Sunday, February 21, 2010

Times have changed over my career. (30 years)

There was a day when one might work in a "pure" Cardiac unit, where one saw primarily persons with just Myocardial Infarcts, Heart Failure, etc., and their various treatments. Now, those places are few and far between. Sure, the patients had other problems, but most just dropped in for 2 or 3 days, to receive treatment, for just their heart problem. Thus, all the nurses in the unit became Cardiac experts over time. Fast forward to now, with people living longer, getting more health problems over the years, with a greater degree of complexity, and we critical-care nurses, must become near-experts in whole-body medicine.

Essentially, what I described above, undoubtedly represents the maturing of the nurse-individual over a long career. I guess I share that distinction, yet I remain highly interested in the diseases, therapies and arrhythmia's of the heart; that's what I bring to the table. Luckily, I work with many other highly educated and vastly experienced nurses, and together we form a powerful force of good, for the patients that we care for.

But still, I poke a finger at us and try to make it funny.............go figure?!?

The Battle Of The Brady's

'Twas the battle of the Brady's
Jousting in the corral,
Was it caused by poisoned water
Like the famous Love Canal?

Were they age-related impulses
Unclear just how to work it?
Or knotted myofibrils
In the conduction system circuit?

Was the SA node too sickly
Or the AV node too slow,
Were the atrial motor pathways
On the stop and not the go?

Well, I opened up a chart or two
And discovered other answers,
There was a Digitalis suicide
And the other, a heroin dancer.

He was a boyish seventy-fiver
She, an ancient forty-sixer,
She'd mix heroin, cocaine and crank
Thrown together in her KitchenAid mixer.

He was despondent and lonely
His investments had gone down the drain,
So, why not take thirty Digoxin
And say "Goodbye, bon voyage", to his pain?

Now parked in a critical-care place
Where cardiac experts are few,
It's ho-hum when the heart-rate hits thirty
Quite frankly it interferes with the view,
Of Bobby-Joe showing his photo's
On Facebook, Picasa and Flickr,
"Oh look now, there's Bobby-Sue's baby"
And the local chums, giggle and snicker.

But here in the 21st century
We juggle mysteries like the jesters of old,
Knowing that illusions are paramount
For selling the goods in the hold,
We manage such multitudes of misery
Looking like mavens of medicine,
Caffeinated nurses got it covered;
We'd be the envy of good Thomas Edison.

Hence, the battle of the Brady's and Boomers
Neck and neck, at the end of the night,
The Brady's were beating at twenty
While the Boomers were ready for flight.


Saturday, February 20, 2010

Either we're getting really good, or some people don't die easily. This patient was a Type 1 Diabetic. For lack of insurance, she hasn't bought Insulin in 2 months. She was found down at home. Upon admission her pH was 6.8, a glucose over 700 and an unmeasurable bicarbonate. In any population, that is considered so near death, as to be considered as virtually waiting before the pearly gates. Now it's 24 hours later and she's talking about little Muffy her dog. Like I said, some folks just don't die easily.

Diabetic Curse

The diabetic patient, can
Be their own enemy, my man,
If they don't follow their diet orders
Their blood sugar will go beyond the borders.

Or say, they're on the Insulin shot
Two times a day, whether cold or hot,
But then they stop for a month or two
Surprise, surprise, their death comes due.

We try to save that unfortunate mate
Whose blood pH is 6.8,
And a glucose of one thousand two
Of the many we treat, we save but a few.

It's a foolish death, but survival may be worse
And that's the diabetic curse.


Wednesday, February 17, 2010

There is a job opening, and I figured, better to hire the local guy who knows the ropes. Too bad, I can't tie a decent knot.


I was interviewed
And it was good
Like any righteous grilling should,
By, just the Boss,
I had prepared myself
With mental floss.

It took place
In the hospital venue,
And followed the tried and true
Interview menu,
To pose ten questions
About this and that,
To find out where
My head is at.

To ascertain
My sanity,
Did I seek the position
For vanity?
Do I want to rule
With an iron hand?,
And will I do
What the boss has planned?

All in all
I think it went well,
Like a well cooked pot-roast
With that barbecue smell,
And now I must wait
On bended knee,
Wondering, "Who will be chosen
That other guy or me"?


Friday, February 12, 2010

Am I a Nurse or a Waiter / Waitress? Last night it seemed like I was a Waiter, but I sure didn't get any tips!

I'm A Waiter

Tonight, I'm a waiter
Tomorrow, I'm not,
What is the difference?
I won't be here in this spot,
Catering to
That man with a switch,
He makes an announcement
"Hey Buddy, I've got an itch".

But he's not really helpless
He worked 5 weeks ago,
He didn't break any bones
He had an earache, to show,
But it morphed and it broiled
And seeped into his neck,
Now he's landlocked and bedded
The train crashed, he's the wreck.

Twenty minutes times three
That's 3 calls an hour,
He's 27 years old
And he must have more power,
Than the strength of his thumbs
Dancing Salsa on the call-light,
"Yes sir, what do you need"?
It will be a long night.


Wednesday, February 10, 2010

The world is so weird, that I have an endless supply of ideas to tap into. Take the story I read that was posted in the newspaper, "Telegraph" from the U.K. The writer reported how in China, there are unscrupulous vendors who are marketing a diet pill, that actually contains viable eggs of the Ascaris Tapeworm. Well, hot damn! I guess that will cause you to lose weight......among other things, especially when one understands that they can produce 200,000 eggs per day. Yowza! That's gross.In fact, it makes me squirm.

It Makes Me Squirm

Because it's in China
It's the reason I believe,
I've heard they'll eat most anything
What an accomplishment to achieve

Yet, despite this foreknowledge
These things that I learned,
I'd think there'd be limitations
That even Chinese, would have spurned.

So imagine my surprise
That turned to horror
When I read it,
There's a brand new crazy supplement
You can buy with cash or credit,
To assist the overeater
Shed those pounds
They need some help,
After failing with the Exlax
The Colace and the Kelp,
The concept, the idea
It really makes me squirm,
What kind of crazy dieter
Would swallow a worm.

A tapeworm at that
The Ascaris parasite,
They lay a hundred thousand eggs
Every day and night,
But don't worry, it's safe
If it's on the Internet,
Guaranteed truth in advertising
Are you willing to take the bet?

The Ascaris tapeworm diet pill
Is a winner, there's no doubt,
Don't believe the medical experts
They don't carry any clout,
And don't worry about nasty side effects
The worms are always pure,
Infestation is the way to go
It's the latest obesity cure.


Wednesday, February 03, 2010

Young, large, seemingly getting along ok. He holds a job, still lives at home, drives a car. What could go wrong? It's not unusual to have Otitis Media, but an abscess in the neck, can cause swelling and compromise the airway of just about anyone. However, if one weighs close to 500 pounds, the potential sequelae of an invasive infection, well that's quite another story, indeed.

500 Pounds

500 pounds
With an infection in his neck,
It swelled his airway
And what the heck,
He couldn't breathe
And all hell broke loose,
Now he has a trach in his throat
And his bowels are loose.

500 pounds
27 years of age,
His weight is a shackle
In the obesity cage,
He thought a simple ear ache
Was just a bother, with some pain,
Now with respiratory failure
He might be easily slain.

500 pounds
His skin is wearing thin,
Septic emboli and toxic shock
He's rotting deep within,
His gut is sloughing out
Drained with a tube and bag,
His family hang by the bedside
Waving their hopeful flag.

500 pounds
It's a horror and a curse,
It's a premature invitation
For transport in a hearse,
Not a typical expectation
For one so young and in their prime,
Trapped by morbid obesity
Is the sentence, to the crime.