25-F-in Cowards #4

Oh, my god, they pulled up the corpse of Elmo and shot him again.

Shield your eyes, children.

And just like that the path in childhood has been closed to CHILDREN. No more education programs that are not ads for toys or ads for movies or just plain ads.

The Corporation for Public Broadcasting announced today that it has begun shut down procedures. People are being laid off, with the corporation shuttering in January 2026.

The CPB was authorized by Congress in the 1967 Public Broadcasting Act to ensure that everyone, and I mean everyone, has access to non-commercial, high-quality content and telecommunications. They used 70% of their own funding to support more than 1500 locally owned radio and television stations.

This means that the shows and the broadcasts are not trying to sell you anything.

Unlike the rest of the world.

Every minute of every day.

But, alas, this is no more because congress yanked its funding in order to give money to millionaires and billionaires in the form of tax credits.

“But, but you will get a tax credit too!”

pffft, I’ll believe it when I see it.

We certainly did not receive any money during the pandemic and those 2017 “tax cuts”? Our taxes went up. By a lot. Many thousands of dollars a lot.

No, I don’t believe you when you tell me that it was worth it.

Fucking cowards.

Mr. Rogers is very disappointed in you.

I believe Horatio in Hamlet said it best “Now cracks a noble heart. Good night, sweet prince/and flights of angels sing thee to thy rest.”

Or maybe Inigo Montoya when he is advancing on Count Rugen, “Hello, my name is Inigo Montoyo, you killed my father, prepare to die.” Count Rugen pleads for his life in the final duel, offering Inigo all that he wants, money, power jewels anything Inigo wants.

And Inigo, stabbed, bleeding, facing down the man who murdered his father twenty years before, tells him “I want my father back, you son of a bitch.”

Let me tell you, we are all Inigo.

We want our PBS and NPR.

Again, Mr. Rogers is very disappointed in all who voted for this.

North Carolina is going Surgical Smoke FREE

dun-dun-DUN–dun-dun-DUNan–dun-dun-DUN-dun dun

This is the opening guitar riff of Smoke on the Water by Deep Purple. Go to YouTube and check me. You know that I am right.

It was 8 years ago that I recognized that other people, often with less years in the OR, would react to the shall we say unsightly odors of some surgeries. Smells would hit me later in a case than others. A surgeon and a tech would react to the smell of an appendix or open abdomen and it wasn’t until it was closer to me such as when I was collecting the specimen that the smell would make it to my scent receptors, and I would become aware of what they were talking about.

This was a very gradual awareness, brought on by what I assumed was a very gradual over- exposure to the bovie smoke.

Let’s talk about the effects of surgical smoke. It has been compared to smoking 30 unfiltered cigarettes per day. Surgical smoke also contains arsenic, smoke particles, people particles (live tissue fragments), e-coli, SARS-Cov-2 (aka covid), toxic gases, benzene and hydrogen cyanide. It can cause a decreased sense of smell, asthma, allergies, chronic bronchitis, chronic sore throat, and even chronic lung diseases.

Forthwith I became aware that my sense of smell had been altered by 23 years in the operating room. Many of those years were in heavy surgical smoke plume cases- total joints, plastic surgery, and open abdomens.

Surgical smoke is created by use of an electro-cautery device, most often a bovie. This piece of electrical cautery equipment was named after the Dr. William T. Bovie who developed the electrical cautery machine in 1926. This was used to stem the bleeding cause by incisions and surgery.

In 2018, Rhode Island became the first state to enact legislation to ensure that all hospitals and free-standing ambulatory centers used a smoke evacuator in the OR. Many other states joined them- Arizona, Colorado, Connecticut, California, Georgia, Illinois, Kentucky, Louisiana, Missouri, New Jersey, New York, Ohio, Oregon, Minnesota, West Virginia, and Washington.

AND NORTH CAROLINA!!!

We make the 19th state that has elected to protect their nurses, scrub techs, surgeons, and patients.

Smoke free is a misnomer. It is a short hand way of saying that the surgical smoke plume is contained at the site of surgery with smoke evacuation.

However, Governor Josh Stein just signed it into law. To go into effect January 1, 2026.

The hospital system I work for started mandating surgical smoke evacuation during covid. Because, as you may have noticed above, covid is carried by surgical smoke.

Did I write this legislation? No.

However, I have written, and spoke to surgeons, and written legislators, and called legislators, and signed petitions. Basically, we kept up pressure. I even used surgical smoke legislation in the Health Care Policy and Ethics class that I took fall semester 2023. This was when the NC legislature was waffling about it. I did presentations and wrote papers about the dangers of surgical smoke and the importance of going smoke free. I shared the papers and presentations with anyone who asked.

I needed this win today.

Oh, happy day!

School Me Saturday 6/28/25- Students and AI- Part 1

ChatGPT was set forth unto the world like a biblical plague on November 30, 2022.

I was just finishing my first semester of the PhD program when our statistics professor announced it to the class. They said that AI was going to be a big thing for, well, the world. There was not going to be anything that AI couldn’t touch. These programs had the ability to analyze reams and reams of data in a blink.

Less than 3 years later we know better.

Yes, AI is capable of doing amazing things and has vastly sped up the analysis of critical data.

If you know the correct prompt. Or the proper way to word your request.

When it isn’t hallucinating citations and facts that aren’t there.

The pro-AI people say well, that’s because it wasn’t trained well enough. I say that if you put crap in, you get crap out.

My statistics professor also cautioned using the new programs for schoolwork.

Don’t forget, it was released just in time for finals.

Colleges and universities had to scramble to put in rules and explanations of the rules. Some AI is encouraged at some places for some papers for some classes. Some instructors have embraced it and are teaching students about it. Some instructors have not.

It is very confusing.

For me personally, I have only used an AI engine when it was an assignment. I want to be responsible for all that I write, incorrect or not. After all, I was able to survive all of my primary and secondary education without online search. In 1993, Creighton had just put all of their books into a computerized card catalog. I didn’t write my first paper using facts from the internet until 2015.

Now Google is a verb and AI slop is everywhere. AI slop refers to low quality media, including low quality writing and low quality images. Kind of like AI hallucinating things.

Yes, I am older than Google. Hell, I am older than the internet. What a time to be a student! The rules are made up anyway.

One thing that is a bit comforting is that AI is not subject to copy right. Because a copy right means that it was human made and AI is not human.

FFS Friday 6/20/25- Fed, fussy feline

This is a change from my normal FFS Friday content and is brought to you because I wanted to.

Also my husband suggested it. After suggesting the four horsemen of the apocalypse, War, Death, Famine, Pollution and Pestilence, all of which were well represented this past week in the past week, we had to stop talking because the cat was SCREAMING at me to get my attention. He laughed and said I needed to write about her.

This is a FFS Friday on the lighter side. I believe we all need something on the lighter side today in the midst of all the chaos.

You can’t tell me that cats do not have a rudimentary grasp of time.

Ask me how I know? Dot knows roughly when I am due back from work. Dot knows roughly when the spare human is due back from work and also when he goes to work.

Before the other cat died last summer, Dot would wake me to make sure the other cat got fed at 0800. Even if I had just gotten to bed at 0700. Dot is free fed, which means there is always dry cat food in her dish.

Conversations I have with my cat every day include.

Yes, you’ve been fed.

Yes, I will touch your food.

No, I will not top off your dish. You get food added at 0800 and 2000.

No, you cannot have your wet cat food. You don’t get that at 1000 and 1600, you know that.

Cats also have a grasp on simple mathematics.

Dot, despite not having any sweet receptors on her tongue, long ago developed a taste for mini marshmallows. She knows I keep a bag in my desk for her. She knows that she gets TWO at 2000. I fear for my safety if I only have 1 to give her. Not really, but she will plant herself in front of the monitor and STARE until I give her the second one. Even if that means I have to go downstairs to the kitchen and pull out another bag. And if we are ever out of them? She pouts.

Did you know that it is possible to be too touched out by a cat? Again, ask me how I know.

Dot has to be within arms reach of me at all times. We’ve compromised to where she will sleep in her window perch if I am reading on the couch. If I get up to come upstairs to the computer she follows me. If she wants my attention she yells at me. If I am on a zoom meeting she wants in. In fact, I warn people that they will see a white cat, her name is Dot and she has zero Zoom or Teams manners.

If I am called in she is waiting for me, her little head visible in the sidelight, when I pull in.

She absolutely HATES thunder and will hide under the bed. Fireworks are somehow okay though.

Her latest cute-ism is demanding to be lifted to the lip of the bath where one of her water cups is while I am brushing my teeth. You know, so she can keep an eye on me while I am brushing.

She has perfected sitting between me and the keyboard but I can still reach the keyboard and type.

She’s perfect the way she is.

This is a PSA that most of the US will be under a heat dome Saturday-Wednesday. Maybe put out some water for outside animals to drink. Maybe provide shelter/shade if you can.

It’s gonna be hot, damned hot.

Yes, that is an Airplane! reference.

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.

Post-it Sunday medical non-fiction series 5/25/25- When Breath Becomes Air

This was another book I read pre-BSN. I was a working nurse and had been for 13 and a half years When Breath Becomes Air by Paul Karanthi was published January 12, 2016.

Admittedly this was mid-BSN course work but I just had to read it. I love neurosurgeon medical non-fiction, I always have. From the first one I read in 1997- When the Air Hits Your Brain: Tales from Neurosurgery by Frank Vertosick Jr., MD. This goes along with the ditty that I learned in nursing school- when the air hits your brain you are never the same.

This is the story of a neurosurgeon resident before and after he is diagnosed with lung cancer in the final years of his training.

Neurosurgeon training is a loooonnnnggggg haul. The google results vary. Some call it 15 years after high school (includes a bachelors of some sort and medical school, internship and residency) and other programs clock it at 7 years (which is minus the bachelors years). In a simpler format, it is seven years after the undergraduate degree and the medical degree. Of course, type-A personalities that 100% of them are, there may be additional fellowship after the end of residency.

In short, you have to REALLY like cutting into people’s heads.

Or the aforementioned type-A personality.

Or just want to care for people who are sick and have no where else to turn.

Sit down.

I’m going to hold your hands and gently explain that I didn’t enjoy this book.

Like, at all.

Take your fingers off your pearls. It isn’t personal.

I get that Dr. Paul Kalanithi wrote this while he was actively fighting lung cancer and actively dying. And that his wife, Dr. Lucy Kalanithi wrote the final chapter explaining his death.

I understand.

I just don’t think it is that great a book.

Seriously.

I re-read it this past week to make sure that I still felt that way. Also I re-read it with the knowledge that I had finished two whole nursing degrees and am most of the way through the third in the intervening years.

There are entire passages of brilliance. I marked 11 pages of them.

This book is this man’s journey to coming to grips with a fatal disease. I can understand that.

I can also appreciate how they let his voice drive most of the way through the book. It starts off strong when he was a boy and stronger when he is in medical school, before petering out over the course of his illness. If this was intentional this is masterful editing. If this is not, it is still masterful storytelling.

My biggest pet peeve with this book is that it is over-confident in its own brilliance and the author is a huge name dropper. Granted most of the names dropped were author’s names but nurses were not named. Not once. His surgical nurses were only mentioned a handful of times, including the conversation about his long hours at the hospital that apparently the nurse didn’t understand? I bet she did. Oh, and they were always women, nameless women who didn’t understand the pressures on a rising neurosurgeon resident. My feminist heart didn’t like this one bit.

I appreciated how he let his patient’s be fully realized people in his mind. I find that is the best way to approach a patient. As if they are people too, not just a problem for him to do surgery on. This I liked.

But I kept thinking how one note the nurses were. In fact the only named women are his co-resident, his wife, and his oncologist. Otherwise they were referred to as the relation to him and his wife and his family. No, thank you.

I stand by my first impression of the book as a memoir of residency. That there were better instances out there. Even as a memoir of his death I give it an 8/10.

Would I read it again? Yes, and I have.

Would I shelve it on my bookshelves? Yes, and I have.

Would I recommend it? Yes, as a book on dying.

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.

Best Kept Secrets of the OR #25- Conference edition

I am an introvert who is also quite shy. That is a double whammy when it comes to being engaging in large groups. Especially people I don’t know. Even people I probably will never see again in my life.

That being said conferences are particularly hard. It is best that I am rested. Not well rested, this is a hotel that I am most likely staying in with its vagaries in bed comfort and light levels. The hotel that I just stayed in had a night light in the bathroom with no door to the bedroom. Low levels of light all the nights. Which isn’t exactly conducive to sleeping.

The operating room encompasses so much space in nursing. Goodness knows that the department encompasses a pretty big majority of the operating revenue. Goodness knows that running an OR is a very very very very costless enterprise. Never mind the human capital, the outlay for supplies and equipment is immense.

That being said, conferences are important. Not only to meet the people who are like minded and that you have loads in common with, but also to share experiences across the board.

Did I have fun at the conference? Sure. For a value of fun.

Was the conference exhausting? You bet. I suffered a fall at work just over two weeks ago and my left lower leg, knee to toes, is such pretty colors and shades of purple. The hotel was half a mile from the convention center and I walked it every day. Well, I limped it.

Except the morning it was raining too hard to contemplate it. This was also the day I was to do a poster presentation of my pilot study that I completed last year. The one about the pre-Wheels out behaviors of the operating room. So I had makeup on.

Every night I peeled off the compression socks and elevated my foot/leg. But the pain was worth it for the opportunity to present my own research and talk with the chapter that I belong to in the organization.

I made sure that my carry-on was mostly empty. Because conferences give out a lot of swag. By that I mean that conferences give away paperwork and pamphlets about their products. There is also a certain amount of toys and soft things that are given out. I don’t collect a lot of the pens that these companies give out but I pick up a few to give away to my coworkers.

The majority of what I bring back is education that I learned. I get to impart to my coworkers the latest and the greatest of nursing knowledge.

I also collected many colleges so that I can curate a binder for shared governance and to share it with, again, my coworkers.

The thing about conferences is that you are at the mercy of the weather in the host city. We were in Boston and it rained every danged day except for the day we arrived. That day was beautiful and showed off the city well.

School Me Saturday 3/29/25-Suddenly, all at once

Spring Break is over. I hope you had fun because now is when the real work begins.

But, Kate, I’ve been working hard all semester, in all of my classes with readings and lectures and papers and quizzes and tests.

Oh my.

I know. Trust me, I know. But think of Spring Break as the 7th inning stretch.

Yes, I know that I am mixing my metaphors here. Or I will be very shortly.

The end of the semester is barreling down upon us. Which means the projects that most classes have been working toward for weeks will be due soon.

This makes students panic. Knowing that there is a large amount of work to be done and a suddenly, all at once, finite amount of time to cram the work into.

Don’t panic.

Of the several universal truths from The Hitchhiker’s Guide to the Galaxy by Douglas Adams, the most important is DON’T PANIC.

You see if you had read the book, you’d be at least smiling now..

Another universal or, in this case galaxial truth, cheating is not the answer. Just ask Zaphod Beeblebox, the hapless leader and President of the Galaxy. Because 2 heads are not better than 1.

The biggest takeaway from the book is that it is not the answer that matters. Anyone can give you an answer, especially since AI has entered the chat. Anyone and anything can give you AN answer.

It is knowing that the answer is not the right answer is where the true learning begins.

Deep Thought spent several millennia thinking on the meaning of life. Their answer was 42. And it did not expound on what is the meaning of 42. To be clear, the meaning of life and the semester is not to get a 42. By any measure that is a failing grade.

True learning is not knowing the answer to the random question but WHERE and HOW to find the answer. Because that will survive the memory reset that so many students do at the end of the semester.

That is what the professors want you to know.