24-adjusting expectations

This was a HIGH bar for me to clear.

My expectation was that I could move heaven and earth to graduate with a PhD in 3 years. Eminently doable, I smugly thought to myself as I signed up. Doing the program in 3 years means that I will graduate before I turn 50!

I’m not sure why that arbitrary number was important. After all, I will turn 50 with or without a PhD.

Also of importance was the fact that I wanted to clear the triple hurdle and get my third degree in 10 years. No matter that the world was on fire in 2020 and 2021. And I was a working hospital-based operating room nurse the entire time.

Who was I competing against?

Myself. That’s who I was competing against.

Because this will not set the nursing world on fire.

Oh, and yeah, 2024 was a horrible year health-wise for me. Horrible. Your forties are like a gift. This is heavy sarcasm.

Sometime in the past months, I came to the realization that the thesis will not be finished and defended by the graduate in May deadline of March 20th. There just isn’t enough time to do all the tasks.

Everything takes longer in academia. And I mean EVERYTHING. Through a series of pitfalls, and, yes the personal physical challenges, and the university challenges, it has taken me 6 months to start my pilot project and 2 months to complete it and finish the class. This process should have taken me 6 weeks to start the pilot project and 2 months to complete it and finish the class.

Okay. I’ve written before that age is just a number and time means nothing. Why was I so worried about the PhD being completed by a deadline I made up in my own head? I will finish this degree in my own time. I should just enjoy this dedicated writing time.

The take-home lesson is that plans may change. Some people might look at a change as the opportunity to drop the idea completely. They would not be wrong in doing so.

Their path is their own.

Your path is your own.

Paths may change. I know that my personal path has taken a few right turns and a couple of u-turns. And that is okay.

Whether you stay on the path or decide that it is not the path you want, the important thing is to keep learning. Being an adult learner is hard but remember the reasons you started on the path and the reasons to keep on the path. Even as it changes underfoot.

You might surprise yourself.

I hope you do.

School Me Saturday 4/20/24- personal end of semester update

On this palindrome Saturday I am going to be digressing from the Alice in Wonderland school series I have been writing and will be writing about myself and my program.

Why?

Because it is nearly the end of the Spring semester and it’s been a hot minute since I did an update.

Two weeks remain in the semester.

That is 2 more times driving to the university for my research assistant job. I did decline to work this summer for the department as I anticipate life is going to get very interesting and busy over the summer.

That is 2 more assignments. One in the qualitative research class and 1 in the measurement class.

As the qualitative, I should have seen the writing on the wall. I do not care for math. Especially the kind of math that is required for quantitative research. Statistics makes me itch a bit. You know? I am leaning into the qualitative sphere. And this is shocking to me.

Talking? To other people? Not really a strength of mine. But here we are.

For the third class, the directed research class, I was thrown off a bit by being sick for 2 months starting in February. I just feel like I got a slow start. But that’s okay. I am chipping away at it. Next week I will be presenting my directed research project, an observation project, to the corporate research council. After that, and after the blessing of the school IRB and the hospital IRB, I will dive into the observations and finish the class.

Thankfully, I am not the first person to have a slow start and there is a process for this.

For the rest of the summer, I will be preparing for and taking my preliminary exams. These are exams that separate the PhD student you from the PhD candidate you. These are also the threshold that must be crossed to begin dissertation work.

The exams are timed, kind of, and meant to be written over two weeks from home, or 3 days at the university. I will stay home, thank you, and write them from here.

After I pass the preliminary exams (I hope) I will start work in earnest on my dissertation project and my dissertation itself. As I understand I will need to have it completed and defended by March if I want to graduate in May. The directed research informs the dissertation project research.

I have had so much support from the university in this journey. And a journey it is. And support from family and friends.

I need a better answer to what are you going to do after graduation?

For the longest time, the answer has been write for publication. I might throw in some teaching in there too.

After the end of this semester, I will be a 3rd year PhD student. If you had told my younger self that I would someday be looking at and surviving a dissertation she would have laughed.

Oh, boy.

Let’s get started.

Dissertation topic

On Wednesdays we wear pink. Deliberate Mean Girls Reference.

On Wednesdays, I write about the operating room Not so weird, considering Dispatches from the Evening Shift started as an OR blog. And then it became an operating room/nursing/post-it notes to me discussion/Tuesday Top of Mind where I discuss politics and things that are top of my mind/Cookie Thursday is a Thing/School Me Saturday blog.

Yeah, I know that the topic of my dissertation might be more of a School Me Saturday post but this is very operating room-centric. I just felt like it fit here best. And I’m doing an Alice in Wonderland theme for School Me Saturday for a few weeks.

My idea for the dissertation project that will take me nine months to do and write the damned dissertation (name of a dissertation service I’ve seen) is solidly in the OR.

Not to go too deep into the details but the OR is consumed with turnover.

This is not when people leave and new people are hired. While that is also called turnover, this is not it.

Turnover refers to the Wheels Out to Wheels In time. This is the length of time that elapses when one patient leaves the room (Wheels Out), the room is cleaned, the equipment is brought in, the next case is opened and counted, and the next patient enters the room (Wheels In).

There are industry standards. There are goal times that the hospitals strive to meet. The industry average is 26 minutes.

And I am over here doing 10-12 minute turnovers. Often in the same room, always with the same team, and always without anyone but us to clean the room/get the equipment/open and count the room.

The question is why.

Why is the evening night team so efficient?

So efficient that several doctors remarked on it. One of them went so far as to suggest they were going to schedule all of their cases after 1500.

The thing is… I don’t know.

Being a circulator is a job in a solo. We don’t know what the other circulators are doing.

This leads me to the pilot observation study that I will be doing as soon as the IRB allows.

It is my hypothesis that there are tasks that can be done to potentiate a faster turnover.

These are simple tasks.

Make sure there is no trash on the floor.

Make sure all the linen is in the linen bag.

Make sure all equipment is away from the OR table.

Make sure that all extra supplies are either put away in the room or readied to be taken out of the room.

Make sure all the suction cannisters are prepped for removal.

Be thinking ahead to the next case and the equipment that might be needed.

Be thinking ahead to the positioning requirements of the next case.

In other words, prepare to room to be left.

I only know what I do. I don’t know what other circulators do.

Hence the pilot study.

The pilot study will be in one hospital during the day shift.

The big dissertation study will be controlling as many variables as I can and observing in other venues. Such as a bigger hospital. Such as an ambulatory surgery center. Such as the night shift. Such as the weekend shift.

The thing I’ve learned about the dissertation during my program is to keep it simple.

There are many downstream effects that an efficient turnover can do. Keeping to the scheduled times. Getting people out of shift on time. Decreasing overtime costs.

The end goal is to create a checklist for pre-Wheels Out activities.

But that is NOT the dissertation goal. That’s for later.

Because creating a checklist and getting it validated can add 2 years to the dissertation time.

I don’t have time for that.

Remember. Keep it simple. This is not the best work I will ever do. This is not the most important work I will ever do.

The dissertation project is just enough. Because although there is a degree at the end, it is really about the journey.