Saturday, March 18, 2017

No snacks.............worth eating

The graham crackers are gone from our Patient Nutrition Snack drawer. In our two ICU's and also over at Trauma and SICU where I visited last week. What's up with that? In my opinion, and I am sure, many other Nurses would agree, Graham crackers and Peanut butter have been a regular option in our Patient Nutrition area, in our "pantry"for nigh, 40 years. Now these items are gone. There was no warning and no explanation from the Dietary Dept, so I'm thinking it was a result of the "higher-ups" slashing costs, just like our knuckle-head in Chief. It's the equivalent of pulling the funding for Elderly Meals on Wheels! If I am ever in the hospital, I won't eat any darn thing on that menu. My mate (or support group) will be responsible for providing me all of my nutritional needs. I'd rather have TPN than any of that hospital garbage (meals). Only the Graham crackers would be acceptable.

Folks know that I never, ever eat anything from the cafeteria. I did it once, about 8 years ago........and very likely had food poisoning. That's 38 years of passing up hospital food.

Graham crackers are gone
What's up with that?
It's not like anyone
Was getting fat,
From a couple little packages
Maybe a one ounce portion,
Human kindness in action
Oh, what a distortion.

No graham crackers
No peanut butter too?,
The whole world is not allergic
Probably not even you,
Plus, the sorbet is missing
Along with ice cream,
Our human kindness menu
Will make you want to scream.

Yep, we're going out of our way
To satisfy your appetite,
When you want a little snack
In the middle of the night,
And all we have to offer
Is pudding and jello.
Plus, an old turkey sandwich
Its color, chrome yellow.

More Items Branded

Our Big Brother agency, is still placing their colors, branding, kindness logo's on everything, except.............the vomit bags. Everybody in the worker force now has their own special color and we are "given" a number of outfits (uniforms) per year, so at least that might be a perk. But wait, there's more; I bet you haven't heard about the Human Kindness Underwear !!!!...........Look for them soon at Ross.

Magical Frog

Diggity branding messages
Even on the soap,
Back when we were CHW
We had soapy Pope-on-a-rope;

But the Pope was excommunicated
And now the suds are alcohol,
With gentle soft emollients
But friends, that isn't all......
Now, you can get two more
With a nail brush, that's no jive,
Six dollars shipping and handling
For nineteen ninety-five.

And if you call right away
You're one lucky dog,
Within sixty minutes
You'll get a magical frog,
But that's not all
We have more to share,
Are you ready for the latest?
Human kindness underwear.

Tuesday, March 14, 2017

Gourmet Thrombus

Do remember, when travelling in planes, trains or automobiles, to stop now and then for a simple walk. Wear support hose, and maybe even take a baby aspirin
(ask your Dr., of course).

Another big story
About a very large man,
How truck driver Bob
Just sits on his can,
Hundreds of hours
Week after week,
He eats far too much
He's an overweight freak.

A heavy tobacco user
He breathes his own second-hand smoke,
Driving the long haul
It's a wonder he doesn't choke,
With the windows rolled up
Like he's afraid of fresh air,
He has nicotine stained fingers
And tar in his hair.

Science has taught us
That long periods of sitting,
Are about as physically demanding
As a knitter at knitting,
In that sit down position
On an airline or a bus,
You have a high risk to develop
A Pulmonary embolus.

One thirty five kilos
Driver Bob, is pretty big.
He stops at the trucker diners
And eats like a pig,
These are not gourmet restaurants
They use the cheapest ingredients,
Lard, salt and sugar
Because it's expedient.

For sure, it satisfies cravings
Big men in 18-wheelers,
I'm not saying their work is easy
But these are heart attack dealers,
Stopping at Cafe' Cholesterol
Fill up their bellies, and refuel the truck,
And if they happen to get sick?
Just call it dumb luck.

Truck driver Bob, had pain
Man, he was aching,
In his legs and his loins
He was practically shaking,
Like that place on his flank
When he had that kidney stone,
But then he waited two weeks
Before he picked up the phone.

He went to Emergency
The man was in dire straits,
His thinking was all messed up
Couldn't remember any dates,
About what exactly happened
And when did it start,
All he knows, he kept on driving
He was in denial; not very smart.

The Cat scan did show
A massive venous clot,
From Inferior Vena Cava
To the Femoral shot,
His legs and his scrotum
Swelled up like balloons,
Plus, he was already built
Like a giant pontoon.

Did I mention that he weighs
One hundred thirty five K,
That's three hundred pounds
In the middle of the day,
About the size of three
Asian, new Grad nurses,
Who are mumbling
Into their iPhone's,
Obesity Curses.

TPA and Heparin drips
In bilateral Femoral lines,
Trying to dissolve big thrombus
Without infarcting his spine,
Absolute bed-rest
Be observant for emboli,
If they migrate to his lungs
Trucker Bob, could easily die.

That would be a memorable
Like doing chest compressions
On a Mini-Cooper car,
Rarely successful
Even in the ICU setting,
Odds makers in Jersey
Are already betting.

Thursday, March 09, 2017

Fake News

Fake news, Part 2. Sure, we in the public have been beat to a pulp with this non-news story of fake news. It has always been around, but now, the concept is being used as a tool for harm.

Consider this "news" that isn't:
I graduated from an accredited Nursing school, in 1983. The school diploma did not specify that it was in Nursing, but rather just an AA degree. The record of my classes though, did identify that I graduated from the Nursing program. The Board of Registered Nursing has believed it, along with the AACN, about 60 hospitals where I worked, yada yada yada. Even Wisconsin issued me a Nursing license ten years ago, and they were really picky.

Imagine my surprise, when some dweeb from Corporate, the one who looks at Point of Care device authorization, apparently caught sight of my nondenominational AA degree, and said to himself, "Hmm, this guy didn't go to Nursing school". After a couple more dull moments, he must have thought, "I gotta inform someone". He fires an alarming email off to HR, my ICU Manager, and a couple others who might care. And finally, a copy came to me, but not from the Dweeb himself. I mean, why bother to ask me in the first place, when I might be the guy who has qualifiable supporting documentation that I am really an RN, that went to a real Nursing school.

Here is a story
Of epic distortion,
How the facts of the tale
Were bent out of proportion,
To present a version of truth
With no hint that it is factual,
We call this false news
And present it as actual.
_ - -

I'm not letting this one slide.


Faked out in Fargo

Saturday, March 04, 2017

GI Prep

I suspect some of you have already had your own ("elective")  Colonoscopy, or you have needed to prep your patient for a GI procedure. You know all about Bowel Prep and what fun it can be; However, in terms of the greater group of our outpatients:............. they are usually stuck with the same old instructions: "Just add water to this bottle. When it is full; if at all possible, drink one 8oz glass of fluid, every fifteen minutes, until the container is empty. this should take you about two hours total. You should be at home when you do this, and you should have a functional toilet for your frequent bowel movements.

GI Prep

There comes a day each week
Where I like to empty out,
Of course, I would share my remedy
And shout that sucker out,
But, if I were to do that
I would certainly lose my edge,
And the next thing you know
I could be hiding under the hedge.

Hedge fund managers
Would be chasing after me,
They want to tap into my secret
Regarding this intestinal evacuee,
It's a multi-million dollar
Investment cycle milieu,
There is a lot of shit to spread around
And it all begins with YOU.

Some things are just SO sensitive
One can't inform the general population,
After all, I could really profit
From bowel medicine exploitation,
No more Golytely preps
With that vague citrus taste,
Whereby, most prescribed users
Will lie about, how much they waste.

It might seem drastic
Regarding what I do,
When I need to promote
Digestive doo doo,
It's a method and a madness
And it really works for me,
If you want to know about it
Step right up, and pay the fee.

I switch back and forth
A cup of tea, a cup of beer,
After four rounds of that
The toilet you will fear,
And after seven sit-downs
Take a glass of purple wine,
Your day will be complete
When you're flowing loose and fine.

There is one more ingredient
I can not mention here,
It may have religious connotations
To rile folks, that's what I fear,
So, if you want the full on Mondo
Just send me twenty dollars,
You will receive the secret Mojo
Known to very few scholars.

We take all major credit cards
Anything debit, that’s for sure,
Food stamps, cash, aluminum cans
Any questions?, read the brochure,
Anything recyclable
Goes to a local buyer,
Together we're custodians
Our Environment, Doth Inspire!

Your G.I. Doc, will recommend
GoLYTELY, for purification,
Do think of us, consumer
For a clean-out kind of vacation,
It won't seem as crazy stupid
As drinking a gallon of soap, 
Plus, you'll get a little buzz
Along with a pleasant sense of hope.

Friday, February 24, 2017

Intra-aortic vs. Intra-erotic

Well, the title tells it all; so be careful with terminology.

Intra-aortic vs. Intra-erotic
A swap of one letter
And timing dicrotic,
Both involving position
Of a foreign body,
Regarding cardiac output
Or your favorite hottie.

Key factors, stroke work
Performance and action,
Attention is paramount
There should be no distraction,
You will achieve the best results
If  you control your design,
Those intra-aortic-erotics
Then, everything will be fine.

Tuesday, February 21, 2017

Bad Investment Part I

Bad Investment

What a classic case
Of non-compliance,
Disguised as defiance,
Anxious, stressed out
About the whole crazy scene,
When his girlfriend came to visit
She brought amphetamine.

Two days pre-op
Aortic valve repair,
This surgeon will cut anyone
That seems to be moving air,
Active drug user?
Sure, that's OK,
Used drugs while in the hospital?
Hope ya had a nice day.

Lives in the bushes by the river
Ya, he's a great candidate,
Cut him open tomorrow
There's no reason to wait,
Are we worried about follow-up?
Well, just a little bit,
He promises to take his medicines
Each time he takes a hit,
With amphetamine, marijuana
And cigarette smoking,
Does this doctor have ethics?
Come on, you must be joking.

He says, I am a surgeon
And that's what I do,
He offered a two week tuneup
Before he cut on you,
Saying that is enough for
A good surgical choice,
No one wants to argue
When he raises his voice.

Some might say
Well, who am I to judge,
That I don't like this doctor
And perhaps I hold a grudge,
But this is public medicine
And all of us are paying,
Take care, this is an investment
That's all that I'm saying.

Bad Investment Part II

Reason for admission? Benzo & amphetamine overdose. Lives on the streets, chronic drug user, and by chance a routine chest x-ray identifies a bulge at his aortic arch. Health insurance? heck no! A CT Angio reveals an Aortic Aneurism at the critical stage........Once the dude gets off the ventilator, becomes somewhat lucid, the multi-disciplinary team (lacking discipline, if you were to ask me) get together with Joe Bob and have the big discussion. Something like this:

Team: Joe Bob, we saved your life and we want to do it again, how about it?
JB:   Uh, ok. Hey, can you get me some dope first?
Team: No, Joe Bob, you're done with that stuff now, forever.
JB:   Uh, ok.........but, can't you just let me roll a doobie now, so I can think it over?
Team:  No, Joe Bob. What we are going to do is let you get clean for a couple of weeks, then we're thinking of sawing your sternum in half, rip open your aorta and put it back together with wires and staples and other shit, and then you'll be all better in about 9 months.
JB: Hmm, sounds crazy. You know, I need to go to the powder room right now.

Over the next two weeks, Joe Bob goes to the parking lot about 4 times, to clear his head. Right; how about for a little snort of Meth!

And that's why he was the winner of an Aortic Valve repair.

Monday, February 20, 2017

Age-Weight Score

Another way to measure up.

Twenty-eight years old
Weighing twenty kilos,
She weighs about as much as
Two boxes of pillows,
Which isn’t enough
To sustain prolonged life,
Hopefully a husband
Didn’t starve his wife.

Whether kilos or pounds
It rarely works out,
If it’s the same as your age
There is reason to shout,
Something is wrong
Almost all of the time,
Forty kilos at age forty
Isn’t optimum prime.

Ninety kilos at ninety
Or maybe, ninety pounds,
In this day and age
Where too much abounds,
Either unit of measurement
Gives cause to investigate,
What is Aunt Betty eating
How much is on her plate?

Protege 2

Here is the sick and twisted sequel to the original "Protege" (December, 2016). This story is pure fiction, but would make for a great hospital whodunit.

Oh protege
Look what you did,
You killed that guy
And then you hid,
But worry not
Listen to your mentor,
When the blame is cast
I will be the dissenter.

I will show you how
To make them look,
Somewhere else
In another book,
To obscure the trail
Of evidence and blame,
This is not the time
To ruin your fame.

Now, there is a pittance
A fee to pay,
So your good reputation
Doesn't fade away,
So early on
In your distinguished career,
Just pay it once
At the beginning of each year.

You won't tell
And neither will I,
What caused Billy Bob
To die,
It seemed natural enough
And it was kind of expected,
But, going out of the window
As if ejected?
That was a tough sell
And you gotta be thankful,
So, pay your fee each year
To keep my bank full.

Oh protege
I knew at the start,
He's the cream of the crop
Clever and smart,
With career potential
Clearly off the charts,
And if you do as I say
You'll be the Master of Arts.


Oh boy, finally we don't have to play dress up in bio-hazard yellow, when we enter the room of the patient with MRSA. Sure, of course, we practice Universal Precautions, cuz that's what we do for everything (especially when eating in the hospital cafeteria). Since I be the achey-breaky nurse, anytime I'm helping with cleanup, I'll wear yellow, because I visit a lot of different patients during my six hours, and thus, I'm a highly developed fomite under power, so to speak.

But here's the real news, once again:

MERSA used to be the thing
Everyone had it, tra-la-ling,
We did isolate and wear the garb
And we poked your nose with a mini-barb,
But now the latest directorate
Says, oh why bother, to protectorate,
If everyone has it, then so do you
Goodbye MERSA, so long, boo hoo.

What this all means, we need a new adversary
To don the gowns and gloves, and act kind of wary,
Until we know the enemy and develop our tools
And someday our descendants will call us fools.