25- This just in, a nursing degree (any kind) is not a professional degree

This is more of a Tuesday Top of Mind topic but the intersections with education cannot be ignored.

In a slap in the face heard around the country, the Department of Education dropped guidance that a list of degrees would no longer be considered professional. Do you know how many nurses, registered or not, working in healthcare or not, are in the United States?

4.7 MILLION, according to the American Association of the Colleges of Nursing.

Yeah, you done fucked up and insulted 4.7 million people.

The so called professional degrees that were listed

medicine
pharmacy
dentistry
optometry
podiatry
law
veterinary medicine
osteopathic medicin
clinical psychology

The so called non-professional degrees that were listed

NURSING
physicians assistants
physical therapists
social worker
speech therapy
architects
accountants
educators

I first read about this on Wednesday and the everyone else had read about it and were giving their reactions. I held onto my reactions until today. They are in three sections.

The first is that this downgrade means that there is less money for all of these professions to go to graduate school. The “professional” degrees (see above) can borrow up to $50,000 per year, with a cap of $200,000. The “non-professional” degrees (see above) are limited to $25,000 per year, with a cap of $65,000. Massive difference, right?

They do know there is a nursing shortage, right? And the shortage is exacerbated by the severe shortage of MSN and PhD prepared nurses to serve as nursing school instructors. I fear this would only deepen this shortage.

It’s like only rich people can obtain graduate degrees. I mean people have the option go into crippling private loan debt. Things to consider. I would not recommend private loans for school. I know too many nurses who have been destroyed by them.

The second is that the “non-professional” degrees are, with the exception of the architect, mandated reporters. Being a mandated reporter means that the social workers, the health-care professionals (including nursing, duh), the teachers, the child care providers, and law enforcement are mandates, by law, to report child abuse or neglect. This definition comes from the childwelfare.gov.

I know that most people love their children and would never abuse them, but there are always those that will. And, as a mandated reporter, I have to report it. This is to save children’s lives.

The third section is that the “non-professional” degree workers are mostly women. And those in power love nothing more than to treat women as less than. This has been happening more and more in the last few years.

If women can’t get loans to go to school and the cost is prohibitive, I guess they will have to stay home and have ALL THE BABIES. Even though nurse practitioners and physician assistants make up the bulk of the rural healthcare that is available. According to an interview I saw with Dr. Jennifer Mensik Kennedy, the president of the American Nurses Association (ANA), if there were no NPs or PAs a patient in need of care would have to drive 90 miles for care. Each way.

I am not less than. I am a professional working registered nurse. I am not a doctor or surgeon’s handmaiden.

Ew.

In 5 years we’ve gone from hero at the bedside during covid to non-professional.

I have called or written my representatives and the ANA has an online petition at RNaction.org. You better believe I signed that as soon as I heard about this travesty.

It’s like they want women in the home, having babies, and to cripple higher education. If only we were warned (this is heavy sarcasm)! Oh, wait, we were. This is all in Project 2025.

In simpler terms, to keep women dumb and in the homes so they can have all the babies. After which I guess we die?

Nice try and fuck all the way off!

Call Secrets of the OR 10/29/25- all call cases are emergencies

All call cases are emergencies. I admit sometimes they are emergency adjacent but still the case must be done. There are the rare exceptions when the call team did a total knee in the middle of the night and then discharged the patient because the surgeon, who was 5 hours late, insisted. That’s for another time.

All call cases are emergencies. To that end, it is okay to tell another department who has their gurney waiting outside the room when you go to pick up a patient that their non-emergent test is just going to have to wait.

Yes, that happened.

Another nurse and I were up on the 4th floor picking up a patient. We packaged the patient up. This means that we removed all the monitors, and replaced them with our own, we cleared all the stuff from the bed that wasn’t the patient. We unplugged the bed and told the family to follow us to the elevators and opened the door.

To be confronted by a worker from another department, ready with a gurney, to take the patient to their department for a non-urgent test.

Um, no you may not have the patient for your non-urgent test.

No, I don’t care that this patient is next on your to do list.

No, I don’t care that it looks badly to your supervisor if you don’t get the test done in a timely manner.

This patient is ill, ill, ill and requires emergent surgery to fix what is wrong with them. Well, not fix, but to remove the offending body part that was making them so sick.

No, we have to rush down to the OR and start the surgery.

No, you will have to do your non-emergent test on them after surgery.

No, I don’t know how long the emergent surgery will take. Surgical cases take as long as they take for the surgery.

No, I don’t care that this is the last thing on your to do list and you get to go home after the non-emergent test.

Sometimes you just have to say no and mean it.

Even if it means blocking another department from getting their hands on the patient for a non-urgent test that could wait until morning. But they don’t want to tell the hospitalist the non-urgent test wasn’t done.

Sorry for delaying this non-emergent test for a real, honest to goodness emergency surgery without which the patient has a good chance of dying.

Nah, not sorry.

I’ll probably hear about this later from my manager.

Oh, well.

At least we saved that patient’s life.

Secrets of the OR- Sterile processing, the unsung heroes of the OR

You think you know the OR? As if.

We know the usual cast of characters in the room.

The circulating nurse who bosses everyone around and ensures that the patient has everything they need. Including activating an emergency team.

The scrub tech who is in the sterile environment with the surgeon and assists who knows what the surgeon needs before they ask for it.

The CRNA who ensures that the patient is comfortably anesthetized and is prepared for any emergency.

The anesthesiologist who supervises the CRNA, up to 4 rooms at a time and who pinch hits for the CRNA at times.

The patient without who none of the cast of characters would be there.

But, do you recall the most famous reindeer of all?

Just kidding; it takes more that the usual cast of characters to safely see a patient through surgery.

There is the pre-op team that makes sure the patient is prepared for surgery. They know all about the patient and is a source of comfort for them as they wait for the surgery to begin.

There is the post-op team that makes sure the patient is comfortable waking up from surgery. In the hospital where I work the pre-op and post-op teams are comprised from the ACU/PACU team.

But the one you hear the least about? The ones who cleans the instruments, readies the trays, sterilizes the instruments, and puts the sets back where they live so that the OR can find them.

The sterile processing department. SPD in the hospital I work at.

They know everything there is to know about the trays. They should they put them together from the jumbled mess that the scrub tech might leave. Depends on the scrub tech. If asked about a certain instrument that was dropped they might be able to point the circulator in the correct direction for a replacement instrument.

The first thing they do is decontaminate the instruments that have just been used in a surgery. There are washing machines, similar to a dishwasher, that are used. But, just like in real life, the gross bioburden has to be washed off many of the instruments. By hand.

They inspect all instruments that they get out of the washers. They make sure that the tips of the instruments meet and are not out of alignment. They make sure that all the lumens of instruments are clean with air or a brush prior to set assembly. They make sure that all the very fine instrument tips are not broken off because of mistreatment. Then they string the instruments together in the order they appear on the count sheet.

They double check the count sheet to make sure that everything is accounted for in a set. If not, they mark the set as incomplete and put on a bright orange sticker that indicates what is missing. If too many things are missing the set it taken out of use and set aside until the missing pieces are located and the complete set can be sterilized.

How does an instrument get lost? This is out of their control. Sometimes the instrument is thrown away (I tried to get a research project off the ground to decrease inadvertently thrown away instruments by using a metal detector. I maintain it would have worked too, but covid shut that down). And sometimes the instrument is in another tray from the same case, just misplaced.

They maintain a bin of lost instruments from the misplaced instruments that are retrieved after the sets are put back together. These instruments can be from the core, where there is an entire shelving unit full of sterilized single items. Sometimes it is a replacement for the scissor the surgeon just dropped, sometimes it is a replacement for the orange sticker. SPD puts these back up in single sterilizer packet. This is a down time occupation. The downtime of which there is very little because some of the sets are needed later in the day and the set from the 0700 first case has to be washed, inspected, put back together and sterilized in time for the case that starts at noon.

They know everything there is to know about the instructions for use of the sterilizers and the instruments that might go in the sterilizers. These are the IFUs. These indicate what is the best sterilization method for a given instrument, including parameters of time and exposure.

We’ve come a long way since the days of one set of instruments that was washed and flash sterilized for ALL the cases of the day. Or the care and maintenance of the Cidex, which is a semi-sterile instrument dip that was sometimes used the before times that would expire. Or the care and maintenance of the Steris machine, which used an acid bath to delicately clean scopes and cameras that could not be sterilized in the autoclave. Or the care and maintenance of the newer machines like the Sterrad that uses plasma to sterilize cameras and scopes.

They had to have all of that in their heads. Or at least readily accessible to look up on the spot. But in my experience, they kept it all in their heads.

SPD workers have to be efficient and know their stuff. And keep all the rest of it in mind as they do so.

No sterile instruments? No surgery can be done safely. There aren’t enough antibiotics in the world to cover that.

Call Secrets of the OR 10/8/25- Call bootcamp

There’s this thing I do with new to the OR nurses or new to our OR nurses. It is called Call Bootcamp and I am the guru.

I’ve been taking all the call for so many years it has become my favorite.

And so I teach the new ones about how not to fear the call.

I call it Call Bootcamp. This is where the new nurse and I meet for about 60-90 minutes and talk about call. I also optimize their Epic situation to make it work better for them everyday. Not just on call.

I’ve done this well before the call shift. I used to buddy call with the new nurses and get them comfortable with call. I’ve done this for at least 10 years.

But I have never been able to justify the little call bootcamp on my clinical ladder. There isn’t a space for education items that are not posters or ANCC credited in person experience. That is my next step but it is a helluva lot of work and I have never dedicated weeks of my life to getting ANCC credits for the work.

The following is an attempt to get credit for the call bootcamps that I run. These are not part of my job description but rather are born from wanting to get a new nurse the best shot at a successful call shift.

1) How did you determine the date, location, and time frames for in-service? How did you communicate information to promote attendance?
This is a rolling in-service for new hires to the OR. These are one on one sessions that are not part of my role. When a nurse is deemed ready to take call for the department, the session is set though the assistant nurse manager. This is not expected in my role.

2) How was the need identified for this educational offering?
Surgery call is specific to the types of cases that you might encounter on call. Each time you are called in follows a pattern. This need was identified in new employees, many who had not taken call before. I was the natural answer to this need as the week call nurse.

3) Resources utilized?
None as I was available because of the call hours. The new nurses are paid for their time. Each call bootcamp takes 60-90 minutes, depending on their experience with call.

4) What is the objective of educating the team member?
The program objective is to familiarize new nurses to the call process at this particular hospital. This is done by a mock run through of a call case. From initial contact with the nursing supervisor, scheduling the case, picking up the patient/arranging for transport, picking the case supplies, doing the pre-op checklist through the Quick Prep tab of the operating room navigator, signing consents, doing the actual call case, when and how to call the recovery room team.

The new nurse and I walk through surgical services and talk specific to the OR things and specific to call things. Highlighted is the overhead call system, and the code button location in the OR. Specifics of code situations in the OR are discussed as well as where to find the department code carts. The silver anesthesia emergency binder is located and gone through with the nurse. In the PACU, the highlights include the Broselow cart, the Malignant Hyperthermia cart, the supply room and what might be needed from there. In the ACU, explanation of the pregnancy testing on all patients per policy and where the kits are, the supply room in the ACU is explained. The availability of the test tubes is discussed and demonstrated. The location of general ACU supplies are demonstrated. Matching Broselow band location is demonstrated, specific to pediatric patients, along with a discussion of how important it is for the responsible parent to have a band on as well. Tips and tricks specific to the call routine are discussed. I want them to be at least familiar with emergency procedures in the OR that can happen on call when there is a skeleton crew.

The Epic platform for each new nurse is optimized for the operating room. Specific to the OR flowsheets are added to the flowsheets (perinatal demise, and hysteroscopic use). Location of the code button hyperlink is explained but not demonstrated.

The Call Preserver notebook is highlighted. This is a step-by-step FAQ of specific OR things- including blood administration, how to schedule a case, how to put in a culture, what information is necessary to book a case, what specific orthopedic instrument sets are on site, how to use the iPads to do the surgical and anesthesia consents, how to run a code, and more. With a section of the supervisor has called me and I’m on call, now what?

The tour ends with the location of the call sheets. These are the pages that list who is on call for the day. In this hospital there is a call sheet for OR, PACU and Endoscopy.

5) Describe the benefits of the education to the unit/department?
Being on call is a scary proposition for new nurses. It is basically a mini shift, alone in the department with only the other call people and surgeon to rely on. This Call Bootcamp sets them up for success by answering their questions in a controlled environment when there isn’t a patient on the table, or a surgeon staring at you. I continue to offer support after the bootcamp by encouraging them to call me with any call question when they are in the middle of a call case if necessary. In the last week, I have received phone calls about specific supply locations, scheduling a case, and where the tonsillar bleed bovie was located.

By making myself available I alleviate their fears. Sometimes I do their first call with them. It is one thing if you are lectured about what to expect, it is another thing to actually do the thing. I iterate and re-iterate that I am always available for questions, should the need arise.

All of this stuff and there still isn’t a place to take credit for it. Shame.

FFS Friday 10/3/25- The right is lying to you, to your face. Again, and again and again

Who are you gonna believe? Your republican senator/congressman/”news” outlet who had to come clean that they are an entertainment company and not a news company even if it is in their company name? Those who would lie to you to gain imaginary political favor with their king?

Or your own eyes as you read the 1996 Personal Responsibility and Work Opportunity Act (PQRWORA) that states that undocumented immigrants and those immigrants without permanent status like DACA recipients, temporary protected status (TPS) holders, or nonimmigrant visa holder are BARRED from access to most federal benefits, including health care programs and assistance, including Medicaid and the Children’s Health Insurance Program (CHIP). This is taken verbatim from the Immigrant Migration Forum. And a check of healthcare.gov states that people in the groups that can get coverage are United States Citizens, U.S. nationals, lawfully present immigrant.

Oh, you’re being hung up on the word immigrant and ignoring the lawfully present part. These are the people with green cards. According to HealthCare.gov lawfully present people are people who have qualified non-citizen immigration status, humanitarian status, valid non-immigrant visas, legal status conferred by other laws.

To hear that “news” program call it the current government shutdown is caused by Democrats who want to extend medical care such as Medicaid to all the groups who don’t qualify for government health care assistance.

This is a fucking, disgusting lie.

The Democrats want the ACA tax credits that made healthcare affordable for millions of LEGAL AMERICANS to be extended. Without the tax credits the cost of healthcare will double at a minimum for those who are cannot afford it. This has a trickle down affect on anyone else’s health insurance rates to go up as well.

I am going to hold your hand when I tell you that it is a good thing for people to have health insurance.

People who don’t have health insurance don’t get regular check ups or preventative health care.

People who don’t have health insurance use the emergency room as their primary care doctor.

Without it, ERs will be over-run, more than they already are. People will ignore symptoms until they cannot be ignored anymore, far longer than what would have happened if they had access to healthcare. The patients in the hospital will be sicker. The patients in the operating rooms will be sicker.

This is because of another federal rule known as the Emergency Medical Treatment and Labor Act (EMTALA). This act mandated that anyone who presented to an emergency room be treated. End of story. Because of this act, the ER does not care if you are female, non-binary, male, immigrant, naturalized citizen, citizen, everyone must be treated.

But what do I know?

I’ve just been training in how to research for 10 years (through the BSN, MSN, and now PhD). I’m just a nurse who has over 24 years experience.

I’m just a woman who gives a damn.

Do those who you are listening to you care about you? Or do they care about lying to you? Consider that.

Call secrets of the OR 10/1/25- Participating in PACU games

When I started the call shift, almost 4 years ago now, I was asked if I could be the second nurse in PACU. Because I liked learning and shit. And so they wouldn’t have to call in their second PACU nurse.

I like learning and shit so I agreed. Every opportunity to learn is a good opportunity in my books.

Not every call nurse does this. I know this.

However it is a good avenue to learn about what happens after the drapes go down.

But what if there is another case? And only the call PACU nurse is there?

Well, you get the details of the second case. You give them the standard time. I have gotten some push back here. “Aren’t you already there?”

Yes, but the second PACU nurse isn’t. The first step is to call the second PACU nurse in.

The next thing you do is call the anesthesia team and give them a heads up. And then you coordinate with the scrub tech to pick the case and prepare the room.

And you schedule the case.

This is when you ask the CRNA to wait in PACU and be the second nurse while you get the patient from the ER. If they cannot (OB), you call the nursing supervisor and ask for them to come down and be the second nurse or send someone from the floor.

I mean you could put in transport but you know that there is limited transport at night. And the OR is never first priority.

It seems like a lot but it really isn’t. It is basically all the steps that you do when a call case is scheduled. Plus a second nurse in the PACU who is caring for their own patient. The second case is just stacked on the first case.

A second nurse has been obtained. You get report from the ER nurse and you go to the ER to pick up the patient. It takes less than 5 minutes usually.

This is where the 2 back to back cases blend into each other. This is normal.

The only thing you have to remember to do is bring the patient and their family member to the other side of the PACU.

Privacy reasons, you know?

The second nurse is dismissed.

You prep patient number 2. This is also familiar to you because you do it every call case. Anesthesia is alerted to the patient in the PACU, the surgeon pops in (if it is the same surgeon, but that doesn’t always happen that way). Consents are signed, pre-op checklist is completed and the Quick Prep that you always use to prep a patient is completed.

And just as you are finishing, the second PACU nurse arrives.

You hand over the patient’s family to the second PACU nurse and they take them to the waiting room. But not before you mention again the instructions to pick up the waiting room phone if it rings.

In truth it takes about 20 minutes to prep on a more standard day. This is just a little wrinkle.

But both PACU nurses are now in PACU, the second patient is in the OR, and the first patient is still waking up.

If the surgeon complains about the thirty to thirty-five minutes it took to get the second patient on the table kindly remind them that back to back call cases at night are not the usual. But next time they could go get the second patient from the ER. Or they could sling a mop and turnover the room.

OR call is all about managing the expectations of the surgeon, the anesthesia team, the scrub tech, and hoping there is a bed. Plus thinking about all the possibilities and ensuring you have what you need to answer them. It is a matter of perspective.

This is your reminder that it is probably time to renew your nursing license or at least work on the continuing education units

I renewed my North Carolina nursing license yesterday.

North Carolina, like most other states, has a 2 year limit on their nursing license.

In North Carolina, there are many options for proving you’re still registerable. The requirement I chose is 640 hours as a working nurse. This translates to roughly 16 weeks of full time 40 hours per week nursing work. Which is roughly 4 months out of 24 months. To choose this option, you also have to do 15 hours of CEUs.

These requirements must have been fulfilled in the 2 years window.

Additional options include

national certification by a credentialing body recognized by the board of nursing
30 hours of CEU
completion of a refresher course approved by the board of nursing
completion of a minimum of 2 semester hours of post-licensure education. This is your MSN and BSN bridge and DNP and PhD programs
15 CEUS and completions of a nursing project as the Principal Investigator for a nursing problem
15 CEUs and authoring an article, paper, book
15 CEUs and developing and doing a nursing CEU presentation of at least 5 contact hours

Of course I am an over achiever and have completed 6 of the 7 options. The only thing that I haven’t done is the refresher course.

What can I say? I am passionate about being a nurse.

The hospital systems do a good job of keeping you on task for renewing your nursing license. But pull it out and check it anyway.

Mistakes do happen.

But, Kate, what happens if my nursing license has expired?

This is a big bad.

Like really bad.

Like being charged with assault bad. The reason of the assault charge is that you are not licensed, therefore you are practicing nursing without legal protections. Both for you and your patient.

There is a reason it is called Fitness to Practice and the entire reason behind the two year cycle.

It is up to you to keep current on education, hence the CEUS. No one wants a nurse who isn’t aware of the newest things that affect patients. Remember 2020? I do.

So check the expiration date of your nursing license.

But if you have questions about how to find free CEUs, I have loads of options for you.

Best Kept Secrets of the OR #?- Happy 23rd birthday, surgical time out!

Once upon a time, when I was just a mere baby nurse, new to the ways of the OR, there was a wrong site surgery in the operating room. I was listening to my preceptor talk about the schedule when a more experienced nurse burst out of their room, nearly in tears, babbling about the video tower being on the wrong side of the room.

The video tower is just what it sounds like. Remember those AV carts in high school and middle school? The ones that the teacher would wheel into a room when they wanted to show a video. Do they still do that? I have no idea. It was a video monitor, a light source and a camera box. Sometimes a printer. That is so the surgeon can insert the arthroscopy camera and see what they need to see and, because of the video set up, so can the rest of the room. The early early scopes didn’t have the camera and a surgeon would hold up the scope to their naked eye and no one else could see. We’ve come a long way, baby.

Another detail that non OR people need to know is that the video tower is on the opposite side of the patient than the operative side. For example, a right knee arthroscopy requires that the video tower be on the left side of the patient.

Clear as mud, right? Just go with it.

The case left knee arthroscopy was the first case of the day in that room. The problem was that the last scope of the previous day had been a right knee arthroscopy and the video tower was pushed back to the wall to the left side of the room. The tower for a left knee scope should’ve been on the patient’s right side. And the nurse, not thinking, had just pulled the tower next to the bed and prepped what she assumed was the correct leg. She assumed that the knee arthroscopy that the patient needed was a right one because the tower was on the left side.

It wasn’t until the surgeon was in the knee, looking around and not seeing the anterior cruciate ligament defect that they even asked to see the consent. The operative consent was for the left knee and they were in the right knee.

Early morning, first case of the day. That was when we didn’t set up the rooms for the next day. It was just convenience that led to the video tower being on the incorrect side. It was just bad luck that the nurse and the surgeon and the scrub tech and the anesthesiologist didn’t recognize the error. This is the very definition of Swiss cheese error.

This is the kind of stuff that I came to understand, very quickly, was nightmare producing. It goes against everything healthcare is supposed to be and a patient was temporarily injured. And inconvenienced. The surgeon had to stop the surgery and, accompanied by the charge nurse, go out to speak to family and tell them what happened. And get permission to do the real surgery on the correct leg. I imagine while this was happening the surgery manager was on the phone with the hospital lawyer. But maybe not, it was a simpler time. The family agreed and the patient got the surgery on the correct leg, and three port sites in their other knee as well. As this was before bilateral orthopedic surgery became more commonplace.

This was before the surgical time was developed and introduced. But wrong site surgery was such a bad thing that the National Quality Forum included it in their never events. These are medical error events that should never be. The surgical time out was the solution developed by AORN.

All members of the OR team must stop what they are doing, agree that this is the correct patient, correct laterality, correct equipment, correct surgeon, correct surgery set up, and correct surgery.

The surgical time out is kind of like the 5 rights of medication administration that they taught us in school. Scratch that, the surgical time out IS the 5 rights of operation.

I still remember when the manager gathered us around not too terribly much later and explained that there was a new WHO tool that had to be done on every surgery. Also why it is called the WHO surgical time out in some hospitals that cling very tightly to their traditions.

Whatever it is called, the surgical time out or “pause” has been integral for stopping surgical mistakes. Thousands, if not millions of them, in the 23 years since its adoption.

Taking the time to pause or stop and agree on all the things is the very best we can do for the patient.

Tuesday Top of Mind 3/25/25- Laughing in the face danger is so nursing

There is a well-known, little understood meme about Ralph Wiggins of Simpson’s fame sitting near the back of a bus and saying, with a chuckle, “I’m in danger.” I say well known because Ralph Wiggins is a popular character on the Simpsons. I say little understood because this scene is not part of the Simpsons. Instead, it is from a Family Guy crossover episode.

It is understood that Ralph is laughing in the face of danger. Or that he doesn’t understand the consequences of the danger he is in. Both things can be true

Why I am writing about this will become clear.

There was a bulletin released last week, on March 18 about the danger in hospitals.

Do you know what I am talking about? It’s okay if you don’t. So much crap is thrown at us every damned day by the administration and various ill-intentioned groups. Often young men who don’t have their entire pre-frontal cortex completely formed yet who are susceptible to rhetoric.

Hint, hint, part of why we are in this mess with this administration that is acting illegally every day and no one in the other 2 branches of government are doing diddly squat.

The American Health Association (AHA) and the Information Sharing and Analysis Center (ISAC) issued a joint bulletin warning of a potential terror threat that targets hospitals. These hospitals are not named, just that it is to be multi-city terrorist attacks, in mid-sized cities.

This information is from “chatter” from ISIS-K groups and the likely methods noted are likely to involve vehicles and explosives. At level 1 trauma centers. You know, the ones most likely to be able to handle such a mass casualty event.

My hospital system has already taken steps in the face of this bulletin. And my hospital has already done the

After covid and working through a global pandemic is this supposed to scare us nurses?

Um, have they met us?

Nurses are the ones who wade in where angels fear to tread.

We care for all who come through our doors.

Is this horrible and could a lot of people die?
Absolutely.

Will we as a society meet the challenge?
Absolutely not.

Will nurses save us?
Yes. Yes, we will.

Are nurses laughing in the face of danger, while also acknowledging that we are in danger?
Always.

Tuesday Top of Mind 3/18/25- Where’s Buttercup?

This post is about our current political situation and the greatest movie of all time “The Princess Bride”. If you haven’t seen it, stop reading and go find it. It is probably playing on tv somewhere. And then come back when you have an inkling of what I am referring to.

You know when Wesley is panicked after being dosed with Miracle Max’s pill and he is demanding answers to, among other things who are you, are we enemies, why am I am on this wall, where’s Buttercup, why won’t my arms move? And Inigo Montoya calmly responds “Let me explain…” and pauses and continues “No, there is too much. Let me sum up.”

That is the mood today.

There has been an entire stream of shit decision and shittier actions from this administration. A firehose stream. The intention is to drown us. Or to give us so much information and things to react to that we cease to react.

The hits keep coming.

There are hits to education that are the 50% reduction in force to “return the education to the states”. Well and good, but there are states that are struggling with what the government gives them. West Virginia, are you paying attention? West Virginia is frequently 50/50 states, and not in a good way, in education.

There are hits to the healthcare industry. Medicaid is on life support at the moment. Reminder, there are over 72 million Americans on Medicaid. This pays for elder care, nursing homes, the children that are under treatment for all sorts of things. You know, like the children that survive being born at 23 weeks that are heralded as miracles. Miracles that will most likely need care for their entire lives. Medicaid also provides healthcare for at least 37 million children. These are vaccinations and well child visits. To lose Medicaid would put a double whammy on the hospital systems that are already struggling.

There are hits to the National Parks system. Not only did 1000 workers lose their jobs, but some parks had to adjust hours and are no longer allowing overnight visits. There are 63 named National Parks but that does not come close to explaining the breadth of what they do.

There is an unelected person who bought the election running around with a group of under aged 25 boys pulling the pieces of the government apart. A la the neighborhood bullies torturing the neighborhood pets.

There is the megalomaniac despot wanna be running a smear and revenge campaign against anyone he thinks has ever wronged him. Someone needs to remind him that it is speak softly and carry a big stick, not scream and shout and use the stick against anyone he deems as lesser. Psst, that is everyone who has less than $1 billion dollars.

That is where we are now. At the mercy of the man child.

I love that for us.

We need a Dread Pirate Roberts. Or, at the very least, an Inigo Montoya. Or a Brute Squad Fezzik.

I’m not picky.

But we need a Miracle Max, not a Prince Humperdinck flailing about.