Tuesday, February 06, 2024

The Scolding Machine


In my recent hospital admission I shared the room with a completely disoriented patient who needed a Sitter. But "Sitters" need to be paid, might get injured, need health benefits and so on. The tide has turned; now the patient can have a bedside machine that watches them and Yells at them if necessary. I am not fooling. And I am amazed that I, the guy in the next bed, was not educated about the Scolding machine.

Let me tell you about the scolding machine
My disoriented room-mate had one,
The device was at the foot of his bed
To keep an eye on Jerry's type of fun,
Pulling at all of his restraints
Climbing out of bed,
It was like a game for him
Despite what the nurses said.

As his agitation would progress
First there were flashing lights,
If he began to untie things
A man-voice would read him his rights,
And if he tried to launch his body instead,
The machine would yell loudly
"Don't Get Out Of Bed!"

When I arrived to this room
No mention was made
Regarding the Scolding Machine,
I nearly jumped out of my skin
When the yelling began
Without warning or anything in between,
Well that was an oversight
On the part of my greeting committee,
I was just seven hours post-op
And this place seemed like the inner city.

I think Jerry transferred to rehab
Three days later,
His mental status did not improve
And don't call me a hater,
But having a climb-out-of-bed artist
At work sixteen hours a day,
With repetitive loud scolding?
I was feeling murderous in my own way.

Patient Room Video Technology

Microbiome Trade-in


I don't really like writing about myself but this is a topic for our times; Microbiome. 
It seems like every week I read about some new discovery regarding our digestive system. There are billions of microorganisms seemingly working in a sort of harmony with each other (healthy gut) and influencing all the other organs in the body including the function of our brains.

However, sometimes the gut microbiome can be wiped out by some really nasty entity such as C. Difficile or Norovirus. In 2013 I had a Norovirus correction and now in 2024, Appendicitis and Ileus.............each experience gave birth to a new gut environment.

After Appendicitis
My microbiome left the house,
This has happened before
Certainly not quiet as a mouse,
These are drastic changes
In the digestive system,
It happened to me 11 years ago
And the old gut?
I really missed him.

Believe me
This has happened before,
I can tell you
It is a vigorous 
Not so pleasant chore;
Once you go down that road
It is initially bumpy,
And the end result is
Sometimes rather lumpy,

Anyway it does give one a pause 
New ramifications 
Without a rejection clause,
It is kind of like buying a new car
And having to learn 
New gadgets and controls,
Not knowing if I will really like it
And kicking myself for not reading
Any customer exit polls.

The only persons who truly have a choice
Of selecting a new microbiome,
Are those persons who receive fecal implants
And even then it is not a simple road home,
Consider it a very new 
Application of science,
The doctor will tell you, 
“We'll just let your gut
Figure out how to use this new appliance”.

The microbiome
Is uncharted territory,
A trillion microorganisms
Telling their own unique story,
Manufacturing chemical precursors
Biomarkers and agents of change,
Enough to alter thought processes
And expand emotional range.

My old microbiome exited Stage Left
Not just a minor vacation
No, a vast uncrossable cleft,
A break into a new frontier:
2024 is turning out
To be a whiz-bang New Year!

Saturday, January 27, 2024

Out of Control Family


Crazy Foam

They said over and over

"Now, please don't forget,

If you remember this thing

We will be in your debt".

And every time after that

They said it again,

It would have been better

On occasion, now and then.

If you will, tell the doctor

The nurses and the tech,

Uncle Bob has a problem

His kidneys are a wreck,

Please measure the contrast

As careful as can be;

I said, yes I will do that

It's important, I can see.

When Hector from Transport

Came into the room,

Aunt Mary looked at him

All dire and doom,

And once again launched

The tale of the kidney,

Like a crazy old wombat

Down Under from Sidney.

Later on, after

Man, they wanted to book,

Uncle Bob and Mary

They just had that look,

Like coming down here

Was all a mistake,

A couple Wombats from Sidney

That stepped on a snake.

We bend over backwards

Primp and placate,

Give them sausage and capers

On porcelain plate,

But some of them leave

Good behavior at home,

Instead of proper manners 

They spray crazy foam.

Thursday, January 18, 2024

Double Occupancy Room


I had 3 different roommates over the course of 13 days. The first one had a serious head injury following an MVA. He was totally disoriented, awake 18 hours a day, 4-point restraints and constantly trying to escape. The second roommate is the subject of the following story.

Stabby Roommate

He does not want a tetanus shot,
Maybe if he had been shot three times
He would throw in his lot,
To have a simple jab
That would provide 10 years of protection,
Better than a Kevlar vest
And natural selection.

He doesn't want wound dressings removed
Because that hurts,
He doesn't want blood drawn
Needles and blood spurts,
He hasn't walked yet
He is here Day #3,
But he wants food and cigarettes
Is what he asks everybody.

Stabby stomach wound
Equates to the Diet called Clears,
To advance in a couple days
He wants smokes and beers,
He was granted a Patch
To curb his cravings,
He's a 20 year old kid
Full of posing and ravings.

Stabby young punk
Brags to compatriots on the phone,
He changes his story each time
Like he is Al Capone,
Some family arrived
Three of them said he was a fool,
Going for a slugfest with girlfriends new man
You called him out to the yard
And he pulled out a sharp tool,
And oops, your rival had backup
With a knife also…………..

So you jumped in your car
Gushing blood all over,
Drove to a closed Mercy Clinic
And finally you called 911
They saved you from pushing up clover.

And still I overheard
Your secret silly recovery plan,
You’re going to hunt down your rival
And put him down like a man.

Stabby Roomate
What a kid,
Only one family praised you
For what you did,
And you get sent home with a walker
Now, that is a piece of work,
You need to go to school kid
And become a postal clerk;
Or at least, something useful.

An Unexpected Christmas Gift


The poem is a retelling of "The Christmas Story"

Happy Itis

That's not exactly what it seems
Itis, ambushed me,
Three days after Christmas
I got a two week vacation in the hospital
For free.

That was a present
Something inside of me
Was fermentable,
Unknown to this owner
Thinking, hmmmm
Just indigestion?
A CAT-scan said Nope
The appendix requires ejection.

Hey, I'm 70
Complications are like ripened fruit,
Ready for consumption
To a person in their birthday suit,
But my Doctors showed genius
And the nurses have no rival,
That was key
To my blessed survival.

One more plus:
I worked there twenty years,
It made me be kind of royalty
And banished any fears,
Made sure I was on my best behavior
No complaints from this bloke,
Here I'm home 3 weeks later
Ready to write the next joke.

-- -- -- -- -- -- -- --
Christmas by itself was great
A mix of family
Good times on every plate

If Putin Was A Nurse Manager

In 1999, I joined a nursing group at our University Medical center known as "Action Nurses". Essentially, this idea was to have a Rapid Response Nurse individual (or pair of) on hand in the hospital, 24 hours a day. This idea was circulating nationwide and certainly showed value as soon as it was launched. To be an Action Nurse we needed certification in just about everything: Procedural Sedation, Radiology practices, TNCC, PALS, ACLS, at least five years (preferably more) of ICU experience. Strong IV insertion skills were necessary, across all ages preferably.

Side Note: I recently returned to the Mother Ship as a patient (not planned, but serious). The second day there, much to my surprise, I discovered the Action Nurse Team was still going strong, with quite a few more team members compared to 22 years ago. Action Nurses are revered by all who need their help.

In retrospect, many of us believe a better Manager would have been better. This poem is my take on that person, whom I have named Martha Polo. 
Without further ado:

Nurse Manager Putin

Martha Polo, sure as shootin'
She was just like Vladimir Putin,
She ruled her department with an iron fist
Her laser beam eyes never missed.

A better Commander would have been better
Than having Hannibal Lecter down to the letter,
But managers last if they are frugal and frightening
Every week they brag the budget is tightening.

Managers can be dumber than dirt
When compared to their peers,
But if they stay under budget
They will keep the job for years.

Yes, Putin had all kinds of plaques on the wall
For being fiscally frugal and that's about all,
The nurses she governed had a different opinion
But those things were kept secret in Putin's dominion.
-- -- -- -- -- -- -- -- --  -- -- -

In 2004: I had an injury and Occupational Medicine would not clear me to work patient Care.

When Vlad signed the papers for me to be separated from Nursing Services department, I discovered they swapped those out with papers for separation from the University. Two months later I got a COBRA notice from UC indicating that I no longer had health insurance. It took me a mad frantic scramble to get my benefits reinstated.

Sunday, November 19, 2023

I Think Chocolate is Safe


If you worked with me you might wonder "what in the heck is he eating at work?" I don't ever recall buying any cafeteria food. I always brought my lunch. During the many years of hospital work, I was a non-meat eater. As a result, many of the "potluck" items brought for sharing at work, I avoided. Typical foods I might bring to work for eating: cup of yoghurt, some dried soup kind of thing (no msg), "healthy" corn chips with added nutritional yeast powder, nuts, and chocolate. Also, I would commonly bring in "good" coffee because the hospital only offered us the cheapest stuff you can imagine (bad taste).

Like many nurses I worked extra shifts in other hospitals; I called it mercenary nursing. Usually I brought good coffee! Maybe that is why I had a lot of call-backs?

You all might remember
A Nurse named Pete,
A hard worker, sometimes grumpy
Who might only eat,
The "treat" foods of Christmas
Holidays and more,
He said, "I think chocolate is safe"
Most especially "Lindor".

After all, it is packaged
One at a time,
The chocolate goodness
Is definitely sublime,
And for hardworking health-workers
Any day with a sweet,
Is a requirement my friend
According to Pete.


Monday, October 23, 2023

A Ghost at the Front Lines

I worked from January of 1978 until January of 2019 mostly in ICU settings as a Respiratory Therapist and then a Critical Care Nurse. I did my best and worked alongside many brilliant and astounding medical professionals. Like those others I have a niche of PTSD associated with that, but who doesn't?
What is more important to me are the persons I worked with during those decades whom I trusted during times of technicality and duress. I can't possibly remember them all (and I worked a lot of hospitals in California!) but it matters not, I remember the best, regardless.

I admit I'm a ghost
But I never disappear,
I worked with hundreds of people
And if you see me in ten years,
I will be just the same
As if we talked only yesterday,
It's wonderful to see you
That's what I will say.

Our service together
We worked side by side,
Sometimes it was easy
And other days a rough ride,
But I trusted your decisions
Your ideas and actions,
I never walked away thinking
There ought to be some redactions.

I will think, ya, we're survivors
Warriors of the same ilk,
Maybe I came from cotton
And you were of silk,
But it never really mattered
On the battlefield, my friend,
I'm really glad that I bumped into you
And that's not pretend.

Friday, September 29, 2023

See the Angels


The demands of our job, the knowledge we must acquire drive us to achieve something known as "Critical Thinking". This is defined as the mental process of active and skillful perception, analysis, synthesis and evaluation of collected information through observation, experience and communication that leads to a decision for action. One does not graduate from Nursing school with this tool fully formed; experience in the workplace, further knowledge obtained and a solid degree of personal confidence will move the new nurse towards that goal.

But what of critical Feeling skills? That is another thing altogether. I know that I do not have the words to lay out the recommended steps required to become an empathetic caring individual but I will say that when the tears started falling, the sobs and wails cried out, I headed for the door and called upon someone else to handle that. 
But there is another type of feeling - perception that is not taught or is little discussed in the realm of Nursing education. Perhaps when cultural topics are addressed there may be discussions regarding different spiritual practices, "pagan" beliefs, a use of amulets or items of power (the Catholic crucifix for example). To add to that, a belief of spirits, angels, demons and what have you very near to us while remaining unseen. Could all of this be possible?

Now consider that the first telephonic spoken word was transmitted electrically in 1876 by Alexander Graham Bell. Certainly, the engineering was complex but millions of people were not believers. Some would say that now in 2023 our understanding of the universe is “light-years” ahead of 1876, but that was only 150 years ago. Quantum science has demonstrated that two elemental particles can and do communicate with each other across vast regions of space, so why is it so difficult to accept the possibility that there is a spirit realm? I propose that is because science has not yet developed instruments to measure these kinds of things and as such, I will keep an open mind about it all.

Nurses and Doctors are right to keep some of their observations “unknown” in respect to things of a paranormal nature. We don’t want to be labeled as quacks or fools; however, over the past four decades of my career hundreds of patients, family members, elder relatives and friends have admitted their belief of a spirit world. In fact, most modern religions are steeped in spiritualistic unprovable phenomena. When we interview our patients & families, we are advised to keep an open mind and not to judge. Let us all agree that is a good idea and open our own minds to vast possibilities that are not yet measurable.

For the record, I witnessed a person (DNR status) come back to life after thirty minutes while being flat-line, pulseless, not breathing and declared dead by an MD. This was in an ICU in a regional medical center in southern California. That man was later discharged home in an improved state. I suspect he had some help getting back his heartbeat. Incidentally, he suffered no neurological deficit. I felt rooms become icy cold for no apparent reason and sometimes associated with the death of a patient. And also at times, where the patient expressed there were demons terrorizing them

I witnessed patients who indicated they were talking to dead relatives that were present in the room. I did not argue with that because it was obvious I had not been granted that privilege. A case in point: In our Coronary Care Unit we had a patient that had end-stage heart and organ failure and was designated as DNR. She knew her life would soon end and she stated that her Uncle and other dead relatives were in the room and telling her it was time to go. Some current family members would visit and tell the patient to stop with her crazy talk and all the while tell the patient that she was going to get better and soon come home. (now, that was truly crazy talk). At some point, the dayshift nurse encouraged the family to go to lunch so that “Mom could get some rest”. About five minutes after the family stepped out, the patient went “flatline”.  Now this was a kind of thing that I observed a number of times too, where the family effectively prevented their loved one from moving on to the next realm of life. Afterall, billions of people do believe in an Afterlife and I can accept that as a possibility.

All of this has been a lead up to a patient experience I had in May of 2008. The patient I was assigned to had developed rather suddenly a cancer that affected her heart. There was no cure, therapy or surgery that was going to interrupt this end-stage condition and she chose to die when it would come. I knew her just 12 hours and when she departed, with family at her bedside and me at the door, I felt a sensation like a cool breeze puff past me the moment she died.

See the Angels

"If only we could see the angels taking her away"
I heard those very words, when I was present the other day,
When that good woman died at the end of her shortened life
She'd been a loving mother, she had been a wonderful wife.

I can't say that I knew her
We had the briefest of introductions,
I can say that I cared for her
Because those were my instructions,
And during those few hours of care
Her spirit, I came to know,
Such that I can tell you truthfully
I felt her spirit go.

If only we could see the angels
Taking her away,
I didn't see them but they were present
When she departed yesterday.


Saturday, April 22, 2023

1st Debris Belt

In the Charlie Brown Cartoon stories there is a character named Pig Pen who seems to leave a wake of dust and mess behind him wherever he goes. Let's just say that I was not a total neat-freak (like some dayshift nurses that followed me) because my main focus was getting my patient's through the night alive. The next morning an occasional muttering was heard as that day nurse fussed around the patients room making it look pretty, to their standards.

My best pal Nurse was the type that needed about 5 feet of desktop space to spread out papers, files and charts (before the EMR) leaving very little space for even one more nurse to chart. It was a bit of a joke between us and did not cause discord. Besides, she was a veritable encyclopedia of Cardiology and a great teacher as well. Anyways, a great team of nurses we were and that is the key to success wherever you work.

I have a 1st Debris Belt in Messiness
But Lana, she's got me beat,
Just trying to start an IV
There are throw-away wrappers
Covering her feet.

I have a 2nd Debris belt in Organization
I couldn't follow a list if you paid me,
That's why it's not a good idea
To try to coerce or persuade me.

Then there's my 3rd Debris belt in Entanglement
I can conjure a knot in any shoelace or cord,
Why untie, when I can more easily break it
I'm one of those employees you can not afford.