25- 29 ways

The post-it reads “29 ways to make it to the hospital”.

This is, of course, in the reference to the Marc Cohn song 29 Ways to Make it to My Baby’s Door. Yes, the same Marc Cohn who sang Walking in Memphis. Both songs are from his debut album in 1991.

Marc Cohn was the first bar concert I ever saw. I want to say it was in 1996 and in a small bar in the college town near where I grew up. Between 1993-1996

In the song, the protagonist lists off the ways he can make it to his baby’s door. Near the end of the song he sings that if she needs him real bad, he can find two or three more.

I know that people already think that I have an unnatural attachment to the hospital. I don’t, I swear. I do have an unnatural attachment to work, though I am trying my best to overcome it.

But I was thinking of mass casualty events when I wrote this post-it. Probably after one of the hospital shootings we’ve had nationally for a lot of years. Or being the second runner up to Oklahoma City when I was at Creighton. If that is even true, we talked about it in clinical just after it happened.

However, if the hospital needed me in a hurry, and they have, I could get to it, at night, in less than 5 minutes. This depends on hitting the lights right and no traffic.

However, I thought about it and counted the many ways I know how to get to the hospital during the day. I counted at least 10. And I only live 3 miles from the hospital.

Those are the 10 that I have found. There is probably more.

It just depends on how badly they need me.

And the traffic lights.

Tuesday Top of Mind 3/4/2025- The real tragedy of modern times is being afraid of the light

The proper quote, attributed to Plato, can be summarized by “The real tragedy of life is when people are afraid of the light.”

The PhD student in me knows that this is a reference to Allegory of the Cave. Also by Plato.

In the cave the only perspective is that of what is projected on the walls. What you see projected on the walls is entirely left up to your own experiences.

For example, if a republican was attracted to a drag queen they would question their manliness and therefore be afraid of drag queens exposing their secrets. But they can’t be afraid of something so silly, so they hate it. Worse, they teach others to hate the shadows on the wall of the drag queen as well.

Oh. This argument got a bit away from me. I don’t mean to point fingers, but if the pattern on the wall fits…

The Allegory of the Cave is also about truth. It is a warning not to take the easy path and believe everything your eyes tell you.

Or believe what the voice on the television or podcast tells you.

Critical thinking is a must, especially in these times when the wrong voices and the wrong actions are vying for our attention and our belief.

In simpler terms and the phrase I remember hearing or reading as a child, that what you hate is something that frightened you as a child. Instead of another person just trying to live their life, they are hated as other.

Well, going back to the cave, who decides the other.

And, more importantly, why do we listen and sometimes blindly follow the hatred that is spoon fed to us in increasing amounts? Perhaps in the hopes that we will drown in filth and be reborn hating the things that caused us to be drowned. Instead of real fear of those who drowned us.

To make light of it, perhaps they were frightened by a drag queen as a child.

As Master Yoda says, “Fear is the path to the dark side. Fear leads to anger, anger leads to hate. Hate leads to suffering.”

Don’t walk the dark path.

And don’t believe what other people are telling you about the shadows on the wall.

They may get something out of frightening you.

Tuesday Top of Mind 1/21/25- Limbering up the “NO, I don’t think so” muscle

Warning: this might be a VERY SWEARY and a VERY CAPS-LOCK post. Or not. Behave accordingly.

Somewhere not very far from where I am, about 390 miles give or take, is a man who has never heard the word no and not reacted like a spoiled, entitled brat.

To parody the meme, “Someone has never been told no and sent to bed without supper and it shows.”

Has anyone ever told this man no and slapped his hand while he was reaching for something that wasn’t his?

Strike that. I am sure that plenty of people have. He has the guilty verdicts to show for it.

Has this man ever had to face the consequences of his own actions? I would hazard a guess at that. And that guess would be no.

It helps to know that the crap that is going on in Washington D.C. amounts to nothing more than a tantrum.

A tantrum from a spoiled brat.

I just feel sorry for the people who will be hurt/killed/smeared out of existence by his very presence where he is. For the people who will lose their healthcare coverage, or their right to exist as they want to. The group that I am afraid will suffer the most are the women. I am lumping in ALL women, be they born female or not.

We are facing a very dark and dangerous future.

Because we as a nation told this spoiled man-child no.

How dare we?

And then we went and fought the pandemic that he mismanaged.

Inflation sucked, yes, but it sucked WAY harder in other countries who didn’t enjoy our “soft” landing.

Greed is the rot and the root of all the challenges that everyday Americans have lived with over the last four years. Corporate greed, individual greed, billionaire greed. Billionaires who are not content to have all the toys in the sandbox but instead demand the sand as well. Normies like you and me can play in the dirt. Until they want that too because we are surviving without them and that IS NOT in their business plan.

Today I am just going to breathe. I am not going to react, I am not going to rend my clothes or pull my hair, or do something rash.

What I am going to do is breathe and document. Just like a nurse in an emergency should.

I know I’ve written about my first ACLS teacher, the beginning of my first ACLS class, and her counseling us that the first thing to do in a code is to take our own pulse. This is to check in with ourselves and remind us that there is a patient who is dying in front of us, and we have to do something about it.

This is our code, Democracy and the America that I love is dying in front of us.

Take your pulse, check in with yourself, and get ready to resist.

Because he has been told no once, time for him to hear it a whole bunch of times. From every corner of the country. Together we can drown out the sycophants and cultists that, until now, have been shouting louder.

Bullies try to silence those who stand up to them. Have you ever considered why? If our voices didn’t have power, they wouldn’t try so hard to silence us.

As I tell my coworkers, if they are afraid to speak up call me and I will. I will absolutely yell back at the men in power, real or imagined. Tell me if you want me to be louder because you can’t. I don’t even need a reason to raise my voice.

See if I don’t.

I know how to use the word no and I am not afraid to use it.

Grieve if we must. I certainly understand the impulse but we also have to be ready to counter moves by the administration. Bought as it was.

Dispatches from the Evening Shift Disclaimer Sunday 1/11/25

I usually do this on the first day of the year so I am a little tardy this year.

Happy New Year!

Let’s get down to business.

Every year I write this disclaimer. And add to it. And tweak it. And if I knew how to pin it to the blog start page, I would.

I began writing the yearly disclaimer to be able to point to my posts and say, see nothing to give away the patient here. You know, HIPAA. In case the corporation, that I work for and discuss my blog openly in meetings etc., tries to tell me I cannot write this. Not that they have, but I can believe they would.

I believe in protecting patients’ and staff’s privacy.

I do not include details that make it clear or easy to figure out which patient or staff member I am talking about. If I am talking about any.

I do not use names. And if I do, they are changed.

I change ages. I change gender.

I change details such as which limb is fractured. I change details such as which surgery is performed.

And the cases that I do talk about obliquely are changed in how time is perceived as well. The cases/people/staff may not be the same at the time of the surgery.

I definitely change aspects of time. By that I mean there is no relationship between the moment I write the post and the actual events that prompted it.

Some of the stories aren’t even mine, but even they are changed so as to be unrecognizable.

That being said, I change a lot.

So that, if you knew where I worked, you could not figure out who I was writing about or when.

I discuss issues that impact healthcare broadly.

And, after the events of the two past years, issues that impact women’s health. There has been a LOT to unpack here.

And covid. Can’t get away from covid. XEC is the newest variant and it is currently causing over 50% of the cases. People continue to die; not that we know it because they stopped keeping track years ago. And there is a new game in town, or should I write games. The bird flu that has made the jump to infecting and killing humans, and the human metapneumovirus which isn’t new but is making noise in China.

I do swear sometimes. But mainly to make an emphatic point.

I write themed days. Post-it Sundays which are from notes to myself, usually on a Post-it or a gown card. Monday I take off. Tuesday Top of Mind is the most political day of the week where I write what is weighing heavily on my brain. Wednesdays had been a free day that I wrote exclusively about OR things. This has morphed into the Best Kept Secrets of the OR where I divulge the secrets of the OR. Cookie Thursday is a Thing is where I write about the cookies I make for the department. This is a long-running morale project in the OR of homemade cookies or candies are brought in around 1400. This started as an evening shift things and remains so. FFS Fridays is the newest day that I write about things that begin with F, F, or S. This is the day that has the most swearing and I started it as a reaction to the 2024 general election. Buckle up, it’s gonna get weird. On Saturdays, I write about being an adult learner.

Phew.

I may miss a day here or there because 6 days is a LOT, even if the blog posts are shortish.

This month marks 10 years of Cookie Thursday is a Thing! I had no intention of baking cookies for so long, but it gives me a handy bookmark for my week. I also theme the months and this month’s theme is Favorites. Along with the departmental favorites, I also tell a story about CTIAT.

School Me Saturday 12/21/24-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.

Post-it Sunday 12/15/24-Napoleon who?

The post-it reads “The shortest surgeons are the biggest assholes.”

That could be the complete post right there. It is truth. If we have all decided that this is truth, we have to unpack it a bit.

The question remains what level of asshole.

Because, yes Virginia, there are levels to asshole. It is nearly Christmas and that IS a Christmas reference. It refers to the 1897 editorial where Virginia’s question is answered.

There is the instrument-throwing asshole. These are the ones who decide that the instruments are not up to snuff and they are tired of complaining about it. Hence, the throwing of the instruments. This is also one of the angrier assholes.

There is the globe-trotting asshole. These are the ones who absolutely, positively need to add on a case and the case has to be done as soon as possible because they have a plane to catch. Do they really? Or is that a handy excuse.

There is the gotta make dinner with the spouse asshole. These are the ones who swan up an hour late and try to get finished with surgery in time to meet their spouse at a restaurant. This is a close cousin to the globe-trotting asshole.

There is the deity’s gift to surgery. These are the ones who decided that the rules do not apply to them and they can absolutely jump the add-on line. After all, do you not know who they are?

There is the my father will hear about this asshole. These are the ones who followed in daddy’s footsteps and became a surgeon. They are a short step away from deity’s gift to surgery type but there are enough of them I decided they needed their own subcategory.

There is the operate on holidays because they are a miserable bastard asshole. Yes, I’ve worked with one of these. They were not religious and called us out on every, single holiday, especially Christmas. And 4th of July. And Memorial Day. And Labor Day. And President’s Day (this is a real holiday in California). And Thanksgiving. And New Year’s Eve. And New Year’s Day. Why they were on call every danged holiday, I don’t know. At least we were guaranteed call-back pay.

There is the too smart for this room asshole. These are the ones who are convinced that they are the smartest one in the room. We’ve all worked with this one. They delight in the “Well, actually” put down and mansplain or womansplain or theysplain the ENTIRE case.

Of course, there are exceptions to every one of these categories. Sometimes a short surgeon isn’t an asshole, sometimes a surgeon really does need to catch that flight, sometimes the spouse will leave them if they are late one more time because they have been taking care of patients, but sometimes they are just assholes. No matter their height.

School Me Saturday 12/14/24- CV reminder

A CV is a curriculum vitae. It is beyond a resume, which may cover a portion of your working and school life. The CV covers all the amazing things that you got to do, not only in your working life, but in your schooling life.

Writing your CV is important. It shows the ways you’ve changed in your working or schooling life and it also shows ALL the things that you’ve done in those lives. These can be awards, committees that you are on, or organizations and certifications that you have.

If you are still at school ask the writing center for help crafting your CV. Do not raw dog it like I did.

Just like you have a current and up-to-date resume ready to go at all times just in case, you should also be looking at your CV and adding things that you’ve done.

I recommend doing this yearly. Or when someone asks for it. I have several saved on the cloud, each named with my name and the year. But, Kate, why keep the old ones? Sometimes you want to reminisce who you were before all the work.

Personally, I update both the resume and the CV every year after I submit and receive confirmation of the clinical ladder. Seven years I’ve been a level 5 at my hospital. That is an accomplishment that makes me proud.

I was polishing my CV for a project not related to school or work when I realized there is a big chunk missing. I was a subject matter expert when the hospital system I work for was building out their EPIC. This means that I gathered with a bunch of other OR people and we hashed out the bare bones of what the EPIC should look like. I went back to the training computers when the build was complete and EPIC ready to release the system’s version to us so I could train other nurses and be the superuser for the surgeons.

The surgeons have never forgotten that I am the point person in the department with EPIC issues. It’s been 13 years and I still field questions regularly.

This was no where on my CV. Of course I had to add it. I also added the part about the subject matter expert and I also updated the non Dispatches from the Evening Shift writing that I do.

The moral of today’s story is when you get invited to do amazing things don’t forget to put it on your CV. Doing so shows that you are willing to take risks and also be involved in the hospital’s affairs.

Today’s homework is to bring up your resume and read it for completeness. Also get started on your CV. Be aware that this may take several passes. But it is so worth it.

Even if the only person you amaze is yourself.

School Me Saturday 11/2/24- minding your p’s and q’s and citations

As an adult learner, I have had to unlearn and re-learn so much.

I write unlearn because I picked up some bad habits when it came to writing essays as a high schooler. I would spend a lot of time thinking about the essay that was due. And then I would research what I had to do. I would finish the book if it was a book report. I spent a lot of time thinking about opening hooks and sentences and essay structure.

I still do a lot of my writing in my head. Even during my fourth degree. I am unsure why this is the way that I have worked, am working, and will continue to work.

Writing is my favorite, after all.

Much better than math. Or statistics. So many statistics classes. I am not sure if I’ve shared this before but I decidedly do not have a math brain. At least not a higher-level math brain. I mean, simple math, algebra, and even geometry are doable. But beyond that? Anxiety city.

This was supposed to be a post about spelling and citation errors.

Apparently, I am not in the mood.

Spelling errors and citation errors will tank your grade because at the collegiate level, they include that in your grade and absolutely will take points off for errors.

There are many different kinds of citations. Find out the citation style that your program uses and embrace it. Embrace it hard-core. This will only help you.

Also embraceable is the spell check. I cannot stress this enough. Nothing impacts a grade more than using the incorrect tense/spelling/contraction/conjunction in a sentence. It makes your essays hard to read.

As a former editor and a current reader, I can tell you that nothing knocks me out of a written article or paper than a spelling error. Or badly used punctuation.

But nothing gives me more glee than noticing an error in a school document, such as the syllabus.

Typos happen, acknowledge that this will happen to you and go on and write the danged essay.

Just be aware of spelling mishaps, and the stray badly written sentence. Your writing will be better for it.

School Me Saturday 10/26/24-Study Music: yes or no?

This past Wednesday I titled the post “Mister, are you tall?”

This was about one of the songs that I used to listen to at Creighton and my first nursing program. Dr. Demento’s songs made me smile and I found them easy to listen to while learning.

When I was writing the post (which was about height differences in the operating room), I vaguely remembered that there was a height reference in one of the Dr. Demento songs. I was pretty sure the song was “Existential Blues” by Tom “T-Bone” Stankus but I had to relisten to make sure.

This led me down memory lane. So many silly songs. So many not very politically correct songs. It was a great afternoon and I listen to a lot of songs while I was folding laundry. What a great afternoon. I finished folding the laundry and cleaned the kitchen while tripping down memory lane. I remembered some of the songs that I listened to while writing a presentation on 1993 Rawanda or learning anatomy.

The point of this post is to encourage all adult learners to find what inspires them to focus and learn.

There has been interest in recent years about listening. I am writing, of course, of ASMR. Which is defined as autonomous sensory meridian response. If you Google the term lots of information pops up. Some people find it relaxing and stress relieving to listen to.

Those people aren’t me. I find most ASMR content mildly infuriating. Kind of like how I find all stress balls infuriating. So ASMR is not for me.

It might be for you, which is okay.

As an adult I confess I don’t listen to music when I write or study. I am not sure when it got away from me.

On Thursday as I was preparing for a presentation I had to give Friday, I decided to listen to Dvorak. Specifically Symphony No. 9 “From the New World”. I wanted to see if it would work as presentatin preparing music. It is one of my favorites after all.

I found it distracting. I wanted to conduct.

I tried a different classical music, one that was recommended by a writing group member.

No go. My brain kept picking out the repeating parts and it would be jarring when the music didn’t follow pattern.

More evidence that working through a global pandemic and working in ORs for 23 years with its music has changed my brain.

The overall point of this post is to find something that calms your brain and lets you think and learn and write.

This might be silence.

This might be ASMR.

This might be classical.

This might be old TV shows on repeat.

Listen to whatever speaks to you in that moment.

As with so much of being an adult learner you get to choose what works best for you.

I’ll be over here in the office, writing in silence, listening to the taps on the keyboard.

I guess that might be a form of ASMR. And I found a playlist that was entirely cats’ purring. I bet that might work for some people too.

Keep exploring until you find what works for you. It might be dusty CDs from your own high school years.

Dispatches from the Evening Shift end of semester impromptu vacation

The end of the semester can bring up many feelings.

Too often the weeks and days leading up to the end of the semester are busy, busy, busy.

Final projects.

Final papers.

Final presentations.

Yeah.

All of those.

I was gonna contradict myself and say that there were no presentations. But there was one.

I would say the majority of my feelings are exhaustion.

I don’t want to read for school, I want to read for pleasure.

I don’t want to write for school, I want to write for pleasure.

In the past few days, I’ve mostly been reading.

A lot.

Like a lot a lot.

The Women by Kristin Hannah was the first book I read. It is about the forgotten women in Vietnam, the nurses. Oh, so good.

Maddening and tear-jerking all at the same time.

This country did those women dirty.

Oh, and I worked a few shifts in there too.

After my last 10 hours as an RA.

And it occurred just now that I didn’t turn in my last time card.

Oh, dear.

Okay, that isn’t what I said. But drat!

And it was due today.

Bother.

I’ve got to get that in.

Oh, and I’m on my fourth and fifth antibiotic of the Spring. Can I use that as an excuse?

Too late, because I’m gonna.

Tomorrow I will write another Dispatch from Wonderland regarding school life.

I can’t wait to find out what I’m going to write about.

Time card first!