Oh, boy.

Another series.

This one will be the secrets of the OR that your preceptor hasn’t told you.

The OR is many things. It is demanding, and fast-paced, and a steep learning curve, and demanding.

Yes, I know demanding is there twice.

And it is, in fact, the first secret.

The OR demands excellence from all of its workers. From the orderly to the circulator to the scrub nurse to the anesthesia team to the surgeon.

Why?

For the patient who is under anesthesia and has put their trust in us, the OR team.

Is the OR for everyone?

No.

No shame to the ones who are unable to work in the OR.

It isn’t for everyone.

Not everyone can rise to the level of excellence that the OR demands of us.

See, demanding.

The first thought in an OR person’s brain is not when is lunch/break/home time or I don’t want that case, or I had the hard room yesterday, make my coworker do it. It is and it should be how can we take care of this patient.

You have to park your stomach in your lunch box and keep going until you are relieved. You have to not whine when the hours are hard and Becky got to go home early yesterday and Joe never does any work, ever! You have to be aware of the steps of everyone else’s job and can step in if the circumstances demand it, within the scope of your license.

The hours are long, the floor is hard and your back WILL hurt. If you ask others, there is never enough help, and the doctors are demanding, and the charge nurse plays favorites.

None of that matters. Only seeing the patient safely through the steps of surgery matters.

And is our mission.

The OR is demanding. This is the first secret of the OR.

What can I say about the liars on the Supreme Court?

Are we surprised?

What can I say about the hellscape they have dropped women into?

I’ve said plenty.

What can I say about criminalizing homelessness?

I mean, we can’t teach humility and grace to people who have never had it.

What can I say about taking power away from federal agencies and giving it instead to judges and even legislatures?

Whatever makes the most money.

What can I say about legalizing bribes AFTER a judgement comes down?

It is either about money or control. There is nothing else.

Because that is the currency they understand.

What can I say about unearned immunity?

My God, why don’t you just crown them king?

No matter that we fought several wars, including the founding fathers to get away from absolute power.

Our Supreme Court, the best crooked and deep money can buy.

Pay no attention to the hundreds of millions of people who are against like 90% of what they do.

We don’t matter.

Only those holding the checkbook do.

Hell, I won’t stop screaming into the void.

To be silent is to be complicit.

And don’t tell me well if Ruth Bader Ginsburg would have retired before she died…

And what if Mitch McConnel hadn’t put his fist on the scale after Antonin Scalia died and refused to do so in 2020 after Ruth Bader Ginsburg died in virtually the same scenario.

Register to vote.

Check your voting registration.

But, most importantly, vote.

This is the only voice we have in the maelstrom.

The post-it reads “Maybe this time. The OR lament.”

Apologies to Liza Minnelli and Cabaret and Fred Ebb and John Kander.

Who is singing? A circulator? A surgeon? A scrub tech?

Who knows.

The OR Lament

Maybe this time it’ll be lucky
Maybe this time the fix’ll stay
Maybe this time, for the first time
The fracture will hold

The screw will hold the bone fast
I’ll get to go home on time at last
Not in overtime anymore
Like the last time and the time before

Everybody loves an on-time start
And nobody loved me
Hey, charge nurse please
Home is where I long to be

Well, all the odds are, they’re not in my favor
The add-ons are bound to begin
It’s gotta happen, happen sometime
Maybe this time I’ll plead

‘Cause everybody, oh, they love a cancellation
Not an add-on case
Hey, charge nurse please
Home is where I long to be

Well, all the odds are never in my favor
The phone’s bound to ring
It’s gotta happen, happen sometime.
Maybe this time
Maybe this time I’ll get to go home first

Being an adult learner often teaches you more about yourself than you knew before.

This is the greatest lesson that the Blue Caterpillar gave to Alice.

The Blue Caterpillar gave Alice permission to explore in Wonderland. And explore she did. There were hatters driven mad by the mercury used in their trade but he was still jolly and could be counted on for a rollicking good party. There was the Red Queen who insisted on absolute loyalty from everyone and everything, even the white roses but who could be defeated. There was the White Rabbit that was always running late but tried to keep to schedule. There was the mysterious Chesire Cat who talked in riddles but still imparted important information to Alice. Even the Dormouse at the picnic taught Alice the importance of rest. And what is more important than resting when you can. Just don’t take it to extremes.

Being an adult learner is exciting and hard. It is hard to juggle all the parts of your life, your real job, your children, your spouse, your habits, good and bad. Add in another few balls, such as classes and assignments and you might drop them all.

Or, you might not.

School or classes or whatever new thing you learn will teach you as much about yourself as the things that you learn.

Just be forewarned, that the more you learn about yourself, the less you know.

And that’s okay.

Adulthood is a learning time.

None of us, and I mean NONE of us, has it figured out.

Of course, not right this second as we welcome rain. It is apparently 78 degrees with 70% humidity. And raining. I wouldn’t kick the rain out of the forecast, you know.

But it has been in the upper 90s all week. The roses are drooping, as are the berry plants. Despite watering every day.

This is something I remember from my childhood, schools out, it must be hot. And it was. Depending on where we lived at the time, I could look forward to afternoon thunderstorms (Denver, CO), or dry heat (Sonoma, CA), or humid heat (St. Charles, MO).

Today’s make is refreshing to some. Others told me not to do it because of the raisin ants that were on the celery log. I made antless ants on a log.

No ants here. No raisins here.

Just celery and peanut butter. Both creamy or crunchy.

I find it refreshing. And simple, just like all the best after-school snacks.

This is the last week of the after-school snack theme for June. And I am still undecided about what I will do for July. Last year I did Christmas in July and that was fun. The year before I did If You Want Women in the 18th Century So Badly… after the Dobbs decision.

This year?

I’ll figure something out.

The gown card reads “Girding your loins to address the elephant in the room. This is harder than it looks.”

This can be about many things. Today it will be about the so-called sacred animal in the OR. I know that I’ve written about this previously but this gown card brings it back full circle.

These are the sacred rules. Sometimes called a sacred cow and in today’s gown card is referred to as the elephant in the room.

These are the often nonsense rules that are followed. Just because they have been done for as long as there is memory.

There is no research behind them.

There is no common sense behind them.

One day someone just made up a rule to make it easier for them in that moment. And they foist this rule upon us forever and ever and ever.

Even if they don’t make sense.

What are these sacred animals?

Stand up and give your chair to the doctor is one. When I was a baby nurse, nearly 25 years ago, we had several older MDs who would demand our seats and our pens and the charts (back when we had paper charts) even if you were using them.

Wearing shoe covers on the shoes that live in the locker room. My hospital shoes live in the locker room if they are not on my feet in the OR. I do not wear them outside. This is me protecting the outside from the OR, and the OR from the outside. And is a very good practice. Anyways, shoe covers make me fall down. Mostly because they are made for men’s shoes and too big.

Or the elephant in the room can refer to treating the surgeons and other doctors like gods. It is okay to stand up to them. It is encouraged to talk back to them if you know that what they want to do is not right.

The patients are counting on us to be able to stand up for them. Because they can’t.

Before you develop the spine to speak up put my number in your phone and put me on speaker. I’ll tell them no for you.