Ten to One Ratio

 

November 12, 2020.

There is a newspaper story sourced to an Italian hospital, where a patient suspected of suffering from Coronavirus, died prior to being admitted to a hospital room. In fact, the story refers to the incident where the man died while using the restroom, presumably in the Emergency Department.

In the course of my career as a Nurse, death did occur several times in bathrooms. It is not advised, because usually the room is small, and should you be discovered unconscious on the floor, about 25 people respond to your Code Blue, and we can't fit in the room. Of the hundreds of Code Blue situations I attended, family was present at maybe 20% of those events. It is always hard for loved ones to grasp what is truly going on. 

Anyway:

A dead man was spotted

In a hospital restroom.

As a Nurse I can tell you

That's not the  best room,

To discover a death

The recently deceased,

Both administrators and family

Are most certainly not pleased.

Where were the attendants?

The authorities will ask,

The family will shriek

And take us to task,

Blaming doctors and nurses

For ignoring Uncle Jerry,

Hell, he was gasping for breath

Didn't you notice?; It was scary!

Normally ICU patients

Are but two for any Nurse,

In these COVID days

Take ten patients and curse,

And if you work in North Dakota now

It's okay if you're infected,

Just don't expect bonus pay

You're disposable and not protected. 

I retired two years ago

In just the nick of time,

I feel bad for my brethren

And that's why I still rhyme,

Expressing frustration

Regarding this dire situation,

We are all in this together

But that's no consolation.

Invested in Sickness

Sooner or later every nurse will enounter a patient who loves to talk about their health issues. A month by year dissertation of procedures, surgeries, inflammations, trauma and so on. It is nearly impossible to turn off this faucet of misery. It is an attention seeking behavior and usually a huge waste of your precious time. After all, it's probably in the EMR by now. Alternately, they may actually have Munchausen Syndrome which is indeed a mental illness. 

Invested in Sickness

Agnes says she has HOCUM
Bobby declares he has POTS,
Juniper states she has COPD
And brags about Prednisone shots.

I nod my head and move on
To a question that demands a clear answer,
Sir or Madam please tell me right now
Were you ever an exotic dancer?
Because the woman who said she had HOCUM
I'll pretend that she really said hooker,
Trying to distract the launch of her story;
If she slugs me, I'll call Security to book her.

I met a few folks over the years
Heavily invested in their sickness,
Taking command of a regular conversation
With an extraordinary powerful quickness,
Naming their six favorite doctors
All their surgeries, therapies and more,
The numerous hospitals and procedures
As if they were keeping score.

It is hard to put a stop to this train
'Twould be better to never get on,
Prompt them with yes or no questions
With the demeanor of Genghis Khan.

A Bloody Requirement

I retired two years ago and still I have the dreams.

Flashbacks of bleeding

No, never my own,

Billy Bob and Esther

Patient's I have known,

Was it ever my fault?

Yes, a couple of times,

Caught my foot on an Art-line

Was one of the crimes.

ICU is a tangled place of

Wires, tubings and clutter,

Careful maneuvering advised

But what if your patient is a nutter?

Delirium in progress

Thrashing and flailing,

I was kicked in the head once

And I went sailing.

Nightmares of bleeding

Have followed me into retirement,

This burden in my dreams

Must be some kind of requirement.

Cull the Herd

Hopefully the bulk of current healthcare-at-the-bedside workers  are with me on this: the Coronavirus poses a significant risk of shortening life expectancy. No matter where it originated from (which hardly matters in the ICU), it is a bad mofo. I believe that social-body-space distancing, mask wearing in public and hand washing, represent our best defense. This poem speaks to the folks who don't believe these recommendations, nor do they recognize the severe risk of death to themselves, and to their loved ones.

Cull the Herd

Herd immunity?
It will take at least three years,
Culling of the herd
Should be added to your fears,
If you're a big old fella
With diabetes or hypertension,
You better watch out boy;
You've got the Grim Reaper's attention.

Who do I speak to?
All the careless folk,
Who love to tell themselves
The Coronavirus joke,
How it's no worse than the Flu
Of which they already have immunity,
Coronavirus will cut them down
At the first opportunity.

Go ahead with your demonstrations
Shake hands, wear no mask and hug your brother,
Perhaps he will share the virus with you
Which will kill your mother,
But you frequently boast
"Well, ya gotta die sometime",
How about your eight year old daughter
Who caught it during lunchtime?

You will weep and moan
And smack the side of your head,
Realizing your foolish actions
Made them dead,
Or, maybe you won’t
You will blame it on the Democrats,
Deep state, Cabal, CNN
And mysterious Fat Cats.

You know the saying
You’re a part of the problem or the solution,
Will St. Peter or Beelzebub?
Offer absolution;
Stay tuned, old buddy
You get to choose,
Your survivability
But will your family lose?

At Home PCI Kit

In the April 9, 2020 Journal of American College of Cardiology, is an article reporting a reduction of admissions for STEMI during the recent COVID crisis. One assumption being proposed, is that patient's are afraid to come to the hospital, fearing they might catch the virus.

In my current state of being retired, I have a lot of time to imagine possible solutions. Here is my latest genius solution.

The Do It At Home PCI Kit

Here's the way I see it
And how the data was reported,
If you're having a STEMI at home
You need a hospital to thwart it,
Yet in these viral days of our lives
The hospital might seem too crazy,
We fix your heart, you catch the bug
You die and we look lazy.

A retired old Nurse
He worked in Cardiac Care,
All of the old and new ideas
Are in his brain somewhere,
He spends his retirement hours
Inventing Rube Goldberg devices,
A STEMI repair is just plumbing; and
You won’t believe the results and the prices.

You can do it at home with the PCI Kit
Assembled from household goods,
You will need a source of electricity
So you can’t do this out in the woods,
And it’s helpful to have an assistant
In case you pass out or you’re bleeding,
And not only that, if you work with a mirror
It will reverse the instructions you’re reading.

Call right now to Amazonabon
One kit delivered in an hour to you,
Review the supplies that you need
Not satisfied?, then nothing is due,
It’s advisable to examine the kit
And carefully read each instruction,
You might think it ought to be easy
But remember, this ain’t liposuction.

It’s important to have good lighting
A comfortable couch or a bed,
With a suitable selection of pillows
Under your feet and your head,
Having an assistant to aid you right then
Is like having a Musketeer,
Anxious? and you poke the wrong vessel
And the pipe cleaner comes out your ear.

Supplies found in the Kit
Dental floss - waxed
Ultrasonic toothbrush handle
Olive oil
Pipe cleaners
Disposable gloves
Merlot
Sewing needles-8,9 or 10
Stat-Seal Powder
6 Rare earth magnets

__ __ __ __ __ __ __ __ __

When You Are Ready:

Assemble the list of items: Place in order of use, on a clean towel at the bedside.

Wash your hands and wear a mask…………….if you don’t have one, just hold your breath during the times of puncturing.

Thread the two sewing needles with a five foot piece of dental floss (waxed is best) and lubricate with Extra Virgin Olive Oil (if there are no extra virgins available, no sweat)

Don your gloves (don’t ask me why it’s Don, if you like, use Dawn)

The usual site of puncture, if you’re old school, is the Femoral artery. You have to pull down your underwear to expose the area. Your assistant might be embarrassed at this point and run away. Therefore, it is better to be new-school and choose the Radial artery at your wrist, (and if you are alone) use your non-dominant arm for access.

Sterilize your intended puncture site: Hopefully, you have some alcohol on hand or some really good soap. Minimally, you can use the Merlot, which was included in the instructions.

You may have consumed a glass of Merlot already, to aid in the numbing of the puncture site. There is some disagreement about that, as the developing intoxication might alter your aim, but the jury is out on that detail. Suffice to say, the Radial artery is very superficial, and this writer assures you, (having done 5000 arterial punctures himself) if you can’t cannulate a radial artery, you don’t deserve to survive anyways.

Regardless of which arterial site you puncture, you may note a bright red sticky substance squirting out; that’s when you shout "Hurray, I hit the artery". At this point, I suggest you apply some digital pressure a little upstream from the puncture site to slow the leak. If you did use the (highly recommended) sewing needle with floss attached, you are finished with one of the most anxiety provoking moments, the gushing blood. Here you can apply some of the Stat-Seal powder to slow the gushing blood to a drip.

Now, take hold of the Ultrasonic (toothbrush) handle and turn it on. Your assistant will have several rare-earth magnets stacked together, and move them slowly up your arm, in the direction of your heart. The vibrating toothbrush handle needs to be moving in tandem, immediately next to those magnets. The vibratory ultrasonic wave will help to keep the needle in the middle of the artery. Slide up the arm, under the clavicle and then take a sharp turn down toward the heart. It gets a little tricky then, but if you just happen to have an iPhone with a visual Ultrasound attachment, then this will be a piece of cake. Otherwise, you just have to use the back and forth approach to hit the desired arterial take-off on the Coronary ostium; sooner or later, you’ll hit it. More than likely, if you send the needle down the wrong artery, you will actually have an upsurge in pain and symptoms, because you are now disrupting flow down one of the remaining open arteries.

The objective is to find the blockage and attack it a few times with your magnetically directed sewing needle and hopefully pass thru the fresh blood clot. When that happens, a little bit of fresh blood will pass the obstruction and the chest pain should be reduced immediately. At that point grab hold of the nearby tail of the dental floss, and with the help of your assistant, together you can floss the passageway through the previous blocked artery.

If it doesn’t seem like the flossing method is working well enough, pull it half-way back, cut the floss and tie in a long piece of pipe cleaner with a floss tail. Use the magnets again to navigate through the artery, pipe-clean with the same back-and-forth method.

Do realize that although this method has saved a number of lives, we CAN NOT guarantee success, because in the hospital they have machines that will blow your mind. However, you might catch COVID and never go home.

When it seems like the Elephant is no longer sitting on your chest, withdraw your tools. Apply direct pressure to the puncture site with more Stat-Seal, for at least fifteen minutes and wrap it tightly with a clean Scrunchie.

While finishing off the bottle of Merlot: Call your doctor and leave a short message; say something like this: Doc, this is Barney; you may not believe me, but I had a STEMI last night at home. Luckily, I ordered (1 hour shipping) from Amazonabon, the “You Can Do It (yourself) At Home PCI Kit With Common Household Items”.
Damn brother, this thing really worked! How come you never suggested it?

Cavalier Ablations

Paroxymal A.Fib, SVT, ,Brady & Tachycardia's, ectopic beats: When an arrhythmia has either failed drug therapy, has become too bothersome or is indeed life-threatening, then ablation should be considered. While the procedures themselves, done by highly experienced operators, are relatively risk free.............those risks include major bleeding, serious vascular complications, stroke, cardiac tamponade, emergent open-heart surgery and even death. Sometimes those complications occur with persons, who could have made a safer and less invasive choice. The process should be this; Primary medicine to Cardiologist, and lastly, a possible referral to an EP specialist. Many times, stable arrhythmia's can be managed without a trip to the ED or the operating room; what the patient needs is education.


Flecainide saved me
From the Ablator's tools,
Waiting a decade or two
Will expose some of the fools,
Who claim to be magicians
When indeed they are not,
They'll zap or freeze anything
Just to say they're a hotshot.

They act very cavalier
Claiming it’s safe and routine,
Minimizing the risks
Do you understand what they mean?
When they quote a low percentage
Of bleeding, death or stroke?
Percentages based on one-hundred
Statistically, it’s a bad joke.

When bad things happen
During procedures that
Weren’t absolutely needed,
But the hotshot advised
And the patient heeded,
Believing that advice
Without attempting a safer avenue,
If a terrible outcome happens?
The doctor will say,
“We did all that we could do”.

A number of arrhythmias occur
In folks without heart disease,
Some of them require ablation
But not everyone, if you please,
Patient education regarding
Triggers, cause and termination,
Might avoid intentionally scarring one’s heart
And paying for a Doctor’s vacation.

If the average Joe can learn
To replace the oil or change a tire,
I’m pretty sure we can teach him
How to stop his arrhythmia without a freezing wire,
Without running the risk
Of perforating his heart,
Let’s educate and give him that chance
Before the Ablation needs to start.

Down the Road

My forty years in the hospital, 35 years in ICU settings; there were crazy, ridiculous, shifts with people dying a lot and the overwhelming feeling that we couldn't do enough. But those experiences were sporadic, and let's say, not more than one day per week. So, what is happening now to nurses in my profession, is unfathomable. Reading about it is painful, and it drives home to me, how important it is for those agents of good, to talk about it with others who can empathise. PTSD is real, and every one of these workers today, in this crisis time; we want you to survive this, and live long long healthy lives. Whether you need a grief or anger Counselor, do it sooner than later.

Down the Road

During the years that I worked

I wrote very much,

Trying to alleviate the emotions

That get close enough to touch,

A form of escapism

I could call it that,

Working with folks critically ill

Is enough to knock one's psyche flat.

Nowadays PTSD

Is better understood,

One should intervene early

If you want to do any good,

It is difficult to settle it

Miles down the road,

You can pay a lot of dollars

On some ICD-9 codes.

What Happens in the Kitchen

Today, April 22, there are some articles circulating (a couple, repeated over and over) regarding the incidence of calls to the Poison Center. These are persons calling in for Chemical Exposures at home; specifically, sterilizing home grocery items. One of them refers to a person, who left her vegetables soaking in vinegar, warm water and 10% bleach. This person called EMS for difficulty breathing and was transported to an Emergency site.

Clean your vegetables with Bleach?
Well, I sure wouldn't do it,
Not because I know it's bad
But when I do D-I-Y, I always screw it,
Still, it makes me wonder

What was she doing during Home-EC class?

Learning the dangers of household cleaners

Or dreaming of smoking grass.

Ten percent bleach, water and vinegar

Should sterilize any sort of edible,

Of course, that means you ignored the warnings

On the label, yes, they are credible,

As the gas fumes emanate

From your Vitamix blender,

Call 9-1-1, Momma

Before you view heaven’s splendor.

Another produce-cleaning survivor
When all she needed was soap,
The best thing you can do is
Gift her, "Pope-on-a-Rope".

Unmasked

Although I'm no longer working ICU and I'm not in the hospital, I'm still capable of being totally ticked off at the ridiculous decisions that hospital managers and administrators make. Case in point, are the directives that Nurses are not allowed to have the necessary PPE to protect themselves. I recall working in ICU's in the Los Angeles area during the early acute phase of the Aids epidemic. This was when the transmission of disease was poorly understood, and it was unclear if it included airborne precautions. Thus, we wore the similar garb as is recommended for COVID; except, it wasn't rationed.

Regarding certain hospitals sending Nurses off the job, because they voiced complaints of unsafe work conditions.


Working at a hospital
That disallows masks,
N-95 for the most
Dangerous of tasks,
For those nurses who work
Placing their lives on the line,
They should be replaced by administrators
And see if they like it fine.

I worked at that hospital
Back in 1985,
I guess if it was last month
I might not be alive,
And around that time
It was the AIDS epidemic,
We had to garb up like moonmen
Just like this pandemic.

The masks were not rationed
Nor any of that other stuff,
The infection was a mystery
Nobody knew enough,
Until later on
We learned it wasn’t airborne,
Then the nurses relaxed
And went back to making popcorn.

There was a subtle fear
Of mystery and the unknown,
I think our hospital administrators
Would shit a brick if they were alone,
At the bedside
In today’s COVID ICU,
Heck, every nurse should grab one of those fools
And show them what to do.

Of course, it might take two nurses
One on each arm,
Dragging Edmundo
Into the arena of harm;
Don’t let him wear a mask
As he accompanies you,
During the next emergent intubation
I’m sure he’ll lend a hand too.

I’m pretty certain
This method would be effective,
To change administrators minds
They might be a little more protective,
Regarding the well-being
Of every employee and caregiver,
If this doesn’t work
Send them up the river.

https://fox5sandiego.com/news/coronavirus/socal-nurses-suspended-for-refusing-to-care-for-covid-19-patients-without-n95-masks/

Doctor Got Fired

I posted on July 18, 2018 an event of post-procedural syncope by a patient who had angiography earlier in the day.
Part of the telling included how Dr. I-Don't-Call-Back, could not be reached for the update on his patient. I learned that about three months ago, that dude got FIRED.

Doctor I-Don't-Call-Back
He finally got fired,
I'm sorry it happened
After I retired,
Because I would have gladly
Added my kick too,
With King Kong's
Size forty-seven shoe.

It was not a question
Of his Interventional skills,
He probably reamed a thousand arteries
Without any kills,
No, the problem was all about
His aberrant personality,
He wouldn't take responsibility
For his lack of morality.

I bet he's still around
At another facility,
He did some good work
With his technical ability,
But sooner or later
If he doesn't change his habits,
Another frustrated manager
Will dream of shooting rabbits.

Quarantine Shopping

Wow: who would think that after SARS, MERS, H1N1............that someday soon, we the world would be totally schnockered by another Coronavirus? Not a single one of us medical professionals who worked during those other dangerous events, would ever have thought that less than 10 years later, the whole world would be attacked. Shame on us, right?

But still, one needs to consider shopping for the totally unexpected.

We are quarantine ready
In our locality region,
Pretending I'm isolated
Like a remote Norwegian,
We stocked up all week
Getting ready for the bunker,
Both cars are gassed up
Although one is a clunker.

I shopped twice at Costco
And also, Trader Joes,
We hit the asian markets
Because, who knows?
We need a wide range of sustenance
Amer-asian sourced and all,
In our western remote location
Don't bother to call.

We have a punji stick sidewalk
And a rottweiler garden,
Automatic weapons
Lasered sighted, beg your pardon,
We must protect all our stuff
Because who knows what is coming,
And it's one, two, three
Are the lyrics I'm humming.

But what did I buy?
You might ask a pro,
I've had so many years
To decide, yes or no,
The kinds of things needed
And it ain't toilet paper,
Not if I'm going to die
In the Coronavirus caper.

I want to eat and drink
My favorite foods,
All things delightful
The best of all goods,
According to my plan
After six decades of study,
Salt and chocolate are here
Like an old time buddy.

Ok, sure I must accomodate
Others on hand,
I took their requests
It worked out as I planned,
Because first and foremost
I have to honor my mate,
Should we survive armageddon
Then she's still my date.

The List:
50+ Lbs Rice
25+ Lbs Flour
5 Lbs pasta
6 bottles wine
24 cans beer
4 Lbs Sanders Sea Salt chocolates
1  Gal Costco Ice cream
Tamari sauce
Mixed salted nuts
Lettuce in garden
Drugs galore
Netflix, Prime and digital library

Methanol Cure

You would have to be a cave hermit, to know nothing about the Coronavirus, COVID-19, Beer virus...and the accompanying hysteria. Situations of this nature often lead people to make very poor choices, in respect to their own safety. When ignorance, lack of education, fear, illiteracy, and dependence on various forms of dubious information (rumor, social media, gossip, etc), guide your choices; perhaps drinking Methanol or Bleach (MMS-Miracle Mineral Solution) will work to protect you from whatever ails you.

Did you see the news
Regarding the methanol cure?
Will it protect you from Virus?
In a way, that's for sure,
Because, if you're a believer
You drink it and then you die,
You conquered the infection
On your very first try.

https://nypost.com/2020/03/10/dozens-of-iranians-die-from-alcohol-poisoning-in-attempt-to-fight-coronavirus/

Crazy Milkshake

In the course of looking through archives of prior writings, I found a couple poems from 1985 that had not caught up to the collection. Folks, that's a long time ago, but still, 7 years into my healthcare career I was already battered. As a result, something triggered one of those visceral memories of crazy nonsense and I immediately wrote the following: (Actually, I loved working Recovery, but still.......)

You are driving me crazy

And it's all your fault,

First, you asked for a milkshake

Then complained, it wasn't a malt,

You preferred low-sodium crackers

Then said, they weren't very salty,

Now, I'm beginning to think

Your cognition is faulty. 

For a while I could accommodate

The forgetting and confusion,

After all, you were totally doped up

But now it's a forgone conclusion,

That you are a user of something

Unlisted on your preop discovery,

Totally skewing our assessment

During procedural recovery.

Well, as I mentioned once before

Ones real self is exposed at this time,

When your barriers are drugged

Showing the hidden-under slime,

That slithers beneath the surface

Of your facade of normality,

Now all I have to figure out

Is how to prevent a fatality.

Other nurses like me 

Were injured by folks like you,

Your little monsters inside

That were hidden from view,

By a cheerful outward countenance

"Oh honey, he wouldn't hurt a fly",

Except when he kicked my into the wall

I had a concussion.............might I die?

The Finger

Over the past ten years quite a few devices have entered the market to help people monitor their heart rhythm at home. Some of them are junk, others work pretty well, some are simple and others ridiculously complicated or too expensive. Personally, I have the AliveCor two finger device that works on Apple IOS or Android, and I have seen the latest iteration of the Apple Watch application which produces a spectacular single lead, real-time tracing. But, you have to have a $1000+ phone and watch, to use it. But over the years, I have discovered that my ability to do a finger palpation of a Radial artery, is as good as any of a variety of techy-devices.

Finger Patent

I should patent my index finger
As an A.Fib detector,
I'll get so much recognition
But that's just conjecture,
Because I'll be bought out
And my finger will be toast,
Device makers are scared of me
Regarding money; they want the most.

I read a lot of studies
Money is spent like crazy,
But I'm beginning to realize
Research vision is hazy,
Focusing on engineering
To make a convoluted machine,
While my Index Finger detector
Is better than anything you've ever seen.

I place my Right Index Finger
On Radial artery Right or Left,
Upstream from the thumb bump
In the anatomical cleft,
With gentle pressure I palpate
And feel the cadence of the beat,
Irregular rhythm is my specialty
And A. Fib is the treat.

After all, you do know
12-Lead ECG,
Is the industry standard
The Bible, the creed,
Required for billing
For codes ICD-9,
With my patented finger
I know I'll do fine.

I can imagine a future
With royalties flowing in,
A simple device that mimics my finger
A bluetooth gadget with spin,
Proving that touch is superior
To the usual scary machine,
There's bound to be a paradigm shift
"Give me the finger", if you know what I mean.

Itchy

Coronavirus vs. Aromavirus:
Sounds similar doesn't it? Well, listen up and I'll explain it all.
Also, this poem is not about me being itchy, but all about the play on words.

Sometimes at home
I have an attack,
I get itchy and red
On my hands and my back,
It seems to happen most often
When my wife does her cooking,
I wonder what could it be?
So now I am looking.

Is it a simple allergy?
A bush, bug, or tree,
Did I eat the wrong thing?
And now it's inside of me,
Was I bitten by a snake
Or some other kind of predator?
I’m searching the Journal of Medicine
And letters to the Editor.

Little raised red bumps
Itchier than heck,
It started on my torso
And now it’s on my neck,
Traveling down my legs
To the bottom of my feet,
I can’t possibly go to work
Until I’ve got this thing beat.

It’s springtime in our region
Could it possibly be a flower?
As a child it was grasses
That held the itchy power,
I was tested for Allergy
Revealing dander and Iris,
The doctor said, sonny
You have Aromavirus.

He told me, “Kid, wear a mask”
Not the Halloween type,
Beware of new plants
And more of that hype,
Plus, I was introduced
To some magical beans,
The first generation
Of Antihistamines.

In High School I discovered
The drugs had more potential,
If I took four or five of them
I felt existential,
If I added something more
I could channel Miley Cyrus,
Then I knew I had conquered
The dreaded Aromavirus.

That doctor was a trailblazer
Naming my condition,
Now it seems once again
There is a similar rendition,
So I’m filing a lawsuit
A play on words, this something new,
Corona sounds too similar
And compensation is due.

Oh, Pharmacist

This is a gathering of several Pharmacy themes, coming together into one poem. Naturally, ideas pooled from real experiences.

The Pharmacist is a special player
A fount of knowledge, not a soothsayer,
Can be sweeter than a Tasmanian devil
When conversations are on the level,
If discussing matters
Regarding toxic ingestions,
The Pharmacist poses
His list of questions,
What’s the body-mass index
Their age and gender,
Was this a single shot of heroin
Or an overnight bender.

There once was a Pharmacist named Maury
All caught up with his power and glory,
He sold dubious potions
And age reversal lotions
From the back of a busted down lorry,

At his job on San Juan Avenue
In the middle of the city,
Pharmacist Maury
Was sitting pretty,
He was controlling and ornery
If you know what I’m saying,
If I needed something STAT
He might start delaying,
Telling me fourteen other people
Are ahead of me in line,
“ But Maury, if we wait
This guy will be dead on the vine.”

I think working at night
He felt like King of the pile,
With the power to delay
Making us wait for a while,
And I could never figure out
How to play to his good graces,
Never saw the dude smile
Only his control-freak faces.

Other places that I worked
Pharmacists went on rounds,
To be part of the discussion group
Dicing kilograms and pounds,
And the best time to have a Pharmacist
Right at my side,
During a Code Blue situation
Before somebody died,
With that dude on hand
To dispense all those drugs,
Handling the conversions
And refilling our mugs.

Ya, those chaotic scenes
In the University setting,
Sounded like Billy-Bobs club
With everyone betting;
“Hey, pass me a lidocaine
No wait, make that two,
Plus three epinephrines
And an epidural screw.

But there were the times
At other hospital places,
No Doctor or Pharmacist
Arrived to show their faces,
Until the very last minute
A chance to do some billing,
Yep, someone gets paid
Even when there’s a killing.

A Pharmacist in the family
Well that would be handy,
He will know what I mean
When I ask for some candy,
Plus he can probably get it
For pennies on the dollar,
Or sneak them out of the shop
Under a starched linen collar.

Pharmacists are the second
Most trusted professionals,
Good Catholics each one of them
With a guaranteed confessional,
To absolve them of sin
Should they waver from their path,
Like bringing home candy
And cheating on their math.

Monkey Smart

At my previous healthcare organization, we were unionized and that truly is a good thing. However, the downside is, that the pay was divied out based on how many years of experience a nurse had worked. 0-5, 6-10, 11-15, 16-20 and beyond. That was the basis; not talent, motivation, effort, productivity, or even showing up. Regarding that last feature, I probably averaged 3 sick days per year and took a short vacation once a year. Bobby-Joe would call in sick three days a month, take four vacations, beg to be sent home when the daily hours dipped, refuse to keep up with medical knowledge and skills.........and still, if his years of service matched mine (and like me, hadn't killed anybody) then our evaluations were equal. Essentially, even a monkey could do this job.


Today I spent an hour
Shredding old papers,
Those yearly evaluations
The most worthless of capers,
Where the best of employees
Just get a pat on the back,
"Keep up the good work, Bob
You got everything on track".

The stupidity of it all
Is that even the flunkies,
Get paid the same level
Like we're a gaggle of monkey's,
Vying for sweet treats
Plush toys and balls,
Yep, every year is the same
As we bounce off the walls.

You Want Me to Do What?

At Med-school training hospitals, new cycle Interns-Residents are quite often nervous or anxious about doing new things. Sometimes that new Doctor will be bossy, arrogant and argumentative with the new-found sense of power they can wield over others to do a task they themselves, are unfamiliar with. This kind of surly behavior is not welcome to the great society of ICU nurses who know it is their sworn duty, to iron out the creases so readily apparent on the surface of the newly manufactured doctor.

You Want Me to Do What?
No, Doc; you can do that,
A typical Nurse response
To Resident Brat,
Who boldly suggests
Some outlandish proposal;
Dude, if this doesn’t work
You’ll be destined for disposal.

That day Joe Bob had a fever
The 900 pound man,
Laying on two attached beds
Plus a ventilator and a fan,
I needed that Resident
The night guy on call,
He said, you know where to stick it
The suppository Tylenol.

I’m not doing that
Not this nurse, not me,
That’s clearly an experience
For the new Doc on the tree,
To explore the heart of darkness
The depths of the unknown,
Just wear a mask, and 3-foot gloves
I’ll stand by and chaperone.

Rabbits

I am sure every Nurse has discovered something very unusual about a patient, that had been not been communicated during report, or wasn't in the patient history document. The overlooked amputation, the hand with seven fingers, a third breast, or a ginormous schlong; true eyebrow raising discoveries or phenomena.

Rabbits

There was a really big thing
One time, that I saw,
When I lifted the covers
And there ought to be a law,
Where patient's inform us
About their physical anomalies,
Pastor Bob, said
It helps with my homilies.

Every Sunday morning
Delivering the sermon,
He gestures like a hip-hop star
Grabbing his herman,
To emphasize points
In the body of the teaching,
Well, I wish I had known that
Before I went reaching.

At the pre-op appointment
Complete an intake form,
Discover the anomalies
Compared to the norm,
Ask about his medicines
Diseases and habits,
Become well informed
And watch out for the rabbits.