Friday, June 14, 2013


My best buddy nurse pal of 24 years, died suddenly this week, quite unexpectedly. She was brilliant, knew so much, and thank goodness we spent a wonderful day together, just two weeks ago. We worked together from 1989 to 2001, and then emailed, phoned, visited, went on local adventures (any outing with Linda was unique) and basically, she felt like a sister. I think many others feel the same way about her.

We had countless conversations on medical topics, particularly Cardiology, our shared interest. And we talked a lot about Nursing in general; the good, the bad and the ugly. Usually after I would post something on  the internet, she would write me and comment about it. Back in the days before blogging, when the "Underside of Nursing" was in print, Linda was physically present for many of those rhyming vignettes that I wrote about, our shared experiences in the CCU.

She would have enjoyed this poem:


I never met a care-plan
That made any sense,
Inventors of care-plans?
Please don't take offense,
You were feeling downtrodden
Like you didn't have a voice,
You invented the care-plan...
Not the best choice.

Perhaps you were jealous
Doctors wrote all the orders,
Directed the care
And fired the mortars,
And you wanted to shout
“Hey, what about me?”
The nurse doing the work
Our pay?, almost free.

Now look what you've done
You cluttered our day,
With gobbledygook
We must point-click away,
That later will be audited
To keep nurses on track,
A care-plan, indeed
It's a smoke screen; a hack.

Surely this wasn't
Original intent,
You wanted nursing to have a presence
Inside the medical tent,
But to do it this way
With such a pile of words,
Is like trying to fly with eagles
Little chattering birds.

In our current EMR
Care-plans are a POC,
There are hundreds of them
And it's really no shock,
That no nurses love them
It's just a tedious task,
Another auditing tool
“Oh, please pass me the flask”.

That nurse inventor of care-plans
Should have a statue or a plaque,
The kind that pigeons love to roost on
Leaving guano on the back,
A suitable honorarium
Like the birds in Pershing Square,
It seems like they own the place
Cluster-bombing on your hair.

Wouldn't task lists have been better
Just check them off, as the day passed by?,
Did the infant wet the diaper?
How many times did it cry,
Why call it, a variance in digestion
Or a disturbance in elimination,
Babies pooped their pants for a thousand years
Until care-plans called it an alteration.

Those nurse inventors wanted their own language
Without a care how stupid it would read,
Alteration in fluid volume status
That was Joe-Bob, oh man, did he bleed!?!
And then he had an alteration in perfusion
His brain cells were left gasping for air,
Too bad his bedside nurse didn't notice
She was charting on 14 care-plans, over there.

Christ on a crutch, this gobbledygook
Has tangled up Nursing forever,
Another 20th century invention
Truly an Albatross Award endeavor.


Sunday, June 02, 2013


Once again, another “new build” set of dubious documentation improvements has been downloaded and delivered to our digital disaster known as Cerner. Why didn't I realize that I needed to do more documentation.........that it would lead to enlightenment and Nirvana? I should have meditated more, and perhaps that is why, I am now, certifiably crackers.


I've been storing up
I have lots to say,
About all the hospital nonsense
Going on today,
Regarding digital
Documentation and more,
Every three months
They keep adding a chore,
As if hospital workers
Had nothing better to do,
Than to poke at a keyboard
Instead of caring for Betty Lou.

When processes are lengthened
Smart workers are tempted to cheat,
Finding work-arounds and back doors
To get the job done, nice and neat,
Managers and System Analysts
Rail against rebels and hackers,
But why should we care?
They only feed us crackers.