Medical Martial Arts

I am not really a sports fan, but do watch an occasional sporty thing on TV. The big, most recent ridiculous fight of MMA women, (knock out in 48 seconds), is over now and I'm glad I missed it. However, that knockout chick got $3 million bucks, so apparently it's better than a Nurse fighting it out night after night in an Emergency Room.

Healthcare workers are commonly injured when encountering confused, drug addled, mentally unstable, demented, damaged individuals. Because of this factual premise, much that I write, is an attempt to cast a humorous alternate view of what is really going on. Some have labelled my stuff as "sick humor" at the expense of the patient (and family), who can not defend themselves. Quite frankly, we who are in direct contact with the crazed and confused, are not allowed to defend ourselves. We are the ones truly being hurt, sometimes receiving career ending physical injuries.

Heck, I may as well blame all my crazy writing on the kick-to-the-head, brain swelling concussion I received in 1993, at the bedside during a Swan Ganz insertion.

Mixed Martial Arts, Cage fighting in the Octagon, Muay Thai;
this is the analogy I am presenting, to explain what it feels like to be a Nurse.

Crazed and confused
For whatever reason,
Perhaps a teen on PCP
During the football season,
Ends up in the hospital
After a victory celebration,
A dope on dope
With alcohol inebriation.

Naturally combative
Flailing about,
We try to restrain
Then he passes out,
No longer breathing
Emergency! Action!,
Shove a tube in his lungs
Much to our satisfaction.

Quick, get the Propofol
And place him in restraints,
The danger is real
Expect family complaints,
How we tied up boy Billy
Who is gentle and kind,
While his U-tox is positive
For drugs of every kind.

Yep, it's Medical Martial Arts
In the E. R. tonight,
Luckily, not one of us
Were injured in the fight.

God Knows

Leave God out of it, that's just my opinion. However, many folks believe that when they die, and go to the next heaven, they will be able to know all things. If so, maybe you can find out the true meaning of Pneumatosis Intestinalis.

Pneumatosis Intestinalis
Sounds too big to carry in a valise,
What it is; air in the wall
Of the small or large intestine, that's all,
Pathogenicity, the predominant thought
What we know about it; naught,
Is it fatal, or even a bother?
Be sure to ask, when you meet the Father.

Just Stop It

Dear speakers and instructors, go to Toastmasters or something, and learn how to retrain your speech and grammar habits. Yikes, does that make sense?

If you are unclear about what I am referring to, read this short article:
https://hbr.org/2011/09/never-ask-does-that-make-sense

Does That Make Sense 6

Does that make sense?

No, it never did,

And if I had a gun

I would shoot you, kid,

For saying that damn thing

So many flippin' times,

Although, you're keeping me busy

Writing new rhymes.

12/26/16

Sleep ain't Cheap

Discover awake
Is what I do,
Every day
At ten past two,
That's the timer
For minimum sleep,
After returning from
My midnight creep.

We medical folks
That work at night,
Have our rituals
How we sleep tight,
Black-out curtains
Or a quiet closet,
Is like a thousand
Dollar deposit,
To guarantee
Some decent sleep,
Ya, that's a commodity
That doesn't come cheap.

Shot of Ice

"Siri, shoot me some ice!"

Objective:
For the patient who is asking every 5-10 minutes for some ice to satisfy their water cravings. (typically when they are NPO or fluid restricted).

The device could be set for time intervals, or number of spoonfuls.

Mechanism:
Automatic spoonful of ice injector. Hangs from ceiling or is a shelf unit. It might look like a movie projector. Pull the trigger and it drops ice into clients mouth. Alternate delivery where a red laser targets patient's mouth, and device shoots tiny barrel shaped ice-cubes their way.

Side benefit: Range-of-motion exercise for patient's head and neck.

Best benefit: Nurse doesn't have to go in room every ten minutes to deal with whiny patient.

There's a brand new gadget
A medical device,
It will solve a problem
At a reasonable price,
A germ of an idea
That sprouted and grew,
After consulting
With thousands of you.

In the hospital setting
There are certain reasons,
We withhold fluids
Even in the rainy season,
NPO,
Except for meds,
Makes patients crazy
Jacked up in their beds.

A genius idea
Came to me,
After 30 years
Of singing la-dee-dee,
As patients whined
And threatened with violence,
Why, even an ice-chip
Would provide us with silence.

After mulling ideas
And asking advice,
I have finally released
The "Shot of Ice",
A revolutionary tool
With multiple uses,
No no need to fall back
On ridiculous excuses.

Set-up is simple
Quick and easy,
It has a high-tech look
Nothing cheesy,
Plug it in, turn it on
Just follow directions,
One minute or less
It's ready for ejections.

Have the patient hold still
To adjust aim and distance,
Or set it on automatic, for
The path of least resistance,
It can be voice actuated
With timing controls,
Adjust by the teaspoon
Or set it on, "Bowls".

The patient can choose
What they say, for the trigger,
Like, "hit me again, baby
But this time, something bigger",
Or maybe a whistle
A clap or a moan,
For the technocrats
There's an app for the phone.

"Siri, hit me up
I want to roll the dice,
Shoot me, babe
With some flavored ice!"

4 x 900

Around 25 years ago, we served a young man who was massively, morbidly obese. I guess nowadays, he could be classified, as not so big. Back then, we did not have specialty beds to accommodate persons like this, so we had two standard hospital beds attached together. Ya, go ahead and laugh!

I have observed the strange family dynamics, that are entangled with cases such as these, where the Gorilla in the room is running the show, while maintaining a semblance of helplessness. Now, I finally am writing about him.

900 pound Willie
Calls everyone a chump,
He can't fit into the bathroom
Uses his closet to take a dump,
Just stands erect
And let's it plop on a towel,
His Mama helps clean him
Holds her breath, it's so foul.

The whole entire family
Cater to his demands,
They buy him all the food he wants
While no one understands,
How to escape with any dignity
They are slaves to Brother Willie,
Though, each one of them wishes
They could bury him in South Philly.

He was a 4 pound baby
That's right, isn't that silly,
Now he's age 29
900 pounds,
A mean one, Brother Willie.

Retention Enemy

From the Crappy Ideas Department:

When there is a Flexiseal Rectal drain in place: It can be used to perform a "retention" enema, or to load some liquid antibiotic such as Vancomycin directly into the colon...........Do remember, it must later be unclamped to allow to drain.

Retention Enemy

Flexiseal Mechanics
Section Number One,
Retention enema
Is like loading a gun,
Why, you might ask?
Well, it’s locked, loaded and hot,
Time to pull the trigger
To release the shot.

Please release me, let me go
Let my diarrhea flow,
Open that thing now, or you will regret,
The explosion of crap
That makes everything wet.

Be careful where you stand
Towards the head, at the rear,
Pad the bed in layers
And yell, "All Clear",
Wear protective clothing
With a perfumed mask,
These are the necessities
To best perform the task.

Frankly, it's simple
It's just Physics, Bub,
The dude was compacted
With weeks of grub,
That couldn't get out
Because his gut had a cramp,
After last week's surgery
By the reconstruction champ.

Bowel obstruction
Is a dangerous thing,
Toxic constipation
Till you finally blow a ring,
On that old clunky engine
Of the '44 Chevy,
Gut fluids leak out
Like a flood breached levee.

Retention enemy
Number one,
If you didn’t unclamp it
Just hightail it, and run!

Protege

Many of us have played the role of a Nurse Preceptor, to a fresh, new nurse. This is to help that person, get their feet wet, get the hang of what is going on, their duties and just how they should fit in, to this new working environment. This would be a duty that an experienced Nurse would take on, in addition to their regular daily duties. Preceptor works as a buddy to the new Nurse employee and as such, the Preceptor, needs to be cool, calm and collected. We want to build confidence, help expand their knowledge base, and become comfortable in their surroundings and practice. Anyway, over the years, I belonged to the cadre of Nurse Preceptors and hope I did some good.

Last week, I had the good fortune of meeting up with the protege of 17 years ago. This guy, has gone to great heights, but who knows, if my influence had any effect. In fact, he's got the kind of job, that could have made him my boss, had we continued floating in the same boat. Yes, grasshopper; someday perhaps, the student becomes the teacher.

I visited a protege
From way back when, the other day,
I enjoyed the appointment
Immensely, for sure,
16 years of evidence
That my training was pure,
When I imparted my wisdom
Those few days long ago,
His success is the conclusion
My influence?
I don't really know.

In conclusion:
Protege
or Protoplasm,
If they don't develop properly
You might have a spasm.

Web Address

Ever see those ads on the internet that say something like, "Search you own name at this site and you won't believe what you see"?

When searching the name of this blog, I'm happy to be at the top of the list, but looking down the page, most of the selections have something to do with another kind of nursing, that being, the actual feeding of the baby by their mother. Hence, I have to be careful, not to make some horrid social blunder.

Doing a Google Search
The Underside of Nursing,
Leads me to the breast
New mothers cursing,
Their suffering and pain
Sometimes even bruising,
When baby gets a snack
While mama is snoozing.

Although I've written of breasts
It was not on this blog,
I have to watch my language
Not to be labelled a hog,
A misogynist pig
But that isn't me,
I'm a proponent of Rights
For all women to be free.

Ok, that didn't sound
Exactly how I planned,
In my effort to explain
You may not understand,
That the Underside of Nursing
Poses anti-sexist views,
And if at all possible
Avoids political news.

Stranglers

We have a couple stranglers
Gracing the ward tonight,
On their call-lights all the time
Their demands are out of sight,
Re-arrange my pillows
All ten of them, this way,
I need a sandwich, sweetie
And a little perfume spray.

Why does that alarm
Keep ringing every hour,
I didn't like my dinner
This yogurt is sour,
I don't give a damn
If you're saving my life,
Say, could you call my girlfriend
But, don't tell my wife?

This is how we go crazy
It's called TPSD,
Terrible Patient Stress Disorder
Could happen to you, just like me,
There is a shaking of the fist
While mumbling and cussing,
An explosion of breath
And a whole lot of fussing.

We run to a comrade
For strength in this fight,
Look each other in the eye
And say, “It’s only one night”,
Because TPSD
Feels like crucifixion,
I think I’ll call in sick tomorrow
With a creative affliction.

Consumption

Something I've noticed lately: People being admitted for acute conditions such as Sepsis, Heart Failure, DKA, and Pneumonia, are obese and have Bipolar Disorder. What a surprise!

Bipolar obesity
Each side eats too much,
When one is having dinner
The other side can't touch,
They don't get along
But both love to eat,
This bipolar disorder
Is a tough one to beat.

Bipolar consumption
Runs rampant in society,      
A million easy choices
Only lead to more anxiety,
To calm ourselves down
Add drugs to the mix,
Uppers, downers, etcetera
A groundbreaking fix.

Slogans

I am curious about sources of data, slogans, origins of lingo, and always wondering, "how did this thing get started". Recently, when taking a specimen to the Laboratory, I noticed a large Employee-focused poster on the wall, titled "Our True North". It was clearly a "corporate" generated, behavioral modification tool, to repair and improve our employee public image.

What struck me was the bastardization of a common term, that being "Graffiti". Sure, we all know what that means; "writing or drawings scribbled, scratched, or sprayed illicitly on a wall or other surface in a public place. (Dictionary).

The message on the poster, subjugated that term, as "Physical Graffiti" and "Verbal Graffiti", in such a way, as to have nothing to do with writing, drawing or spraying.

Internet research, brought me to the source behind all this gobbledygook:
http://www.wecreateloyalty.com/. This is "a company that creates solutions for elevating the human side of healthcare". (Improving Patient Satisfaction........ahh, now doesn't that sound familiar?) Yep, the whole hotdog,  HCAHPS (the Hospital Consumer Assessment of Healthcare Providers and Systems)

I followed this link: http://www.wecreateloyalty.com/tag/patient-satisfaction/
And discovered exactly where this "brilliant" motivational poster was sourced to.

Anyway, that's my rant for the week; and the poem to go along with it.

Graffiti on the Wall

Hello Humankindness
Is our branding theme,
Attempting to become
A virtual meme,
It's a feel good concept
But is it money well spent?
It depends on who you poll
The workers or management.

Last month I noticed
A grand poster in the Lab,
Orange and white
Near the vivisection slab,
Where dissidents are sectioned
Along with audit prone nurses,
A feel good corporate billboard
With inspirational verses.

"Our True North"
The title, the theme,
Describing forms of graffiti
That almost made me scream,
Physical Graffiti
Old magazines in the waiting room,
Clutter at the workstation
All dire and doom.

Things you can see, touch or smell
That distract the consumer,
Like your rotten egg salad
Or the C-diff, from Boomer,
Over there in room Ten
Near the patient in Eleven,
Who just had open-heart surgery
Man, it stinks to high heaven.

Yep, that's patient centered care
With hourly rounding,
Flip and flop, Q2 hours
Uncle Bob gets a pounding,
Because it's all about perception
Presented to the people,
Human Kindness News @ Five
Rescue a dog on the steeple.

Verbal Graffiti
Just what do they mean?
Not talking kindly
About Jimmie or Jean,
While standing in the elevator
Boisterously laughing,
Saying, I don't have time
Because of inadequate staffing.

I'm on a break;
No, that's not my job,
You're not my patient
And, Mary's a slob,
The things that don't add
To their overall existence,
Then we'll fail in all surveys
Yikes; reimbursement resistance.

Fake news? this isn't
Would they lie to us? Never,
And $200 million dollars
Buys a big lever,
To bring on the smiles
And feel good public relations,
While we hunt for supplies
At the nursing stations.

Elder Barry

Break Nurse, opinionator, sounding board advice solution suggester, critical decision consultant, wise old man, senior citizen elder helper. This beats Walmart any day, except for the lifting, wiping, toxic waste disposal and babysitting the psycho's.

At work
I must be shown respect,
Cuz, I'm a Senior citizen
They must protect,
They can't treat me badly
That would be Elder Abuse,
Finally, age is working for me
Yep, I've got an excuse.

Offence

Does that Make Sense 5

I learned some new stuff

At the hospital last week,

Continuous Renal Therapy

An education I did seek,

Overall, it was worthwhile

Till the 4th speaker did commence,

To end each clarification with,

"Does that make sense?"

This is the fifth time I've written

Regarding this horrible habit,

If I had a shotgun

I would have plugged that rabbit,

To put us out of our misery

At this horrible speech offense,

Let me ask you, dear reader

Does that make sense?

When spoken repeatedly

Over and over again,

I want to perform Hari-Kari

With my best fountain pen,

Because we students don't need

To be treated like fools,

By post-graduate Nurse educators

Braying like mules.

Public speakers, please stop it!

Does that make sense?

The grammar police are coming

To toss you over the fence.

Carnivorous Cleo

At last, a cute cuddly story about a kitten. Sure, it may seem I'm off track here, not writing about hospital nonsense, but kittens are people too.

Carnivorous Cleo

http://www.wnem.com/story/34050656/kitten-survives-car-crash-fends-for-self-before-being-found

Do animals need training?

I suppose they do,

Their mothers nurse them

Just like you,

But the human analogy

Should stop right there,

They have survival abilities

That hu-babes don't share.

I just read an article

About Cleo the cat,

A survivor of a car crash

Where a Chihuahua went splat,

Because he ran into the traffic

After the family car was crunched,

Little Cleo ran away

Without getting punched.

The people were hurt

And the Chihuahua was dead,

Thereby proving that cats

Are way smarter in the head,

Much more able to survive

A week or two on their own,

Cleo probably would have called

If she had her own phone.

The article seems written

In the usual silly way,

Regarding poor helpless animals

Needing rescue every day,

By cockamamy caregivers

Those of the human kind,

While a cat is a predator

A carnivorous hunter in kind.

Per the article:

She fended for herself

In unfamiliar country for two weeks,

Ludicrous, to propose

Cleo had no techniques,

To survive in the wild

Without human intervention,

Cleo wasn’t lost

Nor did she suffer apprehension.

Animals: don’t worry about the future

They survive in the Now,

Making the most of their environment

Without having a cow,

Although, these two cats I have now

On loan for three years,

Will cry like babies at the door

As if I cut off their ears.

No, Cleo was a survivor

Didn’t require a rescue,

Found a good barn to sleep in

In a bed of Fescue,

Plenty of mice to chase

Freedom from rules,

Yet, at the end of the story

Had to suffer more fools.

Genius

We have all heard about Betty Lou the nurse, who had a grand idea, created a sample, had peer review, found a manufacturer, got Angel Investor backing, and is now a bonafide gazillionaire, after selling their gadget to Google.

Me, I just get goofy ideas, give them funny names, and hopefully entertain a few hardworking others like myself.

Over the years I have discovered

Several new conditions,

But as a nurse, no one cares

They don't believe my renditions,

Big Pharma doesn't fund me

I get no University backing,

When I showed them my research

They sent me packing.

When the Internet came along

I figured, this is the place,

I can write up my theories

Without showing my face,

Someone might read it

And recognize my finding,

How brilliant my research is

Absolutely spellbinding.

Perhaps my new gadget

Will be the hottest next thing,

Then I can retire to Fiji

With my Pit Bull Mei-Ling.

- - - - - - - - - -
My "Copyrighted" Condition List:

1. Persistent Vegetative State (no, it's not Tennessee)
2. Circus Movement Brainwaves
3. Physician Index of Acceleration (PIA)
4. Ketchup Brain
5. Hypertension Deficit Disorder
6. Provocative Resting Test
7. Autonomic Reflection

ps.
Stay tuned for goofy gadgets like;
the Cardio Floppen Crappen, Sneezer Pleaser, and the,
Metered Dose Impaler.

Victor the Vector

I think most Nurses agree, that the floor in any hospital is teeming with every dangerous microorganism known to mankind. But it has to be the worst, in those stupid hospitals that have carpeting, particularly in patient-care areas.
So, I am appalled two ways: 1) Bringing any children or babies into the hospital for any reason. 2). Allowing those little punks to crawl, sit, play, and roll around, on the floor of the hospital, and their attendant adult doesn't care one way or the other. YUCK.

Little Victor, came with Grandma
To visit Momma on the ward,
Grandma doesn't pay attention
Little Victor is totally bored,
He's running in the hallways
And crawling on the floor,
He's a collector of bacteria
And has the highest score.

His Momma had some runny crap
Dripping off the bed,
The side-rails are contaminated
Now that crap is on his head,
He's the biggest C-Diff vector
In the whole entire land,
Though it’s probably not a terror plot
It seems incredibly well planned.

He will carry it to his preschool
And touch everything,
He'll share it with the other kids
During morning group sing,
He'll take it to the lunch room
And leave it on the food tray,
The bacteria couldn't be happier
“We’re C-Diff, that’s how we play”.

Little Victor the Vector
Couldn't be more efficient,
Spreading the bacteria
He’s a God, and omniscient,
And though those tiny germs
Know not that they exist,
Little Victor the Vector
Was on their bucket list.

One Beer with Meals

I have worked with a couple Physicians, who felt it was Ok and probably a good idea, to order a beer or wine with the meal tray, as an attempt to prevent alcohol withdrawal. Essentially, the conversation is in regards to persons who drink a fair amount on a daily basis; like the guy last night, who drinks 10 beers a day. I posed that question to Dr. X the other night, in respect to a person with a serious drinking history. He said, "No, not ever would he allow that for his patients". His rationale was to the effect, that this individual made a personal choice to abuse alcohol, and the Dr. could not in any way support this, calling it unethical. I mentioned Dr. Z, who is known to do the opposite. To me, it appeared that Dr. X, was co-mingling some personal beliefs, as opposed to a scientific data based approach. His method, should there be withdrawals, will be dosing the patient with whatever drugs are on the "Withdrawal (drug) Protocol". In other words, medications that will very likely cause more short term side-effects, that could possibly have been avoided, had Billy-Bob been allowed a beer with each meal. This is not all supposition, as the Dr. Z method (Beer/Wine) has proven successful on numerous occasions.


Doc, what do you think?
The subject of prescribing alcohol
During a hospital admission,
Would you allow it for your patient
Under any condition?
Some Doctors say, no
I wouldn't cater to that,
Regarding a self-acquired problem
And that's where I'm at.

But I think a double standard
Exists with that attitude,
Our patient's get addicted
To all kinds of things, Dude,
Like Morphine, Oxycontin
Fatty foods and Coffee,
We let them have those
Along with Grandma's best toffee.

I have a suspicion
Your ethical attitude,
Lies in personal beliefs
Not science, Dr. Dude,
Because we feed our fat patients
And prescribe Norco, like candy,
How is addiction to pain pills
Any different from Brandy?

I heard your argument
Against the alcohol approach,
If I was selecting a doctor
I would choose another coach,
One with a more generous
Perspective and view,
And a little bit older
With more experience than you.

Nutty Nurses

So many crazy, bipolar, demented, disoriented, damaged whacky people lately (the patient's I mean). I began to wonder, could this be contagious?

Senior citizen nurses
Why we get nutty?
Too many loopty'loo patients
Acting like Silly Putty,
Mimicking characters
From The Exorcist movie,
No wonder we retirees
Become demented, yet groovy.

Retired Nurses
Why we might become whacky,
We might have a patient
Infected with Coxsackie,
Or is crazy contagious?
I don't really know,
Like acquiring Whooping cough
At the motion-picture show.

Spasmodicus

Once the gross out theme gets rolling, I just can't stop.
"Twas the night after.............

'Twas the night of diarrhea

And all throughout the house,

Not a Nurse was seen breathing

It smelled worse than dead mouse,

The commode chairs spilled over

And streamed across the floor,

House-keeping refused

To take care of this chore.

I called Dr. Brown

And Suzi called Dr. Runni,

And each one of them laughed

Because they thought it was funny.

I told Dr. Brown

"You have earned payback

For sure",

The next time I get you coffee

I guarantee it won't be pure.

The next night an emissary

Of emesis came over,

To herald a pukefest

On the Cliffs of Dover

We used all the Zofran

Phenergan and Droperidol,

And when I phoned the doctor

He asked, "So, why did you call?"

Another round of threats

Regarding crap in his salad,

Had the good Professor Emesis

Singing my ballad,

Regarding pukus-diareus-spasmodica-loo

Oh, pray with me Brother

That it never happens to you.

Poisoned

This is a little like one of Clive Barkers horror stories, only it rhymes.
Also, I'm the Break-nurse, I'm just reporting what happened to Suzi and Billy-Bob.

Poisoned

She's crazy and screaming

And she's out of breath,

She beat up her heart

With Nicotine and Meth,

She's not confused

It's just her drugs talking,

Wild cursing and growling

Her toxic squawking.

Begging and bargaining

For food and water,

She failed the Swallow test

And now she's threatening slaughter,

She yelled, "I'm going home now"

Ya, I wish that I could let her,

But I know that won't happen

And this night will get no better.

She coughs up yucky mucus

And spits it at her Nurse,

Oh, how did she know

That I keep some in my purse?

Sweet memento's like that

Are the kinds of things I savor,

So, I blew her a kiss

And asked, what is the flavor?

We are her babysitters

At seventy dollars an hour,

And that flavor in question?

Is putrid and sour.

Like the Queen of the Damned

And Satan's child,

Open heart surgery

Made her wild;

Though, truth be told

She was like this before,

From the very first day

She came into the store.

She calls the men names

That rhyme with trucker,

I am her Nurse

And I feel like a sucker,

What she calls the women

Rhymes with itch,

If I had my way

I would drop her in a ditch.

Like that child possessed

In The Exorcist,

That's my patient tonight

We have to coexist,

She's screaming and wild

And out of control,

I'm fairly convinced

She tried to poison my soul.

And someday........

She might possibly go home

In one or two weeks,

Get back with her people

The meth-heads and freaks.