Gash

Bleeding, makes me nervous
Not my own, silly goose,
Rather, your gushing artery
It's a heck of a deuce,
Most special is the instance
Where your artery was nicked,
And nobody knows it
Thus, I do feel tricked.

If the nick is on top
That's a singular thing,
Easier to deal
With the tools that I bring,
But a notch or a gash
On the side of that vessel,
Is like crushing a bowling ball
With a mortar and pestle.

In other words, foolish
To think we can squish,
Hard enough on your artery
To fix the crack in the dish,
And taking into account
Your anticoagulation,
It's like holding a locomotive
At the Brownsville station.

Two and a half hours
We finally achieved,
Another great save
Where nobody grieved,
And even the Irishman
Shook his head in wonder,
Stating, "I even used Ultrasound"
To avoid this blunder.

There is nothing to blame
We all do our best,
Though holding pressure that long
It was certainly a test.

What We Do

What happened this week
You might not believe,
And if we weren't so good
Then someone would grieve.

Monday, we worked late
There were not enough rooms,
There was a late anesthesia
For the bride and the groom,
And sure, that sounds just like
My usual rant,
But Tuesday blew the leaves
Off the Mulberry plant.

Three Rapid Responses
Meaning, we ask for help,
77 year old Clifford
Was drowning in kelp,
Flash Pulmonary Edema
After a PCI,
We got him out of our Unit
'Cuz he was too young to die.

And then there was Willard
97 years later,
He got the leadless pacemaker
But needed a breath locator,
Because he didn't wake up
And he wouldn't keep breathing,
I tell you, this is more work
Than a one year old teething.

The final Rapid Response
Well, it was the best,
Billy Bob Borko
Was taking the test,
His get up and go walk
After Cardiac Cath,
To get ready for home
A short walk on the path.

Off to the restroom
He was looking good,
Didn't lock the door
Just like he should,
The toilet did flush
Then the ground did shake,
Billy Bob passed out
Man, I think he will ache.

Prone on the floor
And face-down, he was,
Not moving at all
I don't know, just because,
Till I called his name
To assess, signs of life,
Hoping to reassure
The whimpering wife.

And I have to admit
I'd rather not call Code Blue,
We don't need 20 helpers
In a bathroom built for two,
So, once again we paged
Our RRT pals,
Got Billy Bob moving
Just one guy and two gals.

All's well that ends well
'Tis the moral of this week,
Surround yourself with good nurses
No matter young or antique,
Because we'll pull you back
From the envelope of doom,
Keep you comfy in your bed
To see the sunrise in your room.

Out-Patient ICU

Out-Patient ICU

Has a nice ring to it, ya.

A day in our hidey hole

Just another average, no crisis day.

Pool of Anxiety

What about today?
Half fussy, half cool,
I never know what attitude
Is floating in their pool,
Could be deep anxiety
Regarding the unknown,
Or they're simply ticked off
Without service on their phone.

I always admire
The visitor in the chair,
If they talk to patient Billy Bob
Instead of the vacant stare,
Focused on their smartphone
Although, how smart is that?
Creating no thoughts of their own
No sharper than fat.

Three admissions and departures
In the first three hours,
Thank goodness I'm endowed
With a couple super powers,
Then later on the same
Like a movie shown twice,
The evening ones are fussier
Demand to leave, not so nice.

We threaten with drama
"Well, you know, you might bleed,
Then, you would have to stay longer
Because safety is our creed,
So, just calm yourself down
And thank that lucky star,
Dude, we fixed your A.Fib
With nary a scar".

Over and over
Day in and day out,
This is what we do
Without a whimper or shout,
Sure, we do complain
Occasional and easy,
But we do the kind of stuff
That makes lots of folks queasy.

Turn, Turn, Turn

While perusing my medical reading / updates a couple of days ago, I came upon an article / advertisement for a sticky pad thing we can attach to patients, to monitor how adherent we are to Q2 hour turning. The website is all touchy-feely-good time stuff regarding HAPU, and reduction of pneumonia and so forth. The kind of stuff that gets healthcare systems to invest another gazillion bucks on hardware, software, equipment and more beeping monitors (and ways to punish Nurses). All of those bazillion dollar expenditures (and branding bucks too), would be much better spent on real live Nurses and support personnel. Of course we who read this stuff, know all that! Phooey; just look at this website. ........http://www.leafhealthcare.com/

 Turn, Turn, Turn

Staff nurses will hate this
A patient-turning alert,
Electronic surveillance
The reprimands will hurt,
Because no one has time
To do Q2 hour turns,
We don't have enough staff
But nobody learns.

HPPD tallies
In case you don't know,
Rule every damn thing
Over at the big show,
It accounts patient care
With a static measure,
As if nurses were dallying
All those moments they treasure.

Another monitor thingy
That we stick to Billy Bob,
He’s as hairy as a Yak
But don’t label him a slob,
He prides all of his fur
And dare not, you trim,
His hair is religious
According to him.

If I place that sensor
On his naked back,
Will the monitor think
It's a face-down hack,
And I will be reported
To the motionless committee?
Could I be fired? (Then I'll sue)
Oh, isn't that a pity.

Q2 turning is great
With caregivers aplenty,
But that concept was banned
Way back in 1920,
While working the most recent
Fifteen year gap,
Any bedside Nurse can tell you
It's been a spank and a slap.
_ _ _ _ _ _

My favorite contributor of hospital nonsense.........in Virginia, has this to say:

We have these thing called VisAlerts.  They hang on the outside of each room.  They have a green, yellow and red light on them, connected to a timer.  When you go into the room, you reset it.  The light turns green.  At approx 54 minutes, it turns yellow.  At 1 hour (that's what ours are set to), they turn red.  If they manager or director see too many red lights, the  nurse gets a "talking to".
We didn't even have a working EKG machine on the 3rd floor last week.  We called a Rapid Response.  Our EKG machine had a broken clip.  We ran to get Ortho's EKG; theirs didn't work.  Renal didn't have one.  We had to go to the 2nd floor to find one.  (Renal didn't even have a bladder scanner.  Renal??)  And then they invest in these VisAlerts.  What a joke.

Enough all ready

If we don't empty out our Unit by the 11pm closing time, we are on mandatory overtime. Now, I'm pretty sure the Nursing contract states something that opposes that concept. Well anyway, usually it has to do with a lack of patient beds on the floors that can accept our patients.
However, in the past couple of months the Master of the Universe is trying to double down on his number of procedures every day.........and dragging his procedural staff and our Recovery Unit right down the rabbit hole with him.
Stay tuned for updates on this one.

We are overwhelmed
With too many clients,
Excessive procedures
Without scheduling science,
Someone calls asking
Can you do it tomorrow?
They say, "Yes, come on down"
It's like Kilimanjaro.

A mountain too tall
To climb in one day,
So many procedures and
Recoveries, we say,
'Cuz we'll have to stay
Until the beds are vacated,
After 43 pacemakers and
Arrhythmia's ablated.

We know who to blame
And we're taking names,
Loading our weapons
We've had enough of these games,
Because we want a bonus
For our overtime care,
And we're charging the doctor
Because that's only fair.

Psychogical Manipulation

When I meet the patient, I address them as Mister or Missus & Last name, while stating my own First name. Sometimes I remember to ask them what name they like to be called. Most of the time going forward, I will then address them as "Sir" of M'am. Just call me old fashioned.

What bugs me, is when that person pulls the psycho-babble name-game on me, by making sure, they use my first-name whenever they talk to me. Supposedly, the intent is to: "Acknowledge my identity, massage my ego, and boost my self-esteem". Well I don't like it; we're not bosom buddies. You want to use my name in every sentence, is an assumption of intimacy, that quite frankly, we haven't yet established. I know you don't love my name, because back when we were kids, it was sometimes used to joke about a particular body part. If you wish to use my name in every sentence, you damn well better, ask for my permission! Just saying.

How about those patients
Who are so demanding,
Like a politician
Doing their glad-handing,
Using that technique
Of saying my first-name,
I know they read that in a book
A subtle psychology game.

I'd rather be generic
And dazzle you with my skills,
Bring you what you ask for
Like 14 pain pills,
But please do one thing
Stop saying my name,
I know you read that in a book
It's a smarmy little game.

Old Fool

The song remains the same. We three nurses, over the period of 11 hours, did recoveries on 2 Interventional Radiology patients; 5 Arrhythmia ablations and 2 pacemakers, where each one of those seven had some version of General Anesthesia; and 6 Cardiac Caths with PCI. Plus, we assumed coverage of 3 other patients who had not yet gone to their procedures. I pulled 4 four Femoral sheaths on one person, had to deal with bleeding groins on two others, had to transport with 5 patient's. The other two nurses did about the same. But heck, I'm just an old fool.

Well, I'm an old fool
I keep coming back,
Like a rusty old truck
On a beaten down track,
Where every hole and rut
Is a forgone conclusion,
After a 12 hour beating
I need a tonic infusion.

Today, for example
No vacancies in the Inn,
The Cath-Lab was stacked
And 6 ablations were a sin,
Because we bore the brunt
Recovering twenty,
With two point five nurses
That's double-down plenty.

One point five hours
Of double time pay,
Makes 13 plus hours
All work and no play,
I walked 13,000 steps
Which is more than enough.
But I'm an old fool
Pretty rusty, but tough.

[dedicated to another Old Fool]