Sunday, June 25, 2017

A Mid Year Resolution


Ok, we just had the Summer Solstice, so why not an old resolution?


It is the week after Christmas
And not much has changed,
The patient’s are still alive
Though, the staff is deranged,
The Care Plans are filed
In the garbage, with care,
Because we finally realized
They work best in there,
The walls have been stripped
Of their bright coloration,
Returned to the original
Theme of sedation,
The nurses are groggy
Their hangovers linger,
The doctors all look
Like they’ve been through the ringer.

Now, the nurses get hungry
And search for nutrition,
Only to discover
Last weeks edition,
Of half eaten cookies
Green, white and red,
A few dared to eat them
And keeled over dead,
Too bad, said the clerk
Who handles our staffing,
You won’t get replacements
Then she hung up, still laughing.

All  of a sudden
There arose such a clatter,
As all of the dentures
Began to chatter,
Some silver, some gold
Some, even acrylic,
They chattered in harmony
A scene quite idyllic,
Because the ghost of this Christmas
Can’t exit our floor,
We all ate so much
He’s stuck in the door.

So what the Hell, we’ll be haunted
Till Easter, I’m sure,
Our floor will be famous
For a new kind of cure,
We’ll scare the old devil
Right out of their hearts,
And the ones we can’t cure
We’ll sell them new parts.

A New Year’s resolution
“Let Us Optimize Your Health”,
Be it cure or consumption
So we can maximize our wealth!

Tumbling Dominoes


One could keep reincarnating every 25 years as an ICU Nurse, and find the same old problems. We unleash new names for the same disorders, apply similar drugs, wring our hands, and have the same outcomes. Sepsis, Sudden Cardiac Death, 1st MI.........at least 50% mortality. Folks, when the Grim Reaper comes for you, we're not much help. But if YOU are willing to help....go for it.

She has been here several weeks
And had every kind of tube,
Can you believe, she was admitted
For just a Jiffy Lube,
Her heart was sort of sluggish
And her blood was quite anemic,
And so, like tumbling dominoes
Her brain became ischemic,
Combative and demonic
Obesity berserk,
She started busting up the place
And nearly killed the Clerk.

We loaded her with Midazolam
MS and Ativan,
Enough to kill an elephant
It knocked her on her can,
But side effects are side effects
And some can lead to death,
We finally had to silence her
But we took away her breath,
She earned the ventilator
It was the prize behind, Door  Number Three,
It includes a year of tubing
And a Therapist for free.

Now, her respiratory failure
Brought on Shock and R-D-S,
Why, in just a couple hours
She became a total mess,
Reversible?, it’s possible
But, that’s not the likely course,
We can treat her up the yin yang
But can’t replace her life force,

The woman was a timebomb
Just waiting to explode,
She had multi-system plug up
From a life on lipid road,
Her triglycerides set records
That will stand for many moons,
She had a steady diet
Of booze and macaroons,
Her husband was no better
He paid the grocery bill,
You couldn’t make them understand
This method of life would kill.

Now, lying here before us
Is a body, life supported,
And we’re rushing around like maniacs
Because her heart beat just aborted,
Thus, it seems a little pointless
To apply our super science,
To a person who spent years
In stubborn, health defiance!

Let the dying die


I wrote this, at least 25 years ago; and the issues and dilemma's of dying are still the same. We do make progress, but death must happen.

Time to Give In

What more can we do for this man
Despite all of our science, he’s dying,
We have done all that we possibly can
His family is so anxious and crying,
But alas, the time comes
When it’s time to give in,
To continue the treatment
Would be a merciless sin,
Prolonging the suffering
With no hope of reprieve;
Let the dead go their ways

So the living can grieve.

Monday, June 19, 2017

The Virtues of Floating


Here is a classic from 20+ years ago. Look, must nurses don't want to float off to another unit. They suffer anxiety regarding their skill set, and feel out of place, and worry about what the folks in that other unit might say about them.

Fortunately, since 2012, I have not been required to float.

I like my job now, well enough
But mind you I’m not gloating,
It has a dirty side to it
The multi-unit floating,
By and large the frequency
Is few and far between
But when it’s time to do your stint
It can be a messy thing.

Now, consider this my friend
You’re floated to Emergency,
The last place that you want to be
If suffering from urgency,
The place is non-stop madness
All bloody night and day,
Those nurses must be crazy
Because they don’t get combat pay.

Or maybe you’re more fortunate
And floated down to Burn,
You’ve got some guy with roasted flesh
And you’re afraid to turn,
Him over in the bed, in case
His skin grafts crack or flake,
Because you know that you’ll be crucified
Then roasted at a fiery stake.

Neuro ICU is like
A foreign land to me,
A lot of spinal action
And labile ICP,
The unsedated wild men
Are screaming out in pain,
They were motorcycle maniacs
And now have scrambled brains.

Is floating any better
In the Medical ICU?
Where microorganisms
Stick to you like glue,
Where charcoal spewing overdoses
Ruin all your clothes,
And G.I. bleeding alters
The function of your nose.

The Surgical Intensive Care
Is different in some respect,
The doctors are fanatics
About the drainage you collect,
Specific gravitation
And countless pus filled drains,
Provides ample entertainment
For all their busy brains.

In CCU it’s different
You must take a vow of silence,
The nurses aren’t restrained
But barely stoop to violence,
The patient are well mannered
But sometimes give you crap,
Just charge the paddles to 100
Then, defibrillate their lap.

All in all, the general feeling
To float, I’d rather not,
To save a lot of misery
Why not have me shot,
Or hang me by my fingernails
And whip me with barbed wire,
You’d better find another fool
I’d prefer to walk on fire.

An Apple a Day


I have unearthed a trove of ancient writings..........

An apple a day
Keeps the Doctor away,
But if you’re always pissed
Just see a Psychiatrist,
If your insides hurt in earnest
I suggest a good Internist,
And if your ankle had a twist
Go question a Podiatrist.

If you see your brain emergin’
Find a capable Neurosurgeon,
If your birth control was in omission
You’ll need to find an Obstetrician,
Should your bladder leak, oh, golly gee
You ought to see Urology,
If your busted femur needs a rod
You’ll need to visit an Orthopod,
And if you suffer from seismology
You better go to Radiology.
_ _ _ _ _ _ _

To Buy a Cure

I drank a lot of alcohol
And blew a lot of smoke,
My liver said, the hell with this
And my lungs began to choke,
My heart is doing double time
And my renal function is poor,
Oh, if I had a billion bucks
I would try to buy a cure.

My bones look like Swiss cheese
That I used to eat on rye,
The ultraviolet rays I worshiped
Wrecked my one good eye,
My libido was revoked
And my sex drive was recalled,
Because, when I raced my engine
It overheated, then it stalled.

The flukes in my intestine
Are thirty meters long,
While a host of other viruses
All sing a little song,
Hail, hail the bugs are here
Crawling in my belly
Coming out my ear,
Hail, hail this guy is dead
What the Hell do we care
As long as we’ve been fed.

And thus, my body fails me
I can feel the hangman’s noose,
I wonder if there is a connection
To this lifetime of abuse.
_ _ _ _ _ _ _ _

Jamming on the Joules

She died, she died
There’s no denying it
We tried,
To save her broken body
And fix her busted heart,
We tried a lot of crazy things
But couldn’t make it start.

We gave her Digitalis
Some Quinidine and more,
Dobutamine and Dopamine
And even Inocor,
A trial run of Nipride
To reduce her afterload,
But she bottomed out her pressure
On the rollercoaster road.

She had total akinesis
With a low ejection fraction,
And to complicate these matters
Had arrhythmia distractions,
At first we gave some Lido
Then Pronestyl and the joules,
She was jamming on 360
As if to say, You fools,
For every problem that you treat
I present another three,
Because the Reaper is standing at the door
He has come to set me free.
_ _ _ _ _ _ _

Humble Student

Talking about conduction
Regarding the upper and the lower,
The former is the faster
And the latter is the slower,
See, sometimes there is a stimulus
Lost in its own travels,
And before you get a chance to breathe
That impulse just unravels.

It can follow any pathway
If the guidance system is shot,
If you fail to snare that sucker
The rhythm will be naught,
So be sure, oh, humble student
To heed the wise instructor,
Because a heart without a rhythm
Is like a train with no conductor.
_ _ _ _ _ _ _ _ _ _ _

Serious Impactions

Oh, Mr. Jones you fail to see
The error of your actions,
A diet low in fiber leads
To serious impactions,
On top of that I’ve noticed
You don’t drink enough to spit,
Now you find you can’t eliminate
You’re so full of it.

There is but one consensus
Your innards must be reamed,
We’ve got a new technique
We’re gonna have you steamed,
It involves a high tech nozzle
Inserted in your gut,
Then we tape a hefty garbage bag
Securely to your butt,
The countdown then commences
As we hoof it down the road,
We have to go some distance
Just in case you might explode.

You know, we’re not to sure
About your chances of survival,
But the competition is fierce
With a scientific rival,
Who is working on a similar
Device to clear the crap,
It’s a vibratory mechanism
Placed upon your lap,
It bombards the microvilli
With microsonic hits,
It has a lifetime warranty
And guarantees the shits.

We apologize, posthumously
We didn’t clear your load,
Unfortunately, Mr. Jones
Indeed, you did explode,
Rest assured, you are remembered
For serving all mankind,
And all of those that follow you
Who find they’re in a bind.
_ _ _ _ _ _ _ _ _ _ _ __ ___

Phaht

Phaht, is but a word
That conjures up many visions,
It confronts a lot of people
With everyday decisions,
Phaht, a simple concept
That shares a lot of weight,
It can generate emotions
That stretch from love to hate.

Phaht, an easy word
That requires little breath,
Yet is powerful enough
To influence life or death.

Phaht, a weighty subject
No matter what your view,
Be cautious when you speak of it
Some day it might be you.
__ __ __ __ _ _ _ _ _ _ _

Niacinamide

Did you ever take
Too much niacinamide,
In minutes you discover
You are scratching off your hide,
It somehow makes you itch
On a scale that's microscopic,
It gets around quite quickly
In the system circulopic,
Blessedly its half-life
Is fifteen minutes short,
If not, I would worry
That the flesh would just abort.
_ _ _ _ _ _ _



Tuesday, June 06, 2017

The Toughest Break


My hot job is apparently being phased out. In some respects, it did look too good to be true, but I did the best that I could while I was there. I think some thought mavens have deduced, that there are some limitations to my position (I'm not supposed to take a patient assignment; just do breaks). Anyway, once I heard about it, I had to jump on the bandwagon and find something else. The tough part, is leaving the crew I have been working with, for the past 14 months. I enjoyed being a part of the team (and can only hope they will muse about the "good old days" when they had a dedicated Break-Relief Nurse).

Here is my farewell:

I enjoyed every minute
Except, just one,
It was back at the beginning
But all the rest was fun,
And do understand
I'm not leaving for that reason,
Nor was it excommunication
Or treacherous treason.

Whether rumor or fact
The position is phasing out,
I couldn't wait
Till I heard the last shout,
Nor could I accept
A return to the bedside,
In ICU; just one step
From the dead-side.

Don't take it personal
It's not about you,
But rather, the clients
The drug-addled few,
The revolving door return
Of non-fixable folks,
I think I might go postal
Attending to those blokes.

My injury risk
As a bedside punching bag,
Dead in the sights
Of some murderous nag,
Who is on the steep downslope
Of Delirium Tremens,
Like gargling with razor blades
With a chaser of lemons.

Proning and flipping
On a whim for mankind,
CRRT and ECMO
You must be outta your mind,
Level-1 transfusions
And fourteen vasopressors,
On a DNR Grandma
'Twould be better just to bless her.

Sure, it's not all that
No, sometimes it's more,
ICU nursing these days
Is a death defying chore,
In for a penny
And ten diseases for a pound,
A lot of dubious solutions
And endless problems all around.

What I will miss?
All of that stuff,
Imagining 12 hours of it
I'm not tough enough,
To maintain my poise
And my youthful good looks,
Thus, I return to the Mother ship
To drink coffee and read books.

The saving grace?
One's comrades at arms,
You are a powerful group
Defying numerous harms,
With synergy and camaraderie
Good fellowship and fun,
Working together
Like a well oiled gun.

And so on, henceforth and furthermore
Gotta go, slipping out the back door,
Fourteen months, didn’t seem like a chore
And God forbid, hope I didn’t catch a spore!


Monday, June 05, 2017

Dutch Jones Disease


Poor old Mr. Jones, always coming down, or happening to, some kind of horrid ailment. I caught up with him back in the gay old nineties. Let me tell you about it:


Mr. Jones, I gotta tell you
You have a strange disease,
You’re the first man to succumb 
To a virus that kills trees,
Your symptoms are unusual
But our data is pretty thin,
As a tree would shed its bark
We note your flaking skin.

Your gait is quite unsteady
As you stumble in your boots,
There’s a striking similarity
To a tree with rotting roots,
And like autumn leaves that change
Drifting through the air,
We notice the alarming rate
You’re losing all your hair.

Though the cause is not determined
There is but one straw that we clutch,
You share a common ancestry
The tree and you are Dutch.


Sunday, May 28, 2017

Come Pliants


Apparently our metrics regarding Customer Satisfaction were abysmal again. So naturally, blame the Nurses. Everywhere in the good old USA, Nurses have to put up with this corporate BS. Essentially, management would love it if we girls would just remain easy and compliant, and always do what daddy says. I say, fuggedaboutit !!!

Come Pliants

I missed an appointment
Two times already,
The Nursing Bungle
That's the name of it, Freddy,
I guess the powers that be
Think we all need retraining,
If our profits keep dropping
They'll start again, with the caning.

Flogging us daily
A customer service reminder,
Do your hourly rounding
And always be kinder,
Remember the 4-P's
No Pass Zone and AIDET,
If I was sure there were refreshments
I probably would have made it.

I've been told I'll be paid
For this mandatory class,
But that doesn't mean
It's not a pain in the ass,
I just think we'd do better
Without our billion dollar advertising,
Invest in the employees?
The results might be surprising.

Instead, they hammer away at us
Regarding the metrics they measure,
Reports of satisfaction
Give executives pleasure,
They throw a big box of money
Focusing attention on our image,
While kicking around the employees
Like a sandlot scrimmage.

Well, I'm not so compliant
Though I am persistent,
I balk at coercion
With intent to be resistant,
When workers are badgered
Threatened and harassed,
Perhaps, that's why I forget
Until the appointment has passed.

I don't want to participate
In this customary nonsense,
Nurses are not to blame
For the usual offense,
Better to focus attention
On the business design,
Management, listen to our voices
Collectively, we decline!



Thursday, May 25, 2017

Just Another Fad


Here is a FAD you ought not to bother with.

FAD

Familial Aortic Dissection
If you don't know you have it
You have no protection,
Just when it will strike
No one really knows,
So you better be careful
What you put up your nose.

Familial ascending
Aortic dissection,
A genetic mishap
Of cosmic selection,
You better have a good surgeon
One who knows what he's doing,
It's a little more complicated
Than light bulb screwing.

Wednesday, May 24, 2017

After the tissues, monetary issues


Pass the Gate

It was a quick death
When he lost his breath,
A short goodbye
Because he had to die,
He hitched a ride
To the other side,
And waved his palm frond
To the great beyond,
And took a key lime pie
To that place in the sky.

St. Peter said,
Did you bring the bread?
You mean Heaven, ain't free
You gotta be kidding me,
He said, just because you died
You don't get a free ride,
If you want to pass through my gate
You better fill the collection plate.

Terminology Murder


I do break-relief in two ICU's. I read the charts of all those patients that I interact with, because I need to know what I'm dealing with for that one hour. This knowledge also allows me to contribute pertinent assessments, to assist the staff member I'm working with.

Bottom line; I read a lot of charts. I have decided to place some attention to the use of home-made Medical Terminology, those abbreviations that are not included on the standardized lists. Essentially, these are unique notations, understood by only that person who is doing the documentation. No nurse wants to end up in a court, arguing about what they were charting on that dark and stormy night; especially, when they were using unauthorized charting terminology.

Medical terminology?
We must agree,
To use the same terms
One, two, three,
To share information
Promotes understanding,
Or we’ll see you in court
And be more demanding.

GUOP, what is it?
Is it something you ate?
Might be GUacamole
On an Outdoor Plate,
And why chart it twice
How much urine amounted,
When it was entered on I & O
The running tally accounted?

Prop for sedation
Now what does that mean?,
A couple large pillows
In a stage-play scene?
When you charted it already
In the IV Drip roster,
In terms of documentation
You are an imposter.

S/W, makes me wonder
Did you mean Smith & Wesson?
What kind of a shot?
Please don’t keep us guessin’,
Because the family wants to know
How Billy-Bob died,
MDR completed, coninue poc
That’s what they cried.

Bld clt
Might have been talking
About me,
I belong to the bald cult
Check Facebook
You will see,
Might have meant
Blood culture
But it’s not our terminology,
Once again, your charting
Approaches pathology.

*  *  *  *  *  *  *  *  *  *  *

GUOP…………..good urine output
Prop…………….Propofol
S/W..................... spoke with
MDR completed, coninue poc…………(What did this convey?)
bld clt...................blood culture

One Ideal Leads to Another


Nice and proper, litigation averse charting; that's what we are taught.

Pretty Nice Terms

All of us are coached
In Nursing school class,
To say anal discomfort
Not a pain in the ass,
We say, you are combative
Not a son of a bitch,
Your wife is unruly
Not a low class witch.

Yes, we pamper our language
In pretty nice terms,
You are infected with Ascaris
Better known as worms,
You ate uncooked pork
With your fermented grain,
Acquiring Cysticercosis
Larvae in the brain.

We leave it to you
To tell your wonderful story,
Hello, Social Media
For your fame and glory,
You don’t need good looks
Just take a picture of your worm,
You’ll get millions of likes
And make everyone squirm.