The post-it says ‘2 super I charge nurse memories this week. 1) telling an irate CRNA to calm down 2) chasing everyone away from the desk because I can’t hear on the phone with 5 conversations going on at once.’

Yeah, this was evening shift in a nut shell.

I had an irate CRNA, who is named in the post-it note, no I will not name them. They were going on and on and on and on. About an imagined slight from the surgeon. There was no time for hand-holding and there there-ing the CRNA. There was a case to begin. I took 5 minutes and sequestered the surgeon and the CRNA as the tech and I counted and told them to hash it out. There was a patient that needed our help and I was not interested in a blow by blow conversation discussing the issue. They would have to be adults and handle it like adults. There was no other choice.

Sometimes you have to be the kindergarten monitor. I stopped short of sending them to their rooms without supper. Because patient was waiting.

Within four minutes they had the conversation they needed to have. And we could get on with the business of helping the patient.

No time was lost on this interaction and the patient was able to have their surgery.

I swear the OR desk has magnets in it. Kind of like a kitchen in a home, everyone congregates at the OR desk. Some are goofing off, some are awaiting the elevator, some are trying to work. hi, yeah, that’s me.

The phone rings and it is someone that I need to talk too.

But I can’t hear them. Because of the 5 different cross conversations going on.

In this instance I have no compunction with excusing myself a moment, muting the phone, and getting everyone at the desk away. I quick assign evening tasks that they know already need to be done and go back to the conversation on hold. With a silent desk area.

Sometimes you have to assign tasks that need to be done and, again, all adults here.

Yeah, shift work is often about being the adult in the room and facilitating talking. Or not talking as the case may be.

Or, everything I learned about how to treat people at work came from kindergarten.

I was aghast, appalled, angry at what was revealed to us at the latest shared governance meeting. People are misleading travel nurses, or any nurse or tech they feel is infringing on THEIR department. This can even be a nurse or tech from the float pool.

They are withholding vital patient information, such as report, from people who are just there to help.

It was a tale of two hospitals as explained by one of the participants in our group.

At hospital A, the flagship hospital, report was withheld from the oncoming nurse. No one was there to greet the nurse when they arrived to, again, help by taking an assignment and patient load. It was as petty as not giving needed information such as parking, or cafeteria hours, or even how to get into the department. How do you think that nurse felt?

By contrast, at hospital B the same nurse had a vastly different experience. They were helped to find parking, that their badge worked to gain access to the department, where they were greeted by the charge nurse, who facilitated them getting report and generally helped them get their feet. Same nurse, different greeting. I can tell you the nurse felt way better about hospital B.

I said that what was described to us made me want to shake hospital A.

And shake the hand of hospital B.

Are we 5? Or toddlers? When has it become acceptable to gaslight, and mislead people who are just there to help us?

sigh

Don’t make me take it back to the golden rule. Treat others like you want to be treated.

No, scratch that. The platinum rule. This is a rule that states that people are to be treated the way they would treat others. This involves having a little empathy.

These techs and nurses are just there to help. And we should let them. Healthcare has been taking it in the shorts since before the start of the pandemic.

We should all be ashamed of treating helpers this way.

Mr. Rogers would be ashamed at some of you.

This is a brief side-step in coconut month. This week is Passover, and I found a recipe that sparked my interest.

The recipe is for matzo crack. I have made it before several times using different crackers. I have used Ritz crackers, saltines, but this is the first time that I used matzo crackers. I am not sure I had never had matzo crackers.

Being welcoming to other faiths is important. This is a skill and a mindset that needs to be ingrained.

And the other recipes I found were above my skill set.

Therefore, chocolate topped matzo toffee.

Because the world is better with butter.

And chocolate.

Covid is not gone.

Despite what politicians will tell you.

Despite what the man on the street will tell you.

Despite what your cousin’s mother’s auntie’s next door neighbor will tell you.

People are still dying. No one is writing it down. No one is keeping track of current infections. No one cares!

I get it.

A giant, broadway in lights covid is over… in neon.

Yeah, keep telling yourself that.

I get it.

It has been a long, hard two years. Because it has been over 2 years of this nonsense. Healthcare is tired. Nurses are tired. I am tired.

But wishful thinking doesn’t make it so.

And don’t wear a mask on an airplane if you don’t want to.

The air is only circulated with every exhalation for however many hours you are on the plane. But what if?

I will be continuing mask wearing when I see fit. No matter what people may say.

You think I care about what people say?

Or think?

Or talk about the crazy behind my back?

Don’t know me very well do you?

I don’t wear a mask for myself.

I wear it to protect others. And those people who cannot be vaccinated. Or the people whose vaccinations didn’t work. Or are too young for vaccination. This is who I chose to protect.

You do you.

I’ll be over here wearing a mask to protect others.

No matter who is against it. Because it is the right thing to do.

Can’t argue with the right thing to do. And if I get to fly to London in August. I will be wearing a mask during the flight.

Let us be honest. Sometimes a surgical case is not our cup of tea. Heck, the entire service is not our cup of tea. Every nurse I know has a case or body function they HATE.

Despise.

Abhor.

Nails on chalkboard would be more soothing.

Please don’t make me go in there; I’ll do anything.

For the most part this can be accommodated. Kind of. If you have the staff.

And the case aversion can be as varied as the human body. This nurse hates teeth. This tech hates feet. My own mother hates vomit, explains a lot about my childhood.

Me? I can’t stand phlegm. Lung butter. Ew. This has roots in training. My patient had a full beard, a raging upper respiratory infection, and green noxious phlegm everywhere. And the patient, not sound of mind, reveled in it. Makes my skin crawl just writing about it. Nightmares tonight.

Do you want to know WHY I did not pursue a CRNA, which means certified RN of anesthesia? For this alone.

Case aversions exist.

However, the body part/function in question is attached to a patient. Someone who needs our help. And we soldier on. This is what we are best at.

Through something we hate, despise, abhor, makes us want to run and hide.

Because someone needs us.

I have and I will continue to care for patients who exhibit my case aversion.

But I will wear gloves.

The post-it reads ‘don’t be married to the plans.’

This is something that the OR does particularly well. Plans change. Diagnoses change. Patient anatomy is not clear cut and pretty like it is in text books.

There can be a tentative plan. A structure in place, a general idea of how something will go. An over all plan.

Beware that overall plans can change. And do.

A does not lead to B cleanly. Sometimes there is a needed jaunt to Z. Don’t be surprised by it. Be flexible in plan changes.

You might surprise yourself.

This is hard lesson in nursing. Despite all of our preparations, plans can change.

And have contingency ideas in the back of your head for how this is going to go. For example, the anatomy is plain weird and there is no safe way to finish the planned procedure. E.g. a lap appy.

Okay. You will need larger sponges, even maybe some appy tapes (long, thin sponges that are x-ray detectable), different suture, and a few instruments.

I guess the lesson for today is not to be married to the plans, but have an alternate in mind for when the plan changes.

The what has become the yearly screed against Home Owners Associations and the associations that tell me how to live my house.

Last year they sent an email to everyone reminding us to make our houses pretty for the inspectors.

Yawn.

There would be inspectors to look at the houses, like they don’t weekly.

And send out nasty letters reminding you to put away the trash can that had been left out for 4 seconds while you opened the garage door. Or mow the lawn that was 1 inch longer than agreed.

Who agreed and who has a ruler?

Everyone I have spoken to gets these letters. And we pay them. Living in the South, where they are prevalent, is so much fun. They love to judge the other down here.

We did the yearly mop up of the front beds. And, as I do every other year, I ran into something. Not poison ivy, not poison oak, poison sumac I think. And instead of suffering the itch in silence, like I usually do, this year I reported to my doctor. With pictures.

And got put on a Prednisone dose pack.

I don’t recall having a taper pack before. It stinks. It chalky, and tastes bad and is generally not much fun. It makes my legs ache. Fun. The cream that they gave me for the rash does much better. I think I will ask for lesser guns next time.

Now that I have three days left of the taper I have thoughts. Is this more symptom management? I’ve gotten through before. Is this something better left in the doctor’s quiver? And could this post be more 1st world problem if I tried?

Time to think of the positives.

I have shelter. I have a house. One that even has new siding, that I paid for with the money we had saved up for two years by not going out or vacationing. To the dismay of my in-laws.

I have my health. I have a short term rash and itches. So many people have it worse.

I have food. Although there is inflation I am careful with our money so it is not impactful on us. I have water. I am thinking of starting a summer vegetable garden. You know, now that I have time.

Covid is doing what covid does. It waxes and wanes and people die. Or have long term side effects. But I, for the grace of vaccination and booster, masks and social distancing, have not gotten it (knock on wood).

On measure I am doing pretty good. I think I will give myself a break and go read.

And spread out the 10 cubic feet of mulch for the front beds. I don’t want a letter. Although I did pick up glow in the dark spray paint for some of my cement animals in the front that need a touch up. I’m still me after all.

Coconut month continues.

Why coconut month?

Because I have a ton of coconut in my baking pantry.

And lots of recipes.

And coconut flour that I don’t care for that I will gladly feed to other people.

For this week, I used the basic fudgy cocoa no bake recipe of 1 stick of butter, 2 c sugar, 1/3 c of cocoa, 1/2 c milk, 3/4 crunchy peanut butter, 3 c of oatmeal. I had plans of using 1 1/2 c coconut and 1 1/2 c oatmeal.

But horrors! No crunchy peanut butter. There are 2 of us in this house and I’m the only one who eats it. Curious.

I did have a multiple nut butter in the pantry. One of those hmm, I wonder how this tastes. And it languished. Not crunchy though. It is a blend of Brazilian nuts, hazelnuts, almonds. All the nuts.

I used that instead of crunchy peanut butter. And 2 cups coconut, 1 cup quick cook oatmeal.

The cookies were softer than usual but still tasted amazing.

I was expecting a stronger coconut flavor.

To the baking pantry!

On nursing side this week, yet another nurse was charged for stopping a med error before it reached the patient. In their mind this is elder abuse. In my mind this is getting scary.

Because we don’t always get the effect that we want from treatment. People get sicker. People die.

It is not the nurse’s fault.

Today was our monthly shared governance meeting for the hospital.

And it was in person!

You think I would be leery of in person after the AORN cluster that did not infect me. Because I was wearing a mask.

But I’m trying. Okay?

There were only 4 of us at the meeting, properly spaced out. Three more were on the phone. And one of the 4 was several people dropping in and saying their piece and leaving. And staying 6 feet away from the rest of us.

Sort of a zoom hybrid.

With snacks.

Will do lots for free breakfast apparently.

I wore a mask into the hospital. And took it off in the conference room, after the door was shut. And also masked up for the restroom and to walk to my car.

I have much to do regarding shared governance.

The corporation is realizing that this pandemic has been very hard on staff and many of our staff have left. For travelling, or other reasons. There will now be conversations about what we all know has happened.

The infection rate is stable and low where I live. Hospitalizations are less than 7 patients per day, with several days (6) in the last month that had zero patients.

I hope this continues.

I live in a high vaccinated area. Next to a low vaccinated area and I will leave my mask on for the foreseeable future when I go out. Grocery store, Target, the bookstore, and the library are always on my radar.

Give me funny looks when I go about masked.;

Don’t care.

But not among people who are socially distanced and vaccinated.

I thoroughly enjoyed by cinnamon Danish and fruit. And the free water.

I was driving home when there was a librarian on the radio, the head of the School Librarian Society, and she was talking about the rush to ban books. And its logical, in some people’s minds, legislation in some states.

Have y’all lost your minds? I mean, what the actual fuck?

This has been weighing heavy on my mind in the last few months. This absolutely is about censorship.

This is about a very vocal, very minority deciding what ALL the kids need to read.

Or not read, as the case may be.

For some of live an all censorship is bad.

Regardless of content.

They are saying that they can only be the parent.

Of ALL children.

And the child that needs to learn about kids that think like them, act like them, have questions like them are not to be thought of, or talked about.

It is in the conversation that these books spark that we are telling these children about the wider world. And there is more in the world than is dreamt of your philosophy, Horatio.

Yes, a bastardization of Hamlet by Shakespeare.

Uncomfortable as that may be for some parents.

Think about what this is doing to your children. Putting your head in the sand like an ostrich is not helping. Also not helping is stopping up your ears and saying na, na, I can’t hear you.

And administrations and politicians are pandering to this very vocal, very minority. Because it is easier to listen to the loud voices who are demanding that we return to when they had the power and, by God, won’t someone listen to the white man?!

Don’t tell me that I do not have a dog in this fight because I am not a parent. Some of you are thinking of it.

I just don’t understand, you are thinking.

Because I don’t have children.

No, I don’t. But we have had many conversations about how we would raise a child, if we had one. And censorship is not on the table. Not for my hypothetical child, and not for another other child.

My favorite quote from that interview was when the librarian said that it is the parent’s prerogative to decide what their child could read. It only slips into censorship when the parent says that ALL children cannot read this book.

You know what else shows nudity, adult situations?

Core curriculum books of nursing school, medical school, dictionaries, encyclopedias.

Are they to be next?

The information contained there may be disturbing for some readers.

Yep.

It should also begin a conversation about why you think it is disturbing and why your children should not be exposed to it.

Because it makes YOU feel squicky?

My parents never monitored what I read, in my memory. If I read something disturbing I could take it to them and this would start a conversation.

But no one ever took a book out of my hands because someone deemed it not for me.

I would like to see them try.