Best Kept Secrets of the OR #28-Holiday weeks are feast or famine

Yeah, I know that Easter/Spring Break was over a week ago. But the next holiday for the operating room will be here in less than a month. Slightly different rules but much of the same vibe.

Eh, things have been happening.

Because holiday weeks are a feast or famine situation in the OR.

On Good Friday all the doctor’s offices are closed. That means there are less phone calls and probably less add ons. Since Easter is a family holiday, much of the staff want it off as well. This is a win-win.

Unless you are in the feast portion of the holiday.

My evening tech, with whom I worked for literal YEARS, and I would nod to each other, regardless of the burgeoning schedule or the echoing schedule and say holiday.

Easter stands alone because it is not one of the drink to excess holidays. Well, not usually. There are always the exceptions. Because it is a family holiday.

The rules also extend, to a lesser extent, to Mother’s Day and Father’s Day but it is less acute then. Those days we try to get people who don’t have children to cover. At least I used to when I ran the schedule.

Feast or famine is what the OR schedule looks like.

Another variable is what week of the month the expected feast or famine days fall upon. Because the 5th week of the month is outside of the block scheduling process and you get a weird bunch of cases.

Feast means that there are more cases than time in the week. Since these weeks the OR is run on a traditionally smaller number of staff, that means there are plenty of cases for everyone. This is particular to the family holidays like Easter or Christmas when everyone wants to be off to be with their family.

Famine means that there are less cases than normal. This is usually due to the surgeons scheduling time off to be with their own families. This can be a bonanza for the people who didn’t get the golden ticket of approved PTO but really still want to be with their families. Or just want to be off. There is usually a list that is kept at the desk and, to make it fair, done on a first come first served basis.

Don’t worry, all the rules will be different for our next holiday. This is Memorial Day, which is the last Monday of May. It isn’t meant to be a drinking holiday, but it is the opening holiday for grilling. Especially here in the South.

Cookie Thursday 12/5/24- It’s beginning to look a lot like Chex-mas

New month, new theme. This December’s theme is Holiday, just like it has been so many years.

I always start December off by making Chex mix and I only make Chex mix in December. I start buying the ingredients when there is a good buy or a BOGO.

The ingredients that I buy are

garlic powder
onion powder
I use the same Lawry’s seasoning salt because I use much less than the recipe calls for. Too much sodium
family sized Chex mix- Corn and Rice
1 box of wheat chex
pretzel rods
containers of deluxe mixed nuts. I find I don’t care for peanuts so I don’t make it with them
And the most important ingredient of all- butter
Worcestershire sauce/I also use powdered. I find that it makes a big difference

Each batch is made in my turkey roaster. 1 box each of rice and corn Chex and 1/2 box of Wheat Chex. 3 melted sticks of butter, 2-3 tbs each of garlic and onion powder, 2 tsp seasoning salt, 3-4 tbs Worcestershire sauce or 3 tbs powder, 1/4 bag pretzels, 1/2 large container of nuts.

I make the seasoning liquid all together in a small pan, over low heat. The butter is melted first, almost browned butter, add the rest of the seasoning and cook until simmering, stirring occasionally as you mix the rest of the dry ingredients.

Low and slow at 350 degrees Fahrenheit, stirring every 20 minutes for 2 hours.

The first two batches I make have gluten in it and the rest are gluten free.

I probably make 4-5 batches as it is a crowd favorite for Cookie Thursday and a family and friend must have.

The nuts and pretzels can be measured with your heart and any additional addins are allowed and encouraged.

Funny story, today I was dropping off the leftover cinnamon rolls from the nursing awards ceremony at around 1130 to the OR lounge. Someone asked me what was going to be the make this week.

Everyone else had their heads bent to their phone or their food or both. I mentioned that I would be bringing in Chex mix. Everyone stopped moving and raised their heads.

Like I said, department favorite.

Post-it Sunday 12/24/23- holiday call

The post-it reads “holiday call can be the pits, depending on where you fall in the seniority list.”

Call is what the department makes of it through policy. Holiday call is also what the department makes of it through policy.

I’ve heard good things and not-so-good things from my friends at other hospitals.

Some places choose holiday calls by seniority. Like the hospital I work at.

Reminder, the department that I work in has 9 ORs, one of which is a procedure room. There are currently 25 nurses in the department, of different hours and different levels. These levels can be PRN. If the nurse who works PRN was working this before 2015, then they are grandfathered into no call. Otherwise, everyone takes call.

PRN means pro re nata. You may have seen it on a medication label. This means as needed.

I’m only going to be talking about the RNs here. The rules are the same for the scrub techs.

Unlike the banking or government sector, the holidays that count are dependent on the state. I believe here in North Carolina, there are 8 holidays that the surgical department is closed. These are the standard holidays like New Year’s, Christmas, Memorial Day, Labor Day, and Thanksgiving.

In the surgical services department where I work, each holiday is split into 12-hour shifts, a day shift 0700-1900 and a night shift 1900-0700. The department also voted that Christmas Eve after 1900 and New Year’s Eve after 1900 are considered holidays. This puts them into the mix.

Going back to our numbers, if there are 8 holidays, including eves, split into 12-hour shifts, effectively doubling the days that need coverage. This means 16 shifts need to be covered. By 25 nurses. This is where seniority comes into play. This is seniority in the department, not in the corporation.

I’ve been there so long (15 and a half years) that I have the most seniority of the OR RNs. Which means I don’t have to take holiday call.

Signing up for holiday call, even by seniority, can be a challenging thing for management to handle. To ensure that no one gets a “hot” holiday, such as Christmas or New Year’s, more than once every two years. There are even lists of the holidays and an A team and a B team who chooses.

Because the OR must be staffed in case of an emergency. Even if it is taking call from home.

This year Christmas Eve, that’s today!, is on a Sunday, which added an extra day to the holiday call rotation.

I’m still senior to everyone else and I didn’t have to take any holiday call this year.

If you are on call this weekend or next, or not, have a Merry Christmas! And a Happy New Year.

Don’t forget to think good thoughts for 2024.

We are going to need them.