24-color me surprised, the articles about mifepristone were retracted by publisher

Shocked, I am shocked. This is heavy sarcasm.

Does anyone remember the debunked articles by Andrew Wakefield that began the most recent wave of anti-vaxers nonsense with a widely exposed fraudulent article in the Lancet conflating autism with childhood vaccines? And how every parent clutched their child to their breast and decided then and there that of course the man was telling the truth. With nothing underneath him but air? Yeah, him.

Healthcare workers, such as myself, have been educating parents about how safe vaccines are ever since. But the idea was like an earworm and refused to die. As a society, we are still dealing with the fallout and the consequences of this. Current measles outbreak numbers do not lie.

Herd immunity works very well. But the public has to be 1) vaccinated for it to work and 2) be protective of those who cannot get vaccinated, like the very young, the people who are anaphylactically allergic to the vaccines, or those who cannot otherwise take the vaccines.

Think of what the planet just went through with covid and you have a good idea of how damaging and heartless this was. People who didn’t get the widely available and FREE covid vaccines extended the pandemic.

To be blunt, autism is NOT caused by vaccines. To mislead the public into believing that was a gross malpractice on the former Dr. Wakefield’s part.

Well.

The 2021 paper that the Texas judge used in a ruling against the use of mifepristone has been yanked. By the publisher. Retracted by the publisher. What the judge did was bend the facts to make his ruling that mifepristone was dangerous and should be stopped. And his ruling was appealed and stayed and overturned. Which is what was the intention.

The case that is in front of the U.S. Supreme Court right this very second.

I’ve said it before, over and over again. This lunacy is a war against women and is about trying to control more than half of the population. Control is at the root of this.

Will they care that the original ruling was based on a retracted by the publisher paper?

It remains to be seen. I have an idea about what will happen. Don’t you?

I hope I am wrong.

Post-it Sunday 2/11/24-Sorry, the universe says no

The post-it reads “Sometimes the answer from the universe is no.”

I’ll just let that sink in.

What does sometimes the answer from the universe is no even mean? Can it apply to all things? Can it be applicable as an answer that I can give people who are asking the impossible of me?

I know that when I wrote the post-it it referred to the sometimes crushing inability of health care to solve all physical ills. That sometimes the damage is too great for even surgery to surmount. That sometimes medicine and medication and surgery won’t have the answer that people are asking. Or the answer that the universe gives back is a resounding no.

Heck, even money isn’t the answer in some cases. Well, in most cases. No matter the rich rich rich seeking to live forever.

Wow, this got dark fast. Well, I’m doing a PhD assignment. (shrugs)

But sometimes the answer from the universe is no and remains no. All the pleading, tears, and money in the world cannot make that answer a yes.

To get RREEEEAAALLYYY philosophical, maybe the no is the answer that you need to hear in that moment.

What about that?

School Me Saturday 2/10/23-Fear of failure

The fear of failure is very real for students.

What if I fail a test? Does mean I fail the class? What if I get an F on a paper? Does this mean I fail the class?

What if my alarm(s) fails to go off?

What if I fail to get into the homework study group that I really want into? What if I fail my parents, my significant other, myself?

What if I fail the class? What if I fail myself? What if I fail the class? What if I fail the test? What happens if I fail? Will I have to leave the program?

Calm down. Take a deep breath. Breathe in, breathe out.

Calm.

You can work yourself into a big tizzy thinking about all the things that could happen if you fail. Your mind can go faster, faster in circles. Like a dog chasing its tail.

Failure happens. I am quite certain that all of academia has seen every iteration of failure. All the ways that people fail.

Some people will tell you that failure is not an option. Obviously, it is or we would not be so scared of it. But what to do about it?

Reams and reams of articles have been written on the subject. All I can tell you, with any certainty, is how I deal with academic fear. Because I’ve been afraid as a student. Many times. it is how to meet the fear head-on that allows you to gain the courage to go on. And go to the next class.

I sit with the fear and play the what-if game. What if I fail this class? What if I fail this paper? There are conversations you can have with your instructors about make-ups, or extra credits, or even if the grades will be on the bell curve.

The movie Dune tells us, through Paul Atreides (the main character, AKA Paul Muad’Dib) that fear is the mind killer. This is very true. Fear can be a paralytic.

My very first ACLS (advanced cardiac life support) told us on the very first class, on the very first day that the first thing you do in a code is take your own pulse. This shocked many of us into laughter because my pulse in a code is the least of my concerns. It is the patient who is dead. What she meant is that you have to check in with yourself, and take a split second to calm yourself. This is taking your own pulse.

When you get the test booklet, the first thing to do is to answer the very first question. It will be your name. And you certainly know your name. First question down. On to the next.

When you get your first F, the first thing to do is take a deep breath and calm down. After your panic has subsided, look at the answers that were missed and read the questions. Square in your head why the question was missed. In the days of the scantron answer sheets, I accidentally skipped a page, which made all the questions after that wrong. Plead your case.

Find your study group, talk to your instructor, talk to your classmates.

Take your own pulse. And breathe.

Cookie Thursday 2/8/24-cheese straw cookies

Continuing on February’s theme of Tracie’s Favorites, cheese straw cookies.

I know, I just did a cheese month in January. Yes, there is still that much cheese.

I don’t care. This is what Tracie asked for.

I did ask qualifying questions. Whether what she had in mind was pepper jelly thumbprints, cheese straws, or pimento cheese straws. She chose straight-up cheese straw cookies.

Okay then.

All of these three cookies have the same base. Flour, butter, and shredded cheese.

It is the application of how much and what to do with it that is a bit different.

These are not a roll-out cookie. So there will be no chilling of the dough. As always, I am going to be doubling down on the spices. The recipe I am using asks for 1/8 tsp garlic powder. Um, no. I don’t think so.

Since I will not be rolling these out, I will use my smallest cookie scoop to portion out the dough balls. And bake at 350 degrees Fahrenheit oven.

There is also the question of how crispy do I want to make these bakes? The longer the cookies are in the oven, the crispier they get of course. But I want a bit of chewiness to them.

The cheddar cheese should not be bagged cheese. There are anti-clumping ingredients added to the cheese when it is packaged. I will be grating my own.

Also, my grater was last seen while making Christmas dinner. I have looked everywhere. Either it got thrown out by mistake, or broken and then thrown out, no one knows. Moment of silence for one of the OG wedding gifts. It served me well for over 25 years.

I bought a new one. Did you know that they are not dishwasher-safe? Probably explains why it broke/got thrown away/ran away.

Nursing is tops again for being trustworthy. But…

According to the 2023 Gallup Honesty and Ethics Poll, nurses remain the most trustworthy profession for Americans. Yay, us! I mean, I’m not surprised, are you? This is the 22nd year as the top dog out of the 23 professions ranked.

Nurses are the hardest working, patient facing group of professionals out there. We are at the hospital, at the bedside, 24/7/52. This means 24 hours a day, seven days a week, and 52 weeks a year there is a nurse at a bedside. There are also certified nurse assistants to assist in the work, environmental services to keep everything clean and hygienic, plant engineering to keep all systems like HVAC running, IT professionals on standby to help with software problems in the electronic health record, admission and records people to keep the records straight and admit as needed, dietary people to keep the kitchen running and the patients fed, and pharmacists and pharmacy techs to keep the medications correct and flowing.

Honestly, healthcare takes a village. We all worked together to get the world through a pandemic!

I am not surprised that nursing is at the top again when rated on honestly and ethics.

But…

Here it comes.

But… the ratings, although nursing is at the top, have drifted from their peak. Yes, the peak was in 2020. We all know what happened in 2020.

All the ratings are lower, except for those at the other end of the spectrum, their ratings either worsened or were the same. These are the members of Congress, senators, car salespeople and advertisers and they were all viewed by Americans as the least ethical. I mean, when you at the bottom, is there anywhere to fall?

Surprisingly, yes.

I am sure there will be additional research as to WHY there is an almost across the board decrease in perception of trustworthiniess and ethics. I have a pretty good idea. Don’t you?

Anyway, nurses are on top again as the most trustworthy and ethical profession, members of congress and senators are at the bottom. Fascinating read.

Reference

Brenan, M. & Jones, J.M. (2024, January 22). The ethics ratings of nearly all professions down in U.S. Gallup. DOI.Ethics Ratings of Nearly All Professions Down in U.S. (gallup.com)

Tuesday Top of Mind 2/6/24-quote unquote suggestions

On this Tuesday Top of Mind, I want to write about (quote) suggestions (unquote).

You know the ones that people, especially women, get blasted with about clothes, and shoes, and hairstyles. A headline I just saw said ‘no woman over 50 needs this haircut.’ Bold statement.

But who says?

Why shouldn’t I buzz-cut my hair if I want to? Or dye it a screaming yellow with magenta stripes and purple spikes. I mean, that’s not my jam but it is someone’s. Why can’t I have long pretty hair when I am in my 50s?

Well, besides genetics. And my hair follicles.

Yes, we do change as we age. Who cares? Age will happen to all of us at one point. The goal is, and always has been, to be yourself.

I am a huge proponent of being yourself.

If you feel the above hairstyle, knock yourself out.

If you want to wear jammies to the grocery store, go ahead. Or go without a bra under your sweatshirt, no one is stopping you.

Be yourself. There is no one else around to be you. You might as well get comfortable.

That means different things to different people. That is okay.

For me being comfortable with myself is wearing rubber duck pajamas to the grocery store. I also got complimented on them while at the grocery store.

Another thing that takes up way too much space in people’s minds, especially women but a surprising amount of men, is wrinkles. Aging in general, I think.

I know that there are people throwing millions and millions of dollars to solve a problem that exists in their own heads.

Make-up, don’t need it. Wrinkles? So what.

The latest television show that EVERYONE is talking about? I don’t watch television.

Have I heard about the latest rumbles in the music industry? So and so is mad at this and that. Nope, I don’t listen to current music. I like NPR, it is always changing.

Am I boring? With my lack of television watching, especially reality, and lack of knowledge of current music knowledge?

Yes.

But I would wager I know a ton about current events from NPR and the newspaper reading I do daily.

In my jammies, with my undyed hair, and my lack of make-up.

I’m okay with that.

Post-it Sunday 2/4/24-Don’t tell me that I can’t call you back in, I don’t control that

The post-it reads “smug person sitting in the lounge wrapped in a blanket as I came in at 1430 telling me not to call them back in tonight at 1900. Bitch please, I can’t control that!”

Ah, a post-it from before my current role as the night call nurse.

Goodness, I do not miss those days.

I do not miss the sighs when I have to call someone back because it is 2230 and I want to go home at 2300. Or the bargaining of whether or not they ACTUALLY have to come in. Or the anger I received when I wouldn’t stay just an eensie 45 minutes past my shift.

Once someone answered their phone and said that they couldn’t come in because they were drunk. I appreciate your honesty but my shift ends at 2300. What are they going to do about getting coverage? I’m not going to call around and find them coverage for a shift that they just assumed I would stay or or assumed that there would not be a case.

Thankfully, this only happened once.

And once when the person on call was in another STATE!

No, I do not miss those days at all.

Let’s go back to the post-it and this person who was 1) in the lounge on company time 2) in a warmed blanket that would have to be rewashed again on the company dollar and 3) ordering me about as if I was a peasant. Thankfully, that person no longer works for the department.

But, Kate, isn’t that a little harsh?

No. No, I don’t think it is.

The evening charge nurse has no way of knowing which surgical cases are coming in after hours, or if there is even going to be a case. Some doctors troll the ER on the way out of the hospital, looking for cases. Most do not, but some do.

Cut the charge nurse some slack, huh?

School Me Saturday 2/3/24-first assignments of the semester

It is hard to go fully into the semester. I know. All the reading, all the getting to know the professor. All the getting to know the other students. It is hard.

Especially if you are not socially gifted.

Believe me, I know.

However, the first month of the spring semester should be just about over. This is about the time that the first assignments are due. This can be a variety of assignments, a paper, a discussion post, a test. School does it all.

The only thing I can tell you is to have a plan for the assignments. Make a schedule if you are gifted like that. Or, if you are like me and write a schedule only to ignore it, write down the assignments everywhere. As discussed, part of my process is largely mental and I do a lot of thinking about structuring assignments. I have heard over and over to use an outline for written assignments. Yesterday I did and I wrote down what each section of the paper was to cover, and the broad strokes of the beginning and conclusion. Where has that nugget of wisdom been all my life?

We’ll see how far that gets me in the next three months.

It wouldn’t be the start of the semester assignment season without technical difficulties.

You are not alone in this. My computer got replaced for the second time over winter break. All the software had to be re-installed. Including the specialized software for statistics.

Oh, boy!

Take a deep breath and make a plan to conquer your first assignments. The first one, I find, is often the hardest to get started. After all, students, like us, are coming off a break where we did little to nothing to prepare for school. It might take a minute to get our brains in gear.

Start your assignments! The checkered flag has been raised!

Yeah, that is a veiled attempt at a NASCAR joke.

Humor me.

Cookie Thursday 2/1/24-Fudgy Cocoa No-Bakes.

New month, new theme. The theme for February 2024 was going to be favorites. And then my favorite nurse in the department put in her resignation. 😦

I mean, I know why she put in her resignation. She isn’t treated very well by management. Sound familiar? But she’s an amazing nurse and an amazing circulator. She always has the patient’s best interest in mind, no matter if that goes against the OR culture. Frankly, the department will be diminished without her.

The theme for February will be Tracie’s Favorites.

As I’ve written before, there were a few bakers at the beginning of Cookie Thursday is a Thing, and one by one they all dropped. Tracie has been involved with much of my planning and discussing of the monthly themes.

Although she never got behind the most popular CTIAT cookie, the Jalapeño Chocolate Chip Cookie. She has always seen it as vegetables in the cookies.

I am starting this month’s theme of Tracie’s Favorites with one of her most requested cookies- the fudgy cocoa no-bake. These go by a bunch of different names. Peanut butter oatmeal stacks, school lunch special but I call them fudgy cocoa no-bakes.

This is one of the recipes that is a good repeat. Quick and easy to make and they last forever. If they last that long.

This is the cookie that I made to bring to the in-person day at school. Speaking of school, Tracie has always been my number 1 cheerleader for school. That isn’t going away, but conversations at the hospital are.

Counting basics #14- yes, the specimen must be counted

I finished the counting basics series in September but I missed one. This past week, I was at the hospital for a call case when I, as a routine part of the evening shift charge nurse duties, checked the cart where specimens stay until they are picked up by the lab.

I know that this was on the list that I left behind for the next evening shift charge nurse. Oh, wait, they have lost four of the five that have been hired to replace me in the last two years. To other hospitals mostly. Because being the evening shift charge nurse is hard!

The list I left behind got lost somewhere. I have to reprint it. But on the list was to check the specimen cart to make sure that all the specimens had been transported to the lab for processing.

There were 9 cases worth of specimens in the cart when I checked it before taking the case specimen that I had to the lab. NINE!

My sister the pathologist was crying and didn’t know why. There were specimens that didn’t even have formalin on them for over 12 hours. Thankfully there were no cultures. Makes my blood boil; you bet I wrote an email to the manager explaining how checking the cart is an expectation of the evening shift charge nurse.

But, Kate, if they didn’t know… Bah! The specimen cart is not magic, drop off the specimen and never think of it again. Specimens have to be treated carefully. Which is why it is the 14th counting basic.

Care and handling of the specimen was also the subject of my master’s thesis and project, the standardization of specimen hand-off.

Imagine if you are that patient whose specimen goes missing but there isn’t any more tissue left in your body to test. Imagine if you are that patient whose specimen is not handled correctly, with formalin, or put in the specimen refrigerator promptly if there is no formalin and the specimen is unusable for testing. Heck, imagine the nurse who failed to collect the specimen correctly and caused all this furor.

Think of how badly you would or should feel.

This is why the correct specimen hand-off is the counting basic # 14. The surgeon has to name what the specimen is, the nurse prints the label, puts the label on the container, shows the label to the scrub tech and they both agree that this is the specimen that is going into the labeled container for this patient that is currently on the OR table.

In fact, the corporation changed its policy to reflect what I had done in my master’s project. Don’t think I didn’t notice!

Specimen hand-off is of utmost importance to the patient. Second is the handling of the specimen after the case. Whether or not it needs formalin, or is a frozen section, or needs to go fresh.

Know the rules of your particular OR for how the specimen gets to the lab, and who takes it, and the hours that the lab collects the specimen. Because they don’t have the manpower to be collecting at all hours of the day and night.