Call Secrets of the OR- FOUR years I’ve been doing this gig

It was the beginning of December in 2021 when I started the night call nurse position.

Let me back up. In the spring of that year my manager pulled me aside. She knew that I picked up the vast majority of the call and she wanted to warn me that the corporation was doing a pilot call team position at a sister hospital. If the call team was successful, the idea would roll out to all the hospitals in the market and then the corporation. If that happened, all my call hours would go away. The pilot was successful and they were going to roll it out to the market hospitals.

When the position opened I took a deep breath and applied.

There were various reasons for this. It was mid pandemic and the dark scary 2020 was over and people were surviving and the schedule was open to all surgeries again. Vaccinations were in full swing in the population. It felt like time to breathe.

More than that, it felt like time to step back from being so involved in the hospital.

I could have stepped away from call and only done my 1430-2300 Monday-Friday shifts. Without every night and all weekend call I would gain 88 hours back. 40 of night call hours, and 48 of all weekend call.

That would have been good. I would get my nights and weekends back.

But the call that I enjoy so much would have been wildly reduced.

Call is my favorite. Have I mentioned that?

I had been working so hard for so long that I felt that I needed to step away from my workaholic tendencies.

I interviewed and received an offer. After a counter offer to keep the ability to maintain my clinical ladder, I accepted.

My new journey as the night call nurse would commence in 30 days.

It was time and this was a good stopping point.

I had been the evening charge nurse for 10 years.

I had been leading shared governance in most of its levels for 6 years. I had been on four hospital committees with their attendant meetings which was about 2 hours per week. I stepped back to 1 committee and from the corporate shared governance levels.

It was time for this workaholic to try to remember who she was without the hospital.

I have maintained the Cookie Thursday is a Thing and I am proud that there hasn’t been any store bought cookies for 3 years. Its popularity is waning and I have to consider what that is going to mean for the future CTIAT. But more on that in the new year.

Carving out a 50 hour workweek out of 128+ hours I had been scheduled was going to take some time to get used to.

But first a nap.

And then maybe I will look around and see what I can do with my new free time.

Since this all happened in the past I can tell you that I spent the next six months applying to a PhD program and I’ve been doing that for the past three years. But that is a story for School Me Saturday.

Being a recovering workaholic is hard. Especially one who jumped straight into another long term commitment.

I assure you that this is slowing down for me.

I regularly tell other operating room nurses that I encounter at conventions or online that I have the coolest job in the world.

And I still feel that way.

Tuesday Top of Mind 12/2/25- Kant have it both ways

Forgive the pun.

Immanuel Kant is a central figure in modern philosophy. One of the key tenets of his writings is the pursuit of enlightenment. Enlightenment is defined by him in his 1784 essay What is Enlightenment as the “Thinking for oneself rather than letting others think for you.” He was for individual human reason above all else.

He doesn’t really have a lot to do with this post. I just thought it was interesting.

Yeah, right.

It is interesting and a lesson that more of us need to take to heart.

Don’t let others think for you. You never know what kind of trouble that will lead you to.

For those who are not following the train wreck around the sinking of a “drug boat” off the coast of Venezuela on September 2, 2025, there are lies aplenty.

And an illegal order. That someone who should’ve known better followed.

There were survivors from the first attack on the “drug boat” and a second strike was ordered by the secretary of “war” and these survivors were killed.

This is against the Law of War Manual from our very own Department of Defense.

In Chapter 7, which is titled Wounded, Sick, Shipwrecked, Dead, and the Medical Services, what should have happened is that the survivors should have been taken into custody. This could have been done by our own military or a relief society, or the inhabitants.

But it wasn’t was it?

What’s the matter? Kant keep the lies straight.

Okay, I’ll stop.

What’s the matter? Can’t keep the lies straight anymore? Letting someone else do your thinking?

There are two stories that the secretoy of war bandied about. That the secretoy of war gave the order for the second strike.

Oh, wait, there was no second strike.

Okay there was a second strike but it was in self defense of the US. (hard to square this one)

Okay there was a second strike but it happened when the secretary was out of the room. And it was the admiral (who the secretary has complete faith in) ordered the strike.

Well.

Which is it?

Or do you not remember/care? Those who serve under the secretary of war will remember this kerfluffle. And the lies. And the admiral that was scapegoated for it.

That’s what happens when you can’t keep track of your lies. Lies are never a good foundation of truth. Americans deserve the truth. As do the families of the survivors you had killed.

By the way, the secretoy typos 8 sections ago? Was no typo. Deliberate typos, deliberate philosophy puns.

Because I think for myself.

School Me Saturday 11/29/25- The realized cost of college is not what it used to be

The latest October 2025 NBC News poll about the value of a college degree, nearly 2/3 of registered voters say that a four-year college degree is not worth the cost of attending college. That means that 33% of those polled thinks that a four-year degree is worth the cost.

In June 2013, the spread was much different. Then 53% of those polled said that a 4-year degree was worth the cost and 40% thought that college wasn’t worth the cost.

I have two thoughts about this.

TWELVE YEARS is all it took to destroy the idea of furthering your education. This was not done in a vacuum and certain people have been working toward this for a very, very, very, very, very long time. All the way back in the 1860s when the department of education was first created by President Andrew Johnson. And people railed about it enough then that the department was decreased to the office of education. (I think this is a genesis point of people realizing that LOUD makes right).
This is a problem of the education purveyor’s own making, in part. College has skyrocketed each year for as long as I’ve been a college student.

My final thought is that y’all are playing right into their hands.

They want Americans dumb. A less educated populace asks fewer questions that they don’t want to answer.

They want Americans without education to realize hey, this isn’t right.

They want Americans without education to realize that there is no way to rise above their station so they should just give up and become a corporate drone.

The questions you should be asking yourself are who is pushing the dumbening of America?Which corporations and billionaires stand to profit from keeping us dumb?

It also isn’t too late to ask yourself “how do we stop it?” Nearly but no.

As always follow the money.

And then read a history book and get ready to fight.

My final thought is to caution wariness about the make up of the poll. Who was their sample? How did they know their sample would be representative of the population? Who is asking these question? What is their angle?

Lastly, who is paying for the poll/study? And how do they profit from it?

FFS Friday 11/28/25- Feckless administration denies human trafficking concern for made up BS reason

Feckless is a fabulous word. It means incompetent.

In yet another broadside to others that the administration does not wish to recognize, on November 15th the “administration” removed a vital report on missing and/or dead Native Americans. This was a mandated report from the department of justice’s website.

This was a report that was mandated in 2020 by the Not Invisible Act.

They disappeared the report in FEBRUARY. After the debacle of the executive order declaring there are only 2 sexes. This was the DOJ’s way of complying with the order.

With a dash of also complying with the anti DEI executive order.

According to the Missing American Indian and Alaskan Native Persons Data 2024, there were ten thousand, two hundred forty eight entries of missing American Indians or Alaska Natives in 2024 into the data base. Of that 10,248, 233 cases are still active as of April 25, 2025. This data is pulled from the FBI Documents.

The vast majority of them are under 18. 7077 under 18, both female (4,179) and male (2,898) to 3,151 over 18. That is the only way the report marks age; over 18 and under 18.

Obviously human trafficking is a concern.

As well as violence.

The missing American Indian and Alaska Native persons has been simmer for a long time. Which is why the report was mandated in 2020. Finally.

Our media is more concerned with the white kids, you see. Especially if the perpetrator is not white.

More sensational.

More eyeballs means more money for the media company. We truly live in an attention economy.

More missing and exploited American Indians and Alaska Natives doesn’t have any juice, you see.

More missing kids that aren’t white or male, the government shrugs. The families are left to wonder why their loved one is gone. The families are left to wonder who took them. The families are left to wonder where their loved one is.

This is agony for them. And the government shrugs and obscures the report for BS made up reasons.

So many executive orders, each one a slap in the face of a woman or a minority or, to put plainly, anyone who isn’t a straight white man.

Reminder, an executive order is a wish.

A wish to put women firmly back in their place.

A wish to roll back the years of hard won progress.

Not a law.

Tuesday Top of Mind 11/25/25- Just a little prick

Yes, there are multiple meaning to the phrase. No I didn’t click all the links that were shown. Be careful looking up stuff on the internet.

But it does include the time on South Park in 2019 that Cartman didn’t want to get his vaccination shot. Which leads to him almost being thrown out of school (remember those days?), and he uses this to negotiate the exclusive use of the volleyball for the next six months.

Of course, he escapes the doctor trying to give him his shots. Again.

Why do people hate shots and vaccinations?

25% of [ep[;e are terrified of the needles.

Some people are afraid of the pain.

I’ve had many, many, many, many, many vaccines and I can tell you my experience.

Many.

In fact the last 2 I got were the Shingles second shot in October, and the flu shot in October.

Let’s talk about the fear of needles. While tatted with full sleeves and choker.

Sometimes it is an irrational fear.

Sometimes it does hurt.

But the hurt always goes away. The hurt is cause by the inflammation of the immune system response to what it thinks as an invader.

The hurt is a good thing. It means that the immune system is activated and will learn the often inactive microbe that was in the vaccine.

When I was giving covid vaccine shots in 2020 and 2021 many people were afraid of the needle.

But they still rolled up their sleeves.

Often I would administer the shot and the patient would ask when would I give the shot. Only to be amazed that it was already done. For the very fearful, I advised them to close their eyes.

These vaccine clinics often led to the how much is it going to hurt question.

Fair enough question.

I would engage in conversation with these people and ask them if they had ever had a tetanus shot, specifically the Tdap, or a flu shot. When they indicated they had, I would tell them that the covid shot hurt less than the tetanus shot and more than a flu shot. With a point of reference, they would nod and allow me to administer the hot.

There is another reason for mentioning the Tdap.

Babies are dying.

According to an article from CIDRAP from the University of Michigan, three infants have died of pertussis aka whooping cough in Kentucky. They were not vaccinated. This is the loss of herd immunity as overall vaccination rates are 90%, well under the herd immunity threshold of 95%.

There have been 2 dead babies in Texas. For the same reason.

The first thing I looked for in the X location transparency that dropped this week was the location of anti-vaxxer bots.

Okay, first I giggled and then I looked.

There wasn’t a lot of information. Most of it was around the bots in the red hats. There were some bots in blue hats. All are to blame here. But the red hatted bots WAY outnumbered the blue hatted bots and from such interesting locations as Asia and African countries.

This 99% accuracy as touted by X is stunning.

But, like most things these days, take with a grain of salt.

But babies are dying because of the inaction of their parents and doctors, fueled by lies from the department of health and human services secretary. They have a new accomplice in the CDC. Which takes vaccine providers to task by not being able to prove a negative.

But babies are dying and will continue to die because of misinformation and lies that have been passed down like grandmothers’ wedding china.

Just like women who are continuing to die under draconian anti abortion laws.

This is nothing to laugh at.

After all, a vaccination is just a little prick.

School Me Saturday 11/22/25- This just in, a nursing degree (any kind) is not a professional degree

This is more of a Tuesday Top of Mind topic but the intersections with education cannot be ignored.

In a slap in the face heard around the country, the Department of Education dropped guidance that a list of degrees would no longer be considered professional. Do you know how many nurses, registered or not, working in healthcare or not, are in the United States?

4.7 MILLION, according to the American Association of the Colleges of Nursing.

Yeah, you done fucked up and insulted 4.7 million people.

The so called professional degrees that were listed

medicine
pharmacy
dentistry
optometry
podiatry
law
veterinary medicine
osteopathic medicin
clinical psychology

The so called non-professional degrees that were listed

NURSING
physicians assistants
physical therapists
social worker
speech therapy
architects
accountants
educators

I first read about this on Wednesday and the everyone else had read about it and were giving their reactions. I held onto my reactions until today. They are in three sections.

The first is that this downgrade means that there is less money for all of these professions to go to graduate school. The “professional” degrees (see above) can borrow up to $50,000 per year, with a cap of $200,000. The “non-professional” degrees (see above) are limited to $25,000 per year, with a cap of $65,000. Massive difference, right?

They do know there is a nursing shortage, right? And the shortage is exacerbated by the severe shortage of MSN and PhD prepared nurses to serve as nursing school instructors. I fear this would only deepen this shortage.

It’s like only rich people can obtain graduate degrees. I mean people have the option go into crippling private loan debt. Things to consider. I would not recommend private loans for school. I know too many nurses who have been destroyed by them.

The second is that the “non-professional” degrees are, with the exception of the architect, mandated reporters. Being a mandated reporter means that the social workers, the health-care professionals (including nursing, duh), the teachers, the child care providers, and law enforcement are mandates, by law, to report child abuse or neglect. This definition comes from the childwelfare.gov.

I know that most people love their children and would never abuse them, but there are always those that will. And, as a mandated reporter, I have to report it. This is to save children’s lives.

The third section is that the “non-professional” degree workers are mostly women. And those in power love nothing more than to treat women as less than. This has been happening more and more in the last few years.

If women can’t get loans to go to school and the cost is prohibitive, I guess they will have to stay home and have ALL THE BABIES. Even though nurse practitioners and physician assistants make up the bulk of the rural healthcare that is available. According to an interview I saw with Dr. Jennifer Mensik Kennedy, the president of the American Nurses Association (ANA), if there were no NPs or PAs a patient in need of care would have to drive 90 miles for care. Each way.

I am not less than. I am a professional working registered nurse. I am not a doctor or surgeon’s handmaiden.

Ew.

In 5 years we’ve gone from hero at the bedside during covid to non-professional.

I have called or written my representatives and the ANA has an online petition at RNaction.org. You better believe I signed that as soon as I heard about this travesty.

It’s like they want women in the home, having babies, and to cripple higher education. If only we were warned (this is heavy sarcasm)! Oh, wait, we were. This is all in Project 2025.

In simpler terms, to keep women dumb and in the homes so they can have all the babies. After which I guess we die?

Nice try and fuck all the way off!

FFS Friday 11/21/25- Fidelity

As I am sure you are aware, a group of 6 Democratic lawmakers, both Senators and Representatives alike, released a video on Tuesday (November 18, 2025) advising military and intelligence communities to defy illegal orders they are given. 2 Senators and 4 Representatives made up the group. All of them had served either in the military or in intelligence work. There were 2 Navy (Senator Mark Kelly, Representative Chris Deluzio), 1 Air Force (Representative Chrissy Houlahan), 1 Army Ranger (Congressman Jason Crow), and 2 intelligence officers (Senator Elissa Slotkin, CIA, Congresswomen Maggie Goodlander).

The message is brief and stark. It is a reminder to the intelligence officers and military members of all services that their first duty is to the American citizens, not the current president.

Illegal orders must be disobeyed.

Their fidelity is owed to the constitution, not the current administration. Not the current Secretary of Defense, now named the SECRETARY OF WAR.

The CONSTITUTION that they have all sworn to uphold.

Not the self styled monarch that is drenching OUR house, the White House, in tacky spray painted shit.

Not the foreign leaders that hold their leashes.

Not the billionaires who bought the election for them. Because their loyalty is not to the Constitution.

The current members of the military and intelligence community owe their loyalty to the CONSTITUTION.

Their fidelity.

As the Marine Corps saying goes “Semper Fidelis”.

Always Faithful to the ideals of America, not the wanna be strong man ruler and his cronies.

The fight will be hard. Hell, it already has been hard. I cannot imagine the pressure that all current members of these institutions are facing.

I’ve written about the Officer Oath that I took at 19 to the Air Force.

I did not swear to Bill Clinton, who was the president at the time. I swore to uphold the Constitution. Against all enemies, foreign and domestic.

And neither did the current and past members of the military and intelligence community. Including the 6 that gave this powerful and timely message.

The current occupant of 1600 Pennsylvania Avenue reacted, of course. Badly, like they always do. Like the big blowhard they are. And of course he reacted with the threat of treason. And death threats. Because that is the only play that they know.

His current press secretary came out with “All the president’s orders are legal.” Excuse me? The fuck they are.

And of course the members of the “right wing” media reacted as if they’d been scalded. Instead of sitting and thinking what the message of the 6 truly was.

Get the military off American streets. Stop threatening United States Citizens. Remember your oath to the Constitution.

And, for the love of America, put that back in your pants before you hurt yourself!

Cookie Thursday 11/20/2025- Pecan pie bark

Yes, another bark.

But this one went better.

Except…

I had purchased graham crackers that were going to serve as the base under the praline mixture. Like Christmas crack, minus the chocolate, plus toasted pecans.

But when I went to make the candy, the graham crackers were NO WHERE to be found. And I mean no where. It doesn’t help that the house is in an upheaval with the dining room light switches being intermittent. Of course, I trouble shot to the best of my ability. It wasn’t the bulbs. I had to empty out the dining room, which was on my list for the week, because we are hosting Thanksgiving next week. The night before the electrician was coming I thought that it might be the original light fixture itself and, wanting no delays in getting the light fixed, I purchased one the day they were coming.

As an aside, when the electrician was here he tried the light switch. And it WORKED! Way to make the electrician think I am crazy, house. The plot thickens after he pulled off the switch plate and found that it was badly put in. Of course it was. When I say that this house was badly made, I mean it.

Back to the candy.

The graham crackers were missing. Strum and Drang, indeed. This is in reference to the late mid 18 century when a romantic period in German literature happened. This period exalted nature and feeling and can be translated to storm and stress. I think of it like being dramatic for dramatics sake.

It was quite the hullaballoo when I couldn’t find the graham crackers. Well, I wasn’t about to drive to the store to purchase more. That is its own trek with the construction going on the only street out of our development.

What did I do?

Like any operating room nurse worth her salt, I made do.

I used Ritz crackers as the base of the praline.

Because Ritz crackers are not unlike well made pie pastry.

I made the praline and poured it over the crackers and baked it as directed for 10 minutes.

And what do you think I found after I pulled the candy out of the oven and placed it to cool? The graham crackers. Safe where I had put them.

Of course.

Call Secrets of the OR- The call team takes all comers

This is a reminder that the OR call team takes all cases.

All surgery types.

All surgeons.

All service lines.

We do it all.

But more than that.

We, the call team, take all the patients who require our help in the middle of the night.

Regardless of sex.

Regardless of circumstance.

Regardless of immigration status.

Regardless of age.

Regardless of what surgery is needed.

Regardless of how much money/clout they think they have.

Regardless of how little money/clout they think they have.

Regardless if the hospital leadership considers them a VIP. I hate to break it to the leaders, all are treated as if they are a VIP.

We take it all.

And we don’t care what other people think about that.

Because it is not the deniers who need to be on the OR table.

It is the patient in need.

You get my meaning

I hope.

Tuesday Top of Mind 11/18/25- Robin getting slapped by Batman for saying he needs antibiotics for a cold

Less than a century ago, common illnesses such as appendicitis or pneumonia, or even extremity abscesses were often lethal. That means the infection, that there was no way of stopping, killed the patient.

It was in 1928 that the miracle of the petri dish occurred. Well, some say miracle, I call sloppy lab control. The petri dishes weren’t cleaned before Dr. Alexander Fleming went on vacation. He got back to his lab and the dirty petri dishes to find the newly grown mold that had developed was keeping the bacteria from growing.

Penicillin enters the chat.

But penicillin would worked on many different bacteria. Today we call it broad spectrum.

Then they called it amazing. And wondered what other antibiotics could be found and developed. Sulfa medications soon followed. And then resistances to the antibiotics started appearing.

Really the march to where we are now is fascinating.

There is a really good article. “Antibiotics: past, present and future” by Matthew Hutchings, Andrew Truman, and Barrie Wilkinson. It has good graphs, tables, and illustrations. But it points out the present we are living in and the future we should all fear.

The present that we are all living in is the rise of antimicrobial resistance (AMR).

This is when the causative agents of the infections are no longer susceptible to the antibiotics used to treat them. This means that the drugs no longer work for that infection.

I am not kidding when I call that the scourge of the modern age.

Because when the antibiotics we have are not the right antibiotic to treat an infection we might as well be back where we were 100 years ago. Shit out of luck (SOL).

And dying from appendicitis.

But how did we get here?

From the free and loose prescribing of antibiotics for nearly 100 years.

I have a cold, try these antibiotics. They aren’t the medication for viruses, but hey, it might help.

I feel better, I think I will stop these antibiotics. Yeah, I’ve only taken them for 3 days and it is a 7 day course but I feel better now.

A new friend from another place, let me shake your hand and give you what I might have and pick up what you might have. From the casual contact.

Oh, is that a rescue animal. Can I pet it?

Germs are like people, they want to live. And to do so they mutate and learn to overcome the antibiotics. Worse, yet, they have the ability to learn from other germs that are nearby. Germ A learns to be resistant to antibiotic a because germ B taught it to be so.

It is a huge problem.

This week is Antibiotic Awareness Week, November 18-24. It is meant to raise awareness of appropriate antibiotic and antifungal use. (not for colds, jan!)

Because we are rapidly approaching the cliff where none of the antibiotics will work and limited new antibiotics in the pipeline.

Your mission:

Try rest and fluids for illness first, especially a cold
always finish the course of antibiotics
do not ask for antibiotics for a cold. The reason you feel better is the placebo effect
when your child needs antibiotics for a cold don’t give your leftover ones from last year
listen to the medical professionals about antibiotics

Governments and scientists are working on it. They were slow to wake up to it, and slow to get going, but everyone is aware that this is a problem.

And hope really hard that it is not too late.