Friday, April 21, 2017

Trust Someone

Trust that my awareness is on my patient's on the job

Who is the first
To get up from their chair,
When alarms are ringing
Anywhere,
This is the one
I can probably trust,
They are listening
Because we must.

To be your Nurse
Means that my awareness,
Should be totally focused
On you, in all fairness,
Because we are here
To attend to your needs,
If my attention wanders
Maybe somebody bleeds.

We are duty driven
And morally inspired,
To perform at our best
Until retired.

Thus....
Turn off your devices
When you come to work,
Check later for updates
Don't be a jerk,
Secretly viewing
When you know you shouldn't,
We could fire you
Don't think that we wouldn't,
You reviewed the policy
On your hire date,
Electronic entertainment
Is tantalizing bait,
That could lead you to
The unemployment line,
When Billy Bob is calling
In room ninety-nine.

Thursday, April 20, 2017

Seatbelt

Pretty much, auto seat belts have been a safety requirement on our American cars since 1966.
Now it is 2017, and if you choose not to wear a seat belt, and drive your car and crash, you are the fault of your injury. Don't try to pin it (to get money) on anybody else. You are the fool.


I didn't wear a seat-belt
Because I'm young and pretty,
Till I rammed that metal pole
Now, I'm one dead kitty.

I didn't wear a seat-belt
Because, what could go wrong?
Now I'm singing soprano
An angel's song.

I didn't wear a seat-belt
Because I was too busy,
Now I'm floating up in the clouds
And feeling kind of dizzy.

I didn't wear a seat-belt
Because it pushed on my breast,
And because of my stupidity
I earned eternal rest.

I didn't wear a seat-belt
Because I'm a good driver,
Now I'm up in heaven
An early arriver.


Monday, April 10, 2017

My (hopeless) Journey


MyJourney is the name of the software application that delivers the bulk of our required yearly hospital education. It is nothing like a journey, it is not a vacation, and we certainly don't get to choose the island. I discovered today, I can do it all in the safety of my home........and they better pay me for it, too.

Oh, I'm such a happy
Old fool,
Lying here
Next to the pool,
Spending the day
On MyJourney,
Wishing instead
I was an attorney.

I could bill for
Hundreds of dollars an hour,
While sipping away
On whiskey sours,
Dreaming of sugarplums
Dancing at the bank,
Instead I'm on MyJourney
In a blitzkrieg tank.

Firing away
At educational objectives,
I don't have much choice
To be very selective,
If I don't show effort
Or participation,
I'll be, persona non grata
At my nursing station.

Friday, April 07, 2017

Another Bungle


Uh, oh, rumor has it another Nursing Bundle is about to be jammed down our throats. I heard one of the ANS crew talking about it last night, and the religious fervor she exhibited while sharing the "good news" (and dismal statistics) had me running to my creative writing space, to contemplate, Nursing Bungle #2.

The Nursing Bungle requires a testament of belief
Give all of the appropriate answers to avoid any grief,
It's not an annual Revival, but they would do it if they could
Gather around the campfire boys, because the bungle is good.

This latest Nursing Bungle contains all the new thinking
Grandiose ideas to keep this ship from sinking,
And with new management in Washington you better hang on to your seat
Next time the Nursing Bungle will be delivered by tweet.

Excitement is high, at the place that I work
Unveiling the new Bungle with a wink and a smirk,
Promising wonderful top-notch Avatar Scores
Whiz-bang H-CAHPS, and C.Diff. s'mores.

Oh, I can hardly wait to travel on My Journey
After 8 hours of study, they'll transport me on a gurney,
Down to Radiology, for the implants in my brain
I'll be a Nursing Bungle Cyborg, with a built-in ball and chain.




Thursday, April 06, 2017

Out of Rhythm


Well, I caught another Rhythm interpretation screw-up and it's a doozy. From what I can see, nobody really cares, but I have fun doing the research and exposing the fraud.

Betty Lou, age 85, admitted to the hospital with nausea and vomiting. She's in mild Renal failure and her potassium really low (which got corrected). She had a history of A. Fib (paroxysmal) but was only on Coreg at home, and in Sinus Rhythm on admission. About 12 hours after admit, her heart starts to have 3 second pauses, and her heart rate drops into the 40's. Several 12-Leads were obtained, but the quality was horrid, such that neither the machine nor a person would be able to make any good call on the rhythm. Neither the RN nor the Monitor Tech (Cardiac Tele) could figure out the strip, and the nurse actually writes that in the record, along with stating that the EKG 12-lead reads "undetermined rhythm". When the patient drops to 35 and a pause, Nurse calls Hospitalist...........he says, don't give Beta blocker. When the HR dropped to 22, the Nurse charted, "Patient Asymptomatic". Finally, after a call to the Cardiologist, there is an order for Bedside Pacer Zoll, and Atropine prn. As this was Cardiac Tele, and presumably they are required to have ACLS, I would have thought the Nurse would have gotten the Zoll into the room already, without waiting for doctor's order.

Ok, so I take a look at the strips from Tele. They were monitoring Lead 2, and V3. In Lead 2, there was a broad stubby T-wave, followed by a prominent U-wave and a little pointy P-wave. So, with this heart rate of about 45, the Monitor tech, was interpreting those lumps as flutter waves, although that would have placed them at a rate of about 90, which I've never seen, no matter how many heart meds a person has been on. Now, in V3, amplitude was quite low, but there certainly was a P-wave, with a PRI first degree block of about, .38 seconds. Sometimes it even looked like there was some 2nd degree block, but all of the EKG's and strips were crappy. Over the course of about 12 hours, the strips were labeled "Undetermined, or A. Fib, or A. Flutter. The Cardiologist came in, identified the real problem as advanced Heart block, with a slow escape rhythm, and Betty Lou is getting a pacemaker today.

ps.
I am sorry to say, that the ICU nurses were calling it A. Fib too...............

Here's my report:

It bothers me
When I do see,
A misinterpreted
EKG,
I can give a pass
To untrained Docs,
Who specialize
In Chicken Pox,
But Cardiac nurses
And their monitor crew,
Should nail every rhythm
In their purview,
Because that is a skill
Required of them,
And when they blow the rhythm
I say, "Ahem"!

How could you call that strip
Atrial Flutter,
When there is a "P"
"T" and "U" wave
You're some kind of nutter,
A rhythm so slow
With a triplicate block,
'Twas not even A. Fib
You got your head in a sock.

Ah, woe is me
And Auntie Em,
Under the watchful eyes
Of the likes of them.




Friday, March 31, 2017

Infusion Pump Apocalypse


From the "New Brilliant Stuff" Department: (jokes and more)

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

Admission Database question:
Q: Have you ever had an infectious disease?
A: No I haven't, but some people say that I have an infectious laugh.

- - - - -

Here is a retirement business (or hobby) that I am considering:
I will have a sideshow / shooting range or even a mobile unit, perhaps a repurposed mobile home. At this location, Nurses will be able to shoot the weapon of their choice (Sig Sauer, Desert Eagle, Mossberg shotgun, you name it) at old, retired IV Pumps. Heck, I'd be more than willing to pay $20 for a chance to do that. Just think of the satisfaction you could have, sending one of those infernal beeping monsters, to it's bloody grave.

Stay tuned for the Infusion Pump Apocalypse!



Incompetent


Incompetent employees exist to make all of the rest of us look really good? Now that, is an interesting theory.

The truth of the matter, is that incompetence should not be rewarded, by allowing that individual to remain in their job. Some folks never improve, and as any industry changes and moves forward, Joe Bob the Incompetent, becomes a dangerous liability. Employers should have a contract clause that states, “JB, if you don’t learn the new stuff that is expected of all employees in your department……...YOU ARE FIRED!

The Headmaster
Turns a blind eye,
Intentionally ignoring
The incompetent guy,
The one who hasn’t kept up
With the changes in Nursing,
Every day that he works
The experts are cursing.

The Assistant boss
Ponders other things instead,
Ignoring the possibility
A patient might be dead,
Under the care of
Incompetent Billie,
Boss holds the thought
Oh, that’s just too silly,
Figuring the other nurses
Will keep an eye on that punk,
But, everyone else
Would like to throw him in a trunk.

Incompetent Billie
Types with a single digit,
If you’re standing nearby
Oh surely, you will fidget,
Watching with frustration
As he searches for each letter,
He skipped typing class in High School
He never gets any better.

Perhaps Billie believed
It’s all rumor and hype,
Someday I won’t be writing
That I will have to type,
So, why should I bother
To learn any new stuff,
Patients are just people
And I know enough.

For eight years now
Billie has restated,
I don’t have enough time
And it’s so complicated,
I can’t take another patient
Because I’m too far behind,
Floundering on the keyboard
He appears to be blind.

Your career in Nursing
Exceeds twenty years,
But watching you work
Doth bring me to tears,
You don’t know jack
And you ask me every day,
“How do I chart this
They didn’t teach me, no way”.
            _  _  _  _

When I ran to the break-room
Stating, “Oh, I think I saw my son”,
I was really going to my locker
To retrieve the loaded gun,
That I keep there for emergencies
And that time has come today,
Goodbye, Billie
Let me assist you, on your way.


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.