Friday, August 28, 2009

Maybe you know someone who gets a "bee in their bonnet" regarding some affront to them, whereupon the offended one has to "share" their misery, with anyone within earshot.
I say, get over it dude, or prepare to meet Mr. Hammer.

Mr. Hammer

When she gets a bee in her bonnet
She won’t take off her hat,
I just stand back and watch,
And wonder, what’s up with that?
She starts to holler and screech
With moaning, all about,
"Just remove the damn hat"
I am tempted to shout!

It’s some ownership thing
This pain that she earned,
I can’t take it away
Or I will get burned,
By the heat of her anger
Regarding the bee in her bonnet,
But I have a solution
I’ll slam my hammer upon it.


Thursday, August 27, 2009

People are admitted to the ICU for many reasons. Usually their first questions will not be regarding their length of stay or treatment, but rather, they want food and and they want to to know how to turn on the TV. Let's take a look at that:

On Admission

The most important thing
That we explain,
It's not the heart
It's not the brain,
It's not the
End of life decision,
It's the wired remote
To the television.

What's more important
Than our Nursing role?
The channel-choosing
Volume control,
But heed my warning
You better listen, right now,
That Nurse-call button?
Don't teach them how!


Wednesday, August 19, 2009

Over and over again, I repeat, I WANT A DIFFERENT ASSIGNMENT, every night that I work.

Apparently, nobody gives a rats ass about what my theory is regarding the "care-experience". Heck, it's probably because they don't follow the writings of "The Underside of Nursing".

One Night

We're not family
And we're not friends,
Particularly if
I have to clean your bottom end,
More than 5 times
In the course of 12 hours,
Super-nurse that I may be
I lack certain powers.

I don't want to know you
Longer than one night,
Some relationships are short
And ours just ain't right,
There's no need to prolong
An association such as this,
When I return tomorrow night
You're not the one that I will miss.

I'm a natural born mercenary
I want to choose my own battle,
Continuity, is a concept
That works well with cattle,
But these patients have personalities
With excretions, you can't envision,
Every day a new assignment
Is my career decision.

It's so easy to become enemies
When you're fighting hand to hand,
With a sick and twisted adversary
In the jungles of hospital land,
So, if I had my druthers
I'd fight a different one each night,
They're not my family, friend or neighbor
If I want to treat them right.


And then it came to this:

Transfer To The Floor

Last night my patient
Took her life in her hands,
Wrote notes by the thousands
And made her demands,
Let me walk to the toilet
Let me walk in the hall,
No, I replied
I believe you will fall

Her Doctor had written
That she could transfer to the floor,
Though the time had not arrived
For her exit out the door,
He postponed her departure
Because she acted a bit strange,
He felt she wasn't quite ready
To roam on the range.

She had a previous history
Of alcohol and drugs,
And in my esteemed opinion
Her brain was full of bugs,
Clearly she was infected
With a disordered personality,
I thought, if she gets out of bed
She'll be the next fatality.

Be as that may, she decided
To ante up her score,
In the middle of the night
She transferred to the floor,
Climbing out of bed
Without notifying her nurse,
Was she going to the bathroom
Or looking for her purse,
I'm sure I'll never know
And it doesn't really matter,
On the floor or in the bed
She was as mad as a hatter.

No injuries were apparent
When we hauled her back to bed,
Her escape had been aborted
And she wasn't even dead,
Perhaps a Posey-Vest would hold her
Until my shift was over,
After that I will not care
If she falls from the Cliffs of Dover.


Sunday, August 16, 2009

It's my biannual rant regarding restraints. The regulations regarding what to chart, how often, and what must be addressed are ridiculous for those of us who work in Critical Care areas. So let's roll............and then one follow-up, Coup de Grace.

Extremity Management

By now it's the 21st century
And clearly time to revise an old term,
Regarding a particular topic
That causes some people to squirm
If you're a nurse in the hospital arena
You will know what I'm talking about,
Regarding, the rambunctious patient
Whose mental acuity is in doubt.

For the safety of the patient in question
There are times we must secure foot or hand,
Perhaps they are climbing out of bed
Without a lick of a chance that they can stand,
They may not remember the surgery
The amputation, of five necrotic toes,
They'll leap out of bed like a revived Fred Astaire
And go crashing to the floor; so it goes.

Such an outlandish occurrence as identified
Demands mountains of details in writing,
Old Gimpy, on the floor, has just busted his hip
And his family and I, are now fighting,
They were the ones, in the first place
Who were outraged, when we tied Poppa down,
When we complied with their wishes, and released him
He just figured he’d go dancing downtown.

We’re sued when we do, and screwed when we don’t
Any injuries will be blamed on the Nurse,
Thus I believe, it’s time to toss out the word
The terminology, “restraint” is a curse,
I’ve researched for hours and interviewed for more
And I think I have found the solution,
We need to obscure, the description of our actions
And resolve it with a binding resolution.

I recognize the value of convoluted terms
That were popularized in the business domain,
With an acumen for language, I believe I found the answer
“Extremity Management”, will be the name of the game,
An umbrella of sorts, for a variety of methods
To achieve the best outcome, over time,
Securing, old rambunctious Roberto in bed
And never to be sued for a dime.

We won’t be required to document
The same, silly details each hour,
I’m telling you, that’s such a waste of our time
A guaranteed drain of Nursing power,
We’ll Implement “Extremity Management”
The latest, hot care-plan in town,
With a protocol like that, I can chart in nothing flat
Forcing the Joint Commission to back down.

_ _ _ _ _ _ _ _ _ _ _ _ _

Coup de Grace

Extremity Management is my coup de grace
In the face of excessive regulation,
The protocols in practice, regarding Restraints
Are a conglomerate of nonsensical information ,
Foisted upon us by unreasonable voices
Claiming human, and animal rights,
They don’t have a clue to what happens
When Billy-Bob goes bonkers each night;

His Nurse won’t be found at his bedside
With continuous attention for hours,
She has to attend to her other 9 patients
For their meals, dressing changes and showers,
Upper management won’t find us a “Sitter”
A lowly-paid person to watch Billy,
After all, they would have to pay benefits
And for minimum wage, that is silly.

Now sealing our fate, like a 500 pound weight
Are the regulations regarding restraint,
And the all-seeing eyes, of the management guys
Want a guarantee, there's no legal complaint,
While the Nurse on the street
Spends 12 hours on her feet
Walking miles to appease every master,
When old Billy gets loose
He is one wild goose,
And his condition deteriorates that much faster.

I chart every two-hours
So much that it sours
I mark the same boxes each time,
On my 12 hour night
Billy remains snug and tight
In the morning, he's still alive
Is that a crime?

Some officials might claim
I have doctored the game
To tie down the patient, for convenience,
If Billy falls out of bed
Busting a hip and his head
I am sure a court of law, will show no lenience.

So, I tie when I can
If escape is his plan
Don't look to me
For psycho-social recommending,
Patient safety is my mission
And I'll hook him like I'm fishin'
I've got 12-hours to keep him alive
And that's my ending.


Wednesday, August 05, 2009

Floating (working in an unintended area) can be a nightmare. Not always, but it's a good set-up for a bad shift. Anyway, it was my turn, and off I went to Trauma ICU.

Cut Out

I'm not cut out for Trauma
It just isn't my gift,
Too many busted young guns
Too heavy to lift,
Now, don't get me wrong
This ain't about knowledge,
Why everyone knows
I spent a few years in college.

I'm not cut in the mold
Of the great Trauma nurse,
Masters of bone breaking
And they know how to curse,
Now me, I'm content with
The cardiac arrest,
Stent an artery or seven
Why, it brings out my best,
And let me play Sherlock Holmes
For that complicated EKG,
Just please keep your busted femur
Far away from me.

A visit to Trauma
Once a year, is enough,
C-collar practice and log rolling
Just to prove I am tough,
And then a visit to ICU
To catch the latest in slicing,
Oh, the secret is out
Floating: is so enticing.

Take it from me
I'd rather see Trauma,
Than Neuro ICU
Stuck with Godzilla's Momma,
Fresh off a stroke
In her right hemisphere,
Now that is a nightmare
Where I'd rather keep clear.

All in all, I am jealous
The news-clipping is in my purse,
Down at the big house
There's no floating a nurse,
Or so, the smiley one claimed
But why shouldn't I believe,
UC gets hot benefits
While the rest of us grieve.

I'm not cut out for Trauma
I had a Cardiac birth,
This is no war of worlds
To determine our worth,
We all have our talents
Our specialties and more,
And the patients don't care
When they roll through the door.

___ ________ ___

Slice of Life

A Trauma nurse
No, I am not,
But I love to learn
Why Bob got shot,
And how about Mary?
She paid the price,
When her boyfriend Billy
Gave her neck a slice.

The morbid details
Are fascinating,
The monsters mayhem
Is not abating,
Such an endless scope
Of injuries,
I want to know
So tell me, please.

Hour by hour
In the dead of night,
Visions of trauma
Are always in sight,
And even though
I'm not that kind of nurse,
I keep a police scanner
In my purse.

__ __ __ __ __ __ __

12 Hours

A Trauma nurse?
Oh that, I'm not,
I'd rather have my
Left foot shot,
From a careless moment
Cleaning the gun,
A buckshot foot
Is surely more fun.

Isn't my gig,
The patient's are
Just too damn big,
But like it or not
It's part of the job,
When you buy the corn
You get the cob.

Obstetrics would never
Be my career option,
I just wouldn't fit in
Like a bad adoption,
With lochea's and placenta's
Flinging right and left and center,
Now that is one arena
I have no right to enter.

I considered Neonatal
I heard the babes were really small,
That piqued my curiosity
Call me kinky, that is all,
One kilo is so tiny
I can hold her in my hand,
But to wait for 20 years of growth?
Is more than I can stand.

To be a Nurse Anesthetist
Looked pretty slick indeed,
Passing gas for hours
While I watch somebody bleed,
But I'm a little claustrophobic
Stuck in the operating suite,
I'd rather be more mobile
On my bloody buckshot feet.

I'm settled in with Cardiac
In the middle of medical mysteries,
Instead of just dealing with body parts
I get to know the whole sordid histories,
Dwelling on complex disorders
Fills me with ideas and drama,
And having stuck with this job, for all of these years,
I play the role of the old and wise Lama.

I'm not a trauma-pedi-bari-neo
O-b kind of guy,
But when forced to float, I'll do my best
To make 12 hours fly.