Waiting and Watching

When you live in the hurricane prone areas of the US, one of the things that you learn quickly is that the Weather Channel’s Jim Cantore has an uncanny skill in predicting where a hurricane will make its presence felt, then doing live broadcasts from that spot in the days leading up to the hurricane making landfall. The last thing you ever want to see is Cantore standing in front of a camera in your neighborhood.

It turns out that Jim Cantore is doing his reports from Clearwater Beach tonight. As for me, I usually have a lot of supplies and don’t need any. Still…

So keep an eye on the hurricane (now a tropical storm) as it approaches. The 1700 report just came out, and the storm has slowed its approach since I last posted. We should have been, based on Friday’s reports, been at 48 hours out from storm conditions this evening. Instead, we are now supposedly looking at the center coming in between Cedar Key and Horseshoe Beach sometime on Thursday night as a Major Hurricane upper end of Category 3, or the lower end of Category 4.

What is significant about this path is that it places northern Central Florida on the east side of the storm, which is the ‘dangerous’ side. This is the side of the storm where most of the wind field, rain, and tornadoes are found. At any rate, we are in a good spot for avoiding the worst of it, simply because we are dozens of miles from the Gulf of Mexico. That means we will avoid most of the bad parts of the storm, but will still be looking at hours of winds in the 40-60 miles per hour range, as well as rain of a foot or more.

Storm strength is in categories, which is set by wind speed. An increase of one category increases the pressure on your house by a factor of four. The good news is that the area of highest winds is near the center. The bad news is that tropical storm force winds extend out for hundreds of miles, as does the chance of tornadoes, and the large amounts of torrential rain.

So if you want to evacuate, do so now. If you wait too long, you can find yourself stuck in traffic. If you must evacuate after the rest of the thundering herd has taken to the roads, you might think about wanting to head the opposite way from the rest of them. For example, heading south. That is a mistake, because Florida will institute a plan called “contraflow” where both sides of the highways leading away from evacuation are used to move people in the same direction, making travel in the other direction impossible. I expect Hurricane Watches will go up in the southwestern parts of the state tomorrow, and evacuations will be announced at that time. Once that happens, people will start losing their shit.

Having worked as the shelter medic at multiple shelters during my earlier career days, I will tell you: don’t go to a shelter unless you’re told to evacuate and have no other options. Shelters aren’t fun, and they’ll be at capacity. They are packed with dirty, smelly, and sick people that are not pleasant to be around. Many of them are drug addicts. Avoid them unless you have no other choice.

While forecasts at day four or five are a coin toss, the accuracy begins climbing rapidly when we look at the 2-3 day timeframe.

If you are anywhere on the Gulf Coast between Biloxi and Miami, I would recommend keeping an eye on this for at least the next couple of days.

Me Medical News

The Effect of Cost Cutting

Five days ago, I posted about the hospital where I work trying to save money by cutting out the shift bonuses that were being used to entice the staff to work 50 and 60 hour workweeks. Today was the first day where I worked and there were no overtime people. Where a 50 bed ED normally needs 14 nurses to operate? We had 10 for most of the day. Meaning that we should have 5 patients to each nurse.

Nope, we were too busy for that. We tried to tell EMS agencies that we couldn’t take any more patients (it’s called being “on divert”). It didn’t work. At one point, we had 90 patients. For ten nurses.

I work a swing shift, which is supposed to be 11am to 11pm. Most of the ED works 7-7. By 9pm, my patients were:

  • A 37 year old female who kept having seizures. She had 6 of them the first 2 hours she was my patient.
  • A 26 year old male fentanyl overdose.
  • A 76 year old with a bowel obstruction that is vomiting coffee grounds.
  • A 35 year old who came to our facility two weeks ago complaining of chest pain and went into cardiac arrest. He is complaining of chest pain and has elevated troponin levels.
  • A 78 year old woman with perforated diverticulitis.
  • A 56 year old intoxicated woman who is with us for altered mental status and is covered head to toe in her own feces.

For those of you who don’t know, most of those patients need to be in a unit that offers a higher level of acre than what we can provide in the ED. The problem is that all of those units are already full.

In the meantime, there are 22 people in the waiting room, waiting for us to have room to treat them. At one point, there were 7 ambulances lined up at the door, waiting to drop off patients. So I wound up ordering Wendy’s through DoorDash at around 8pm, and eating it at the nurses station while I wrote notes on patient’s charts.

Needless to say, everyone was getting testy, patients AND staff.

As 11 o’clock approached, the charge nurse asked me to hold over because we still had more than 60 patients, and three of us were scheduled to go home at 11, which would leave her with no techs and only 8 nurses. Because I like her and she always does me favors, I agreed to hold over for a couple of hours.

Right at 1, when I was planning to go home, all hell broke loose. An intoxicated woman was brought in by EMS, who claimed they were unable to get an IV. Ten minutes after they dropped her off, she vomited about a 1.5 liters of blood.

So a third of the remaining nurses spent the next 45 minutes trying to keep her alive. All of their patients were getting ignored in the meantime.

One nurse remarked, “As long as we keep doing this, they will keep making us do it, until it becomes the ‘way we have always done things.'”

I finally left the place at around 2 am, having worked a total of 15.5 hours. But think of all the money they are saving by not having to pay those bonuses.


Today is Action Day

If you are anywhere on the Florida peninsula, today is the day where you need to decide what you are going to do to prepare for this storm. It’s tough to do, because we are still 4 or 5 days from landfall, meaning that the cone covers virtually the entire state of Florida. Will you evacuate? If so, to where? Will you prepare to ride out the storm? What you decide will depend on your own unique situation.

If you are a tourist in the Keys, for example, get out. There is no reason to stay. All of the tourism businesses are going to close, so there will be nothing to do. Why risk it?

If you live in the state, make a plan. Use the Florida evacuation zone maps to guide you. Staying put in a home on the shore in the face of a hurricane is a pain in the ass at best, and dangerous at worst.

Me? I live dozens of miles from the coast and I don’t live in a flood zone, so storm surge and flooding aren’t an issue. Wind, having to live without power for up to 2 weeks, and possible tornadoes are. So for me, I don’t even consider leaving for anything less than being in the direct path of the core of a Category 4 hurricane. If you do decide to leave, do it early. If you haven’t left by 48 hours before the hurricane is due to make landfall, you risk being trapped in traffic on the road as storm force winds approach.

This is forecast to be on the low level of Cat 3, or the upper end of Cat 2. So I am staying put. My three day checklist is done. One of the items for the day that many overlook is data. If for some reason your possessions are destroyed, the one thing that is most difficult to replace is data. Make sure that there are scans and backup copies of personal data: your driver’s license, professional licenses, birth certificates, bank information, etc. I used to put them on a thumb drive that was encrypted by True Crypt, but that software has been discontinued. I do not yet have a recommended replacement.

My suggestion would be for the people who invented the ransomware that attacked me in 2020 to write some encryption software. No one can crack that shit, so go legit and make a pile of money. Anyhow. BE ready.

For now, I am off to work.


5 days

As of this morning, all of the Florida peninsula is within the 5 day cone of a potential major hurricane.

Now if you have been watching these sorts of things for any amount of time, you know that the 5 day predictions of hurricane paths are about as accurate as a coin flip. The hurricane is as likely to hit here as not. However, it is still prudent to keep an eye on things. Even a 40% chance of disaster is worth keeping an eye on.

So I have a well used checklist for hurricanes around here. At 5 days, we do the following:

  • Retrieve extra fuel and water containers from storage.
  • Ensure that there is a good supply of batteries.
  • Check the yard for loose debris.
  • Since you can’t run a genny during a hurricane, you need chemsticks for light when the power is out. Safer than candles and more reliable and useful for general light than flashlights, you can get them for less than a buck apiece. Make sure you have plenty.
  • Watch the storm updates as they come out every 6 hours: at 0500, 1100, 1700, and 2300.

It’s important to remember that the predictions of the hurricane folks are for the center of the hurricane. Tropical storm force winds are located far from this point. For example, in the case of Hurricane Fiona, the latest forecast shows 35 knot (40 mph) winds extending 290 miles to the northeast and 350 miles to the southwest of the center. Since the storm is moving at 35 miles per hour, damaging 40 mile per hour winds can be expected to begin 10 or 12 hours before the center arrives. If the above prediction cone is correct, we can expect the onset of heavy winds to begin on Tuesday night, sometime around sunset.

What this means to those of us in Florida is that the five day cone is really a 4 day warning of storm conditions. That means my three day checklist would have to begin tomorrow evening, except I am working tomorrow. That means I will have my wife get some of it done.

The pre-event checklist will need to be complete by Tuesday Morning. We haven’t had to prep for a hurricane since Labor day weekend 2019, and that one was a bust. The last storm we had here was Hurricane Irma in 2017, and we were without power for about 4 days.

Race baiting

Dangerous Road Rage

Check out this video from Dade county, Florida. I was going to make this post about using force, but the left as usual made it a racial discussion.

The comments saw someone saying this would be a legal use of force against this road rager. The exchange went like this:

You are easily wrong, his life unfortunately was still not in danger yet..the last thing you wanna do is take someone’s life away when you are still in your car an can drive away.


The law in Florida doesn’t require you to drive away. What he is doing here is a forcible felony and a person may use lethal force in self defense.


This is not a crystal clear case and certainly if the guy behind the camera were Black, the prosecution (and the judge) would have been less likely to give him the SYG benefit of the doubt. Studies have shown SYG works more often to the benefit of whites.

Anti American left

Embryology is Science

A member of the party of science ™ has spoken:

Post conception:

  • Day 21 and 22: Single heart tube and pericardial cavity forms
  • Day 23: Heart tube grows rapidly, forcing it to fold on itself
  • Day 25-28: Atrioventriculobulbar loop, common atrium, atrioventricular canal, early embryonic ventricles all form
  • Day 28: Heart begins to beat, ventricular septum appears as a small ridge in common ventricle
  • Day 29: Pulmonary veins form
  • Day 31: Atrioventricular node develops
  • Day 33: Tricuspid and mitral valves form
  • Day 34: Sinoatrial node develops
  • by Day 35: Four-chambered heart forms
  • Day 42: Coronary arteries and Inferior vena cava form

They can’t agree on what constitutes a man or a woman, and they ignore well understood science, but they claim to be the party of science.


Nuclear Blundering

Putin warned NATO that threatening the integrity of Russian territory will result in a nuclear response. He accused NATO of nuclear saber rattling, which the linked article is denying.

Biden responded to Putin’s statement by antagonizing Russia even further. “No one threatened Russia and no one other than Russia sought conflict,” Biden said. Except that is false.

Biden alluded to the US using nuclear weapons before when he advised Putin not to use nukes now, saying: “Don’t. You will change the face of war unlike anything since World War II.”

Not that the F35 is certified to carry nuclear weapons, the US raised Russian concerns by basing B61 bombs in the UK, joining the 150 B61s already in the European theater.

The MSM is excited at the prospect as Biden claims Putin is bluffing.

Emperor Poopypants is going to blunder us into a nuclear exchange over a nation that the US has no national interest in, beyond the grift enjoyed by government officials.


Dead Laptop

I’m typing this post on my phone. My laptop is a Dell that I bought in April of 2020. I started having problems with it about 2 weeks ago. The battery charge level was falling even though it was plugged in. I got a low battery warning and the “unrecognized charger” warning.

I ordered a new charger and that seemed to fix it.

For about a week. Then it began again. The battery level would drop even when plugged in. Eventually it said 0%(plugged in) even after charging all night.

The computer finally died and won’t restart. I ordered a new battery. It is supposed to be here today. I hope that fixes it. There were some files on there that I hadn’t saved to the home server that I don’t want to lose.

At any rate, blogging will resume when I have a computer.

War on the Right

Just Following the President’s Orders

You won’t see this getting much coverage in the MSM, but in North Dakota, a 42 year old Democrat murdered an 18 year old man. What makes this noteworthy is that the murderer says he killed the victim because the victim was “part of a Republican extremist group.”

Listen to what they are telling you. Never forget what the President said:

The MAGA agenda represents an extremism that threatens the very foundations of our Republic.

It doesn’t respect our Constitution.
It doesn’t believe in the rule of law.
And it doesn’t recognize the will of the people.

Open warfare edges closer. Those on the right are being attacked and killed. The right is not yet responding.

economics Me Medical News


Last month, I mentioned that the hospital where I work is bringing Philippino nurses in to fill vacant positions for less money than hiring Americans. There is more news on that front.

We have been short staffed for nearly three years. They have made up the shortfall by paying huge bonuses to get nurses to work extra shifts. They tried foreign workers. Still, they don’t have enough. Determined to save money now that the COVID funding has dried up, hospital administration announced on Saturday that there will be no more bonuses offered. Once the shifts that are already promised bonuses are paid out, they will be no more. Nurses who were making $2500 a day for working a 12 hour over time shift are now being asked to work the same overtime hours, but for $600-$900 each 12 hour shift.

I know that I was working 60 hours or more a week. I was making good money to do that, but now that the money has dried up, I am not working those kinds of hours for a fraction of the pay. No one that I know is willing to do that.

So now the entire staff of the ED is not taking any extra shifts. They are working their contracted hours, and that is it. Me? My contract says that I have to work 4 shifts a month. That is all I am doing. Everyone else is doing the same. So now the hospital is even more short handed.

Here is what was texted out to us this morning by the ED department head:

Hello team
We know this week has definitely had its ups and downs already and we appreciate all the hard work done by everyone. While we all fight this same battle we still have patients who are expecting the best care we can provide.
Starting tonight through the weekend we could use anyone on any shift to assist your fellow team and patients.
Please any help is appreciated.

As if guilt tripping us will get us to work all of those extra hours for a third of what we were making before. I want to help my patients and coworkers, but at the end of the day, this is a financial arrangement. It’s business.

So now the hospital is getting desperate. A third of the ED beds were shut down today for lack of staff.

The hospital where I work can only fill itself to somewhere near 60% capacity because they don’t have enough nurses, and that was when people were working extra shifts for bonus money. That means that patients often stay in the ED until there is an open bed on the inpatient floors. Our ED is frequently more than half filled with patients on “admission holds” awaiting beds. Couple that with the fact that the ED is also short nurses, and you have a problem.

Picture a 50 bed emergency room. To staff a 50 bed ED takes 14 nurses, 4 paramedics, 4 general technicians, 3 doctors, a nurse practitioner or PA, a respiratory therapist, secretary, three registration clerks, two lab technicians, three radiology techs, and two janitors. Every shift.

Now picture that you only have enough nurses for 10 per shift. Now you can only handle 40 patients at a time instead of 50. Now also picture that you have 30 admit holds, taking up beds and waiting for an inpatient bed- some for more than 48 hours. Now you can only handle 10 patients because your staff is busy caring for holds. So the waiting room backs up.

This means you have people sitting in the waiting room for 4, 5, or even 6 hours as they wait for treatment. And all of that was happening before you cut off the bonus money.

Now instead of 60% staffed, you are more like 45% staffed. Instead of 10 nurses, you only have 7. Now picture that across the entire hospital. A 600 bed hospital with a 50 bed ED requires 100 nurses or more each shift. You only have 50 or 60. Now what do you do? There aren’t enough foreign workers to fill that many spots.

My hospital can’t be alone in this. Here is the warning: there is a potential collapse of health care coming. It takes 3 to 4 years to train a nurse to the point where they are licensed, and another 2 years or so for that nurse to be proficient enough in their job to staff an ED, even longer for places like the ICU.