Friday, April 21, 2017

Trust Someone

Trust that my awareness is on my patient's on the job

Who is the first
To get up from their chair,
When alarms are ringing
Anywhere,
This is the one
I can probably trust,
They are listening
Because we must.

To be your Nurse
Means that my awareness,
Should be totally focused
On you, in all fairness,
Because we are here
To attend to your needs,
If my attention wanders
Maybe somebody bleeds.

We are duty driven
And morally inspired,
To perform at our best
Until retired.

Thus....
Turn off your devices
When you come to work,
Check later for updates
Don't be a jerk,
Secretly viewing
When you know you shouldn't,
We could fire you
Don't think that we wouldn't,
You reviewed the policy
On your hire date,
Electronic entertainment
Is tantalizing bait,
That could lead you to
The unemployment line,
When Billy Bob is calling
In room ninety-nine.

Thursday, April 20, 2017

Seatbelt

Pretty much, auto seat belts have been a safety requirement on our American cars since 1966.
Now it is 2017, and if you choose not to wear a seat belt, and drive your car and crash, you are the fault of your injury. Don't try to pin it (to get money) on anybody else. You are the fool.


I didn't wear a seat-belt
Because I'm young and pretty,
Till I rammed that metal pole
Now, I'm one dead kitty.

I didn't wear a seat-belt
Because, what could go wrong?
Now I'm singing soprano
An angel's song.

I didn't wear a seat-belt
Because I was too busy,
Now I'm floating up in the clouds
And feeling kind of dizzy.

I didn't wear a seat-belt
Because it pushed on my breast,
And because of my stupidity
I earned eternal rest.

I didn't wear a seat-belt
Because I'm a good driver,
Now I'm up in heaven
An early arriver.


Monday, April 10, 2017

My (hopeless) Journey


MyJourney is the name of the software application that delivers the bulk of our required yearly hospital education. It is nothing like a journey, it is not a vacation, and we certainly don't get to choose the island. I discovered today, I can do it all in the safety of my home........and they better pay me for it, too.

Oh, I'm such a happy
Old fool,
Lying here
Next to the pool,
Spending the day
On MyJourney,
Wishing instead
I was an attorney.

I could bill for
Hundreds of dollars an hour,
While sipping away
On whiskey sours,
Dreaming of sugarplums
Dancing at the bank,
Instead I'm on MyJourney
In a blitzkrieg tank.

Firing away
At educational objectives,
I don't have much choice
To be very selective,
If I don't show effort
Or participation,
I'll be, persona non grata
At my nursing station.

Friday, April 07, 2017

Another Bungle


Uh, oh, rumor has it another Nursing Bundle is about to be jammed down our throats. I heard one of the ANS crew talking about it last night, and the religious fervor she exhibited while sharing the "good news" (and dismal statistics) had me running to my creative writing space, to contemplate, Nursing Bungle #2.

The Nursing Bungle requires a testament of belief
Give all of the appropriate answers to avoid any grief,
It's not an annual Revival, but they would do it if they could
Gather around the campfire boys, because the bungle is good.

This latest Nursing Bungle contains all the new thinking
Grandiose ideas to keep this ship from sinking,
And with new management in Washington you better hang on to your seat
Next time the Nursing Bungle will be delivered by tweet.

Excitement is high, at the place that I work
Unveiling the new Bungle with a wink and a smirk,
Promising wonderful top-notch Avatar Scores
Whiz-bang H-CAHPS, and C.Diff. s'mores.

Oh, I can hardly wait to travel on My Journey
After 8 hours of study, they'll transport me on a gurney,
Down to Radiology, for the implants in my brain
I'll be a Nursing Bungle Cyborg, with a built-in ball and chain.




Thursday, April 06, 2017

Out of Rhythm


Well, I caught another Rhythm interpretation screw-up and it's a doozy. From what I can see, nobody really cares, but I have fun doing the research and exposing the fraud.

Betty Lou, age 85, admitted to the hospital with nausea and vomiting. She's in mild Renal failure and her potassium really low (which got corrected). She had a history of A. Fib (paroxysmal) but was only on Coreg at home, and in Sinus Rhythm on admission. About 12 hours after admit, her heart starts to have 3 second pauses, and her heart rate drops into the 40's. Several 12-Leads were obtained, but the quality was horrid, such that neither the machine nor a person would be able to make any good call on the rhythm. Neither the RN nor the Monitor Tech (Cardiac Tele) could figure out the strip, and the nurse actually writes that in the record, along with stating that the EKG 12-lead reads "undetermined rhythm". When the patient drops to 35 and a pause, Nurse calls Hospitalist...........he says, don't give Beta blocker. When the HR dropped to 22, the Nurse charted, "Patient Asymptomatic". Finally, after a call to the Cardiologist, there is an order for Bedside Pacer Zoll, and Atropine prn. As this was Cardiac Tele, and presumably they are required to have ACLS, I would have thought the Nurse would have gotten the Zoll into the room already, without waiting for doctor's order.

Ok, so I take a look at the strips from Tele. They were monitoring Lead 2, and V3. In Lead 2, there was a broad stubby T-wave, followed by a prominent U-wave and a little pointy P-wave. So, with this heart rate of about 45, the Monitor tech, was interpreting those lumps as flutter waves, although that would have placed them at a rate of about 90, which I've never seen, no matter how many heart meds a person has been on. Now, in V3, amplitude was quite low, but there certainly was a P-wave, with a PRI first degree block of about, .38 seconds. Sometimes it even looked like there was some 2nd degree block, but all of the EKG's and strips were crappy. Over the course of about 12 hours, the strips were labeled "Undetermined, or A. Fib, or A. Flutter. The Cardiologist came in, identified the real problem as advanced Heart block, with a slow escape rhythm, and Betty Lou is getting a pacemaker today.

ps.
I am sorry to say, that the ICU nurses were calling it A. Fib too...............

Here's my report:

It bothers me
When I do see,
A misinterpreted
EKG,
I can give a pass
To untrained Docs,
Who specialize
In Chicken Pox,
But Cardiac nurses
And their monitor crew,
Should nail every rhythm
In their purview,
Because that is a skill
Required of them,
And when they blow the rhythm
I say, "Ahem"!

How could you call that strip
Atrial Flutter,
When there is a "P"
"T" and "U" wave
You're some kind of nutter,
A rhythm so slow
With a triplicate block,
'Twas not even A. Fib
You got your head in a sock.

Ah, woe is me
And Auntie Em,
Under the watchful eyes
Of the likes of them.