Wednesday, September 11, 2019

Future Charades

I still have plenty of words to share regarding what it's like to be the Nurse at the bedside; but my drive to expel those words, has diminished, now that I am freshly retired.
I continue to teach the science of EKG Interpretation, but that incurs no stress at all.
Still, I feel that I have an obligation to write, because my pals remain at the Western Front.

Absentee writer
That's me,
A lot of it was stress
Now I'm a retiree,
Am I any happier?
Not sure, just saying,
My thoughts are still professional
There's a balance shift playing.

I still keep up
With scientific curiosity,
Though, considering the old days
There was a degree of monstrosity,
Which changed its morphology
Over the years, and more decades,
What was believed back then
Was like a game of Charades.

If you're still a Clinician
Keep an open mind,
Best Practice isn't always
Give it a decade, and you'll find,
If all of the posturing
And big ideas in play,
Still hold any legitimacy
In that future day.

Thursday, August 15, 2019

Joke Disorder

Not highly regarded for my social skills, nor ability to lead perky conversations, I did develop a keen ability to make puns, cynical/sarcastic innuendos , sharp observations, and conveniently, my thoughts frequently rhyme in patterns. There is probably some kind of Psychological disorder, to explain all of that. (no doubt, carefully delineated in the DSM-5)

So, without further ado; new words and definitions:

Alcohol Use, Disorder:
When you tell the Bartender, you don't really want this particular cocktail.

Vernacular Fibrillation:
Making vocal utterances, which make no sense. 
(somewhat like this definition)

Break-out sessions at the Acne Convention 

Diawheaties:  The latest breakfast cereal from Shaker Mills.
Improve your blood sugar management, while
enjoying your old favorite morning breakfast cereal.

Part Anti-Coagulant, part Fiber supplement.
Prevent blood clots & prevent colonic (clots) obstructions.

Consider the similarities:
Q: A Creamcicle ice-cream treat, and the IV tubing used for hanging a piggyback medication.
A: The, suck on dairy;
      The IV tubing set is called, a Secondary.

Sunday, July 28, 2019

High Expectations; Low Standards

I'm on the mailing list of various Nurse recruiters. Recently there was an ad placed looking for an RN, at a hospital I recently worked at. The qualifications were: High School diploma or equivalent (G.E.D.); plus satisfactory completion of a formal Registered Nurse program pursuant to the Division of Allied Health Professions or military training that is equivalent to an accredited Registered Nurse program. Wow, those qualifications are kind of I got to thinking about Hospital X.

Easy Job at Hospital X

Good old Hospital X
Has a job for me,
Cuz all they ask for
Is a G.E.D.,
Along with a basic
License for Nursing,
You just memorize scripts
And practice rehearsing.

You don't need to know much
Just smile and wave,
Fluff the pillows
And be a good slave,
And if you're ever asked
About your education,
Mumble some credentials
With obfuscation.

At Orientation
They emphasize certain rules,
That are never enforced
I ask, what kind of fools?
Can run a business like that
A hospital, for goodness sake,
Where every employee is on the phone
During the hours they are awake.

In Recovery, after your procedure
You started bleeding,
Joe holds pressure on your artery
At the same time, he's reading,
About the the latest pistol
Using the phone, in his other hand,
Sure doesn't look smart to me
But we can't make him understand,
If the rules aren't enforced
Until a sentinel event,
That means, until it's too late
And there's no chance to repent.

Precious Flower
Works intensive care,
She charts with earplugs on
Watching Vanity Fair,
No attention on the monitor
For yonder patient, Jack,
Work-time hours watching YouTube;
Don't have a heart attack.

Nurse; can you read an EKG?
Not really, but I have a Monitor Tech,
Hope they are not using their cellphone
Wait a minute, let me check,
But aren't these all Heart patient's
Under your care?
There are some things you must know
As important as breathing air.

Sensible policies
Without enforcement,
Can you trust the care
With this kind of endorsement?
While the public is influenced
With colorful advertising,
Unsafe practices are the norm
Broken rules, not surprising.

Yep, good old hospital X
Will hire me soon,
No more Orientation
We’ll just chant and hum a tune,
Because it was clearly a waste
Training twelve turtles,
About best practices
When they couldn’t run hurdles.

Monday, July 22, 2019

Wide and Bizarre

Over the years I have written numerous times about SVT & TVS (or a similar iteration). Depending on the urgency, the disease process, or even the on-site knowledge base, wide complex tachycardia can present a conundrum, in terms of proper naming of the rhythm. In the event that the patient is critically unstable, cardioversion may be the best choice of therapy.

Wide and Bizarre

It's the middle of the night
And you are a newbie,
You're dead asleep
And dreaming about Ruby,
When your pager goes off
For the CCU,
It seems that Billy Bob Borko
Had some dying to do.

The nurse asks, Doc
Will you look at this for me?
Billy passed out
When he was taking a pee,
And you notice his rhythm
Looks wide and bizarre,
Enough room for a semi
And a Mini Cooper car.

Is it SVT or TVS
If you don't know
You won't impress,
The Attending physician
In the morning meeting,
You better talk to the nurse
Before you take a beating.

There's a guy at the desk
With arm raised and beckoning,
Don't bother to argue
Or there will be a reckoning,
A teacher of EKG
With 30 years of knowledge,
You're not even that old
After eight years of college.

Sure, he can't name a diagnosis
His license won't allow,
But his barrels of experience
Are available, like free chow,
And any self-realized
Brand new doctor,
Will understand free
Without asking a proctor.

Don’t get your knickers in a twist
If he knows more than you,
Regarding Torsades de pointes
And accessory pathways too,
Just sit down and listen
Maybe take a few notes,
On rounds, in the morning
You might get all the votes.

If the Attending should ask you
To cite an article or source,
Please do be honest
Don’t be the butt of the horse,
Embarrassed to admit
A nurse explained it last night,
Let’s have mutual respect
Because payback might bite.

Beguiles folks
You must confess,
If you’re haven’t learned
The nuances and rules,
Your Attending will know
How to separate the fools.


I haven't written on this particular theme in quite sometime, but any bedside nurse will agree, this is a stinky subject. Frankly, I have penned an awful lot of crappy rhymes, over the years.

Poo Poo patty-cake
Practice your ability,
A simple test
Regarding GI motility,
The bane of all Nurses
Having to deal with all that crap,
And please listen to me
We don't want it in our lap.

Don't play the revenge game
When we turn you in bed,
Please don't bear down
And make your face turn red,
Because I'll flip you over
Back on your bottom,
Wink at my pal, saying
This time I got him.

Sure, it's kind of funny
When you rip a loud one,
Only if it's empty
Like an unloaded gun,
Because, if I get splattered
I won't be singing, "You're So Vain",
I'll be thinking Chernobyl
And acid rain.

Too much poo poo patty-cake?
We order a Flexiseal,
A miraculous invention
That's how we deal,
And it helps with the odor
Until emptying time,
Then it's the same old crap
Except, this stuff is slime.

G.I. Had a Good Time

You may know the routine; live to be fifty, and your doctor will propose Colonoscopy (and have another one in ten years). Or have another one, when you suddenly develop anemia; then they propose to do EGD + Colonoscopy.

Also, a bit of  history, when I administered the Sedation medications for an ERCP, about 18 years ago (at this same GI lab)

G.I. Had a Good Time

Thursday, last week;
Upper and lower, endoscopy,
There were at least two Nurses
Plus the Doctor with me,
Everyone performing
Their professional best,
Plus, I didn't feel a thing
And that was the test.

There were a number of people
Bonnie, Bill and more,
A great experience indeed
After coming in the door,
Just a three hour trip
Talk, scope and depart,
Plus, they weren’t offended
With a burp or a fart.

One thing I do know
How best to reward,
Coffee and chocolate
Together in accord,
Keeps the motor running
Without skipping a beat,
So, take a break today
With coffee and a treat.


History Revisited:

History, hysteria
Regarding my recent visit,
Before I did arrive
I wondered, who is it?
Performing today
I hope, it's the best staff,
Well rested, and relaxed
And willing to laugh.

Because, I have a secret
Regarding all of the fun,
In GI Room 2
Back in two thousand one,
When a certain young Fellow
Whom I won't reveal,
Performed an ERCP
For three hours; unreal!

It was an in-house patient
Thank goodness for that,
I pushed gallons of sedation
Like a liberal democrat,
As two or three doctors
Flailed around with that scope,
I hoped, I don't get arrested
For main-lining all that dope.

Well, she didn't stop breathing
Nor was she awake,
Long after the procedure
And the doctor's coffee break,
When they wanted to leave me
Alone with Betty Lou,
I said, No, Dr. C
When I leave, so do you.

Still, why did that happen?
'Twas a short staffing day,
Action nurse was invited
To come over and play,
Those favorite clowns
Of nefarious deeds,
Juggling chain-saws
While the big Lion feeds.

My nursing approach?
Sure, I’ll try to swing it,
Jump into a situation
And figure, I’ll wing it,
Try to grab a pal or two
And hope for the best,
Survival, the key
Yes, that is the test.

Sunday, July 14, 2019

Talk About Sex

Nurses; men or women, it doesn't matter. Somewhere in your career, and probably more than once, a patient will start speaking with sex based innuendo's or blatant, sexual harassment, and you need to shut that down, right at that moment! You might have to come right out and talk "Assault & Battery", where speech alone constitutes (threat) Assault, and laying on of hands / touching you, is Battery (causing harm or injury).  Hopefully a firm professional rebuke will halt this behavior in its tracks.

Anyway; here was my response last year when 64 year old Joe Bob just had to know how soon he and his partner could resume sexual activity.

Talk About Sex

Those patients
Who want to fluster their Nurse,
Talk about sex in some way
To embarrass, or worse,
Is it sexual harassment?
Do we snicker, smirk or wink,
It's usually a guy
And he's talking about his dink.

The dude had an Ablation
For his Atrial Fib,
He asked, "How soon for sex?"
Then I said, ad-lib,
Well, how about a week
That should be prime,
But if you just can't wait
Sex yourself, any time.

Saturday, July 13, 2019

Common Sins

Not fake news, just old truth. Joe Bob, somewhere over sixty, had strained his back. He had Aspirin at home, and knew it was pretty good stuff for back pain. He remember it was OK to take two every four hours, but after a while he thought, this isn't really working, so he began to double up on the dosing. After about two weeks, he noticed he was feeling weak......................until he finally had Betty Lou take him to the Emergency Room.

Severe anemia
How was that begun?
One guy was popping Aspirin
When his knee had come undone,
Taking it every four hours
For the past two weeks,
His Hemoglobin was four
He had acquired many leaks.

Maybe you need platelets
Or clotting factors,
Though sometimes blood products
Have their detractors,
Perhaps you have a religious
Belief, where you'll refuse,
A standard life-saving therapy
Guess we'll watch you bleed and ooze.

We medical persons
Shake our heads in wonder,
What happened to common sense
Regarding your Aspirin blunder,
How could you think it was OK
To take it so often, for so long,
No Doctor told you that
You wrote your own song.

Over-the-counter medicines
Gotta be safe, right?
Millions of people use them
All day and all night,
If one or two don't work
Take a couple more,
But if you should overdose?
Please unlock your door.

Tuesday, June 04, 2019

Heinous Crimes

Beating, whipping, slapping, spanking, boiling hot water, running in the yard for 2 hours, locked in cages, closets, water-boarded, bottom of foot or lower leg, hit with a flexible rod or branch (switch), starving, hidden from society..........dare I go on? IT IS ALL WRONG. Particularly, against children.

I read about a man
He beat his child to death,
Momma, was at work
When Billy took his last breath,
When she came home after work
She saw him sleeping in his bed,
She claimed in the morning
That she didn't know he was dead.

Beatings for an hour
When homework wasn't complete,
Meals and water withheld
Children not allowed to eat,
Make them run in the yard
For two hours at a time,
In ninety-degree heat
These punishments are a crime.

Dad said, "Never in a million years
did I want this to occur",
I thought I was the best Dad
Loving and pure,
But my kids wouldn't listen
When I cussed, barked or yelled,
Never understanding
Kids just want to be held.

Parents or their surrogates
Most often perpetrate these crimes,
Children beaten and bitten
Hundreds of times,
Men claiming, their own father
Did the same thing, when they were young,
Getting a good whipping
When they stuck out their tongue.

Then going on to say
I leaned my lesson, don't you know?
That's why I do it to my kids
Because now I'm a pro,
I'll teach them a lesson
Beating harder than my old man,
Those kids need a whupping
I gotta do what I can.

These days our domestic animals
Are often better treated,
They are provided a "forever home"
Identification and shots completed,
A soft comfy bed, toys, snacks
And rawhide bones,
Meanwhile little Billy is locked in the basement
Dreaming about ice-cream cones.

Heinous crimes perpetrated
Domestic violence and child abuse,
It is never OK
There's not a single excuse,
To allow for this behavior
It is abhorrent and evil,
A parent, such as described
Is lower than a Boll weevil.*

* Boll weevil: the most destructive cotton pest in North America. Best eradicated via pesticide, or crushing beneath one's heel.

Remember, all we healthcare workers are Mandatory Reporters.