Wednesday, May 25, 2011

Wonders never cease. She's one hundred and four; Alzheimers, dementia, blind, living in the nursing home. A GI bleed brought her to the hospital and a visit to Interventional Radiology, where she had a cardiac arrest on the table. Well yes, of course she is a full-code, because her adult kids want everything done. Now she's on the ventilator in our unit, with the family expecting a "full" recovery!?!

One Hundred and Four

One hundred and four years of age
As if that’s not too old,
To perform goddamned heroics
And still the family will scold,
The doctors and nurses,
During that long CPR,
Because Momma is busted
Like a broken down car.

Suffering forty years of old
She went bad, after sixty-five,
It’s a wonder, this woman
Can even claim to be alive,
She has a spongiform brain
And Alzheimers too,
Her children are convinced
That she can still count to 2.

She’s on the ventilator
She had a GI bleed,
Her skin is like tissue
Where the bacteria feed,
Her heart beats a rhythm
Unclassified in the books,
This is not rocket science
Despite how it looks.

She's just an old, worn out woman
She can't tell day from night,
But her family wants everything
And they're willing to fight.

__ __ __ __ __ __ __


Grandson takes care of her
He's on the county dole,
He's hoping she'll make it to 105
Before he puts her in the hole,
Then he can put all of his attention
On his sadly, stroked-out Mother,
He hasn't been employed in ten years
So he'll be looking for another.

Impaired relatives are his specialty
They can name him in their wills,
Who would ever suspect this caregiver
Who is handing out the pills,
Yes, this grandson, is a piece of work
He's found his niche in life,
Taking care of family members
Instead of taking a wife.

I'd be careful if I went visiting
To the house of his holy endeavors,
Expecting trap-doors in the floors
Controlled by hidden levers,
Incapacitating me in the process
To become, his next bedridden fool,
Suffering to the very end of my days
As his financial-freedom tool.

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

Little Miss Last Century

Extubated at last
Comfort measures, and a no-code,
Maybe Miss Last-Century
Can finally retire to her abode,
An impending celestial discharge
To be carried gently to her Heaven,
Her grandson stepped out
He's down at the 7-11.

Pain and suffering
And unsavory medical measures,
Are finished at last
She's done with earthly treasures,
She may appear unconscious to us
But she's in direct communication,
As the Divine beckons to her
Her spirit reaches out, with anticipation.

Grandson raises a ruckus
When little Miss Last-Century dies,
Five minutes after her transfer
He's full of anger, that's no surprise,
He lost all precious control
When Grandma finally checked out,
His true nature clearly exposed
Absolutely, there's no doubt.

Sweet, little Miss Last-Century
We suffered too, there by your side,
Administering your care so gently
Until the day that you died,
Rejoicing in our own ways
That you cast away the shackles of Earth,
A little piece of advice to you
Take a long rest, before your rebirth!


Sunday, May 15, 2011

On the theme of old nurses again..........I'm one of them.

Diagnosis: Aging

It's a strange world I live in
As nurses, we're getting older and aging,
Body parts moving around
And other battles are waging.

High blood pressures
And gall-bladders perturbed,
Crazy habits that we had when we were younger
Now just leave us disturbed.

Quite a few things we used to eat
That we no longer can do,
Most of us have gotten fatter
And a few of us can't chew.

And now we stand around the water cooler
Chewing the fat,
Talking about our body image
Because that's where it's at.

Like some kind of one-upmanship
My disease is worse than yours, Mabel,
Then she talks about her high blood
Diabetes and psoriasis
And man, I don't want to be at her table

We compare our doctors
Our therapies and our medicine,
You think yours is better than Einstein
And mine is better than Edison.

Some talk about their family's
And their irritating habits,
Others exaggerate their problems
Like reproducing rabbits.

This is life after 50
We’re all drifting downhill,
The diagnosis of Aging
Is one bitter pill.

I heard the term, "hostile abdomen", while attending a seminar yesterday. I immediately recognized it as the perfect line to a new poem; have a look.


He had a hostile abdomen
An angry bowel,
A devilish duodenum
And a gall-bladder scowl,
His kidneys were complaining
His pancreas perturbed,
His liver was livid
And his spleen was disturbed.

All in all, his hostile gut
Was threatening to rebel,
His appendix was the renegade
Leading them all to Hell.


Friday, May 13, 2011

By and large (sometimes, very large) here in the nation of California, we are generally, a baby-boomer nurse constituency. So what happens around the proverbial water cooler? Yes of course, we talk about our own aches, pains, disorders, changing shapes and so on. And just like our patient population, we would all benefit if we could only improve our choices of food. Anyway, that's my diagnosis.


When Diverticulosis
Becomes Diverticulitis,
You'll know your diagnosis
Has become a diagnitis.

Your doctor advises
Take no nut,
Because they won't exit
Out your butt,
Instead they'll fester
In your gut.

Sage advice
One would think,
That's nuts and bolts
And the kitchen sink,
Don't be chewing
On that chunky stuff,
Your gut will protest
And scream, “Enough!”

Pain will ensue
And you'll visit your doctor,
He'll advise colonoscopy
With a GI proctor,
Inviting all sorts of
Differential diagnoses,
Scaring the crap out of you
With your diverticuloses.

Get a clue now
And change your diet,
But if you don't want to
Please keep quiet.


Tuesday, May 03, 2011

It speaks for itself:

PoGlobin Index

An anomaly last night
Caught my ever-sharp attention,
There were laboratory values
That deserved a special mention,
The potassium was high
And the hemoglobin low,
In fact, their numbers matched
I saw the light, and it did glow!

A new prognostic indicator
Struck me on the head,
When the “K” and Hemoglobin match
You might soon be dead,
In the telling, what the value read
Was a gentle seven-point-two,
But those of us, who know the stuff
See the Reaper, coming for you.

Values incompatible
Organ systems halt,
Prognostic probes and platitudes
Propose a deep gestalt,
Code-status lurks beneath the waves
With nurses standing by,
Will we flail another suffering horse
Or wave a fond goodbye?

The new PoGlobin Index
Could revolutionize our field,
Retrospective analyticals
Would have a tool, that they could wield,
In the ever growing science
Of hindsight recognition,
PoGlobin Index data
Would be like gold to statisticians.

I am sure my future practice
Critical-this, and that beyond,
Whether here in good old USA
Or there, across the pond,
Will build upon this moment
Of genius in the rough,
PoGlobin Index was my baby
Building my fortune and that's enough.


My nightmare came true
During that 12-hour shift,
I had a one-to-one patient
Plus two others, get my drift?

My dream came to life
On that 12-hour trip,
I was a desperate crewman
On my own sinking ship.

No, I couldn't do the things
That needed to be done,
I couldn't load the bullets
Into my gun.

I couldn't shoot the captain
Of this crazy ship of fools,
Because our leader was missing
Having broken all the rules.

I couldn't do my duties
That needed to be done,
But nobody died
So I guess, somebody won.


(* It's a recurring nightmare that I've had for years, where I've “forgotten” a patient for an entire shift.I'm sure it is a symptom of work-related PTSD, but still, to act it out in reality, is disconcerting).