25- It’s okay to lie to the Senate under oath, I guess. Noted.

This headline can mean so many, many things and so many, many lies. <Cough cough> Brett Cavanaugh, Amy Coney Barrett Neil Gorsuch and the settled law of Roe v Wade. <Cough cough> Michael Cohen and the plans to build a Trump tower in Moscow. <Cough cough> W. Samuel Patten and the little matter of being a foreign agent.

Man, I should really see someone about that cough.

But I will not see RFK Jr. as he is the latest one to outright lie in order to get confirmation.

He told the Senate that he would leave in place the vaccine advisory panel at DHHS. This is a board made up of outside experts on illnesses that can be mitigated by vaccines. You know, people who have been working for literal YEARS in the fight against illnesses that we have a vaccine for.

By this firing and attempting to ram in the anti vaccine zealots and toadies in their place, RFK has come out soundly against science.

Well, we knew that.

He says that to re-establish faith in vaccines this is a step that must be taken. Collectively the entire research community rolled their eyes so hard they could see their very big brains.

Um, dude, the person who broke the faith in vaccines was you. Just you. Also anyone who professed anti vaccine rhetoric for the ‘gram and for the views. And for the money that thrown at them.

It is always the money. The money and the power.

The call is coming from inside the house. And we should all be afraid.

The kicker is we warned you. And warned you. And warned you. We did everything except sky writing. But since we aren’t pretty blond trad wives we were ignored.

People are gonna die. I feel like I say that all the time. Let me check real fast the last several months/years of Tuesday Top of Mind.

Yes, I say it all the time and no one is listening.

Are you paying attention yet?

School Me Saturday 5/31/25- Personal school dispatch

Well, I’ve not done one of these for a while now. In fact, I can’t remember the last one I did. And I find that is completely normal. After all, the not so stated plan for a PhD program is to remake you. It just might take a little longer.

In the beginning I was so energized and full of zeal to learn. What a difference three years makes. I am still energized about learning. I am still zealed (?!?) to learn about research.

Here comes the big but.

If I followed my learning timeline of what classes and when I was supposed to graduate at the beginning of May 2025.

Spoiler alert, I did not graduate in May 2025.

All of the core classes are completed. My pilot study has been completed. I even presented a poster based on the pilot study in April at the AORN convention and I am slated to present virtually at the hospital system research symposium in the beginning of June. I am also responsible for a virtual symposium presentation in November.

Yes, all based on the same research from the pilot. The last two are podium presentations where I have to actually talk to people. Maybe there will be a podium, if not I will pretend.

All of these different presentations, the poster and the podiums, is known as dissemination. Getting the information that I’ve worked very hard on for over a year out to the public. Well, other healthcare professionals.

Instead I had the most challenging health year of my life. Getting older is not for sissies. Midlife crap threw me for a loop. We don’t talk about that enough as women and I am so excited that perimenopause and menopause talk has entered the conversation in the mainstream. Perimenopause can cause a host of problems and I had most of them. Cutting to the quick of it, it certainly made my life hell in the last year and certainly knocked me for a loop. But that is a blog post for another time. And not the core reason my school plans got knocked a little awry.

That not so lovely reason is the 2024 election.

And the crap fall out from that.

Suddenly research was under even more stress, if not outright attacks from the people who find it more profitable to pretend not believe in it.

And then the attacks on the institutions who have massively contributed to our modern way of life through their research began.

Every day it felt like there was another strike.

And another.

I felt as if I had to bear witness to it all because someone has to be paying attention.

It was exhausting. Kind of like never ending bullshit torture akin to what I think being waterboarded feels like. Except it is shit decisions that have set the research community back many years. So many years.

All I could do was hold on and not give into the numbness that this crap is supposed to engender in people. Because that is their endgame.

I felt like we were thigh deep slogging through shit.

And then something flipped the mental switch.

I went from mad at the situation and the relentless attacks on research, on institutions to mad that they were making me doubt my path.

So what if research is a skeleton of what it used to be? I will be part of the resistance.

So what it publication is under attack and will no longer be the same. I will continue to write these dispatches.

So what if teaching jobs and professorships and colleges and programs and universities are retrenching their program offerings and job listings. I will continue to teach as I have, in small settings like the Call Bootcamp I run for new to the hospital nurses.

Because we are at war.

This is the “watch me” mad that fueled much of my other academic endeavors.

They think that they can make me stop? Through their pretend shock and awe campaign against the American people and institutions? Though unending waves of nonsense and threats and more threats?

It was a bad idea to make me mad to the “watch me” level.

Watch me resist this crap. Because I believe in science. I believe in research. I believe that colleges and universities. I believe in love. I believe that people have to right to own who they are. I believe in LGBTQIA+ rights. I believe that people have the right to read whatever they want to read, to watch whatever they want to watch. I believe that people are not pawns for the establishment.

You want me to fail because I am older? You want me to fail because I am a woman and that makes little men feel bad?

Fuck that.

Watch me succeed.

Tuesday Top of Mind 5/25/25- Be careful, germs are still trying to kill you

In a stunning surprise to no one who is interested in anything other than pursuing power and strengthening the echo chamber in which they live, this past however many days it has been since the inauguration and the shameful confirmation of an avowed anti-vaxxer to the chair of HHS has been an exercise in what the fuck.

Seriously though, is this man and his ilk interested in anything besides the cockamamie bullshit they believe, to the detriment of, well, everyone in the US.

Let’s count the says his administration of HHS has gone.

Number one is his insistence that, against all medical judgement and against swift action of diseases that we know are trying to kill us, that all vaccines must have an extra layer of blinded nonsense, a placebo barrier. The only thing that ‘obecalp’ ever did was kill people. (that is placebo spelled backward, they came up with this nonsense in the 1990s. It is basically a sugar pill to make you think you are being treated. Additional nonsense is up to and including the appointment of a known vaccine skeptic and all around terrible human and has no medical degree, David Geier, to investigate for the umpteenth time the debunked, but very real in their heads, link between vaccines and autism.

Maybe this time they will get an answer they think proves what they think. Spoiler alert, doing research with a foregone conclusion in your head is a terrible way to go about doing research.

THREE HUNDRED Americans are dying and will continue to die every week because of covid.

Yeah, still.

Bet you didn’t hear about that.

That is over one thousand a month.

Last week when the news broke that they were no longer recommending updated covid vaccines to those under 65, I immediately, without hesitation, made a covid appointment for the very next day. Not only that, I immediately texted my husband to make his own appointment. Again, for the very next day. This nonsense was released on Wednesday and by noon on Thursday we both had been vaccinated.

Other vaccine recommendation changes include that the vaccine is not recommended if you are under 65. Unless you have a concurrent comorbidity and are over 50, luckily obesity in the US is 40.3%. Otherwise you are out of luck. Today, they announced a stop to recommending that healthy children are no longer to get the covid vaccine. Never mind the one thousand and eighty six children who died from covid during what they consider the active pandemic. Taken against the estimated number of children in the US of 73,602,753, this comes out to a mortality rate of 0.0015%.

Not significant but not immaterial. Especially to the one thousand and eighty six families.

And whose definition of healthy?

Nothing was ever gained by denial and thrusting our heads into the sand.

Today HHS also came out against recommending the covid vaccine for pregnant women. Why? No idea. Because we know there is a link between covid infection and miscarriage. According to a study in the Lancet that Covid infection before or during pregnancy was associated with a two- to threefold increase in risk of miscarriage before 20 weeks. And since we already know that 1 in 4 pregnancies end in miscarriage, I feel that this is vastly short sighted.

Par for the course.

Of course, covid data is HARD to come by.

As if no one wants us to look at it.

Gee, I wonder why? (this is heavy sarcasm)

Congratulations to us! After canceling the meeting to decide on the 2025 flu vaccine, the FDA got their heads out of their collective asses and chose three viruses to include in the vaccine. Of course, selecting the viruses to be included is always a crap shoot. Just ask the 20,000 Americans who died of the flu in the 2024/2025 flu season.

Let me tell you, as a working nurse in the hospital during flu season and one who monitors bed usage and ER bed availability in my spare time, this last season was the worst one in years.

Tuberculosis remains a threat to school children in Kansas. Why is this important to know? TB kills the most people per year around the world. True it is most common in crowded living conditions. Like in jails or the new housing model for gen z. This is also known as pod living where you rent a bed (pod) in a house with other gen zers.

This most current outbreak in Kansas is still of concern. But you don’t hear of it, do you?

This bring us the third disease in our merry go round of death in America 2025, measles. There have been one thousand and forty six known cases in 31 states. Slightly less than the children who died of covid since 2020 (that we know of) but there have only been three deaths in this latest outbreak. Of course, two of them were children.

Yep, still a thing. Still spreading like wildfire because it is the most contagious illness in the world.

It is as if they want the immuno-compromised to die. After all, we spend sooooooooooooooooooooooooo much money on the chronically ill in America. According to the NIH, over ONE TRILLION dollars a year.

Do you see why medical professionals like me are concerned?

No.

Okay, well get your vaccinations. While you can.

I turn 50 in July and 50 is the age they offer the shingles vaccine. You bet I will be getting it the first week.

Idle question that popped into my head as I was finishing this, what happens if the autism rate goes up without vaccines? Or are they just “kidding”.

School Me Saturday 5/17/25-Preparing for a fall college fair

It’s been a minute since shared governance put on a college fair at the hospital.

There are a myriad of reasons so go ahead and pick one.

The pandemic. The four bulwark members were on zoom meeting for over a year.
Lack of interest by hospital members. We were too tired, too demoralized by watching the public ignore common sense protections. See reason 1.
The Great Resignation. This hurt the hospital in so many ways as people sought to make more and go to travel nursing or people left the profession all together because of, you guessed it, reason 1.

But now the units are bulking up their shared governance presence and interest. Even though some departments are still hurting for staffing they survive.

Seems like the perfect time to stage a comeback for the hospital college fair.

At one of the last college fairs we did, there was an overarching theme of “What if healthcare isn’t what I want to do for the rest of my life?” There were a few requests for colleges and trade schools that were not healthcare related.

Fair enough. Because not only do we have nurses and techs and CNAs who want to further their education, they also might have husbands and wives and children who want to do so as well.

I want to make this fall’s college fair at the hospital the most inclusive one yet.

Nursing schools will be represented.

But so will schools that have something other than nursing.

I have to start calling and emailing places soon.

Just as soon as we have a firm date. You know, other than “fall”.

Ideally it would be just before or in the of tuition reimbursement application window. Those dates I know.

Wish me luck. I already informed the president of the hospital that this was something shared governance was hoping to host in the fall. I also laid out the reasons for inviting not healthcare related school. They were fine with it although they would prefer that the team members stay at the hospital.

Again, fair. But we have to allow those team members who want to fly to fly.

You know?

Tuesday Top of Mind 5/13/25- Fluoride and why getting rid of it is a bad idea

There are a lot of dumb hills to pitch a fit over these days. My least favorite is the anti-fluoride movement.

Fluoride is important because it prevents cavities and strengthens teeth. As someone who has a complicated relationship to my dentist I am in favor of everything and anything that decreases my chances of additional tooth decay.

Fluoride has been shown in some shoddily done studies to “alter your gut microbiome and has suggested associations with thyroid disorders, weight gain and possibly decreased IQ”.

Note the important shoddily done study in question that indicates decreased IQ has been roundly criticized and recommended for retraction. Yes, it is that bad.

The measurements used to ascertain IQ decrease were 1) not validated, 2) used different testers, 3) done in multiple cities. It is the first point that is the most crucial. I can swear to you that the sky is pink, not blue. I can have other swear the same to you. But I won’t let you look at it to see for yourself that it is pink.

It is the same energy as the question that captivated the internet in 2015, is the dress blue or gold.

Bitch please, it depends on the lighting. True, sometimes the sky is pink, especially in the early morning as the sun is rising, or later in the day as it is setting.

For a sarcastic example: Yay, you proved that the sky was pink at 0635! Now prove it again and again and again. Also, prove it at noon.

I’ll wait.

Who are you going to believe? Me, or your lying eyes?

Ugh.

Nothing that the troglodytes and mouth breathers have brought up, none of the studies have been replicable. That means no one else has been able to do the same study, as outlined in the study, and gotten the same results. This is the major finding. This is the flaw in the study.

Trust me, I’ve taken many graduate level courses to make sure that the studies that I will create are able to be replicated. This is why what these people who are playing with fire drive me so insane with anger. They don’t know enough not to touch the hot stove. But they will blame the resulting burn on vaccines, don’t worry.

This is more bluster and nonsense coming from non-science believers.

There is a big story going around now that the Secretary that is pushing for this swam in feces contaminated water. Worse, he let his grandchildren swim in the same water. Gross.

Also, double ugh.

As someone who has spent thousands of dollars at the dentist in the last year, I will keep my fluoride toothpaste and my fluoridated water. Or is someone going to tell me that the hole in our bank account is a figment of my imagination or the pain that I’ve suffered through is in my head or is because I am overweight?

Triple ugh.

School Me Saturday 4/26/25- Funding changes, what do we do now?

Yes, I know I have written about this before. I don’t care. It is too important. Every day research that has been in the works for I can’t even tell you, research that has already been paid for, is shriveling in the petri dishes.

Research is expensive. Proper, well structured research is expensive. You have to pay for the researcher, you have to pay for the research assistant, you have to pay any adjunct helpers who are conducting the research, you have to pay for the computer you use to write up the reports, you have to pay for the electricity that run a lot of this, you have to pay for the IRB, you have to pay for the data analysis, you have to pay for the lab time, sometimes you even have to pay to get it published (those are the predatory publishers, don’t give in to them), and if you are offering an incentive to garner participation, you have to pay each participant the incentive.

It gets expensive. Capital red letter expensive.

Oh, not only do you sometime have to pay to publish, you have to pay to present at conferences. With all of those attendant costs as well. At AORN there were several international hospitals and countries and research presented. Each of them had to pay for the conference fee, the flight, the hotel, and the food while they were in Boston. Or Orlando, or Chicago, wherever the conference is held.

Many of these are covered in grant indirect costs. These indirect costs are not well understood and is more than a line item in the grant. Not being understood, like at all, means that people overact when they see the line item.

The hammer has fallen. Nascent grants are not being approved. Existing grants are being yanked, even as the research is underway. That is what I meant when I wrote that research is shriveling in the petri dishes.

Why?

This is a very good question. Because the researchers are daring to research something that isn’t white or male. It is being stripped because of the specter of DEI.

Another not well understood concept that is being used as a bludgeoning tool.

DEI doesn’t mean what they think it means. Inigo Montoya snuck in the chat.

This, of course, has started panic at the research universities. Especially the ones who don’t have billions of dollars in endowments. But even if you have that kind of money doesn’t mean it is just sitting around in coffers, or under a dragon like Smaug.

It has been a long time since the students (hello, that’s me and my cohort), had any guidance in the matter. Probably because those doing the reaping are being mum on the matter.

No DEI is all they know how to chant. Again, it doesn’t mean what they think it means.

Yesterday we had a rare in person day on campus where the second and third years who were interested, were given a ground level “this has happened and this is how we envision going forward” talk.

We had a group discussion about how to find and secure funding. Ideas about other funding sources were floated. It was a good conversation. Remember, all of us are nascent nurse researchers.

I know I left feeling a little more hopeful about this crappy situation we find ourselves in. I hope others did too.

I offered my notes to the rest of the cohort that were not there and I hope to have the notes to them tomorrow. I just want to reflect on it some more.

I wore my “Baking is Science” tee shirt with a baking cat on it. On my husband’s recommendation that I leave the political shirts at home. I think a stronger worded tee would have been better. There is always the August in person day.

Tuesday Top of Mind 12/17/24- Your grandparents would be rolling over in their graves if they knew!

I am not going to ask how we got here. It’s bad enough that we are here.

By that I mean the rampant feeling by some LOUD segment of the population that vaccines aren’t important. So unimportant that they don’t want them and, furthermore, their children don’t want them. Yes, I know that is grammatically incorrect.

They feel that the diseases that are currently being vaccinated against are a thing of the past. After all, THEY never heard of anyone getting whooping cough, or tetanus, or measles. And THEY certainly never had it themselves.

Now the anti-vaccinator himself, RFK Jr., has ingratiated himself into an essential job at the government level. He will be handed control of the Health and Human Services. This is a man who caused a fatal outbreak of measles in Samoa tby peddling his snake oil and misinformation about vaccines.

This man is not a doctor.

Like the yummy mummies on social media who are anti-vaxers and never expose their precious offspring to “chemicals” like di-hydrogen monoxide, that’s water, by the way. Until one of their children comes out with a PREVENTABLE disease, like influenza or measles, and dies. Then comes the rending of the clothes and the gnashing of the teeth and the wailing and fake tears. And the claims that no one told them that precious little Timmy-kins could die. After all, they just wanted to fit in with Tiffiny and Karin.

Spare me.

I’ve only read examples of death by tetanus. This is where your muscles lock up so tightly because of the toxin. The muscles are so rigid that bones break. Sounds horrible and not something I’d wish on my worst enemy. If I had any enemies, that is.

My great, great-aunt died of pertussis in the 1930s, even though a vaccine had been developed in 1914. The vaccine wasn’t widely used until the 1940s.

The DTP (diphtheria, pertussis, and tetanus) vaccine is a 3 vaccine for 1 shot deal. The caveat is that it only lasts for 10 years.

The flu shot is widely available, beginning in the fall. This is a yearly vaccine that everyone should get. After all, 28,000 people died of the flu in 2023 and the young, the old, and the immunocompromised are at risk, even with a vaccine.

Is this ringing a bell?

Same things we said about the covid vaccine and there were still millions of people who died worldwide. How many? We don’t know because they STOPPED collecting/reporting the data.

Your grandparents and great-grandparents lost children to what we can now prevent and would look at you in disappointment when you decide to listen to disgraced doctor Andrew Wakefield and his many, many, many, many times disproven paper that linked vaccines and autism.

Double spare me.

Better yet, spare your kids.

Post-it Sunday 11/24/24- Bbbbiiiiiggggg stretch/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.

Post-it Sunday 9/29/24- the in crowd

The gown card reads “Drs are a collegial bunch. As if having an MD gets you into a special club.”

My sister is a doctor. A pathologist, in fact. I know all about the years of schooling, the internship year, and the resident years, and the fellowship years (if they do that).

I get it.

I also understand why there is a special handshake doctor club.

I get it.

No one else can possibly understand but another doctor.

However, there is also a hierarchy among doctors. The general surgeons generally look down on the ob-gyns, the orthopedists look down on the podiatrists, and the neurologists and cardiothoracic surgeons look down on everyone.

Bullying between doctor groups is not okay.

It smacks of high school. And all the doctors I know have at least 10 years of post-high school education.

There is also a rivalry between the PhD nurse and the DNP (doctor of nursing practice), for no good reason. The PhD nurse does the research, and the DNP puts it into practice.

Stop acting like a bunch of teenagers!

Did you not learn in high school that bullying and snobbish behavior are not how to treat a colleague?

I was gonna write act your wage, but I don’t think so.

Definitely act your age.

Bullying is not on.

*** As an aside, reading the rest of the notes on the card I wonder if this was not a note about healthcare. The rest of the gown card is about a serial killer mystery I plotted out. And the main characters. The age of the gown card definitely bears this out. But the message is still the same, fictional doctors or non-fictional doctors need to stop acting like a bunch of teenagers and act your age.

Tuesday Top of Mind 9/24/24-They don’t care about anything but control and money… do you?

I realize that not everyone is as informed about the news as I am.

I realize that everyone doesn’t have the same reaction to the news that I do.

I realize that the reason for this is because some people just don’t care.

They don’t care that over half of Americans are being told that we are worth only what our uterus can produce. AKA the tax revenue that can be brought in by the potential uterine output.

They don’t care that women are dying.

They don’t care that babies are being tortured into existence where they will live their short lives in agony.

They don’t care that medical professionals, those who have gone to school for at LEAST 20 years, and those who don’t want to torture women or the cells that will become the baby, are leaving the red states in droves.

They don’t care that the patients who are left behind who cannot/will not move, are in what we term as an OB desert. This means that the number of doctors who stay in the red states is not enough to care for the women of the state.

They don’t care that women over 50 are still of childbearing age. Instead, they find it easier to mock them and ask why they care about the bodily autonomy of those who can still have children. Never mind that women over 50 can still bear children and never mind their daughters and granddaughters are impacted by the abortion can she or can’t she shell game they have going on.

They don’t care that anyone can be a signatory to an abortion amendments petition without the police/sheriff showing up at their house and interrogating them about it.

All these things they don’t care about. All of these things have been in the news in the last five days.

What do they care about?

It isn’t the unborn. It is money; It is the control of women.

What are they afraid of? Women.

Vote in November like your bodily autonomy depends on it.

Or someone you love.