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.


Monday, April 17, 2023

Nurse: Things To Look Forward To


I posted this in 1997, when this Underside was a self-published endeavor. Here I am 26 years later, no longer working at the bedside but still performing some education duties. Look, Nursing isn't easy (not then and not now) but it is extremely fulfilling helping others in their time of need.

In Days Long Gone

In days long gone
Of innocent youth,
You could go to a Doctor
To get at the truth,
Because disease back then
Was fairly simple,
Unwanted babies
Or maybe a pimple,
A week in the hospital
Would do the trick,
If you didn't die
You weren't really sick,
Because medicine men
Didn't have many drugs,
No antibiotics
For bacterial bugs,
Just common sense
Like fluid and rest,
Surgical wounds
Were debrided and dressed,
Life support measures
Not yet invented,
Many more sinners
Took stock and repented.

But today, man, it's different
This hospital scene,
Each organ system
Has a machine;
Any mechanic can tell you
This carries a price,
It's Russian roulette
With a medical device.

Central line catheters
A bacterial threat,
Ground fault dysrhythmias
If a pacer gets wet,
Gastric perforation
From sump pumping hoses,
After long-term use
They'll have a nasal necrosis,
And traumatic intubation,
Will lead to a permanent
Hoarse voiced oration,
Tympanic rupture
From a doppler detonation,
Uremic poisoning
From bladder ablation,
And that's just the patients
But what about the nurse,
Each day at the job
Is surely a curse.

Consider the dangerous
Equipment itself,
Monitor boxes
That fall off the shelf,
Land on your head
Bruising your brain,
There's no medication
For this kind of pain,
Suspended televisions
That swing in an arc,
Causing serious damage
At night, in the dark,
Colonic disasters
From overfilled pans,
Body fluid exposure
On your clothes and your hands,
Broken thermometers
With mercurial spills,
Inhaling poisonous dust
From all those crushed pills,
Exposure to X-rays
That zoom through the walls,
Effectively neutering
Ovaries and balls.

Good god, it's a nightmare
There is nowhere to hide,
But who keeps statistics
On the nurses that died,
In the course of their work
By their choice of career,
They silently vanish
Year after year,
As their spirits race homeward
At the crack of each dawn,
The days of their innocent youth
Are long gone.

Wednesday, February 15, 2023

Things Hospitals Don't Want the Public To Know

I was viewing the news and spotted a ridiculous reveal regarding multiple hospital entities sharing (what should be) private patient information with META (owner of Facebook). You and I both know, that is off limits.........I think we had our souls hammered with threats regarding HIPPA. 

Anyway, here is one of the links:

and, in Louisiana (same problem)

I guess we didn't understand the HIPPA  acronym, after all. We were told it was:
Health Insurance Portability and Accountability Act

Instead, it must really mean: 

Health Insurance Portability and Advertising Act

Sheesh, I'm finally catching on.

Monday, December 26, 2022



Unaverge: What does that mean? 

According to Merriam-Webster dictionary, it allows for "uncommon, unusual and not ordinary". I like to think that it is a good description of my own self. After all, I certainly know I am not a great writer, but not so many "writer-poets" diligently pursue rhyming as their chosen medium. Therefore, I'll settle for "unaverage".

Was I the best ICU Nurse to walk the hallways of  Tinseltown? Assuredly not, but I did attempt to be one of the best, wheresoever I worked. So again, I like the identification of "Unaverage". And now that I ponder that, I believe it is a reasonable description of the multitudes of Doctors and Nurses (and others) I worked with, who made a point of staying current in skills and knowledge in their field of expertise.

I dedicate this to those of you who might identify as Unaverage:

I'm just an Unaverage MD
Don't tell anyone
I got through Med-school for free,
While attending an Ivy League Residency
I found myself in play for the Presidency,
I had to turn it down, of course,
Because I might have suffered Med School remorse.

I'm just an Unaverage RN;
If they knew my history
I might be locked in the pen,
But I learned early 
To keep a low profile,
Plus, have all the answers 
On speed-dial.

Yes, the two of us together
Would have been a heck of a team,
Our ingenuity and brilliance
Could capture a dream.

Tuesday, December 20, 2022

Golden Retriever, RN

 I retired from the hospital almost four years ago, but I keep in contact with my old crew via an occasional visit to their battlefield. 

The latest news included a couple recent retirements, an EP doctor departed without a replacement, the work flow has not changed at all (still supremely understaffed at times) and the arrival of two new staff members with purported ICU experience. Oh ya, one of them came from an ICU but did not complete the three months in training (never had gone solo). The other hiree came from an outpatient surgery setting, where the day ends at 5:30pm. Now, being assigned to a shift that is 11a-11p, this person wants to leave early every day. What the fooey??

Here is my solution:

Last year, the hospital advertised
“Hiring experienced nurses”,
This year they hired the uneducated
Because they tightened the purses,
How is it working out?
Not too well, it was a lousy solution,
I think a Golden Retriever
Would be a better substitution.

And energetic, 
That is not cosmetic,
Never tiring
Until they are told to rest,
About any test.

Not prone to fail
With standard training,
With no complaining, 
They won’t pretend
To do things well,
Hire a Golden Retriever?
What the Hell!

Everyone knows
I’m no fan of the canine,
But where I work
I think they’ll be just fine.

Tuesday, September 20, 2022

New Hospital Equipment

In 2010 at our Level I trauma center there was a new wing of the hospital and the opening of a 20-bed ICU for Neuro, Cardiac, Thoracic and Medical acute care. What a combo! There were four large rooms designed to accommodate Bariatric patients and in general, people weighing 400 pounds and more. Lift tools and devices hanging from the ceiling on movable tracks were part of the standard room setup. Plus, there were new air beds designed for really big clients. The Administration had their fill of hype on all of this stuff, but we nurse discovered things were not so rosy when working with the equipment.

These hot new Bariatric beds
Are super mondo slalom sleds,
We position patients every hour
They slide right down under gravity power.

The bed hydraulics are definitely weak
I'll explain it now, just let me speak,
When we lower the head below the feet
It’s easy to move the patient, slick and neat,
But to bring the head up beyond a 30 degree angle
The hydraulics are too feeble, oh what a fandangle!
The nurse at the bedside must help raise the head 
Another “safety” device, liable to make me dead.

These new tech beds are for the super-heavies
Supposedly stronger than Sacramento levies,
Holding back the 100 year flood
But I'm not too sure about this BillyBob stud,
He weighed in at two hundred and twenty kilo's
And we weren't even weighing the pillows,
On beds that are rated to 500 pounds
We're approaching that number in leaps and bounds.
Beds with all the bells and whistles
Not suitable for an ICBM missile.

The beds can rotate side to side
It's really quite a pleasant ride,
But here again this weight thing irks
If you're really heavy it barely jerks,
There's a tendency for big boy Jimmy
To get stuck on one side while the bed just shimmies,
It wiggles and strains to pump air through the bellows
I wonder, “Where is the lift team, I really need those fellows?”

There are lifts on the ceiling with slings down below
When Jimmy's feeling better we can swing him real slow,
Into the chair by the window to improve his outlook on life
Then the bed will be vacant for his long suffering wife,
Her kilo's are many, her cankles are like stumps
I'm praying to Euphemia, “Dear Sister, bless these chumps”
Don't let either of them have a cardiac arrest
Our defibrillators aren't prepared for that test.

We have negative airflow isolation rooms
With lifts on the ceiling on super-strong booms,
But honestly, I'm wary about the safety of it all
Bad things happen when big people fall,
Caregivers damaged, lawsuits are brewing
When the dust has all settled, corporate will be screwing,
Around with the numbers, statistics and more
The science of big is a titanic chore.

Please, don't misinterpret my harangue on what's big
It's really an expose on the bureaucratic jig,
Million-dollar decisions from dubious advice
High cost vendor contracts at an unbelievable price,
End-users suffer at the whim of corporate decisions
Are Workers Comp injuries in the provision?

This light-hearted muse ended somber and dark
But the business of healthcare is no walk in the park.


Wednesday, September 07, 2022

Getting Promoted


In my Nursing career I never did aspire for multiple degrees, all kinds of abbreviations after my name or stuff like that. My plan was to be the best ICU nurse in my realm and I studied accordingly. Yes, I attained the CCRN certification and kept it renewed for about 18 years until I was sidelined by an injury and I had to leave bedside care. Would you believe that when I was sidelined I applied (and interviewed) for 32 different positions in that organization and was not selected? It was very clear to me the facility was worried that I would get injured again. It's time on disability counted for employment service and I retired when I achieved year 20. 

Then, I went back to work at another hospital agency in town (for 11 years). While I was there, I did apply for a Clinical Coordinator position in the Neuro ICU. Now I'm glad I was not chosen because I never did like Neuro care.

Off The Bus

We interviewed

The four of us,

And then they left us

Off the bus;

It wasn't moving

But it was gentle,

But I guess too much talent

Can be detrimental.

I interviewed

'Twas a lengthy affair,

Two separate times

In the victims chair,

The jury's decision

Was just executed,

And like a computer

I've been rebooted.

My grandiose dreams

Of wealth and power,

Lasted for only

About one hour,

Now I must return

As the horse with no fable,

Just chewing my oats

In the nursing stable.