Friday, February 24, 2017

Intra-aortic vs. Intra-erotic

Well, the title tells it all; so be careful with terminology.

Intra-aortic vs. Intra-erotic
A swap of one letter
And timing dicrotic,
Both involving position
Of a foreign body,
Regarding cardiac output
Or your favorite hottie.

Key factors, stroke work
Performance and action,
Attention is paramount
There should be no distraction,
You will achieve the best results
If  you control your design,
Those intra-aortic-erotics
Then, everything will be fine.

Tuesday, February 21, 2017

Bad Investment Part I

Bad Investment

What a classic case
Of non-compliance,
Disguised as defiance,
Anxious, stressed out
About the whole crazy scene,
When his girlfriend came to visit
She brought amphetamine.

Two days pre-op
Aortic valve repair,
This surgeon will cut anyone
That seems to be moving air,
Active drug user?
Sure, that's OK,
Used drugs while in the hospital?
Hope ya had a nice day.

Lives in the bushes by the river
Ya, he's a great candidate,
Cut him open tomorrow
There's no reason to wait,
Are we worried about follow-up?
Well, just a little bit,
He promises to take his medicines
Each time he takes a hit,
With amphetamine, marijuana
And cigarette smoking,
Does this doctor have ethics?
Come on, you must be joking.

He says, I am a surgeon
And that's what I do,
He offered a two week tuneup
Before he cut on you,
Saying that is enough for
A good surgical choice,
No one wants to argue
When he raises his voice.

Some might say
Well, who am I to judge,
That I don't like this doctor
And perhaps I hold a grudge,
But this is public medicine
And all of us are paying,
Take care, this is an investment
That's all that I'm saying.

Bad Investment Part II

Reason for admission? Benzo & amphetamine overdose. Lives on the streets, chronic drug user, and by chance a routine chest x-ray identifies a bulge at his aortic arch. Health insurance? heck no! A CT Angio reveals an Aortic Aneurism at the critical stage........Once the dude gets off the ventilator, becomes somewhat lucid, the multi-disciplinary team (lacking discipline, if you were to ask me) get together with Joe Bob and have the big discussion. Something like this:

Team: Joe Bob, we saved your life and we want to do it again, how about it?
JB:   Uh, ok. Hey, can you get me some dope first?
Team: No, Joe Bob, you're done with that stuff now, forever.
JB:   Uh, ok.........but, can't you just let me roll a doobie now, so I can think it over?
Team:  No, Joe Bob. What we are going to do is let you get clean for a couple of weeks, then we're thinking of sawing your sternum in half, rip open your aorta and put it back together with wires and staples and other shit, and then you'll be all better in about 9 months.
JB: Hmm, sounds crazy. You know, I need to go to the powder room right now.

Over the next two weeks, Joe Bob goes to the parking lot about 4 times, to clear his head. Right; how about for a little snort of Meth!

And that's why he was the winner of an Aortic Valve repair.

Monday, February 20, 2017

Age-Weight Score

Another way to measure up.

Twenty-eight years old
Weighing twenty kilos,
She weighs about as much as
Two boxes of pillows,
Which isn’t enough
To sustain prolonged life,
Hopefully a husband
Didn’t starve his wife.

Whether kilos or pounds
It rarely works out,
If it’s the same as your age
There is reason to shout,
Something is wrong
Almost all of the time,
Forty kilos at age forty
Isn’t optimum prime.

Ninety kilos at ninety
Or maybe, ninety pounds,
In this day and age
Where too much abounds,
Either unit of measurement
Gives cause to investigate,
What is Aunt Betty eating
How much is on her plate?

Protege 2

Here is the sick and twisted sequel to the original "Protege" (December, 2016). This story is pure fiction, but would make for a great hospital whodunit.

Oh protege
Look what you did,
You killed that guy
And then you hid,
But worry not
Listen to your mentor,
When the blame is cast
I will be the dissenter.

I will show you how
To make them look,
Somewhere else
In another book,
To obscure the trail
Of evidence and blame,
This is not the time
To ruin your fame.

Now, there is a pittance
A fee to pay,
So your good reputation
Doesn't fade away,
So early on
In your distinguished career,
Just pay it once
At the beginning of each year.

You won't tell
And neither will I,
What caused Billy Bob
To die,
It seemed natural enough
And it was kind of expected,
But, going out of the window
As if ejected?
That was a tough sell
And you gotta be thankful,
So, pay your fee each year
To keep my bank full.

Oh protege
I knew at the start,
He's the cream of the crop
Clever and smart,
With career potential
Clearly off the charts,
And if you do as I say
You'll be the Master of Arts.


Oh boy, finally we don't have to play dress up in bio-hazard yellow, when we enter the room of the patient with MRSA. Sure, of course, we practice Universal Precautions, cuz that's what we do for everything (especially when eating in the hospital cafeteria). Since I be the achey-breaky nurse, anytime I'm helping with cleanup, I'll wear yellow, because I visit a lot of different patients during my six hours, and thus, I'm a highly developed fomite under power, so to speak.

But here's the real news, once again:

MERSA used to be the thing
Everyone had it, tra-la-ling,
We did isolate and wear the garb
And we poked your nose with a mini-barb,
But now the latest directorate
Says, oh why bother, to protectorate,
If everyone has it, then so do you
Goodbye MERSA, so long, boo hoo.

What this all means, we need a new adversary
To don the gowns and gloves, and act kind of wary,
Until we know the enemy and develop our tools
And someday our descendants will call us fools.

Thursday, February 16, 2017

Dental Dana 58

Apparently an old dog, may not learn new tricks.........

Dental Dana
Prepares for duty,
She straightens her hair
And shakes her booty,
For a memorable entrance
Walking into the room,
And every time she does it
My heart goes boom.

DD took an oath
To perform at her best,
In the eye of the storm
No matter what the test,
Because dealing with the public
In a service role,
Requires finesse
And a sharp pronged pole.

Every single appointment
Is unique and fairly risky,
I try to be good
But I always get frisky,
I just claim that I’m weak
In the presence of a goddess,
(But it surely doesn’t help)
When I sneak a peak
Beneath her bodice.

Wednesday, February 15, 2017

Hot Diggity Outsourcing

For some reason, not shared with the general regular employees, the hospital is now undergoing a very deep cleaning. So deep, the job has been outsourced to a group of blue garbed, female tape-scrapers. Can you imagine the very unsafety of their job, that a person would employ a razor-blade window scraper, to remove tape and other sticky substances from hard / smooth hospital surfaces? Even in the Laboratory?!? I'm wondering if there is a special clause in their contract (probably denying them compensation) should one of them accidentally perform a finger laceration with a blade carrying 42 layers of resistant bacteria, when they were cleaning the Laboratory two weeks ago.
Once again folks, I am not creating fake news; this is real-time reporting!

It is super-hospital-cleaning week
Five contracted specialists
Down on the floors take a peek,
At all nooks and crannies
Including the chairs,
Deep cleaning the swivels
I ask you, who really cares?

It’s another hotdog diggity
Delirious decision,
Five cleaners at a time
An eight hour vision,
Of scraping and wiping
Tape removal and more,
I figure at twenty per hour
This is one expensive chore.

Night after night
An outsourced cleaning crew,
They didn't query me
And they didn't ask you,
If this was a sound
Clear-headed decision,
Yet, these are the ways
Of hot diggity vision.

Monday, February 06, 2017

Pain from the RASS

I am a little late writing about this, as it has been in use for a few years now. But thanks to somebody, I have now given it my attention.

Here is another Audit-glory Tool; allow me to present to you the:

Richmond Agitation-Sedation Scale.
Never, in any Nurse-to-Nurse report did Betty Lou say to me, Billybob has a RASS of minus two, positive. Instead what they probably reported; Billybob is totally whacked out, slugging and spitting at his caregivers between bouts of profound somnolence. And incidentally, I told the Doctor the same thing. So why is there a RASS? To audit us, of course, you fool! It probably fits in somewhere, on that down-home favorite, the APACHE score.


As if we didn’t
Have to do enough.

Always remember
To do that RASS, mutt,
Or some invisible Auditor
Will kick your butt.

At first there was AIDET
And then there was NO PASS,
Ask any honest nurse
They’re all a pain in the ass,
And don’t forget that Apache Score
One more shackle
To grapple with on your shift,
I doubt the CEO must do it
Do you get my drift?

Is Management forced
To use precious time,
To pull up Apache
And make everything rhyme,
A non-productive part
Amidst every day duty?
Makes me feel like calling
Death Cab For Cutie.

Atrial Chatter

Question: "What do you call it when a couple of Atria are hanging out, and he says:

"Hey Miss Atria, you are looking finer than fine tonight in your new mini-skirt".

And she replies:

"Well, Rockstar, you are pretty fine, yourself. Your appendage is looking really awesome!"

Atrial Flatter.

Dog Joke

Picture this:

Sven, an honorable Animal Breeder, he raises dogs, Dachshund specifically. One might say, he is in love with these sturdy little fellows. At some point, there is a litter of identical twin brothers, which he names Huey and Louie. They are so cute, playful, fun and spirited, they become the joy of his life.

Now, they are a couple years old, and at his side day and night. One morning at breakfast, his two pals walk into the dining room, greet their owner, and then keel over together, unresponsive. Sven races to their side, and no matter what he does, Huey and Louie don’t wake up.

Sven bundles them into a blanket, and races to the Veterinary office. He yells, “Dr. Mergatroyd, something terrible has happened to Huey and Louie, what is it?”

Dr. M performs a thorough, albeit quick examination, and suddenly declares;
“Eureka, this is Pulseless Pair’o Dachsunds!”


Q: What is the commonality when comparing Sepsis, and, a Nursing Staff Meeting?

A: They are both an Inflammatory Process.

Sunday, February 05, 2017

Clorox Showers

What a fabulous invention,
It works pretty good
For the stuff we don’t mention,
At Thanksgiving dinner
Though, it looks like gravy,
Occasionally chunky
And usually wavy.

Flexiseal drainage
Is now incontinence control,
Placing a tube
In your nether-hole,
So the drippy and runny
Won’t mess up the bed,
And the toxic smell
Won’t make us all dead.

Part of your go-to-kit,
When Billy Bob Boomer
Has another shit,
For the 17th time
In the last eleven hours,
Earning you the right
For Clorox showers.

Hospital Acquired Pressure Ulcer


If you give me a HAPU
I’m gonna SLAPU,
Oh, don’t make such a FLAPU
It’s all because of your CRAPU.