24-old song, new verse

On this Tuesday I am struck by the US measles rate. In the last three months, there have been 64 suspected cases in the US. According to the CDC, this is in 17 states and surpasses the total number of cases in 2023, which was 58. FOR THE ENTIRE YEAR! And there have been 64 in 85 days. How high can the number go in the next 280 days?

Like Covid, the answer is the same. Vaccination. The MMR, measles, mumps, and rubella vaccine that has been given to millions of people. If not billions. The same titer that I have had to have drawn at every level of schooling: ADN, BSN, MSN, and PhD. To make sure that I was not a danger to my classmates and that I was not in danger from the very random person who has those diseases. I also got the booster in the 1990s.

If another booster was deemed appropriate today I would roll up my sleeves. Right now.

Like Covid, the reason is the same. People who are against vaccines. For a variety of reasons. I don’t really care what your reasons are. I have heard them all.

You know what I read that was jaw-droppingly stupid? That the Florida surgeon general, whose state is enduring part of the measles wave, said it was okay to send your children to school even if they have measles. Oh, and the vaccinations? Not necessary.

Wall, meet head.

As the magazine Scientific American put it, this is a direct effect of the peddling of covid-era pattern of medical misinformation.

I will say it again, if you are against vaccination and part of the tide of cases that is threatening our herd immunity, your great-grandparents are spinning in their grave. They watched their children die and fought for vaccines. The same vaccines that have allowed us to build up the herd immunity that everyone enjoys. Even those assholes who think that they are not part of the herd but are enjoying the effects of our rolling up our sleeves and taking it for the good of humanity. Or allowing our children to be vaccinated so they are not in danger.

You might have been lucky and continue to be lucky, but what happens when your luck runs out?

Post-it Sunday 3/24/24-School or keeping up with family over video

The post-it reads “Zoom, Teams, and Skype, oh, my. How far we’ve come.”

Yes, I definitely heard Lions, Tigers, and Bears, oh, my when I was writing it.

These are video conferencing platforms. Kind of like FaceTime but you don’t have to be in the same room.

I’ve done a version of these since about 2015 when I first started with shared governance. The meetings had a Skype option if you couldn’t get to the meetings. And it was easier to log into the meeting than drive to the meeting, fighting traffic, finding a parking spot. After 2020 most of the meetings were online through Zoom. And then the hospital got way into Microsoft 365, which has Teams.

Schools also use these platforms. During the pandemic, college and universities, and schools, all the way down to elementary, used a conference platforms for classes.

I could go through how not every child had access to 1) internet access, 2) a computer with a camera, or 3) an adult who was savvy enough to sign them on until they learned.

The pandemic forced us to take a leap forward in a lot of ways. Including classes, funerals, weddings, and the humble check-in with our families.

All of these platforms are still active, by the way.

But the university and the hospital use Teams.

Tips for all of the conference platforms

keep them updated
Be patient with the technology
Be patient with the people you are trying to connect with
Sometimes it just plain doesn’t work

In my readings for school, a qualitative project had 2 conference meetings for an interview. The first was to make sure that the technology all worked. I thought this was very smart and I did the same in the interview that I had to do. It was a dress rehearsal.

Before the main event.

Cookie Thursday 3/21/23-baker’s day off

Would it be a Well That Was Easy month if there was not a baker’s day off?

This day was even easier than last week when I bought cookies. Today I didn’t bake/buy/go to the hospital at all.

Why?

Because I worked last night from 2100-0100. Well, Kate, you say, that doesn’t sound too bad.

Yeah.

Because it gets worse.

Immediately upon returning home I greeted my husband, who had returned from work, sat down at the desk to continue reading for Friday when a surgeon called me directly. There was a patient in the ER that needed surgery urgently.

Okay, that’s what we do.

I didn’t get home until 0430. I fed the cats half of their morning portion, in the vain hope that they would leave me alone at 0800. I made sure that both of them saw me put food in the bowl. No dice.

Dot woke me up at 0830. I staggered downstairs with my eyes half shut and put the rest of the portion in the bowl and returned to bed.

Dot did not like that.

She proceeded to paw at me until I just gave it up and got up at 1100.

Brat!

Even as I write this she is hovering over my hands on the keyboard.

I decided I was too tired to do the Cookie Thursday is a Thing bake today.

I had a brief moment where I was going to make chocolate chip cookies. But no.

I am going to post this, finish up with my writing group at 1445 and take a nap!

What to do when the person you are on call with does not answer their phone

I get it. Sometimes you don’t hear the phone ring. Sometimes you are in such a deep sleep you don’t hear it again. When that happens, I try the alternate number. When there is no answer there I make alternative plans.

This happens to everyone. Even me, after the thousands of call shifts I’ve covered in my career. Once upon a time my phone and the pager malfunctioned at the SAME TIME! I am not sure of the odds of that but I bet they are astronomical.

I should have bought a lottery ticket.

My point is that it happens. It happens often enough that I’ve developed a task list on how to deal with it.

I could call management. And I have when it is warranted. But that doesn’t get the patient, who was sick enough for us to be called in during the night, on the OR table. Calling the manager at the moment delays care. They would do the same thing I’m going to tell you anyway.

Pull out the staff phone book. Every OR has one. This is where the pager numbers, phone numbers, and alternate numbers are stored.

Start down the list until you find someone able to come in.

Off cookies if you have to.

Eventually, someone will say yes. Sometimes it is after you’ve called all the scrub techs and no one is answering their phone or available.

It is important to note that after 5 no responses (about 2 minutes) you should call the manager. In case they have to come in. But of the tens of times I have had to find another person to come in, this has never happened.

Another alternative is to call the people you know can handle the role in the OR. Some nurses, myself included, can scrub.

It is also important to cultivate a list of contacts that probably won’t say no to you. Don’t tap that resource too often, or you will burn them out.

The next day have a friendly chat with your manager about the problems overnight.

There you have it. What to do if there is a case and the person on call is not answering their phone/page/alternate number.

Tuesday Top of Mind- March 19th Certified Nurse Day

I know I just wrote about how recognition can be cringey. Especially for an introvert.

However.

Touting your accomplishment is not cringe.

I’ve been a certified nurse operating room (CNOR) for 15 years now. I just renewed!

When you are in a specialized area such as the operating room, emergency room… heck, all hospital areas are specialized and all have their own certification.

But what does certification mean?

It means that the nurse

To me, it means that the nurse cares enough about the processes of their care and their patients, to study hard, find a certification test, often pay money out of their own pockets to take the certification test. Yes, it means an additional set of letters after your name, but all the certified nurses I know say it is not about that.

They speak to their dedication to the art and care of nursing and this has caused them to want to be certified. It is not about the money. It is about showing everyone that you are proud to be a nurse. It is also a declaration of what kind of nurse you want to be.

To the certified nurse, nursing is not about the paycheck, of putting the hours in and stamping that time clock, or working or not working that overtime. Or getting everything done so you can get off the floor, off the unit. It is about caring and wanting to see the best outcomes for your patients.

That is why I am and have continued to be a certified nurse.

Post-it Sunday 3/17/24-Recognition can be paralyzing

The post-it reads “Being recognized is hard.”

I didn’t add anything else to the post-it so I can only guess at the meaning.

Being recognized when you aren’t prepared for it is hard. It is paralyzing.

Years ago a patient approached me at the bookstore. I remembered them as being a patient several weeks back. They asked me if I was a nurse. I said that I am. They asked if I was their nurse.

This is where it is paralyzing. At least for this OR nurse.

Most of our patients are asleep. Even if I do the pre-op check-in and check-list with them I am not expecting to be remembered. There is a reason that the only Daisy nominations for the OR people are us recognizing our own.

I remember this patient. I remember that the outcome was not necessarily positive. But I couldn’t come out and say that.

Instead, I said, “Yes. I remember you. How are you doing?”

Taking the pressure off of me as an OR nurse and them as a patient. And recognizing them in return was a good thing. Perhaps they didn’t feel alone after their surgery and especially during. They had a hand to hold and a calming voice as they went to sleep and as they woke up.

I don’t think all OR people are awkward. But enough of us are. I definitely count myself in that number.

Because being recognized out of context can be weird. And paralyzing.

I hope that the patient is continuing to do well. I haven’t seen them in the bookstore in a while.

School Me Saturday 3/16/24-keep working after break

Many colleges and universities had Spring break last week or are having it this week. This is well-timed. Far enough in the semester that you have a handle on your classes, not so far that your brain has completely given up.

Midterms are likely over. This goes to the mind being tired.

And then, like the sunrise after a dark cold night, the break appears!

Good. Have the break, and relax your mind.

Now what?

Back to the semester. The end of the semester is just around the corner and will be here before you know it. Not to panic everyone.

It is time that thoughts turn to end-of-class projects that need to be done. There may be homeworks due, finals to prepare for, or papers due. Or all three. If you are like me, you calculate how many points will get the grade that you need to continue.

As always, keep the end in mind.

Maybe you are just beginning your college career. Maybe you have returned to college as an adult learner. Maybe you want to explore learning. It’s all good. But there is an end in mind. There is a degree or a certificate. Keep that in mind as you toil toward the end of the semester.

The university I go to will be opening fall scheduling soon. This is a fraught time to get the classes you need for your degree or the classes you want. But, as my instructor pointed out, once the fall schedule is set, the bill for the fall schedule comes due.

This is the reminder to get your FAFSA done if you haven’t already done it. This is also the reminder to get scholarship applications in. I put in the application for the market nursing scholarship weeks ago. Next, I will work on the NCNA scholarship.

But that is a tomorrow me problem. It isn’t due until April 30th anyway. Today I have a 5-page paper due tomorrow night.

Break’s over, time to get to work! The semester end is coming fast and you don’t want to be left behind.

Cookie Thursday 3-14-24-bought cookies

Happy Pi day. You know, the date of 3.14 is the beginning three numbers of the irrational number of pi that never repeats. Or, not that has been figured out. I imagine some AI is out there working on the problem now.

Normally I would make pie for Cookie Thursday is a Thing. Especially when it falls on Pi Day. But this is the last day of my marathon week.

I presented my Cookie Thursday is a Thing poster at AORN. I also got lots of comments. There will be a separate post for that. Did I mention that we drove 8 hours to the conference Friday, had busy, busy four days in conference Saturday through Tuesday, and drove home Tuesday? Since I was gone at the conference on my usual RA Monday, the professor and I agreed that I could work on Wednesday. I drove 90 minutes to the university on Wednesday, worked 10 hours, drove home, went into the hospital for 2 hours, was on call all Wednesday night. Deep breath, I’m nearly done. Today, Thursday I had a three-hour mandatory education class for the hospital at 0730. I went to two different stores for groceries and the fixings for St. Patrick’s Day, took the cookies to the hospital.

I am exhausted.

Currently, I am reading the material for tomorrow.

It is a good thing that this month’s theme was That Was Easy because I was not about to make/bake anything today. I bought cookies instead, and cut them in half.

The cookies that I bought at Aldi were Kitchen Sink cookies, Oatmeal with cranberry cookies, and Chocolate Chunk Cookies.

Wow. That WAS easy.

I will be back to baking next week.

I just have to find an easy recipe.

Oh! As we were driving down the mountain I saw ads for moonshine and my husband asked that since I made cookies with booze, could I make a moonshine cookie?

That will be for another week.

The OR patients are vulnerable

All OR patients are vulnerable.

Think about it. We take their clothes, their electronics, their glasses, their hearing aids, their family members, their dignity (at times). They are left with warm blankets, an electronic signature on an electronic consent, and a gown that doesn’t fasten in the back. And non-skid socks.

Sometimes there’s even a pillow!

There is always an IV.

Of course, the OR patient feels vulnerable. Some react by lashing out and being unpleasant. Some react by being meek. It takes all kinds of patients. The trick is knowing when they are acting out because they feel vulnerable and when they are in actual fear. A soothing hand and a soothing voice go a long way to defusing the situation.

The reason I write about this is because I was defending my dissertation interest of the OR during an assignment. The assignment was to write about a measurement tool that is being given to a vulnerable population and how it is translated into another language. There are MANY steps to the translation of a measurement tool. The professor looked surprised when I claimed that OR patients are vulnerable. I think I will incorporate the first paragraph explaining why the OR patient is vulnerable into the assignment paper. I just have to de first-person it.

I can do that.

During a session at AORN, the presenter echoed my thoughts that the OR patient is a member of a vulnerable population. I felt very smug because she was making all the points that I did.

Often when other nurses consider the vulnerable patient, they think of mothers, and children, and prisoners, and the mentally unwell, and they don’t even consider the OR patient. They are vulnerable as well.

And we should consider them. Imagine if I took away your glasses, your hearing aids, your clothes and your family. Think how you would feel.

We also speak another language that not many people know or understand. There is another vulnerability there.

Covid 4 years later

March 11, 2020, was the date that the WHO declared covid-19 a pandemic. I remember where I was; do you?

It was Wednesday and I was on shift. The lockdowns were not to start for over 2 weeks, the operating room schedule was normal. Little did we know what was to come.

I could not let this day go unrecognized.

So much has happened in the past 4 years. People have died and continue to die of covid. Long covid is the boogieman underneath the bed for many people. Symptoms can last for years. We are continuing to learn how dangerous long covid is and, really, how dangerous covid is. The virus attacks many systems: heart, lung, liver, brain. It can also cause extreme fatigue. I mean the kind of fatigue that makes life unbearable and very hard to survive. There are reports of long covid around the world.

And the world shrugs.

Conflating covid with the flu is dangerous. One is more virulent than the other.

And the world shrugs.

Vaccines and updates to vaccines are ready and willing to go into arms. According to a March 8, 2024 report from the CDC, the population reporting having the updated 2023-2024 vaccine is THIRTEEN POINT FIVE.

And the world shrugs.