High Expectations; Low Standards

I'm on the mailing list of various Nurse recruiters. Recently there was an ad placed looking for an RN, at a hospital I recently worked at. The qualifications were: High School diploma or equivalent (G.E.D.); plus satisfactory completion of a formal Registered Nurse program pursuant to the Division of Allied Health Professions or military training that is equivalent to an accredited Registered Nurse program. Wow, those qualifications are kind of weak...........so I got to thinking about Hospital X.

Easy Job at Hospital X

Good old Hospital X
Has a job for me,
Cuz all they ask for
Is a G.E.D.,
Along with a basic
License for Nursing,
You just memorize scripts
And practice rehearsing.

You don't need to know much
Just smile and wave,
Fluff the pillows
And be a good slave,
And if you're ever asked
About your education,
Mumble some credentials
With obfuscation.

At Orientation
They emphasize certain rules,
That are never enforced
I ask, what kind of fools?
Can run a business like that
A hospital, for goodness sake,
Where every employee is on the phone
During the hours they are awake.

In Recovery, after your procedure
You started bleeding,
Joe holds pressure on your artery
At the same time, he's reading,
About the the latest pistol
Using the phone, in his other hand,
Sure doesn't look smart to me
But we can't make him understand,
If the rules aren't enforced
Until a sentinel event,
That means, until it's too late
And there's no chance to repent.

Precious Flower
Works intensive care,
She charts with earplugs on
Watching Vanity Fair,
No attention on the monitor
For yonder patient, Jack,
Work-time hours watching YouTube;
Don't have a heart attack.

Nurse; can you read an EKG?
Not really, but I have a Monitor Tech,
Hope they are not using their cellphone
Wait a minute, let me check,
But aren't these all Heart patient's
Under your care?
There are some things you must know
As important as breathing air.

Sensible policies
Without enforcement,
Can you trust the care
With this kind of endorsement?
While the public is influenced
With colorful advertising,
Unsafe practices are the norm
Broken rules, not surprising.

Yep, good old hospital X
Will hire me soon,
No more Orientation
We’ll just chant and hum a tune,
Because it was clearly a waste
Training twelve turtles,
About best practices
When they couldn’t run hurdles.

Wide and Bizarre

Over the years I have written numerous times about SVT & TVS (or a similar iteration). Depending on the urgency, the disease process, or even the on-site knowledge base, wide complex tachycardia can present a conundrum, in terms of proper naming of the rhythm. In the event that the patient is critically unstable, cardioversion may be the best choice of therapy.

Wide and Bizarre

It's the middle of the night
And you are a newbie,
You're dead asleep
And dreaming about Ruby,
When your pager goes off
For the CCU,
It seems that Billy Bob Borko
Had some dying to do.

The nurse asks, Doc
Will you look at this for me?
Billy passed out
When he was taking a pee,
And you notice his rhythm
Looks wide and bizarre,
Enough room for a semi
And a Mini Cooper car.

Is it SVT or TVS
If you don't know
You won't impress,
The Attending physician
In the morning meeting,
You better talk to the nurse
Before you take a beating.

There's a guy at the desk
With arm raised and beckoning,
Don't bother to argue
Or there will be a reckoning,
A teacher of EKG
With 30 years of knowledge,
You're not even that old
After eight years of college.

Sure, he can't name a diagnosis
His license won't allow,
But his barrels of experience
Are available, like free chow,
And any self-realized
Brand new doctor,
Will understand free
Without asking a proctor.

Don’t get your knickers in a twist
If he knows more than you,
Regarding Torsades de pointes
And accessory pathways too,
Just sit down and listen
Maybe take a few notes,
On rounds, in the morning
You might get all the votes.

If the Attending should ask you
To cite an article or source,
Please do be honest
Don’t be the butt of the horse,
Embarrassed to admit
A nurse explained it last night,
Let’s have mutual respect
Because payback might bite.

SVT or TVS,
Beguiles folks
You must confess,
If you’re haven’t learned
The nuances and rules,
Your Attending will know
How to separate the fools.

Patty-Cake

I haven't written on this particular theme in quite sometime, but any bedside nurse will agree, this is a stinky subject. Frankly, I have penned an awful lot of crappy rhymes, over the years.

Poo Poo patty-cake
Practice your ability,
A simple test
Regarding GI motility,
The bane of all Nurses
Having to deal with all that crap,
And please listen to me
We don't want it in our lap.

Don't play the revenge game
When we turn you in bed,
Please don't bear down
And make your face turn red,
Because I'll flip you over
Back on your bottom,
Wink at my pal, saying
This time I got him.

Sure, it's kind of funny
When you rip a loud one,
Only if it's empty
Like an unloaded gun,
Because, if I get splattered
I won't be singing, "You're So Vain",
I'll be thinking Chernobyl
And acid rain.

Too much poo poo patty-cake?
We order a Flexiseal,
A miraculous invention
That's how we deal,
And it helps with the odor
Until emptying time,
Then it's the same old crap
Except, this stuff is slime.

Talk About Sex

Nurses; men or women, it doesn't matter. Somewhere in your career, and probably more than once, a patient will start speaking with sex based innuendo's or blatant, sexual harassment, and you need to shut that down, right at that moment! You might have to come right out and talk "Assault & Battery", where speech alone constitutes (threat) Assault, and laying on of hands / touching you, is Battery (causing harm or injury).  Hopefully a firm professional rebuke will halt this behavior in its tracks.

Anyway; here was my response last year when 64 year old Joe Bob just had to know how soon he and his partner could resume sexual activity.

Talk About Sex

Those patients
Who want to fluster their Nurse,
Talk about sex in some way
To embarrass, or worse,
Is it sexual harassment?
Do we snicker, smirk or wink,
It's usually a guy
And he's talking about his dink.

The dude had an Ablation
For his Atrial Fib,
He asked, "How soon for sex?"
Then I said, ad-lib,
Well, how about a week
That should be prime,
But if you just can't wait
Sex yourself, any time.

Common Sins

Not fake news, just old truth. Joe Bob, somewhere over sixty, had strained his back. He had Aspirin at home, and knew it was pretty good stuff for back pain. He remember it was OK to take two every four hours, but after a while he thought, this isn't really working, so he began to double up on the dosing. After about two weeks, he noticed he was feeling weak......................until he finally had Betty Lou take him to the Emergency Room.

Severe anemia
How was that begun?
One guy was popping Aspirin
When his knee had come undone,
Taking it every four hours
For the past two weeks,
His Hemoglobin was four
He had acquired many leaks.

Maybe you need platelets
Or clotting factors,
Though sometimes blood products
Have their detractors,
Perhaps you have a religious
Belief, where you'll refuse,
A standard life-saving therapy
Guess we'll watch you bleed and ooze.

We medical persons
Shake our heads in wonder,
What happened to common sense
Regarding your Aspirin blunder,
How could you think it was OK
To take it so often, for so long,
No Doctor told you that
You wrote your own song.

Over-the-counter medicines
Gotta be safe, right?
Millions of people use them
All day and all night,
If one or two don't work
Take a couple more,
But if you should overdose?
Please unlock your door.