-British nurse who was a contemporary of Florence (can I call her that?). She was the first Black woman who authored and published an autobiography in England.

Lilian Wald was a nurse whose passion was for safer living conditions for the poor in New York City. She also started community nursing and was an advocate of nurses in public schools.

Harriet Tubman was a nurse whose concern was for the Black soldiers of the Civil War and the newly freed slaves. She is best known for being a conductor on the Underground Railroad.

This is not a complete list. In fact, this is a living list and being added to constantly.

Giants all of them. Today’s nurses stand on their shoulders and fight many of the same battles. Hygiene might be better. There are better medications and treatments but at the heart, nurses remain the same.

Our reason for professional being are the people who need us. Not just the patients, but the doctors and surgeons and people on the street as well.

I have been a nurse for 24 years and I wouldn’t do anything else.

After all, I have big shoes to fill. My mom, the nurse I want to be when I grow up, is still working after 52 years.

Tuesday Top of Mind 5/6/25-Missouri is trying to pull a fast one on abortion rights that they just got back

Send abortion rights back to state? That was the plan after the supreme court released the Dobbs decision, right? After all, restoring the power back to the states would make sure that your state made the right decision. Well, right in more ways than one.

Changing the state constitution or passing an amendment protecting a woman’s right to bodily autonomy is never done quickly. It takes a lot of time to gather signatures and gin up support. It takes more time to get the regular public excited about the measure, hopefully enough to get out to the polls.

There were seven states that passed abortion right legislation in the November 2024 election. There were 10 states with abortion related constitutional amendments with on their ballots. The states that wanted to protect abortion rights and enshrine them into the state constitution were Montana, Nevada, Missouri, Colorado, Arizona, Maryland, Wyoming, and Florida. The state that wanted further curtailing of a woman’s right to bodily autonomy was Nebraska. Wyoming and Florida were unable to pass their measure but so was Nebraska. Nevada has a 2 election pass/fail test, and they are half way there. These states join Ohio and Kansas and California and Vermont and Michigan in protecting abortion rights.

Of the seven states Missouri’s state legislature is throwing a temper tantrum. It’s not fair, they whined. People didn’t know what they were voting for, they cried! We deserve a mulligan, they challenged.

Eye roll.

I mean they’ve done everything a spoiled brat would do except stomp their little feet and threaten to hold their breath.

Pouty McPoutyton.

Well, they are kind of doing the last one.

They have put in place as many roadblocks as they possibly could. Including many bills in the state legislature about classifying abortion pills as a controlled substance, and legislation to treat abortion as a homicide. Also they have stopped allowing abortion pills to be prescribed.

But their favorite is crying foul on the Amendment 3. The amendment showed that women will be dying in hospital, unable to receive medical care.

Show me the lie.

Better yet, ask Texas or Georgia.

Best yet, google deaths post Dobbs decision in states that outright ban abortion. Cough, cough, Texas.

Go ahead, I’ll wait.

But the women who need this often life saving care can’t.

Women have died, are dying, and will continue to die without access to abortion.