Wednesday, August 27, 2008

Luken's Trap

If you're a Nurse or an RT, you know about that simple device known as the "Lukens Trap". It is used in tandem with a suction mechanism, to retrieve specimens from the lungs, most commonly.

Over at Sister-central, in the Medical Office building, there is an auditorium called, Lukens Auditorium. Who knows? Maybe it's named after the same. But in my mind, I can only think of that auditorium, as being nicknamed, Lukens Trap. Thus, since I had to spend 8 hours there yesterday, taking in some somnolent-suggestive lecture, I penned the following observation:

Luken’s Trap

Luken’s Trap
Was filled with tired air,
The personnel who gathered
Had a collective vacant stare,
Nearly somnolent they were
Biorhythms in a trough,
When a momentary wakefulness
Was prompted by a cough.

Since I was being paid
I couldn't complain very loud,
Collective agreement
Was solicited from the crowd,
Call it preemptive education
For us EMR-users,
But even by lunch time
We were professional snoozers.

If the class was under 4 hours
With coffee and pastries and more,
Hooter waitresses and Chippendales
And bouncers at the door,
With pulse-pounding techno
Black lights and disco balls,
There'd be hundreds of employees
Cued up in the halls.

If there were reporters from News 10
Fox 40 and KCRA,
With up to the minute coverage
And the ongoing play-by-play,
The show would go on
With nary a nap,
And the facilitator lady
Wouldn't wake me with a slap!

I awoke with a startle
In Lukens saloon,
Surrounded by my colleagues
15 minutes before noon,
Where 57 bobble-heads
Prayed for a disaster,
Otherwise, there was little hope
To finish the class any faster.

Over at Sister-central, we are in the midst of adopting the grand-all-boomerang of the EMR; ya, that's the electronic medical record. There is a hierarchy of Trainer, Super-user and End-user participants to cover everybody and their brother, within the great big family. I decided to be a Super-user, because I figured I could get more hands on training that way, and additionally, I'd get to boss around a few other people. Little does upper-management know, that I am a stupid-user in disguise.
Now yesterday, about 200 hundred of us Super-users all got together, and had some education-expert talk at us for 7.5 hours. At the end of that harangue, I realized I had a new title:

Stupor User

They call him the stupor user
He sleeps through every event,
Some think, that he’s a loser
They’re curious of his intent,
The stupor man replies
I learn best when I’m half asleep,
I suggest that everyone try it
You’ll find that your learning is deep.


Tuesday, August 26, 2008

I've said it before, but it bears repeating: this mode of communication know as "Active Listening", is intolerable to me. Don't ever talk to me that way, because I immediately tune it out. It's down-right insulting. So, after putting up with it for about 8 hours yesterday, I had to write about it.


Am I an anachronism
For resisting this lingo?
An obstinate curmudgeon
The proverbial gringo?
Set in my ways
Unable to adapt,
There might be an explanation
That defines how I’m wrapped.

What’s up with the word “facilitator”
What happened to instructor or teacher,
I guess it’s all a part of “communispeak"
For the new and improved human creature,
To me, there is something odd about the presenter
Who can incorporate all this strange lingo,
When talking to me, it's offensive
But I'm just the anachronistic gringo.

These communispeak lecturers
Have such a strange way of talking,
It's like they tried to reinvent
A new way of walking,
That is so frickin' awkward
I feel like falling down,
But if I question their delivery
I'll be kicked out of town.

"I hear what you're saying"
Sounds stupid, to me,
Because you were obviously listening
Are you mocking me for free?
Or you speak in present-tense
Regarding something heard before,
I'm thinking, this chick must be crazy
As I anxiously search for a door.

By rephrasing my sentences and words
It seems like you lack any class,
In theory it improves understanding
But to me, you're a pain in the ass,
You might say to me, "you seem to be angry"
Damn right, I suggest that you leave,
I've been insulted too long by your lingo
Adios, or your family might grieve.

I gladly admit I'm a relic
Of an age, where we spoke man to man,
There was no need to invent fufu language
We could cut to the chase, and the plan,
This "active-listening" lingo is insulting
Unless you're talking to somnolent sheep,
But even those gentle farm animals
Will recognize that you are a creep!


Sunday, August 24, 2008

The story tells itself.

A Judgement of Dismissal

Lethargic and sickly
Though not really maimed,
Where life-style choices
Can be easily blamed,
Five decades of smoking
And a lack of education,
At the end of this journey
There will be no vacation.

Depression and lassitude
Are like weights on her shoulders,
She’s only sixty-one
But she’s feeling much older.
While a deluge of stress
Has destroyed her appetite,
And with hardly any options
There’s no end to the blight,

The daughter she lives with
Is anxious and toothless,
With toddlers and teenagers
She’s probably ruthless,
Putting up with her mother
Creates a household dispute,
Like a Colt-45
Preparing to shoot.

It looked like a heart attack
But it turned out, it wasn’t,
Does she have a regular doctor?
The answer is; she doesn’t,
She has no insurance
Although she does have a job,
A discount-store cashier
She’s no heiress-snob.

There are only more questions
And not enough answers,
She had previous run-ins
With a couple of cancers,
Type-2 Diabetes
Ten years of hypertension,
Why she kept smoking
Is beyond comprehension.

It’s another sad tale
So, totally depressing,
Though the results of her heart-cath
Might be considered a blessing,
Her coronary arteries
Are as clean as a whistle,
Yet, the rest of her life
Is like a judgement of dismissal


Thursday, August 21, 2008

Buried in frustration.


This was an evening
Best not to recall,
My patient yelling for ten hours
Regarding nothing at all,
In the hospital for 3 months
With seven organs failing,
Sleep deprived with ICU psychosis
Had reduced him to wailing,
He had legitimate issues
Like diabetic neuropathy and pain,
But the sum-total of this hospitalization
Had disordered his brain.

At any given moment
He was oriented on all accounts,
An astute observer of society
But he had lost some of his bounce,
Short-tempered, self-centered and lonely
He would yell, five minutes after I departed,
While other patient’s in our tiny domain
Thought a war had started,
Asking to have their doors shuttered
Frightened by the uproar,
Ultimately expressing relief
When they departed our floor.

This was an evening
I am pained to recall,
Marked by my supreme frustration
That I could do little at all.


Tuesday, August 19, 2008

Another look at a weighty subject.

Heavy World

I'm getting really worried

About the weight of the world today,

Over the years more people

Are getting bigger and bigger, they say,

Thanks to TiVo and VCR's

Computers and the video game,

Out the window flew exercise

And good eating habits

Extra-large is the name of the game.

Proof can be seen amidst our monster SUV's

Big Boy recliners and giant BVD's,

Double-wide airline seats for Billy-Bob the gamer

Don't block his refrigerator, unless you're

A lion tamer.

All aspects of life, all venues of business

Have expanded their capacity, and it's causing me dizziness,

Being larger than life, has it's drawbacks I say

Our kids are so large, they can no longer play,

Or safely fit on equipment

In the parks of our nation,

Instead, all those pikers

Are hooked on Playstation.

I don't blame the manufacturers

Of those fantastic devices,

Though I could argue for an hour

About their ridiculous prices,

With company research associates

Targeting Mom's and Dad's dollars,

It's no wonder we're a country

A fall-behind scholars.

I am really very troubled

About the girth upon our earth,

Strangely, it's never present

At the entrance of your birth,

It's an acquired syndrome

For the majority of cultures,

Forsaking the native diet

To become processed food mulchers.

It's a new world culture

And a new language-largess,

Poly-syllable designations

That are sure to impress,

Best known as bariatrics

The science of losing weight,

From 16,000 procedures in 1992

To 180 thousand, in 2008.

It's a heckuva way, for a Doctor career

Maximizing reductions, you might say,

Treating multi-causational body mass excess

With a snip of the scissors

A slice of the knife

And like magic, the problem goes away;

Now you might consider me flippant

Careless, without sympathy or hope,

But when BMI expands beyond 35

Puny nurses like me, can barely cope.

Naturally you might think I am whining

But I expect my employer to care,

They promise us bariatric equipment

Hefty lifts, mondo-beds and chairs,

Until the hellstorm of a foreshortened budget

Breaks the surface from the darkened depths of Hell,

Then they tell us, just do the best that you can

“Have some cupcakes, you're all doing swell”.

Well, I know that's awfully homey

It makes me feel so cuddly inside,

The weight of the world, has been lifted from my shoulders

I'm in heaven, so I finally must have died,

Until I suddenly awaken with a jerk

With my head on the desk, and I've been drooling,

There's a 600 pound patient on a thirty year old gurney

And I realize, my bosses weren't fooling.



There is some bad juju going on in the your back!


I'm childish at times
But it's all silliness and fun,
They are immature at times
But they're packing a gun.

I make a lot of stupid jokes
To try to lighten the mood,
We're all crotchety veterans
But some are dangerous dudes.

Ready to scratch across your countenance
If you dare to live your truth,
It won't matter if you own the righteousness
They'll be lurking outside of the booth,
Waiting for you when you're walking alone
On the path to the bathroom, or meal,
A baseball bat hidden beneath their robes
Or perhaps knuckles, that are made of steel,
Attuned to hidden danger, like good nurses are
Your spider-nerves save you again,
When battle-ax Betty, leaps out of a closet
You plant a sap* on that old guinea hen.

This is clearly a case of workplace harassment
But Betty has friends in high places,
As a female member of the canine clan
She's well loved in the family of two faces,
You can't really say boo, 'cause your word will get around
And Betty will be packing next time,
'Tis better to prepare for another canine encounter
Have a Taser and some toxic green slime.

All kidding aside, the joke is on thee
The health-care arena, is not safe nor free,
Be strong thy convictions, for ethics and truth,
And beware of those persons of nursing uncouth.


*Sap: a piece of metal covered by leather with a flexible handle; used for hitting people.

Saturday, August 16, 2008

A casual look at work.

Remember to Swerve

I come to work
To pass the time,
It's a heckuva place
To make a rhyme,
Of passion and glory,
Can change any minute
To be bloody and gory.

I come to work
For amusement, you know,
It's fun as heck
A really good show,
All sorts of gay folks
In this happy place,
A true cross section
Of the human race.

I come to work
For stimulation,
And a healthy dose
Of aggravation,
But after 12 hours
I've had my fill,
What seemed like good medicine
Becomes a bitter pill.

I come to work
For two days at the most,
Any more than that
Then I am toast,
Beat up, worn out
Every joint aching,
But no one believes me
They think that I'm faking.

I come to work
To fill a need,
Alleviate pain
It's part of my creed,
Serving humanity
With a syringe full of dope,
It's a heckuva thing
But I'm helping them cope.

Time to wrap up
This story of Nursing,
It's different every day
No time for rehearsing,
Show up and be ready
Take whatever they serve,
And when the crap hits the fan
Remember to swerve.


Monday, August 11, 2008

If we were paid like celebrities, there would be no nursing shortage!


If only we were in business
Like the local grocery store,
We'd earn a flat percentage
For every pill and chore,
Every spoken word of teaching
Every gesture of compassion,
There'd be seasonal variations
Like the latest winter fashions.

For special big events
There could be a bonus format,
It would beat the present system
Where we're treated like a doormat,
For example, we could compensate
Events like CPR,
If you succeed, and bring'em back
You win the big cigar.

Your patient was combative
He tried to stab the candy-striper,
She’s the daughter of the CEO
You win the keys to his Dodge Viper,
Or you work an extra night shift
Like it’s really no big deal,
Seven patients with infections
Every one with difficele,
By morning you’re exhausted
And finally feeling old,
Your boss comes in, says, “Way to go”
And hands you coins of gold.

There would be no nursing shortage
If these silly thoughts were true,
Pay us like celebrities
It’s way long overdue!


Friday, August 08, 2008

This is a summation of experiences, having taken care of numerous patients over the years, who have a family that expects a healing miracle, in the face of certain death.

Farting Rapture

A GCS of 3, comatose, near dead
No brain activity in his head,
No movement of limbs
No rise of the chest,
His heart is still beating
But it will soon come to rest,
Unless the Lord, Gawd, Almighty
Should hear all the crying,
Of the 70 relatives
Who sound like they’re dying,
With such wailing and moaning
And pulling of hair,
We’ve collected enough
To reupholster a chair.

Then all of a sudden
There arose such a shriek,
The patient wiggled a toe
And lifted a cheek,
While blasting a fart
That blew off the covers,
‘Twas a verified miracle
To those Jesus lovers;
Uncle Joe had been healed
As they had expected,
It was clearly a sign
That Joe resurrected.

A truckload of new relatives
Soon did appear,
And each time Joe farted
They let out a cheer,
While proclaiming to anyone
Who passed by the door,
Joe was just treading water
And almost ashore,
He’d be up and around
Come Easter, next week,
As if in agreement
He lifted a cheek,
And blew off the covers
With a magnificent fart,
And with that, he just died
With the last beat of his heart.

The family was in shock
And took 4 hours to leave,
They had postponed reality
Not ready to grieve,
Having ignored all the signs
Of Joe’s impending death,
Betting dollars and donuts
On each ventilated breath,
That our machines had delivered
Because Joe was in a coma,
They’d had two weeks of rapture
From his blessed aroma.

Sometimes we wonder
What our visitors have been smoking,
What they think is the voice of God
Is the grim reaper joking,
Waiting patiently on the sidelines
For the last tortured breath,
He’s the prince of all seasons
The boatman of death.


Thursday, August 07, 2008

Whether you ascribe to a particular religion or not, I propose that most of us carry within ourselves, our own sacred sanctuary. Additionally, I believe that no particular religion, owns the market on best prayer. The power is in the intent.

So, whether you pray for your patient silently, or perhaps incorporate spiritual healing in your practice, I think we should offer an attitude of openness and acceptance to whatever our patients own spiritual needs are. In other words, we are not there to preach our own beliefs, nor judge theirs. Our role, is to console.


Surely we deliver the best technology
To the patients, within our domain,
But many of them, have deeper core issues
How can we respond to their spiritual pain?

By being supportive, non-judging and open
We can allow a safe place for consolation,
This may be enough, in the company of strangers
To invite the healing presence of creation.


Tuesday, August 05, 2008

Another hopeless joke just came to me:

Q: Why did the Diabetic fall down?

A: He slipped on the sliding scale.

This was funnier than heck. Last week, Ms. B, paid us a visit for 12 hours, and had a patient in Droplet Isolation. Apparently the N-100 masks don't fit her lovely countenance and so she wears a virtual spacesuit all night long when entering the room. Damn, it was funnier than heck!


I can’t say that I’ve ever seen it before
A space-woman working on our floor,
Bedecked from head to toe in a shroud
To hear her at all, she had to yell really loud.

Her backpack air-blower was whisper quiet,
But she sweat so much
‘Twas like she was on a diet.
Apparently the respirator masks don’t fit,
I don’t care
Her outfit was cooler than shit.

Families! Ya gotta love their screwiness, right? Bring the old man to the hospital because he's short of breath, or having the heart attack, and then begin to refuse treatments on the grounds that we don't want this or that!
Duh! Why go to the hospital in the first place?!?


They bring Grandpa to the hospital
Wanting everything done,
Then refuse the treatments ordered
Every hour, one by one.

Grandpa hates the breathing treatment
He'd rather have a smoke,
He doesn't like the Foley catheter
He's a manly kind of bloke,
And if you keep his hands and feet tied
Surely, he will shout,
And we agree with dear old Grandpa
Take those IV's out.

We don't want that Insulin therapy
It doesn't sound much fun,
But I once again remind you
We want every damn-thing done!


Friday, August 01, 2008

Nurses: Day in and day out, we become intimately involved in the lives of humanity (and inhumanity, I'm sorry to say). There is a story to tell around every corner.

My job is to write about it. Catharsis, might be a better description of why I do it. I have to change the names of the players, alter locations and bend the facts, primarily to get the point across more poignantly, and more often, to keep from getting shot at. I only get slapped around on a rare occasion.

Curry & Dal

You might think it’s not true
All the stuff that I write,
Well, I admit I take liberty
When it’s my time to bite,
Because a story reads better
With a passion and fury,
Like a hot spicy dal
In your favorite curry.

I pick simple ingredients
For the stories I tell,
Chosen from factories
Between Heaven and Hell,
Having walked that long road
During my current vocation,
If you've taken that journey
You'll believe my oration.

Sure, I stretch the truth
To lengthen the telling,
You can't knock me for that
And rarely my spelling,
And I use the best synonyms
To color the tale,
Delectable details
So the story won't fail.

I caution, don't take offense
It's not about you,
You might think you identify
But it's really my view,
Perhaps looking you over
And distorting the facts,
If you accuse me for libel
I'll be sharpening my axe.

It's my way of venting
Frustration and pain,
Instead of target-practice
Aimed at my brain,
And although that sounds harsh
I don't trifle with death,
I take counsel for misery
From Lady Macbeth.

Like Mulder and Scully
I'm searching for truth,
Pursuing dirty details
In my career as a sleuth,
Then telling my story
About that 12-hour night,
If I do it correctly;
My narration will ignite!