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.

Cookie Thursday 3/28/24-the ApocaPEEP

This is the final week of Well, That Was Easy March. And the week before Easter.

At this time the surgical schedule is kind of hit and miss. It all depends on where the doctors’ kids go to school and where their spring break falls.

This is also the fourth day of my new antibiotic (third one!) and I needed an easy make.

Enter the PEEPS.

For those who don’t know, the peep candy is a marshmallow body that is covered in sugar crystal, with two itty bitty wax eyes.

You either love them or hate them.

Me, I love them. I am enabled in my love for them too.

I long wondered if I could use the peep in a rice crispy treat. And you totally can!

But as I learned in the execution, you have to choose your peep colors carefully. I used what I had; pink, yellow, and blue. Eh, it was all I had. I kind of expected the end result to be gray.

Nope!

Very much in keeping with Dispatches from the Evening Shift and its war tone, where healthcare is a war and we are all on the frontline, the peeps turned out camo? Blotches of pink, yellow, and blue.

Very cool.

School Me Saturday 12/23/23-where I’ve been and new tool for school

Good morning!

I know, I know. I’ve been very light on posts this week. I blame the December schedule and the hours I picked up to help out. I also blame my old computer which had been limping since I received it in November 2022. It was bought new then to replace the older computer that saw me through the MSN. The computer I used for my BSN had completely fried one day, after the BSN but before I started the MSN. My husband says that although the PhD computer had had good reviews when he bought it there were files that were missing in its programming and after about December there were a lot of bad reviews.

I don’t think I am too hard on my computers. If I were, the computers would die from the same ailments, not different ones each time.

I think it is more that they fail me.

The one this computer replaced, the one I had had barely 12 months, started forgetting all my settings and would routinely dump all my information. This meant I was starting from scratch, with a computer that had to be retaught who I was and how to work best for me.

I admit, it was frustrating.

But having lived through my BSN computer dying and losing aaaaaaallllllllllllllll that work on the hard drive I was more strategic about where I saved my work. Once Microsoft 365 came along and made it easier to save on the cloud, and the computers began to be able to sync to others, recreating my school life, and my work life, and my writing life became a lot easier. This meant that I stopped losing school assignments, personal writing projects, and work writing projects each time the computer either died or had a seizure that made it forget me.

Which is the lesson for this School Me Saturday.

Starting over from scratch on a weekly basis is eminently frustrating. And, frankly, a waste of my time.

The lesson for this week is to have to right tools for the job at hand.

This will look different, depending on the job.

Right now this is a computer that can handle my hours and hours that I spend each week reading and making notes on the class readings. Or the hours and hours I spend each week on assignments.

This new computer is trial. Let us see if it will last through my dissertation.

I hope, I hope it does.

Although everything is in the cloud it is still annoying to bring the computer up to speed every time it decides to dump any knowledge I’ve gathered.

Fingers crossed.