Sunday, December 30, 2018

Career Synopsis


Forty years went something like this:

Oh, what a relief
That last day became,
It was time to step back
From the working game,
After forty years
Of a healthcare endeavor,
Starting in ‘78
When I pulled the lucky lever.

Tired of getting laid off
Then signing in at Unemployment,
I took occasional benefits
Without much enjoyment,
As I searched for a solution
And found a Medical Career school,
It wasn’t free
But it was a workable tool.

I became a Respiratory Therapist
Working five years,
A couple guys inspired me
To conquer my fears,
Moving on to Nursing school
It’ll be a cinch, they said,
Despite working full time
And rarely sleeping in a bed.

I thought I would work E.R.
Or probably ICU,
I majored in Cardiac
With a medical view,
And in that first year
Obtained certification,
To play ICU nurse
At almost anybody’s station.

That’s the road I chose
The knowledge I pursued,
My focus on heart disease
With an occasional interlude,
Worked in clinical Ophthalmology
And Neuro ICU,
A Pulmonary Lab stint
And Legal Consultant too.

I sought variety
I worked all over the city,
Major medical centers
And little itty-bitty,
Hospitals, with maybe
Twenty to forty clients,
With a four bed ICU
Employing rocket science.

That stuff is what made me
The nurse that I am,
Life and death situations
Like cases of Spam,
Still the bulk of my study
Has been Cardiology,
Though sometimes I think
I had a minor in ghostology.


Last Shift is Finished


Yep, I survived my last official day of employment. It wasn't too rough, but again, as mentioned in the log of the final days, the last two weeks exposed me to some stuff I haven't done in quite some time.

1. Two weeks ago, was the night with 2 successive patients for Pacemaker Recovery, requiring a Code Blue and its equivalent Rapid Response, each getting airway intubation and heading to ICU emergently.

2. Two nights ago, the elderly really sick guy, being delivered to me for recovery, and he was purple, cold and barely conscious. A look in the Policy & Procedural manual, calls this Deep Sedation, which should be handled with an Anesthesiologist on standby; not in our unit. Heck, it was 9pm, we had 2 nurses, a total of 5 patients, and three had arrived in the past 2 hours!

3. Yesterday, (last shift), I get a guy who had a Diagnostic cardiac angio, with global arterial vascular disease............he had bilateral Femoral artery sheaths, plus a Left Femoral vein sheath. His BP was 187/88, and the the palpable femoral pulse, superior to each of those artery conduits, was hyperdynamic. Essentially, that means, stiff calcified blood vessels, not amenable to collagen plug therapy so me and my best buddy, do a tandem, Femoral artery sheath removal, where we both do the super-duper fist hold to the groin x 25 minutes, to obtain secure hemostasis. I was pretty sure the guy was going to "pop" one of those punctures, because he kept bending his legs, trying to sit up, roll over, and so on, but he managed to survive his non-compliance for 5 hours and not hemorrhage.

4. That same guy as described above was only 64 years old. His cath revealed that he needed CABG and Aortic Valve repair. He kept breaking into episodes of moaning / crying, having something to do with learning he needs surgery, pretty damn soon. Several times I go to the room, and he's sobbing, "I want to go to Paradise, I want to go to Paradise" over and over, the crying mantra. Oh I finally figured it out; he was beholden to one of those religious faiths so enamored with the Paradise theme.

5. I also had Betty Lou who needed 4 hours of bedrest after Atrial Flutter ablation, moaned and groaned about terrible back pain, which I medicated generously with Fentanyl and Dilaudid, hot-packs and towels. Both the Ablation doctor and Anesthesiologist came around later and asked "how has she been doing" and "Betty, do you want to go home?" I share that she has had a lot of back pain, probably from lying on the gurney for 5 hours. She practically yells out; "I don't have back pain!"

Her husband tells me several times about all of his herniated discs, and how sometime back, he was taking 280mg of Norco everyday, until he finally got Duragesic patches, and is doing much better. Actually, Betty Lou has been regularly dosing with (2) Norco 10mg's, every four hours at home, and some Oxycontin too. When I took her upstairs to her room, her new nurse asks, Betty, "How is your Pain". Her response; Well it's somewhat better, but it's not my back, its really because I have had more than 14 surgeries, and I have a chronic pain syndrome. Holey Moley.

6. The real highlight of my day, was the woman who showed up for a Cardioversion, because she was in Atrial Fib 2 days ago at the doctor office. I put on the Cardiac monitor and.............she is in Sinus Rhythm. Thus, no need for an IV, Propofol, shock or anything. She did get a new prescription for Amiodarone. We had a pretty good time talking about all the books we like to read, and I gave her husband an author recommendation.

7. Best of all, we had a little Retirement Celebration with an awesome cake from the best bakery in town, my pals gave me a very funny card, (all signed with nice stuff) and photo's were made.
Last week I had bought a major pile of Starbucks coffee cards for Xmas presents, and I finished handing those out. Then, one of the Cardiologist, bought us all lunch, so a good time was had by all.
At the end.............we only got out of work 15 minutes early (on a 12 hour shift). C'est la vie.






Friday, December 28, 2018

Retro Future Spect


If you have been following, or visiting this odd spot, (thanks, by the way), it is obvious, my career is approaching a sharp left turn; aka: retirement. I just checked the blog stats, and see I have over a thousand separate postings. I think the first year the blog was up, I tried to post the original Underside of Nursing chapters, from the early printed pamphlets, that were sent out into the mail. Those poems were primarily written between 1988 and 1996.

Now lets consider, that for every published poem, there are probably 3 that were not published, and that means, this blog can go on for years, with fake new material. I know factually, that I will maintain my Nursing license for years to come, keep up with our nursing and medical industries, and keep on writing.

Hopefully within the coming year, there will be a publishing of my favorite gross-out poems, so get your Zofran ready!

And now Ladies and Gentlemen, stay tuned, because this 28th day of December, in the year of our Ford, 2018...............is my last scheduled shift!

The poem will come soon.


Thursday, December 27, 2018

One more shift


Finally, one more work shift tomorrow, Dec 28. I hope I survive it.

Here is what happened just yesterday evening. Another patient, post-Pacemaker implant, late seventies, major comorbidities, had only Procedural Sedation, with a chaser of Benadryl, and he's deeply sedate, purple, and cold. Procedure guys kept him an extra 50 minutes, because they were trying to wake him up and get his blood pressure improved. Luckily, now he has a pacemaker, so pretty good guarantee, he won't go asystole soon. Anyway, we all survived again, although his family was kind of freaked out.

A couple of brothers
In the E.P. Lab,
Bring recoveries to us
Ice-cold, blue dudes
Like they're ready for the slab.

You call this sedation?
This is deeper than deep,
Guess I look like a miracle worker
Hope this doesn't turn into a tear-jerker,
Gotta keep Joe-Bob out of eternal sleep.

I ask the wife
Does your husband always look so dusky?
Well, he has a dark tan,
Because he's such a manly man,
While I'm thinking
I hope he doesn't join Edmund Muskie.



Sunday, December 23, 2018

Old is just as good


I stumbled on this old poem today, a relic from 1997. I imagine there are quite a few readers who know nothing about Jack Kevorkian, MD, a proponent for assisted suicide.  (https://en.wikipedia.org/wiki/Jack_Kevorkian).

Having worked in the ICU as recent as two years ago, I witnessed very little change in the use of intensive therapies, (with similar poor outcomes), little changed since 1997. But of course, we have to keep trying. Fortunately, major strides have been made in other areas of medicine.

Still, I admire Jack Kervorkian, he was a pioneer bringing attention to end of life issues.

When I Retire


When I retire I plan to become
A member of the KKK,
Askance you look
You gasp and fret
But let me have my say;
Kevorkian’s Killer Kadets
He’s a pioneer on a mission,
At the forefront of liberation
I won’t have time for fishin’,
I’m joining the KKK.


After twenty years in critical care
I’ve seen my share of death,
Too many people kept alive
Because we control the breath,
But plenty of folks would make the decision
To cross to the other side,
If the final trip down the River Styx
Were like the ultimate limousine ride.


In the modern world we’ve cloaked our death
In shrouds of pain and fear,
Burying the steel-lined casket
We mourn the bones each year,
But as the 21st century approaches
It’s time to look death in the eye,
Let’s make a date with the afterlife
“Whoopee, it’s time to die!”


This is where the KKK
Can help you plan your trip,
Pick your favorite poison
And remember to leave a tip,
Before your third round of chemotherapy
Or your fourth amputation this year,
Demand to take control of your life
We’ll help overcome your fear.


If you live in relentless pain
The KKK is waiting,
No point in going on until
You’re fit for carbon dating,
The theory, that your suffering
Is God’s will, as some would claim,
Is just another fallacy
In the religious con-man’s game,
Cry for mercy, tithe me
He just might intercede,
Your suffering is a special moment
Just go ahead and bleed.


In my world, that’s a bold faced lie
The Big Guy is my friend,
He wouldn’t have me suffer
For the duration or the end,
So, I’ll dedicate my energy
The KKK has defined my role,
To alleviate the suffering
Of any interested soul.

1997


Saturday, December 22, 2018

Write a little later


Look, I'm not a journalist, writing about now. I write in generalities, that can be applied to many situations that occur over and over. I always hope to learn something every time.

Sometimes I write about
Too close to home,
Gotta wait a few months
Before I post that old tome,
By then, most of memory
Has gone to the ditch,
Where the sad, sorry episode
No longer doth itch.

By then, it is legend
And perhaps we have learned,
The ways and direction
Said worm, stopped and turned,
We have that kind of a feeling
"Something just like this?"
A few months ago
When we avoided the abyss.

Those are special moments
Where threat and danger no longer exist,
Problem solving is so easy
With no threat of heavy fist.




Wednesday, December 19, 2018

3 more shifts


Really winding down now. Today, I went in at 7am, which I haven't done in about 10 years. As a result, I worked the front end, get folks ready for procedures (3) and then do a Cardioversion, plus a TEE. I probably hadn't started an IV in a month in a half, but nailed it first-time on the four outpatients. That last one was tough, on a person vastly fluid overloaded, and just a very tiny under-wrist vein. It worked out well (luckily), because this was needed for the push of Propofol for the cardioversion.
Later, because of the Eliquis (blood thinner) that she takes, that thing wouldn't stop bleeding when I removed it, so she went home with a beautiful bruise and a small hematoma.

Gosh, no poem this time.


Tuesday, December 18, 2018

Last Days


The previous poem (down the page) I herald that I only have 5 shifts of scheduled work left.
Well today was that 5th shift (before the end) and it was a doozy!

Last Days

On my 5th day before the end
Listen to what went down,
A couple post-op sedation patients
Crumped in Recovery town,
They arrived, and went south quickly
At the moment of delivery, not later,
Therefore, I can't be blamed
All focus on the operator.

First it was the aging Ivan
At 91 years, he got a pacer,
Severly hypotensive and then he stopped breathing
We moved fast to avoid the eraser,
Called Code Blue, which brought a huge crowd
The room was a mess when it finally ended,
We saved Ivan, like the pro's that we are
Off to ICU he went, categorically ascended.

It was time to take a breather
Sweep the floors, assemble papers,
Visit the other patients
And replenish my vapors,
Until I got another report
To expect Betty Lou,
Another simple sedation
Hardly anything to do.

Round two disaster
How could I possibly know,
Betty arrived gasping for air
This time, a Rapid Response show,
With stat breathing treatments
And assisted ventilation,
Betty Lou, she turned blue
After AV Node ablation.

Two patients in a row
Surviving Code Blue,
The first with a cardiac tamponade
Then pulmonary edema, for number two,
We all responded quickly
In a fairly organized fashion,
Yes, humankindness was right there
With a spoonful of compassion.



Sunday, December 16, 2018

Five more Shifts


Almost there; that thing called retirement. Of course many folks are pretty sure, they might be able to entice me back sometime in the future, and I don't discount that, because I have done my best, to stay at the forefront of certain areas of interest. That learning switch is not being flipped off.

However, the most recent Friday, two days ago, the wall hit me........even if I wasn't retiring, it would be time for me to bail out again. Over the course of the past 11 years, I have flipped back and forth between two hospitals in the system, where I worked for A and then B, and then A and then B.
So, that's how it is; I jump ship when I can.................and I'm about to do that, after 5 more shifts.

Terminal Burnout

That was not enjoyable
I'm telling you,
Running around like crazy chickens
With too much to do,
And I came to the understanding
That I have finally breached,
Terminal burned-out status
The pinnacle I have reached.

I despise all alarms
And the computerized medical chart,
The former, because it's often so pointless
The latter, because it's not a la carte,
Some kind of crazy committee
Offsite in the middle of Texas,
Declares, you must chart this one way
As convoluted as the mesenteric plexus.

Pharmacy calls me four times
Asking, what is the allergy of Betty,
Quite frankly I don't have a clue
She is snoozing and looks kind of sweaty,
Her daughter just left for tobacco
The son is on YouTube in the lobby,
And I don't have one frickin minute
It's not like I'm engaged in a hobby.

I'm the Charge Nurse, with 5 patient's
On a 12 hour shift,
So many people ask for me
It's worse than the Tokyo drift,
And I do incredibly appreciate
How we work as a team, and all,
But even working five more shifts?
I'm like a plane, gone into a stall.

Even five more days might be impossible
I might explode if pushed the wrong way,
One more migraine headache that needs Percocet
A forty-one year old gal, Sallie Mae,
Who can't lay supine, just four hours
After all babe, you might just bleed out,
If she keeps hopping around on that gurney
With her ten out of ten fussy pout.

Come on chick, you managed two babies
It had to be worse than an Ablation,
“Only Percocet works for me, Bub”
With an attitude, Oh consternation!
And meanwhile the Pharmacy pages me
Asking that allergy question,
Finally, I'm about to explode
With terminal indigestion.

And really, it wasn't enjoyable
Though we did have a lot of good laughs,
That's what nurses do in a typical crisis
Beat with bats and old rusty gaffs,
We gather around the dead campfire
Bemoaning our plight and our pay,
Knowing we'll sleep it all off
To be tortured another bright day.

12-15-18


Tuesday, December 04, 2018

Writer of Notes


I am crazy about writing nursing note narratives. It's not really a lost art, but rather a form of communication / documentation that has been cast to the wayside, because our Over-Lords have fashioned an easy out  (Computer charting). Nurse got lazy! That's all it is.

I write, as if I am going to find myself in court, about 3 years from now. Those who read my notes, would agree to my statement. I write a narrative journal in a sense, on each patient I have that day. I have done that from the beginning of my career, until now, 35 years later.

Anybody who wants to know what happened on Tuesday, at 5pm, when Oscar (me) was that nurse, only needs to go to "Notes and Transcriptions"...........Nursing Progress Notes...........and you will find out, what procedural sheath of 22 French, was in what Femoral artery, and if it bled and how long, and what Doctor was called,  and who the Echo Tech was and so on.........................that's how it still needs to be done!

Note Writer

I'm a nursing note writer
That's my declaration,
Like I'm writing to the Jury
Describing fact and causation,
Every single interaction
For the patient I observe,
In the final court of law
I didn't drive off the curve.

Go ahead, read my notes
You'll know what happened each time,
When Joe-Bob got up
And slipped on his slime,
And I called the Doctor
And the Doctor said:
For Gods sake, keep Joe Bob
Tied down in his bed!

Or something like that
Back in the day, when we could do it,
When Joe Bob broke his leathers
After all, he could chew it,
Whereas, you can be sure
I documented it all.........
You might try to sue me
But I won't take the fall.

In these EMR days
Half the Nurses, they don't write,
They check boxes and forms
And read their phones half the night,
But three years down the line
When Joe Bob's case comes up in court,
They won't remember a damn thing
They'll just shake, whimper and snort.

Yes, Nursing is very demanding
But I write, for each one,
My job is to tell their story
Everything that was done,
During my short contract
Their events, my responsibility,
And if I am questioned later
My notes are my utility.


12/4/18


A Waste of Energy


As a Charge Nurse, I don't prognosticate. I don't call the ER to see if they are expecting to send us people; I don't harass the Nurse Supervisor, to see if we are getting any possible patients. What I do, is keep an eye on my show, keep apprised of what all our patient's need, or what the next two hours of care might look like, and I try to make sure, that patients get out exactly, at their appointed time. That's what drives patient satisfaction.

This poem is about my philosophy in life, and at this chosen career:

Planning

Things that I plan
They rarely turn out,
Whereas, things that I don't plan
Get a high-five and shout,
Because I reserve a place for
Change and spontaneity,
Unconventional outcomes?
I'm filled with gaiety.

Henceforth, I don't plan much
In fact, it produces anxiety,
I want to run to a waterway
To practice silence and piety,
I don't need that type of stress
I'm just a momentary guy, 
Right now, I'll do this thing
And when I do it, you'll know why.

When big decisions come
I gather knowledge and ponder,
Consider multiple outcomes
That could occur down yonder,
But, don't presume that is planning
I'm just collecting information,
Until I whip out the knives
And delare: Captivation!

I work with all kinds of planners
They are good at what they do, 
I know it isn't me
But it just might be you,
I admire the energy
You throw at all situations,
I'm happy to stand to the side
While you collect your ovations.

I don't want any part of that
Yet, we share the same desire,
To reach the end of the road
Without pain or funeral pyres,
And I believe we can achieve that
In our own unique ways,
How about, I take the nights
And you take the days.


Tuesday, November 27, 2018

Germy makes me squirmy


When travelling, the good advice is to drink bottled or boiled water. Also cooked meals, and for us Westerners, remember to carry TP and hand-cleaner, wherever you go.

TP Tourist   

The modern world tourist
Expects toilet paper,
Unlike the locals
Who use their hand as a scraper,
Thus, why we avoid
Handshakes at all,
We wai, with respect
Because your skin
Does surely crawl,
With 17 million
Pathogenic germs,
And probably some eggs
Of your favorite worms.

If you are travelling
Don’t drink the water,
Especially if skinny dipping
With the shopkeeper's daughter,
Consider the potential
Of life-threatening danger,
Instead buy bottled water
From a reliable stranger.

Do peel all the vegetables
The fruit and the goats,
Boil when cooking
Even your steel cut oats,
Served every morning
With slices of Mango,
Remember, don’t eat that skin
It’s not fun, like the Tango.

Just because it is spicy
Doesn’t mean it is safe,
Montezuma’s revenge
May cause serious chafe,
Wiping down yonder
For 24 hours,
Next time, avoid the water
Drink only, whiskey-sours.

Thursday, November 15, 2018

Retirement Security


If you have read anything I have posted over the past 10 years, you know I find bureaucracy to be a total mind-melter. Well, proof of this, is how difficult it is, to actually arrange to stop working and begin receiving any kind of future benefits. I almost wish I was an illegal, and then I could get some hot looking young social conscious do-gooder to help me navigate this quagmire of nonsense.
But instead, I am just an over-educated, short tempered, sarcastic retiring Nurse...........

Unplanned

Social Security office
Makes retirement look hard,
It might look like an inch
But it's really a yard,
To jump through the hoops
Without blowing your top,
I thought working was tough
But it's harder to stop.

Folks there were seeking
Their first SS Card,
Others getting payments going
So they can sit in their yard,
Watching the world go by
As they allocate each nickel,
Wondering why they didn't save
'Cuz now, they're in a pickle.

Grandma Moses
Had a five year old, for show,
She talked to him like he was two
In baby-talk, you know,
Telling him something about school
Study hard, and get a job,
But did she even bring a book for him?
Not a chance; the lazy slob.

In fact, no one had a book
Not even me,
Although I read my journal abstracts
On Medscape, for free,
Thus I know a lot more stuff
About cardiac innovations,
A new pacemaker, for the neonate
For those rhythm aberrations.

Does it, really seem
That I am ready to retire?
No, it doesn't feel that way
My mind is still on fire,
To learn the most I want
In the time I still command,
Life will show me what to do;
The guy that never planned.


Wednesday, November 14, 2018

Train to be Violent


By now, I expect that every healthcare organization all the way out to Timbuktu, has offered free, workplace-violence response training, to all and everyone. At our mega-medical entity, this endeavor seems way over the top intensive, no doubt costs millions, but looks good on paper for the public to read about. But what do I really think?

All the excitement:

What is the latest, hot button topic
For all the people in our nation?
Active-shooter situations
Expounded via oration,
And our own organization
Is spending gobs of money,
Learning to defend ourselves
When some jerk calls you "Honey",
While pointing a weapon
Or threatening you harm,
Got his arm around your neck
His favorite method of charm,
And a blade at your throat
While you gouge, scratch and bite,
Crush his instep with your heel
And kiss him goodnight.

At the Class:

We all learned the blade-stance
Where it looks like you're praying,
Shuffle forward and backward
Keep focused, no swaying,
Yell, scream; don't beg
While showing power, no fear,
Startle that mofo
Then bust a cap in his rear.

Another option:

Or........just arm us with guns
With a weapon I.D.
I can hide it in my scrub pants
A Glock 43,
I'm ready for whatever.........
Oh shit, now he sees us!
But, I'm not really worried
He's about to meet Jesus.







Monday, November 05, 2018

Warm Blanket


Planting a Seed

I changed my mind
Withdrew my prior writing,
I had a good run
No need to be indicting,
We work in a tough business
Life, death and worse,
No need to be remembered
As the disgruntled Nurse.

Work is damn stressful
Till we rise above it all,
Do what we do best
And answer the call,
To comfort those in pain
Some are worried and more,
It might be their own loved one
Or their own, gruesome score.

Expertise is important
So also, is a warm blanket,
Like that Model T Ford
Won't run unless you crank it,
And so does our care
Meet the want where it is needed,
Should we all work together
Our best results are exceeded.

Sure, there are times
When we protest for change,
It is difficult for a system
To work outside a range,
That has been predetermined
Not in a democratic way,
Inhibiting improvement
It won't happen in a day.

In the meantime we care
For those with greater need,
Helping brother and sister;
Is but planting a seed.







Tuesday, October 30, 2018

Mini-moles


This is the fifth, post-symposia revelation; and I wonder, does anyone else doodle in words like I do?
likely not. It is amusement and part memory method. So here is the latest nonsense.

Mini-moles
Very small rodents
Seemingly important, they say,
Something regarding
Umbilical LDL
Not seeing the light of day,

Supposedly at birth
Your U-LDL
Resides at a measure below 50,
But that's kind of silly
You never have eaten
Ya, extraneous data is shifty.

The Cholesteral-HDL ratio
Is a predictor of some kind of risk,
Particular with folks of Diabetes
Don't ask me, but something is brisk,
That's just about where the after-lunch dude
Was guiding us all into sleep,
I suspect he has earned a favorable rating
As we awakened; man, that nap was so deep!

For Giving, that's who we are


End of days ponderings:

I feel kind of alone
Going to classes and such,
It's just one of those things
That I enjoyed very much,
Sharing moments of learning
Perhaps I'm just such a geek,
Feeling a need for expansion
If only just a peek.

Rubbing shoulders with colleagues
Over the years,
We all got a little older
And shed a few tears,
As we all are wont to do
On this human path of living,
And hopefully we have acquired
More capacity for giving.

The Best New Drugs


Every year at one conference or another, a presenter will regale us regarding the use of Wonder drug Z, and all the other great stuff in the cue. Some of those drugs disappear, never to be listed, because the side effects began to show up after 300,000 people had been tested against placebo. Maybe their toes began to fall off, or there were too many folks dying from long thumb disease, or whatnot.

The Best New Drugs

Death eliminates all risk
LDL reduction is very brisk,
Approaching zero, as the heart stops beating
After that, no worries about eating.

Sodium reduction has a lot of hype
Not sodium sensitive? you're not the type,
Regarding all that worry, about retaining fluids
No need to join the low sodium Druids.

Sodium-glucose Cotransporter-2 Inhibitors
If you can say that, you're clearly an exhibitor,
But they never talk about
Those incidental amputations,
Or how Fournier's gangrene
Can ruin a reputation.

Beware, dear public
About the newest, latest drugs,
Testing on rabbits, rats and pigs
May not eliminate all the bugs,
Lurking in the background
Glossed over by slick advertising,
If you should get Angioedema
Death may be very surprising.

10/30/18

Price versus Advice


More nuggets of information, from the symposium. If Joe Bob can drop a kilogram of weight (2.2 lb)
this may lower his Systolic BP, by an average of 5 mm of mercury. This alone, can be an organ saver.
But, there is the topic of compliance, isn't there?

If you drop your weight
By one kilogram,
2.2 pounds
It will be favorable, M'am,
To bring your systolic
Down five millimeters,
That might save you a kidney
Unless you're one of those cheaters,
That puts the weight back on
After you leave the Clinic,
You loved all that praise
But you're just a cynic,
Not believing a bit
About all that good advice,
You don't worry about pounds
You only ask about the price.

10/30/18

Syncope Slide


I went to our local Cardiology Electrophysiology Symposium two weeks ago, and learned some good stuff. Man, those physicians love to strut their stuff regarding favorite topics, but there are usually some good nuggets of information.

For example, about 50% of folks who take blood pressure meds for hypertension, still have lousy control, and as such, remain at high risk for deadly complications. We were informed, that better success is achieved if two different medications are working together, rather than just doubling the dose of a singular drug. However, the discussion did not address the added risk of additional side-effects that might come along with those secondary medications.

Anyway, life itself is risky...........and doctors are averse to blame.

Slide


Lowered your BP
But still you died,
When you busted your hip
Doing the Electric Slide,
Thanks to your doctor
Adding another medication;
The plaque on his door reads:
"Your health, is my dedication".


He’s a BP control freak
He studies all the trials,
And as a result
You should see all the vials,
Stacked on the counter
At Billy Bob’s house,
16 plastic bottles
Between him and his spouse.


Meanwhile, the doctor
Basks in recognition,
Writing books on medicine
The latest rendition,
On BP control
All the methods he has tried,
But nowhere will you find
Just how many have died.


He had no hand in that
Never takes any blame,
P-value significance
Is the name of the game,
Statistical variants
Like a bolt of lightning,
Impossible to predict
And that’s what’s so frightening.


Syncope
Is what happened to you,
Your blood pressure crashed
As its likely to do,
After that fourth medication
Was added to your list,
Now that you busted your head
You will be sorely missed.


We’ll get your pressure down
The doctor had reassured,
You’ll feel a whole lot better
The hypertension cured,
You can fulfill your dream
To learn the Electric Slide,
Yes, I fixed you, old man
But still you died.



Sunday, October 28, 2018

Gunning for Retirement


Gunning for Retirement

Another great plan
For when I retire,
An alarming inspiration
Truly did inspire,
For me to think of a way
Where nurses can blow up their stress,
Come to Billy Bob's shooting gallery
It won't matter how you dress,
Because you get to choose
Your favorite cannon,
Please, let me explain
Just what I am plannin'.

I have endured enough
Of every kind of alarm,
My psyche is maimed
With significant harm,
My ears ring incessantly
I dream beeps and sirens,
That's not what I call peace
In any environs,
So, my plan is a shooting range
To vent your frustrations,
Blast those infernal machines
To hell and damnations.

I figure a five minute session
Ten shots in all,
Pick any weapon you like
It's absolutely your call,
The lockers are stuffed
With every kind of gun,
From small stinger missiles
Or some desert eagle fun,
It's all a part of stress relief
Cutting loose with a scream,
Blow up that IV Pump
Like you did in that dream.

The worse flippin' alarm
That I ever heard,
Is on that CRRT machine
Like a foghorn, my word,
So that is my target
With a shotgun to blast,
10 gauge for sure
Nice and slow, meant to last,
Ten shots in all
To damage and maim,
Twenty bucks admission
Come on, play this game!

Can't Remember


I was talking with one of those young nurses of the day, bright as an atomic bomb, and probably the type I'd want on hand if I was in the ICU. She noticed I kept a small note/list on my phone that covered some of the common IV drip mixes and calculations, and it prompted a discussion of this thing.

Hence, I wrote this:

It's the middle of the night
And you can't remember,
The drip calculation
You learned last September,
And it's really important
Because you're at the Code Blue,
It seems like everyone is staring
And waiting for you.

You reach for your phone
It's in one of your pockets,
In your deluxe cargo pants
That hold 42 sockets,
When you suddenly realize
The smartphone is gone,
When you were rushing to work
It fell on the lawn.

Joe Bob the victim gasps
"You can use mine",
Look up Cardiac Arrest
Dial 249,
Ask for Betty Lou Johnson
Also known as my wife,
First ask her opinion
If you should save my life.

The moral of the story?
Keep your tools close at hand,
Know those drug concentrations
For those moments on demand,
When you're on the spot
And Joe is circling the drain,
In those crazy, clutch moments
You gotta trust your old brain.

Tuesday, October 23, 2018

Prolonging life without consent


Dementia & Pacemaker

DNR
Do not resuscitate,
A reasonable approach
To a dead end fate,
And one might argue
We all will die someday,
But if you have severe dementia
How long would you choose to stay?

Why do I ask? I'll tell you
I just met Betty Jane,
About the only thing she understands
Is to localize her pain,
No kind of simple words
Can appeal to any reason,
Betty's brain is at survival mode
And it's a long and pointless season.

She lives her life in a nursing home
Her cognition is unaware,
She can not form a memory
Nor have a thought to share,
She truly lives in the moment
Each minute is unique,
Though she can't recall the one before
Nor anything last week.

She doesn't know her children
Where she lives, or anything,
No purpose of existence
But she can walk and sometimes swing,
So a DNR is sensible
Yes, she requires a caretaker,
But honestly I think
It's a crime to give her a pacemaker.

She didn't request or pay for it
Just who made this choice?
And why would they do it
When Betty has no active voice,
Regarding her life
Without cognitive awareness,
I'm guessing it was family
Well meaning, without fairness.

Yep, a pacemaker just a month ago
Her heart was slowing down,
She had a bout of syncope
Where she lived in memory town,
A doctor intervened
Made a referral out beyond,
The care-center demanded it
"She might pass out at the pond!"

Naturally her son
Didn't want to miss his momma,
Despite the fact she doesn't know
A period from a comma,
So they shipped her out
Said, don't come back
Until your heart is stronger,
We'll await with open arms
To help you live a little longer.

Betty doesn't understand
Why her chest is sore and tender,
She scratches, picks and plucks
Till the incision doth surrender,
Where infection did ensue
Promoting gross and smelly pus,
Whereby the folks at memory town
Stated; you can't stay with us.

Another long trip to the hospital
A hundred-fifty miles away,
While everyone at memory town
Said, Betty we will pray,
For another speedy recovery
For a long and fruitful life,
When you come back, see Bobby
He is looking for a wife.

Friday, October 19, 2018

Halloweenish


Well, I'm in a bloody good mood lately, feeling like I should bite someones neck, and it is the Halloween season after all. Thus, I'm inspired by vampires and blood donations.

Blood Supply

I have read a lot
Of vampire books,
Depends on the author
Just how vampires look,
But there's a general consensus
Regarding aging, and such?
You'll be frozen at the age
Of your vampiric touch.

The rumor is
That they bite your neck,
A lot more vigorous
Than the little peck,
That you got from Eunice
Back in the fourth grade,
Ya, her mother was a vampire
And that's why you're afraid.

Historically vampires
Get a bad rap,
You may have heard about silver
Crosses and crap,
Designed to repel
Your friendly neck biter,
Every vampire I've met
Was a heck of an inviter.

Well, I suppose that is necessary
To maintain the blood supply,
It has a short shelf life
Because even blood will die,
And they don't bite the dead
So, your chances are good,
How best to avoid a bite?
Wear a chain-mail hood.

Wednesday, October 17, 2018

Blood Donation


I donated blood yesterday and here is what happened.
(In the event that you may be following this blog, my encounter with the blood chick, turned into something like when I visit with Dental Dana).
Who would ever think that donating blood could be so.....................delicious!

Rachel
That woman, she took my blood,
When I swooned
I fell with a thud,
Awoke light-headed
Like a spinning jenny,
Not only my blood
But the blood of many.

Rachel
Caught my eye at first,
Before I understood her thirst,
No, I won't argue
She was really cute,
I needed to see her....
I was resolute.

Rachel
Looks so young, that kid,
When I came to donate
She had the highest bid,
And now I'm drained
I guess; good to the last drop,
Rachel, I begged
Oh please, don't stop.

Rachel
So caring, she held my hand,
After I swooned
I could no longer stand,
I was laid on the gurney
And they lowered my head,
I was too weak to grasp
To pull her onto my bed.

Rachel
She stood to the side,
I caught a little smirk
Plus a wink, and I sighed,
Knowing, she tried to drain me
I guess I have a good taste,
She whispered in my ear:
"To the last drop; I mustn't waste".



Thursday, October 04, 2018

Don't try to sue me


Gotta do something when I retire.

Don't Try to Sue Me

Here's a plan
When I retire,
Publish those books
And set the world on fire,
With all my funnies
And juvenile humor,
Silly as vomit
And bold as a tumor.

Amazing insights
Regarding amputations,
Ridiculous rhymes
And ambiguations,
Touching stories
Regarding life and death,
Spirits in the closet
And the Grim Reaper's breath.

There is a lot to cover
And I think I did,
I worked like a man
And thought like a kid,
Did my best to respect
Joe Bob and his cousins,
See, they looked kind of inbred
With children by the dozens.

There was Billy Bob Borko
And sweet Betty Lou,
Sister Euphemia
To name just a few,
Of the colorful characters
Whose paths I have crossed,
Most of them winners
Although a few of them lost.

I followed most guidelines
But stretched a few rules,
Some protocols, dear reader
Have been written by fools,
Who rarely endeavored
Into the milieu of reality,
Where the evidence of poor science
Might lead to fatality.

Am I an expert?
I don't claim to be,
But I do write with clarity
Regarding things that I see,
Armed with continuous
Ongoing education,
Regarding areas of interest
To support my reputation.

If I can be an inspiration
Let it be known, that I cared,
Regarding expertise
And the knowledge that I shared,
And always willing to work hard
In any kind of conditions,
Admirable traits
Outside of personal ambitions.

Well, I will keep writing
About the usual baloney,
The whackified truth
Not fake and not phony,
And yes, I hide names
So don't try to sue me,
Take your business elsewhere
And stop acting gloomy.