Monday, April 29, 2013

25 Times

Healthcare workers getting sick? Yup, we ain’t no more special than the rest of you blokes. My affliction, appeared to be some variant of food poisoning, or “intestinal bug”. Frankly, a 48 hour trip to the loo, won’t be high on my list of exciting recommended excursions. However, as I speak, it was prolonged enough to earn me a day of paid-time-off.

On another note, I certainly empathize with those numerous patients, who had C-diff, or other similar afflictions, requiring frequent linen changes.

25 Times

25 times,
It sounds kind of exciting
And even though it rhymes,
I wouldn't recommend it
To any kind of friend,
Because 25 expulsions
Makes for a sore bottom end.

25 repetitions,
Like some kind of penance
From a priest with weird ambitions,
Exploring my fortitude
Amidst the storm in my colon,
Like a conveyor belt of garbage
At the dump; it just kept rolling.

25 trips
To the johnny isn't fun,
Quite often one must canter
Or even, flat-out run,
To avoid public embarrassment
And the horrid, proverbial "Oops",
Your pants show the evidence clearly
You lost the handle on your poops.

25 rounds
Of emptying, got old,
I'm feeling so vacant
Like my intestine was sold,
To the junk man down the street
Collecting bottles, rags and cans,
But wait, there's more, I'm just saying
This wasn't part of my weekend plans.


A Liquid Insurgency

At times I think
I'm pretty tough,
But 25 trips
Was quite enough,
8 Hours had passed
I thought, now I am free,
The last chapter played out
On my diaree.

Not so, said my colon
There will be no relief,
Today is day 3
And it's time for more grief,
Let's have more of the same
Your condition didn't pass,
We tricked you for a while
When you only passed gas.

But I was feeling better
And finally ate some dinner,
I slept all through the night
Thinking I was the winner,
But later, after breakfast
There was a rumbling in my gut,
Then a liquid insurgency
Was departing my butt.

I'll hold out till day 4
I'm a tough nut, you'll see,
Then I'll ask for advice
From Doctor McDee,
He might have some insight
On this intestinal issue,
Or consider it a prompt
To invest in toilet tissue.

_ _ _ _ _ _ _ _ _
Gurgling Gut

Diarrhea, Day 8 - Final
I was so damned sore
I needed a spinal,
But that condition waxed and waned
And finally quit,
Thank goodness!; my colon
Had quite enough of it!

Now thirty days later
I still have gurgling gut,
After that scorched earth clean out
Stripped my colon to a rut,
So now I'm rebuilding
New intestinal tissue,
A recommendation?
Don't make this your issue.


Tuesday, April 23, 2013


I saw a memo the other day addressed to nurse-management people. They were directed to show all the HCAHPS (hospital survey, patient perspective of care...... reports, fliers, rah-rah posters and so on, in our break-rooms. This is the place where we are allowed to relax, kick back, raise a non-alcoholic brewsky, attend to our bodily functions, and so on. Why force us to read this gobbledygook? We’re the frickin’ people busting our butts, trying to do an impossibly great job, with too few resources. This is FUBAR! Show the stinkin’ results in the Lobby, if you must, so the consumer public can feel good about coming here.


If you trademark a name
Does it make the product any better?
For example, "Intelligent Surveys"
Examine each vowel and letter,
Are these the best-ever surveys
More intelligent than all the rest?
I pose this trademarking is a gimmick
No more and no less,

Saying, "We are intelligent"
Smacks of superiority attitudes,
HCAHPS, Unadjusted Avatars
And other gobbledygook platitudes,
Quite frankly, I'm not impressed
I don't need to incorporate it into my practice,
This is more corporate subterfuge
Their attempt to redact us.


CV, Again

Would you be willing to undergo ten cardioversions and four separate ablation procedures, including a MAZE procedure, to stay out of Atrial Fibrillation and Atrial Flutter? Some people with Persistent Atrial Fib, who are treated with anti-arrhythmic medications, never feel good, and that was why they opted for Ablation (potentially several). I think the last resort, is to have the AV Node ablated (annihilated) and then, have a pacemaker inserted. How sensible does that sound?

Thus, once again, between rounds of golf, Billy-Bob had another CV, again.

CV, Again

Electrical cardioversion, oh my!
Was the 10th time the best?
Well, let's ask the guy.........
The good man on record
With the most persistent A. Fib,
Ten times he's been zapped
Without busting a rib.

Oh, CV again
His claim to fame,
From Palm Springs to Maui
Working on his golf game,
Then he comes home to Cali
For a breather, and Bam!
While resting on the weekend
His heart dances flim-flam.

Yes, CV all over
And over again,
Ablations times four
Electricity times ten,
Yet still, he maintains
The best outlook, and why not,
Golf needs to be played
To the very last shot.


Thursday, April 11, 2013

Snooze and Play

As nurses, the day comes when we see the person who announces their badge of  "Disability", waving it proudly, as if they served in some kind of liberating war. I am not talking about those actual military veterans, but rather, those persons who regale us with their stories of medical problems, and how, they can't possibly work any kind of job, because they are disabled.

To me, it's like the folks that stand at the Freeway-ramps, begging with a sign, and they have two good arms, two functional legs, they are not blind or deaf, and in other words,  they seem able and functional enough, to perform some kind of labor so they are contributing to society (and possibly the economy), rather than sucking down resources like a storm drain. No, they would rather snooze and play.

Snooze and Play

Here's what I discovered
When I examined your medical file,
You've been alive for 50 years
But you've been dying for a while,
You can place some of the blame
On each beloved parent,
But please, examine your lifestyle
It is decidedly aberrant.

Genetics certainly played a part
But you abused, as well,
Heart repairs times three now
And you quit the drugs from Hell,
You laugh and joke and talk too much
Are you fourteen going on fifty?,
What a carefree life you lead now
Seems you love it, it's so nifty.

And another thing, my friend
Are you working, and why not?
Oh, I'm on permanent disability
Good looking, and I'm hot,
You could ask my lovely wifey
But she's working hard today,
After all, we need her income
So I can snooze and play.

I'm only 50 years old
My wife's best friend is my driver,
She tells me Jesus loves me
She's my right-hand, pal-advisor,
Sitting at my side in bed
Acting like, my loving wife,
Who is hard at work in the Nursing home
As I whistle on my fife.

What is wrong with this picture?
Nurse-me, I ask the wall,
I have a best-friend transplant recipient
Working hard as a nurse, and all,
While Joe Bob with his heart repairs
Sure looks like he could work; it's a fact,
Another abuser of medical welfare
His disability is surely an act.


No Pass Zone Research

No Pass Zone Research

I felt it was time to do some research, in respect to the "No Pass Zone" directives, that I wrote about a week ago. It appears that once again, the East coast got the jump on this idea (in roughly 2010) and then we cliff-hangers on the West coast caught on a couple of years later. It's always like that, so don't complain. Still, I am astounded that I am the only person bringing to light, the potential for liability, damage, Sentinel Event, and so on, with the initiation of policies of this nature.

Don't get me wrong; I am not advocating that we ignore patient call-lights. In fact, I am advocating for the Safety of all of the patient's in the hospital. But I know what the bottom line's all about "patient-satisfaction" scores. The questions that are asked of patients, after they have been discharged, are carefully scripted. If I call Mrs. Jablinzky, and ask if her call-light was answered in a timely fashion, she might say "Yes, ever since they started that No Pass Zone thing". But if I also ask her, "Did you mind it when the stranger in the blue and black uniform, appeared at your bedside at 2am, (when you had rolled over onto your call-light), asked you in a gruff voice, "Can I help you, Ma'am?" She would probably admit, that he scared the bejeezus out of her. And this probably begs the suggestion, that during the night hours, only the Nurse, CNA or MD, enter patient rooms.

The more research I do, the more disappointed I am with our Medical Corporate entities and the nonsense decisions they make, all for the improvement of patient satisfaction scores. Or is there some other reason that I haven't caught on to?
Do tell.


Wednesday, April 10, 2013

Memo Madness

Lacking rhyme inspiration, there is still a continuous supply of nonsense to comment on in my workplace.

This week, another round of regulators are heading our way; The Joint Commission. Ah, if only they would pass out some joint's as a reward for good behavior, because there are times when marijuana has some very worthwhile features. I mean, after all, don't these Regulatory officials just make everybody really nervous and tense? Hot damn, they sure do, and some mj, would be good for all. Hmph, I can only wish.

These forays of FUBAR are always accompanied by a one sheet page of "helpful tips", just in case one of us is accosted by a surveyor. We earned a list of eight key points, and I'll address a couple.

Demand #1. Gloves can not be worn in the hallways by anyone.

  • First, does this include visitors too? Even the sweet and refined elder members of our local society, who sometimes wear lacy gloves when they are out and about? Do I contact the Security Officer, to report a glove-sighting, and perhaps he can issue a citation?
  • Second, what about me, the RN, when I'm transporting a patient via a common hallway, who may have a propensity for bleeding, coughing, vomiting, or spewing some other type of bodily fluid? Per hospital policy and OSHA regulations, I am required to wear protective clothing or gloves. If I am not wearing gloves, and the patient begins to bleed, am I allowed to let this continue, until we arrive in a patient-care area, where gloves are now allowable?
  • Third, Joe-Bob, the Joint Commission Surveyor, slips and falls in the hallway near the lobby, smacks his face on the safety hand-rail and is now hemorrhaging, in view of fourteen other visitors. Nurses and other emergency responders leap to his side to assist and resuscitate (if necessary)............and suddenly realize, they are not allowed to wear gloves on their hands in a hallway.
This is hilarious isn't it? Once again, I propose we bring Risk Management, Infection Control, the CDC and anybody else with a lick of common sense to take look at this proposed nonsense.

Demand #2: Check all doors to assure that locks are working and securing sharps.

  • First, I'm not sure if that is a complete sentence.

  • Second, "Sharps" I guess, have to do with the sharp and pointy things we wield on occasion, usually in proximity to a patient. Does the memo refer to all doors and all locks? If, at the end of my shift, when we are closing up for the night, why can't I just lock the doors of the room; why must I also lock the cabinets. It stands to reason, if Billy-Jo the thief has the know-how to break into the room, he will also know how to bust into the cabinet where sharp, pointy things are held. So why all the locks? (Cabinets and doors, windows and drawers). And technically, the "Used-Sharps" boxes are not truly locked; any person could easily reach inside with a small hand, or with a hemostat, to pull out all the sharps they wanted. Seeing as this "lock up the Sharps" program is designed to reduce the opportunity for bad people to steal good needles, one might suppose those same people don't really care if the needle is clean or not. I say, let them have the dirty ones at their own risk.  

Well, once again I’ve had my fun!

On my previous post regarding the “No Pass Zone”, you may recall the theme of that directive, was that ANYONE is expected to enter a room where a call-light has been triggered. Now we have yet another demand for the proverbial ANYONE................ “can not wear gloves in the hallways”. This is just another perfect example of all those idiotic “Zero-tolerance” edicts, currently being shoved down the collective gullets of Americans. Good-bye to common sense!


Friday, April 05, 2013

No Pass Zone

No Pass Zone

From the "Hot New Idea" Department:

For our valuable patients and attentive, loving visitors, we bring you the "No Pass Zone". We are telling each and everyone of our esteemed employees, that they may not pass by a room, if they see a call-light triggered. The only exception, is if they are currently transporting a patient somewhere else in the facility.

You will love being our patient, because when you need help and put on your call-light, Anyone can help you. Yes, we mean everyone and anyone. (We even told that scary guy who looks like Rasputin, that he should respond to your plea for help, too.) All he needs to do, is to tell you his name and what department he is from and he will help you. Heck, nobody is a stranger at Sister Euphemia's joint; when you become our patient, you join a family of thousands of unknowns.

Now, since Anyone can help you, that includes the freak who delivers the Pepsi-cola to the hospital, because he is wearing a uniform that looks just like the outfits worn by our own, helpful Engineers. Of course, you won't know that, nor the fact that he hasn't undergone a background check. He isn't even an employee here, but he does love helping vulnerable women who are in hospital gowns.

Yes, that is the homey atmosphere that we are trying to create.

The "No Pass Zone".

Yes, this is a dandy new policy, that's for sure. You will have all of your needs attended to, lickety-split, by someone you have never seen before and the odds are, you'll never see them again. And then, maybe you will remember the good old days when you really got to know your Nurse, even though sometimes she couldn't come immediately to your bedside. When she came, you recognized her and it was comforting and you felt safe....well, those simple carefree days are long gone.

Yep, now we are applying the modern concept of crowd-sourcing, to patient-care.
_ _ _ _ _

Now team, how about some communication scripting, to help you get off to a good start with our new policy?

"Call-Light" on:

Joe Janitor just finished his "No Pass Zone" training and he is ready to put it to work. He has just finished unplugging a toilet, when he notices the light on, in room 434-B. He understands he must stop and offer some help.

JJ: "Hello ma’am, I am Joe the Janitor. I saw your light on, how can I assist you?"

At this point, the patient wonders too, because she needs a stool-softener and this guy said he was a janitor and she is so embarrassed, that she mumbles something about making a mistake that she bumped her call-light.

Lady: "Who are you? You don't look like my Nurse and I think you ought to leave."
_ _ _ _ _ _ _ _ _

Come on now, where the heck is Risk Management when these crazy policy ideas are being formulated? What is the review process that allows nonsense like this to be turned into a, "You must do it" policy demand?

This policy creates an open door invitation for any deviant, predatory nut in a uniform or professional attire, to walk into a patient-care area, in the ruse of answering a call-light. How soon will this propagate a "Sentinel" event?

"No Pass Zone"!.................= ............."Insanity!"

If my wife or child was in the hospital, and any Tom, Dick or Scary-Mary could walk into their room without invitation, or appropriate purposeful cause, merely because a call-light is on, I would be very suspicious of their stated intent. An RN, CNA, Monitor tech, MD, Physical Therapist, Dietician etc., these are appropriate. They comprise a group of typical caregivers, and are easy to keep track of. But to have a hospital-wide policy that invites and authorizes Anyone, to respond to a call-light, is absolutely ludicrous, irresponsible and potentially negligent!

We have left in the dust, the bygone days of good, personalized Nursing care. In exchange our employers offer the present day version of an outsourced, fragmented, "who was that guy in my room" open-invitation, free-for-all, toss the chainsaws in the air and let them drop, kind of corporate attitude.

And for that:

I give it a "NO PASS"!