cough

The gown card reads, “Sometimes anesthesia reminds me of doting pet parents every time a cat stretches its entire length out, but instead of saying big stretch, the commentary is big cough.”

If you have a cat, or some dogs, you’ve given this commentary.

The cat stretches out their back legs or their front legs in an elongating stretch that makes you comment, every time, “big stretch”. The human extends the i sound to mimic the satisfying stretch the cat has just done. This comment is definitely a reflex on the human’s part.

When a patient is breathing on their own after anesthesia and is extubated by the anesthesia provider there is often a reflective cough after the tube is removed. Without fail, anesthesia will comment “big cough”. Extending the same i sound to encourage the patient to cough again.

I have a cat. I know how this goes.

The cat stretches for a variety of reasons. To say hi, to loosen up their muscles after a nap, and even to invite their owners to play. These are all positive affirmations by the cat that the human is a good human. A good stretch is also an indication that the cat is content and feels safe in the human’s company.

A good cough after extubation and the accompanying praise can also be a good indication that the patient is safe with the OR staff.

After all, a good couch stirs up the juices (for lack of a better, less icky word) that have been stagnating in the lungs during the duration of anesthesia and surgery. This improves lung exchange and can have a positive effect on the pulse oximeter reading.

The intonation and the elongated i in big is the same.

Both instances are hilarious.

School Me Saturday 11/23/24-punctuation poisoning

With the increased use of AI and the increased reliance of newsrooms to get a story out faster so that eyeballs can look at the story, there has been an increase in stray punctuation marks. Mostly quotations.

For example, I just pulled up a news clearance site. This particular site is the MSN home screen which is the first thing I see when I open the internet. There is a news crawl of stories that are supposedly curated to my interest. I like to bake and my computer has probably figured that out. Or, at least, the algorithm has.

The very first article that was in the news crawl was an article on pecan pie. The gotcha headline was “Pecan Pie Brownies” Are the Cozy Boxed Mix Hack I Make Every Thanksgiving.

There is so much wrong with this headline. Why is the phrase pecan pie brownies quoted? Why does the news crawl assume that I am looking for a baking hack? But mostly, why is the phrase pecan pie brownies in quotations.

It is kind of like seeing a red balloon after reading about a red balloon. And you see it EVERYWHERE. This can be attributed to the Baader-Meinhof phenomenon. This is a cognitive bias, also known as the illusion bias.

Me, I just call it lazy editing.

Another headline on the news crawl “Messy Thanksgiving travel” because of the Thanksgiving Week forecast. Why they felt the need for quotations there I don’t know. To draw the eye? To make the headline stand out?

Just watch out for how many badly placed punctuation marks there are, especially the quotation marks. They are misused everywhere. And take care not to fall into this trap yourself. If school has taught me anything, it is that a proper citation is worth learning. A citation in a headline without attribution is just lazy.

Because it is apparently a hard habit to break.

So sorry if you start seeing horribly written headlines everywhere. But if we don’t demand better editing in our headlines we descend into chaos. And we don’t need the additional stress in this environment.

Also, I would never use a boxed mix. Especially not a brownie mix.

FFS 11/22/24-I’m thinking of a certain word that starts with “C”

Fridays will be the new political day here at Dispatches from the Evening Shift. I may not make or keep friends. The direction will be from a feminist lens. Most of the time I will write about topics that are health care related.

But not today.

I have been thinking about the general election that was 19 days ago and the surprising/not surprising results.

A singular word keeps flashing in my mind.

It begins with a C but it is not the word you are thinking of.

The word is coward. Too many of the voters were cowards. They were too wrapped up in their misogyny and their disordered thinking to even conceive of voting for a woman. Much less a blank woman.

Too often they were caught up in the pretend world where a nearly 60-year-old woman is held hostage by her hormones.

Too often they were caught up in the pretend world of strong men world leaders who would make the poor little old woman cry. Insert eye roll here. As if Harris didn’t make the mortgage lenders and others that she prosecuted cry herself.

That or they were bamboozled by propaganda from foreign agents.

Oh, look an F word.

The F words of the day are feminist, friend, and foreign.

The S word of the day is sigh.

I require a tee shirt with the word coward on it.

Hell yes, I am still mad as hell.

Just wait until I write about what I consider a good holiday gift for those who voted with their wallets and their misogyny and their online “friends”.

No, it is not just that I am mad, it is that I am disappointed in us.

I have decided my tee shirt should read “Cowards! All of you.”

Cookie Thursday 11/21/24- sweet potato cookies

Yeah, this is the same recipe that I used two weeks ago for the pumpkin cookies.

Cookie Thursday is a Thing is nothing but exploratory. That means I experiment on my coworkers. They get cookies, I get to experiment in the kitchen. It’s all good fun.

I’m not a huge fan of pumpkin, I like the milder sweet potato.

The pumpkin cookies that I made two weeks ago were very popular. And since this month’s theme is Fall (so original, I know) I wanted to make two of the popular Fall “vegetables” into cookies.

The pumpkin ones went great, although the recipe was a snickerdoodle in disguise.

I just used the same technique on sweet potato, without the fiddly sugar dip in cinnamon sugar step. I was going to use ginger and sugar but I had a meeting that was starting in 15 minutes and the sugar dipping took so long and was so messy last time I just skipped that step. I think ginger sugar dipping would be delightful and I will stow that idea away for use in an upcoming Cookie Thursday is a Thing.

Without the sugar dip these cookies still turned out. They were soft and cakey (in a good way) and delicious.

This is one experiment that I wil have no problem replicating. Unless I change another variable.

Experiments for life.

Edit to add that I added the chocolate chips that I felt were lacking in the pumpkin cookies to half of the batch. Yep, the pumpkin cookies definitely needed chocolate chips.

Best Kept Secrets of the OR #15- What you ignore or suggest is treated as normal

This isn’t a positive best-kept secret. In fact, it makes me mad and is probably making some of your charge nurses mad too. But not the one who is trying to be your friend and suggested that you call in sick, in front of another charge nurse, because you couldn’t get that day off.

However, this is directed at the other charge nurses who permit this behavior.

Apparently, in today’s working operating room, all you have to do to get the day off that was denied is call in sick. No thought was given to the rest of the OR team that now has to work short. No thought is given to the patients who are going to be worked on that day when the rest of the OR is working short. No thought was given to the person who makes the schedule that you just took a giant dump on.

This is because you didn’t get your way and you are making it everyone else’s problem.

Number one- there are rules for a reason. Only one person per staffing level (scrub tech, registered nurse, orderly) can be off at the same time, on the same day. Writing as a previous staff scheduler whose OR was run a lot leaner than the one you enjoy, there are reasons for that rule. You are damning someone else to work extra. The rules are different in each unit. In this unit, one person per staffing level is allowed off for a specific day.

Number two- this is for the charge nurse who suggested that a team member call in sick to accommodate their desire to have a certain day off. To that charge nurse I say don’t do this. Don’t make the rest of your team work extra so that you can be buddy-buddy with another team member. It reflects badly on you.

Number three- what you permit becomes the new standard. And will most likely come around to bite you in the ass.

Just no.

Don’t do this.

You are UNDERMINING your authority.

Consider that.

Or you might want to be friends with all of your subordinates and wonder why they don’t respect you.

You choose.

Tuesday Top of Mind 11/19/24-time to raise a little hell

This was not what I was going to write about today. Which I understand is a theme I’ve got going on the last several weeks.

Oopsie.

I decided not to write about the original idea because I wanted something a little lighter. Well, a lot lighter. Also something that might make the reader laugh. Because I laughed so hard.

My phone and I have a love-hate relationship. Yes, it is a technological marvel and holds vast amount of data and lets us engage with the world that before 2007 and the widespread advent of the smartphone. Perhaps my very favorite thing that the phone can do is give me a read-out of who is calling.

I know I am amongst friends when I write that I don’t answer every phone call I receive. Because the spam filter we were promised is crap.

There is no comparison between the calls I doanswer, which are mostly friends and family or the hospital, and the calls that I don’t answer, which are scam alerts, or numbers I don’t know.

Because that is a fabulous thing that the phone can also do; identify known numbers.

I rationalize it by remarking to my phone nearly every time, well, they’ll leave a message or call back. But they don’t. Leave a message, that is. And if they call back at least twice, I am more liable to answer a repeat phone call.

But tonight, tonight I was driving to the hospital to run a call BootCamp with a new nurse when the phone rang.

It surprised me when I answered it. No name, just a phone number. Totally goes against everything I believe in. Wild hair made me do it?

I don’t say hello if it is someone I don’t know. I answer with “This is Kate.” No more, no less. I have read the news reports about what not to say and give up to people you don’t know on the phone. I avoid yes, I avoid hello, and I avoid apologizing.

When the caller stuttered, I said again, “This is Kate.” I am unsure if they were expecting someone to answer the phone or not.

It was a cold call from somewhere in TN. The caller launched into a spiel about an energy-saving program.

I assured them that I had no need for an energy-saving program.

They tried again, asking if our electrical bill was consistently over $100.

I assured them that it was not.

Silence on the other end.

And then a click.

That just tickled me and I laughed at the absurdity.

It was a definite dopamine hit.

I don’t know if readers are aware of the 2024 general election and the general malaise that has come over some of us.

It’s been a rough 10 days.

And if I can get a little joy out of confounding a scam caller, I will absolutely do it.

I kind of can’t wait for someone else to call tomorrow. Just to make them hang up on me.

This might be fun.

____________________________________________________________________

I wrote the bulk of this post last night and here is a little post-script.

It was fun. An AI called my phone looking for my husband.

Same set up-

this is Kate
their question
no
their second question
no
click

Post-it Sunday 11/17/24-all the hats nurses wear

The gown card reads “In the day’s culture it is not enough just to practice nursing, you must also wear different hats.”

This is a bit of a tricky one. I wrote this gown card at a nursing symposium on November 6, 2015. I know because it is listed on the card. I also know because I remember that symposium. It was one of my first in shared governance. I wasn’t involved in the planning of this one, but I was expected, as the hospital chair, to be present and participate. The theme for this one was “Batter up.”

No, not really. But it was baseball-themed, coming less than a week after the end of the 2015 World Series.

There I was, in a very new environment, soaking up all the excitement of the speakers and my fellow shared governance chairs. I took copious notes. Three gown cards full. And I have bitty handwriting.

Something the keynote speaker must have said struck me. It was probably about having to do all the things and be all the departments after hours, as a nurse on the floor.

While I was probably not the only operating room nurse in the room, I was definitely the only OR nurse on the team.

This was when I started to advocate the OR nurse’s inclusion in all aspects of hospital life. I was the first OR nurse they had ever had on the hospital chair level of shared governance. I volunteered for other committees, so many committees, so that the OR could have a voice in all of these committees, and shared governance meetings.

Nurses have to wear many hats. This is true. We have to be our own unit secretary at times, we definitely have to function as a CNA at others, and we have to pinch hit for plant engineering when things go wrong and no one is available to sort out the problem. We also have to be able to figure out the computer charting and also how to troubleshoot when things don’t work the way they should. We have to be able to fix or find another route for a piece of equipment that is definitely older than our nursing career.

While we are doing all of that, we also have to take care of patients. We have to make sure that the bedbound is repositioned every two hours, that the diabetic gets a blood sugar taken before they eat, that morning and evening pass medications are given. And for those of us who do not work the floor unit life, we have to make sure that every surgical case goes as expected. That ALL the equipment that is needed is available and ready, and we also have to find a workable solution when there is a failure. Don’t forget about making sure the proper instrumentation is available and sterile for each surgery, and if there is an instrument that is dropped where to find a replacement instrument because you know that what hit the floor is the only one.

No one nurse is better or worse than another.

We all wear the hats.

We all wear all the hats.

But we are nurses first.

School Me Saturday 11/16/24- It’s here, the final push toward the end of the semester. Isn’t it hateful?

Depending on when your university or college marks the start of the semester you may be 13 weeks in or 10 into the semester. Considering a semester is usually 15 weeks, with an extra week for finals, you may be nearly there at the end of the semester.

Regardless of how many weeks, anything after 10 is practically useless.

Your grades are set, for the most part. Only a miracle can bring you up an entire grade. Only a disaster can plunge you into failing, depending on where your grades usually hover.

I think this is the hardest part of the semester. Students are tired. Teachers are tired. Administrators are tired. We are all tired.

This year is especially taxing because someone put a very pivotal election in the middle of the semester. While not all students are up on their politics, they are probably aware enough to pick up on the durm and strang that is at a boil at the moment. Reminder, the literal translation of durm and strang is that there is a storm and stress. The Germans really know their way around a phrase

And it took me 5 times to type durm and retype durm after the autocorrect that I didn’t ask for changed it to drum. FIVE times. No wonder we’re tired.

It is too soon to start planning your winter break and too late to “fix” your grades. But you should have bought your plane ticket home weeks ago. You know, for the best price.

It is too soon to start planning for the Summer semester. Planning for Spring? That started almost as soon as the Fall semester started. Planning for graduation? That started before your first class, dear.

No wonder we are tired.

And stressed.

According to the dictionary being tired and stressed at the same time means we are burned out.

Writing as a long-term healthcare professional of 26 years and a nurse for 23 years, my first response is no shit.

Writing as a long-term student who is on her third degree in ten years, my first response is no shit.

Take a deep breath.

This is where the mantra the only way out is through is useful.

Insert whatever mantra you use here.

Just keep swimming.

FFS Friday 11/15/24-New day in the rotation

Yes, FFS means what you think it means.

It means that we Females are tired of the bullshit.

It means that Feminism is alive and well.

It means that we will Fight the new world order that is trying to stuff us into itty bitty boxes because it makes the boys feel better.

It means that we will not Stop until we regain bodily autonomy.

Care to join me?

There will be swearing.

Oh, so much swearing.

Sorry, mom.

Unlike Tuesday Top of Mind, which is overtly political but not necessarily all female all the time, this will be an entirely specific female space for female voice (me) writing about what fresh hell has been dropped on us.

Buckle up, girls, even the ones that voted for the Orange Menace.

You didn’t think your vote gave you any special privileges did you?

You have much to learn.