Monday, March 31, 2008

Another hard-to-believe tale, that is filled with truth; really, just ask any Nurse!

Looking For Some Sturgeon

Now here's a strange phenomena
I've noticed o'er the years,
The gastroenterologist
Has stomach cancer fears,
And sure enough, before too long
He suffers bowel constriction,
Good golly gosh, I'm not surprised
He was a specialist of the affliction.

And then the neurosurgeon
Has a headache of grand proportion,
A nasty neuroblastoma
Has caused a brain distortion,
And the pain is so damned awful
Like a pterodactyl sting,
He takes a buzz-saw to his head
To eradicate that thing.

The saddest one most surely
Is the cardiology dude,
When the crushing pain and tombstone lines'
Begin to threaten his good mood,
He's inclined to pass the time away
Denying it's for real,
No Cardiologist worth his salt
Would accept such a lousy deal,
Alas, this can be fatal
Unless his family has some guts,
Accustomed to his attitude
They'll take no "ifs or buts",
And haul his sorry, dying ass
To the neighborhood cardiac surgeon,
He'll soon retire and buy a boat
And go looking for some sturgeon.

Many will tell you that it's hell getting old. It certainly is when ye olde hollow husk disintegrates slowly. Nary a nurse looks happily forward to that kind of existence.
Here are some quick thoughts about meeting the ancestors.

I'm Going to Meet My Ancestors

I am hoping to meet my ancestors
Perhaps they'll come and get me,
To join my ancient family
If only they would let me.

I'm old and feeble and misunderstood
And commonly feel alone,
But I have limited capacity
To make my wishes known.

I'm going to meet my ancestors
It's so painful being sick,
I've called my long dead family
To get me soon and quick,
They left so very long ago
But finally it's my chance,
I'm going to party with my relatives
And do the death-march dance.

Oh look, I see my ancestors
They are waiting at the door,
They've come to take me sailing
Yes, my boat is at the shore,
I don't need a life-preserver
Nor a compass for this trip,
I am ready for my maiden voyage
As the captain of my ship.


Friday, March 28, 2008

Deja Vu all over again. Yup, I'm reliving every flippin' nursing experience that I ever had, all over again, one-by-one. Last night it was the "Ketoacidosis, Bipolar, immature, positive drug history, non-compliant, adult-in-childs-clothing, whoops I didn't use my insulin for a week", individual.
I was a party to all of the emotions and behaviors associated with each disturbance. I really can't begin to tell you how much fun I had, (so I won't bother). However, let me share with you what it might feel like, if you were to be picked to be the nurse for that kind of patient, over and over again.

First, here is the cartoon: A wonderful quote from my favorite humorist, George Carlin:

In Rome, the emperor sat in a special part of the Coliseum known as the Cesarean section.
George Carlin, Brain Droppings (1997)

Thank you; and now for the main attraction:

One Nutcase, Too Many

Sometimes I feel like
There's a target on my butt,
It says, "Give him the patient
Who is whacked out of their nut",
Or maybe, I'm wearing
The hat with the logo,
It reads, "Welcome all zombies
From the Whisky a’ Go Go
Whatever the reason
The cause, or the blame,
What to me, is a conspiracy
To others, is a game.

There is probably a lottery
Going on behind my back,
To name the hours and minutes
Wagering when I will crack,
Where I go running and screaming
Yes, totally ballistic,
One nutcase, too many
And now I'm just a statistic.


Monday, March 24, 2008

Over the years I have written often about excrement. And here I am, less than two months into my reincarnated career and I find myself knee-deep in the slimy stuff again. Sheesh, nothing ever changes (at least in that territory). What has changed is the.....................

The Arc of Ejection

Bowel movements times four
And Urostomy leak,
Do I dare disturb the bedclothes
And venture a peek?
It's been a long night
Of cleaning up crap,
Patients lying on their sides
Try to launch it in my lap,
And I covered that topic
Must be 15 years past,
But nothing has changed
They have to crap, really fast.

Fifteen years later, and
What is the matter?
The crap is the same
But the clients are fatter,
The arc of ejection
Has increased in proportion,
The pattern of splatter
Is one of distortion,
And along with my age
And my weary old bones,
I don't leap, hop or scamper
Without a few groans,
As I seek to escape
The crap launched my way,
And I ponder again
About the terms of my pay,
But then I recall
My oath, Hippocratic,
You fool, you’re a nurse!
This crap is automatic.


Sunday, March 16, 2008

It was as I thought; if I went back to work, I would be inundated with a review of topics that I probably wrote about in the past, but now I'm 10-15 years older, and I might possibly have a new perspective. Well, actually I have the same perspective, I just write a little different.


Nineteen years old
With suicidal ideation,
After seven years
Of self-induced degradation,
Popping pills and whatnot
In the name of “I hate me“,
Abusing all who care
I'll drag them down, just wait and see.

Nineteen years old
Whining, wailing, look at me,
Don't you know I was abused
And now my life is misery,
I'll keep trying to kill myself
Because, you know, I want to die,
As soon as I leave your care
I guarantee, another try.

Nineteen years old
What a waste, I say,
I'll care for you tonight
But tomorrow is another day,
Where you'll get the opportunity
To look your sorry self in the eye,
But tonight I'm going to tell you
You're just too weak to die.

Nineteen years old
And you've wasted seven years,
Nobody gives a crap
About your story of abuse and fears,
Your life is really easy
No working, school or tasks,
You just lay around and whistle
Through all of your phony masks.

Nineteen year old persons
I've seen paralyzed and more,
They didn't wallow in their misery
They were wheeling out the door,
With active minds and iron wills
They weren't whining, oh, poor me,
They weren't dreaming about their suicide
On Wednesday, at three-forty-three.

Nineteen years old
You need to begin the day and say,
Whatever happened to me before
Is ancient history and just the old way,
I have one choice, about moving forward
Each day is a fresh new start,
Those who care about me will do so
No matter if I depart,
But they are locking their doors
Watching to see where I will head,
Will I choose to be alive and live again
Or take the easy way out, and be dead.


Monday, March 10, 2008

I clearly missed out on a few "new" things in the past 7 years, away from the bedside. Maybe others did too.

Are you subject to the whole JCAHO "communication" directive regarding the SBAR acronym (Situation, Background, Assessment, Recommendation)? Everybody and their brother seems to have had to start reporting that way, or something similar, I guess. Well, it reminded me a heck of a lot of the old FUBAR acronym, which I'm sure many of you know to mean, Fu**ed Up Beyond All Repair. SBAR looks almost like that, right? Well, I sure thought so. And the following poem spells it out pretty clearly.


I merely left the bedside
For seven short years,
But naturally I wondered
How I'd fit in with my peers,
I need worry not
They are stellar professionals,
But the workplace is different
Thanks to Jayco Congressionals.

Leave it to the Joint Commission
To give rules of communication,
They say it's all about patient safety
But it's more like approbation,
And another thing about it
Is the acronym, or name,
Just trying to pronounce SBAR
Those executives put us to shame.

Situation and Background
Assessment and Recommendation,
Up to five syllable words
Clearly testing my mentation,
Is this some kind of experiment
Are we rehearsing for the future?
If there is a threat of a lawsuit
Can we repair it with a suture?

But my greatest concern
Is with the choice of the acronym,
Having an Engineering background
It sounds like our marching hymn,
FUBAR was our mantra
It covered any possible disaster,
Fu**ed Up Beyond All Repair
Was our answer, to the master.

I know, that I possibly shocked you
But the world is a wretched place,
There are times at the hospital
When all Hell breaks loose
And the SBAR just flies in your face,
And I suspect that some members of Jayco
Were laughing while gasping for air,
Knowing the true meaning of SBAR;
Screwed Beyond All Repair.

Back in the gay old '90's, I wrote frequently about a local hospital system that was suffering through the throes of "redesign". They had adopted some sort of chest-thumping, corporate blah-blah, best-practice BS, that was going to save money, garner applause and launch them fiscally solid, into the 21st century. I think it went hand-in-hand with all the excitement of Managed Care. Fade to the future:

Now, they are heralding a "communication tool", with the acronym of AIDET - Acknowledge, Introduce, Duration, Explanation and Thank You.
I have since learned it is the brainchild of one, Quint Studer (, who at his own website claims, he is one of the "Top 100 Most Powerful People" identified by Modern Healthcare. Apparently, he's also famous for his "Five Pillar" approach to achieving operational excellence, goal setting and measuring progress under service, people, quality, finance, and growth.

It's all a smoking pile of feel-good, smiley-face, top-a-the-mornin'-to-ya, remember my good name on your patient satisfaction form, best hospital in town, front and back door advertising. For Nurses, who have already racked up 20+ years of loyal, back-breaking service to humanity, it all seems a little like heavy-duty glad-handing.

Therefore, I was assigned by my society to speak for all of us.

At the End of the Day

Until you've learned your AIDET
You haven't really made it,
Acknowledge their name
At the threshold door,
Introduce yourself
(Try not to bore),
Define the time
Of the things you'll do,
Explain, entertain
Educate them too,
At the end of the day
When you're on your way,
Say, thanks for the fun
Now, what about my pay?


Wednesday, March 05, 2008

I was thinking about how so many "professional caregivers", such as Nurses, Doctors and many others in the broad spectrum of those who attend to the health-care needs of humanity, commonly overwork themselves way beyond what might be expected of them.

My impression, both as one who has led the life, and also observed many of my colleagues, is that most of the time, we are doing it for others. Sure, once in a while, we're chasing the $ because we want the new car, or the Costa Rica vacation and so on, but really, it's almost always because we are the caregivers in our own personal sphere of influence.

We can earn some major cash, working overtime. If our spouse is just an average wage-earner, heck, we might be pulling down $1000 a day, for a little extra work. So naturally, all eyes look to us and open palms extend our way, and since it is our very nature to care, we just knock down a few more hours. Well, it's a slippery slope into oblivion, substance abuse, auto accidents, suicide and other similar miseries.

I call it:

Our Fountain of Giving

Regarding professional caregivers
Overworked, burned-out, and dedicated,
Performing with such depth of compassion
Commonly coping, self-medicated,
Amidst an over-capacity workload
They perform at the peak of their prime,
Look closely, it's not selfish fulfillment
It's for somebody else, every time.

Each one of us dedicated professionals
Came to our path, perhaps fated,
Like genetics, or family predisposition
A long history, to be traced, carbon-dated,
We often suffer, from a primitive condition
Where we overlook our own precious needs,
Eventually we crash, torn asunder and maimed
And suddenly everyone bleeds.

Because, attached to each one of these professional caregivers
There's a long line of benefited receivers,
They depend on our fountain of giving
We’re their God, and they’re the believers,
But even a God needs to rest
And that is the sober reality,
The ongoing demands of those persons
Deplete our very essence of vitality.

Premature retirement, disabled or dead
Is often the path that we follow,
Many caregivers are completely depleted
Their mortal remains are but hollow,
Left by the wayside of existence
Empty shells, that once held a precious light,
A dedicated professional, drifting off in the mist
Succumbs to the quiet of night.