NurseMart.........just another .99 Cent Store

 

I am a multi-decade ICU nurse and retired from the hospital for three years. Yes folks, I do miss it and I cringe at the reports of what current nurses are experiencing. I know what you know; one of the primary reasons regarding staffing shortages (as are reported today) has to do with the sucky treatment of nurses by hospital administrations. The following is what I wrote in 2008 (and probably ten years earlier too).

If only we were in the business
Like the local grocery store,
We'd earn a flat percentage
For every pill and chore,
Every spoken word of teaching
Every gesture of compassion,
There'd be seasonal variations
Like the latest winter fashions.
 
For special big events
There could be a bonus format,
It would beat the present system
Where we're treated like a doormat,
For example, we could compensate
Events like CPR,
If you succeed and bring them back
You win the big cigar.
 
Your patient was combative
He tried to stab the Candy-Striper,
She’s the daughter of the CEO
You win the keys to his Dodge Viper,
Or you work an extra night shift
Like it’s really no big deal,
Seven patients with infections
Every one of them with difficele,
By morning you’re exhausted
And finally feeling old,
Your boss comes in, says, “Way to go”
And hands you coins of gold.
  
There would be no nursing shortage
If these silly thoughts were true,
Pay us like celebrities
It is long way overdue!

2008

Careful with those words, Boss

I am a certain kind of writer because I pay attention to the usage of words and terms. During my 40+ years in healthcare I paid close attention to the things that were being communicated to me. As a result, I have laughed a lot.

If you work in the hospital you must know about the Johns Hopkins Appraisal Tool for Fall Risk Assessment. At the most recent facility I worked at, it was identified as the Johns Hopkins Tool. If you are a warm blooded adult, you may be aware that there are alternative definitions for the term "tool". Sometimes I wonder who is sitting on the panel of professionals, when they all agree on the naming of something. It reminds me of the acronym of SBAR (Situation, Background, Assessment, Recommendation); now consider what FUBAR alludes to: Effed Up Beyond All Repair. 

Johns Hopkins Tool

I don't think I want to know
About Johns Hopkins tool,
I may be a Nurse
But I'm not a fool,
To be poking around
In his business that way,
I'd rather read a report
Than see that tool, any day.
 
I really don't care
About Johns Hopkins tool,
I learned all about that stuff
Way back in school,
And if he wanted us to know
Don'tcha think he'd send a letter,
Nope, I don't want to see it
'Cuz it don't get any better.
 
You see, I don't understand
How seeing Johns Hopkins tool,
Will make me any smarter
And I'm already cool,
So what could be the point
Of this mandatory class?
It better not be something
About Johns Hopkins ass!

New Poem - Old Problem

 

Bullying, harassment, threatening behaviors definitely do occur in the Tribe of Nursing. There were numerous times over the years where I experienced bullying and/or harassment. Most of those times I blatantly ignored it and went on my way. My method to deal with it was to become better qualified and more valuable, such that I received a more favorable status. 

Now, I can put up with harassment about three times and then, I fight back. The event described in the poem below did result in a conference with my Nurse Manager and Charge-nurse regarding my outburst of aberrant behavior. Fortunately, my nurse adversary was just acting the way she frequently did with other persons. I was the catalyst for her soon-to-be, future departure.

I was better than some
No worse than others
Perhaps the same as a mythical creature,
All the tools that I owned
I brought to the table,
Some complained about a singular feature,
I might propose, a better solution
And offer it up with a question,
Apparently that ruffled 
A couple chicks feathers
Upsetting their delicate digestion.

After absorbing a singular attack
From a colleague at work one night,
I silently decided enough is enough
The next time I will openly fight,
And sure as sure in a couple more weeks 
During night-to-dayshift-report,
Bianca the weirdo demanded details unneeded
I exploded like a gun at the fort.

I slammed the chart on the table
‘Twas like a gunshot in a crowded mall,
All heads turned in our direction
As if waiting for the bodies to fall,
And fall they did, when I demanded 
"Bianca, just take my report",
I felt a silent collective agreement
Bianca’s harassment did abruptly abort.

When DNR is revoked for a few hours

 
Many times I witnessed this sorry state of affairs; the person who is identified as DNR and then, he or she is not allowed to die. Yes, it is true. A DNR designated patient is coerced / urged / guided to undergo some kind of safe surgery and the surgeon declares that the DNR designation is "suspended" during the surgical procedure. This is where doctors think they are gods; where nothing could possibly go wrong that they can't handle. Oops, Mr. Billy coded on the table and the team can't possibly let him die. Well, the primary reason for that has to do with the Physician, the medical practice and the hospital reputation status. It doesn't look good when patients die during surgery. And there you go, Mr. DNR was not allowed to die and quite likely his QOL is now worse than it was preop. In fact, he might suffer fifty times more on the way to his natural death.

Free Resuscitation

When I got too old
To drive my car,
My doctor made me
A DNR,
But when I went in
For my surgery,
They offered resuscitation
Completely free.

That's a heck of a deal
The surgeon said,
If you crump on the table
We'll bring you back from the dead,
Because we don't want people dying
In our operation room,
It's bad for our reputation
It's a flippin', dollar doom.

But worry not, sir
There ain't nobody better,
We operate by the book
Down to the last letter,
And the gist of all this talk
Is about risks and regulations,
You'll come through with flying colors
And standing ovations.

So you did poorly, after surgery
Well, it's clearly not our fault,
We performed what we promised
And you didn't tell us to halt,
When you had the opportunity
Before morbidity and mortality,
Would get the upper hand
And you'd become a fatality.

You should have put your foot down
And stayed a DNR,
Before you let that doctor
Be the driver in your car.

RASS Revisited

 
As the years go by every medical worker must go to hospital orientations or get introduced to new solutions, blah, blah, blah. Man, a huge amount of money is blown on these things and no matter who you work for they will sell it like it's a new pathway to Jesus. 

The one and only………..(no, I’m joking, there are at least fifty of these ridiculous acronym directives that are jammed down our throats). And believe me when I tell you, the primary objective is to audit your performance, while the secondary objective is to guide a metric for billing. 

Here is one of my all-time despised directives:

Richmond Agitation-Sedation Scale.

Never in my career, in any Nurse-to-Nurse report did Betty Lou say to me, Patient Billybob has a RASS of minus two, positive. Instead, I was told that; Billybob is totally whacked out, slugging and spitting at his caregivers between bouts of profound somnolence and manic, murderous mayhem. And incidentally, I told the Doctor the same thing. 

So why is there a RASS? To audit us, of course, you fool! It probably fits in somewhere on that down-home favorite, the APACHE score.

RASS

Remember
Acquire
Stupid 
Stuff,
As if we didn’t
Have to do enough.

Always remember
To do that RASS, mutt,
Or some invisible Auditor
Will kick your butt.

At first there was AIDET
And then there was NO PASS,
Ask any honest nurse
They’re all a pain in the ass,
And don’t forget that Apache Score
One more shackle
To grapple with on your shift,
I doubt the CEO must do it
Do you get my drift?

Is management forced
To use precious time?
To pull up Apache
And make everything rhyme,
A non-productive part
Amidst every day duty?
Makes me feel like calling
Death Cab For Cutie.

2007.......2021

The Family

 

Here it is 2022 and I will admit that end-of-life decision making algorithms and comfort-care medical orders have laid the path to reduced suffering. However, sometimes there is family baggage, dysfunction and outright animosity toward the poor dude that is at death's door. I have witnessed on numerous occasions, family members fighting over what they will "get" when Daddy dies, all the while Daddy is over there in the bed heavily sedated and on life-support devices. 

A dying patient's family, can
Do more harm than good, I assure you, man,
While contesting the contents of his will
They're hovering closer for the kill.

They may be harboring hidden guilt
About the time the milk was spilt,
Then clutch at every thread of life
And claim it's for his loving wife.

When life-support, becomes death denial
He feels like he's been put on trial,
He wonders what his crime must be
The poor fool had a family!

(1992)

A High Stakes Game

 

Dang, I wrote this back in 1991..........and the same game is on.

High Stakes Game

We keep them here for days on end
And try to make their organs mend,
We attack their cells with mighty drugs
To try to kill all sorts of bugs,
That naturally were acquired here
This ain’t no place for the sick, I fear.

Pardon me, I was only rambling
About life and death, it’s just like gambling,
In a high stakes game for those that dare,
Who bet their lives in Critical care.

Flashbacks of Bleeding

 

If you ever stop here to read my writings, you may have noticed that I have been revisiting my past a bit since I divorced the Hospital in 2019. I'm not finished with Nursing, because I still teach about Heart Rhythms.

And I still write new stuff!

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, tubing's 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 of dreams seems like
Some kind of payback requirement,
But I know better than that
This is called PTSD,
Repetitive traumatic experiences
If you’re a hospital nurse, it will happen to thee.

Figure it out early on
Find a pal to listen to your stories,
No reason to brag
All about you and your glories,
No, just unload all the crap
The pain, the suffering and more,
Maybe twenty years from now
PTSD won’t knock on your door.

Crazy Function

 

I graduated Nursing school in 1983 and immediately began working on Cardiac Care units and within a year I was working in all manner of ICU's. My interest in heart rhythm's began before Nursing school, during my career as a Respiratory Therapist, when I took a semester class for basic EKG in Fall of 1978 (Pierce College in Los Angeles). As a novice RT working in the Cardiac Surgery ICU, I figured I better be able to read a Heart Monitor while I was screwing around with the ventilators. 

Anyway, my fascination with EKG rhythm's goes a long ways back and with my current historical review of writings I am getting reacquainted with quite a number of cardiac poems I forgot about.

Crazy Function   (1992)

I have some crazy function
Down in my AV Junction,
The impulse is forgotten
Because the path is getting rotten,
At last a beat gets through
I’m unsure, what it will do,
Aberrancy or retrograde
If refractory, it just might fade,
Back into covert hiding
Until my AV-Node is more abiding.

A Spirit of Visions

 

An old favorite of mine regarding the Tribe of Nursing.

The camaraderie of nurses
That I mentioned once before,
Is like the glue that binds the book seams
And the hinges on a door.

Like the sands of ancient deserts
And the waves of mighty seas,
The gale force winds of a hurricane
And a forest of time tested trees.

It draws from a source of great power
It plays host to a spirit of visions,
It shoulders the pain of all brotherhood
While bearing the weight of decisions.

There’s a loneliness shared by its members
As the givers and takers of pain,
It rests on the heart with a heaviness
We bleed life, in a bottomless drain.

But the law of abundance sustains us
The cup that we pour is refilled,
After quenching the thirst of so many
There’s enough left for us, that we’ve spilled.

1992

Save Your Skin

 

Just as an auto mechanic would believe that there must be something wrong with any car and that they can fix it, I suspect that surgeons feel the same way; there is always something that needs repairing.

Mr. Customer, can't you see
We think you need a surgery,
You’ve got some parts about to fail
And your skin is looking awful pale,
Well, that's a sign of some disease
Don't ask us how we know it, please.

Our surgeons would like to look within
They'll do anything to save your skin,
And frankly, sir, that's all you've got
In our opinion, the rest is shot,
So sell the house, the bonds, the stocks
And give the cash to all of your doc's,
You'll receive a card of heartfelt thanks
From all of our respective banks.

Disaster Relief

 

There were quite a number of incidents over the years when the Doctor in charge of writing orders was hesitant to do so. The cause could be stress, lack of confidence, lack of knowledge in a certain area, or a combination of all three. When a patient is in dire circumstances and near the threshold of a cardiac or respiratory arrest, if the "boss" is frozen and unable to make a decision, he or she should listen to the experts in the room; 

The Wizards of the Badlands.

Can you tell what's real
Do you know what's not,
Can you determine from 50 yards
If it's sputum or snot?
Does a jacked up CO2
Of one-twenty-five,
Give you any indication
About the odds if he's alive?

Well, maybe for a while
But I wouldn't place any bets,
I think it's time to call your markers
And pay off any debts,
Because arguments at this time
Are pointless and invalidated,
Just get the flippin' ventilator
Before you're excommunicated.

Now don't take this personal
We're all hired hands,
But some of us call the shots
While other's holler from the stands,
With an opinion here and there
About what ought-to-be,
And at this very moment
You should be listening to me,
Because this dude is going south
He needs an endotracheal tube,
Please don't stand there arguing
Like some existential rube,
Quoting laboratory data
And his history of CO2,
We're the Wizards of the Badlands
And we know much more than you.

We don't want to code this sucker
We don't want a Rapid Response,
We don't want to toast his remains
With a sterling-silver sconce,
No, all we want to do
Is the best right thing, right now,
And that my friend is to intubate
Before I have a cow!

My, How Time Flies

 

The Underside of Nursing is now forty years old. 
Here is a poem from 1982 when I was halfway through Nursing school.

Lovely Young Lady

Your hospital stay
Is like a kick from a mule,
You’re stuck on your back
Like you’ve run out of fuel,
It seems just like yesterday
You were running around,
Now you’re in this strange place
Without a friend to be found.

You can’t close your eyes
In the middle of the night,
You know, if you were home
It would be a breeze to sleep tight,
Until finally, you doze off
How peaceful it seems,
When someone is shaking you
They’ve shattered your dreams.

You awaken in anger
Looking around for the kill,
There’s a lovely young lady
And she hands you a pill,
Then gives you some water
She wants to know if you’re dead,
With a glint in your eye
You pull her into the bed.

It’s like a dream come true
She has such a nice tan,
Then she’s back on her feet
Screaming, “You dirty old man”,
Then the room becomes light
And you open your eyes,
It was a dream after all
Oh my, how time flies.

We Are All Inventors

I know most of us come up with ideas and schemes that look like a surefire way to do something better and then somebody else comes up with it and makes a fortune. I invented a new disorder eleven years ago and my internet search reveals it hasn't been discovered yet in 2021. Wow! I nailed it.

Hypertension Deficit Disorder

I have named a new disorder
According to my think,
We were discussing low blood pressure
And it came to me in a blink,
As if a cursor were brightly flashing
Within the deepest recess of my mind,
Several concepts were bouncing around
When all at once it was clearly defined.

Rarely do we ever examine
That hypotensive son of a gun,
There are a lot of good reasons a BP is low
Like the planets revolving the sun,
But more commonly our major statistics
Are driven by those hypertensive fools,
Yes, we know these bloody freaks so well
They're the drivers for all of our tools.

And as a result, the naming
Of this barely known uncommon disease,
Has gone for eons without its own title
It's more like a sniffle than a sneeze,
So let it be known upon this day
October twelve in the year twenty-ten,
Hypertension Deficit Disorder
Has now been transcribed by this pen.

Wielded by this one very author
And posted on this world-wide-web place,
If you wish to hijack this naming
I'll throw my copyright into your face,
You see I need to rake in some royalties
My autumn years will come quickly to hand,
I'm open to grandiose ideas and schemes
It's a part of the future I've planned.

Hypertension Deficit Disorder
Is a well-defined disease to a few,
In the many long years of this nurse
I remember just a couple I knew,
Who were prescribed high-salt in their diet
And proposed to render higher emotions,
Because we know in retrospective analysis
These are evidenced and reliable potions.

I am thinking of publishing my data
Though it's a narrow, small selection research,
I'll set up a booth and a table
On Sunday outside of your church,
When it's one-hundred degrees beneath the shade tree
The parishioners will be dropping like flies,
Hypertension Deficit Disorder
Will be easily proven, no surprise.

10/12/2010

 

Under Attack

 

There have been a number of newspaper articles lately highlighting increasing levels of violence and threats against medical personnel. Folks, this is not a new phenomena; we have been under attack for years, lets call it forever.  As a matter of note, I can recall three injuries I suffered requiring time off for my own recovery.

The following poem reviews a Post-anesthesia recovery I partook in seven years ago.

Fist

You tried to punch me with your fist
To do me harm,
With your Mike Tyson grip
You bruised her arm,
And sure, you "got better"
We can blame the anesthesia,
Conveniently, you won't remember
Claiming you seem to have amnesia.

But I know better
After thirty years of Nursing, 
The drugs tear down the curtains
That hide the violence and cursing,
The evil one inside of you
That you rarely let out,
People who live with you, they know 
It's not something they talk about. 

Your faithful wife stands up for you
Asking me, "Sir, are you having a bad day",
Implying that I am the aggressive one
In the midst of this violent parlay,
Where our whole intent is his safety
In this setting of saving his life,
But we're dealing with his hidden demons
And his ever-supportive wife.

Violence in the workplace
This is it folks, it isn't fun,
Potential career-ending injuries
Are the proverbial loaded gun,
Whether intentional or not
It hardly matters when harm is done,
And defensive family members
Probably helped to load that gun.

9/30/14

Repair Shop

 
I think every nurse will think sometime, that all we are doing is working in a repair shop for humans. 

I just unearthed this poem from 2014 that I had not correctly archived.

Nothing terribly exciting to report
It’s life as usual
Down at the Suck & Snort,
The regulars remain
And entertain themselves,
Some have stayed so long
They belong on the shelves.

Imagine working
At only one job,
Frankly, I can’t
I would feel like a blob,
Of secure confined knowledge
Sheltered in place,
Afraid to step out of
My comfortable base.

We’re a mixed up bunch
From all manner of beginnings,
Some days we are losing
And others we’re winning,
In an unpredictable business
The repair shop for humanity,
Surely, you can understand why;
We’re on the brink of insanity.

The owner is a typical
Miserly cheapskate,
Paying his workers
The lowest damn rate,
Cutting corners on service
Supplies and whatever,
All the while advertising
We are the best and most clever.

Yes, it was a standard good day
And now I’m kicking off my shoe,
The bartender has delivered
It’s time to quaff a good brew.

PTSD - All Over Again

 

While reviewing older year posts, I discovered I could trigger a version of PTSD; in this case, getting angry all over again. It is regarding one of the more common complaints of workers; bad managers.

Leadership Fail

When I reported my injury
The Assistant manager said,
“You should have called for help”
“Well I could have done that, but then he’d be dead,
Mr. Demon couldn't wait
For any handy lift device,
Gasping, cussing and fighting
And we paid the price.

What kind of leadership person
Points a finger, as if to blame,
Not showing concern for the injured
What kind of dysfunctional game?
Causes a person to harp on and on
About why I had 30 minutes of overtime,
Two days ago on the day I was injured....
Her management skills aren't worth a dime.

I love my job
But this Assistant Manager is an ass,
The worst I have ever encountered
Thirty years, since Nursing class,
And this will never be resolved
As long as she remains on the job,
It's laughable, that she believes
She is a worthy leader for our mob.

In hindsight, she said
You could have used the right tools,
Me: I thought the guy was going to code
Then they would have called us fools,
For calling a Transporter to find equipment
While the devil's heartbeat raced over 150,
It's not like the equipment we need is on hand
Oh, to work in such a dream hospital, sure would be nifty.

I think the right tools would include
Captains, who care about their team,
I have a wonderful job
And a sergeant that makes me scream.

Omicron, Omicron

 

This one you all know by now

Omicron, Omicron
That name is a winner,
Everybody is talking about it
At breakfast, lunch and dinner,
We're not blaming it on China
No, Africa instead,
Still, we have already imported it
Along with wine, cheese and bread.

Merry Christmas North America
Let's party like 1969,
Back when we laughed about pandemics
And everything was fine,
And now we have a new guest
He is a party animal for sure,
Omicron is the name
And it's kind of catchy, that's for sure.

Over-Sixty Developments

 

Two Bladders

Old men grow another bladder
And I think they ought to be gladder,
They pee like an old horse
For a three minute span,
And then five minutes later
They can do it again.

At first it seems annoying
But one must take it in stride,
Except for those times
If you have just hitched a ride,
With your neighbor next door
His name is Lance,
He asks why you are wiggling
And holding your pants.

Ya see, he doesn't know
That forty years from now,
He will grow another bladder
And don't ask me how,
Because it JUST happens
When you get to be sixty-two,
So, shut your trap Lance
It's bound to happen to you.

Intermediate Explanations

 

My cardiologist is aware that I worked in Electrophysiology for six years and cardiac nursing for eons. Unfortunately, he still has a tendency to explain things like I'm a 3rd grader and in general, never really answers the questions I pose. Sure, I understand that the average consumer he sees in the clinic doesn't know jack about their health conditions. I'm sure he tells them that everything will be fine, don't worry, the tests were inconclusive and just take your medicines (all the same stuff he told me too).

It is frustrating talking to doctors
That are incapable of teaching at an intermediate level,
Just imagine hiring a home construction expert
Who cannot explain the functionality of the bevel,
He might say he needs the bubble
In the middle chamber of the tool,
To prove  the floor is horizontal
Now that's a babbling fool.

I asked my cardiologist about a finding
On my most recent cardiac echo,
He got off track as quickly
As a hot-footed gecko,
I was hoping for an explanation
Regarding age related cardiac dynamics,
I may have well asked him about 
Spinning clay and molding ceramics.

His chosen explanation
Was that echo readings might be different on any given day,
Depending on the technician
Volume status and other factors in play,
It was a wonderful explanation
Regarding details of which I am already well versed,
But he certainly didn't answer my questions
And believe me, this time was not the first.

We also talked about my new arrhythmia
And again he obfuscated,
He said a lot of people have a lot of PACs
Yep, explanations like that are clearly outdated,
I was hoping for more technical details
Regarding the tachycardia mechanism
and impulse location,
But a snapshot 48-hour 2-lead Holter test
Is the simplest of readings without innovation.

He said persons with atrial ectopic beats 
Are treated with beta blockers,
Well that's great since I've been taking them for 15 years
I have enough of them stored in lockers,
He said I could titrate the dosage
Which I am already doing,
Yes, this is like an old piece of gum that I'm chewing.

At the end of my appointment 
He seemed very happy that he had addressed all of my queries,
He invited me back in four months
And maybe I'll bring him some chocolate cherries,
Because he's a really nice guy 
And obviously a very good explainer,
As long as one is willing to put up with
A silly simple answer and that's a no-brainer.

Capsule Endoscopy

 

Most of anything I have posted here has been about the situations I experienced while working as a nurse, and rarely about myself. However, now and then I have undergone an illness or invasive procedure and usually I can find some humorous observance regarding the experience. I can say, that this Endoscopy was way easier than the Upper and Lower scoping I had 18 months ago.

Capsule Endoscopy
It was really quite easy,
Although swallowing that thing
Made me feel queasy,
But has it come out yet?
I'm not sure, I can’t tell,
That's a rare complication
Is what they say; what the hell?

I look in the toilet bowl
Because I'm that kind of chap,
Looking carefully at the residues
In the plethora of crap,
And now it's three days later
The evidence is unclear,
Just where did that capsule go?
I hope it comes out this year.

Ivermectin

 
I offer no advice regarding cures and quacks regarding what options a person might choose for their own healthcare. But as I recently mentioned, I won't hesitate to write about those choices.

Ivermectin
What's the deal?
I took the Pig dose
And now I squeal,
Every time 
I smell leftover dinner,
And I'm fattening up
I used to be thinner.

Joe Bob Bulaski
He took the Cow dose,
Every time he sees a tree
He stands real close,
And just the other day
He yelled, "Moooooove over",
When I was approaching
His field of clover.

His twin sister Carla
Took the one for the Sheep,
Now she wants to change her name
To Little Bo Peep,
And every time I talk to her
She says, "Stop Ba-a-a--a-thering me,
But she'll ask me to scratch her back; 
She thinks she has fleas.

Now, let me tell you about
Old Uncle Morris,
He took three doses of the stuff
Along with Aunt Doris,
They picked the package
Labelled for Equine,
Now they're galloping in the pasture
And everything is fine.

Chemicals: What's Not To Like

 
I'll get it out in the open; I am pro-vaccine. I'm pretty sure the one's I have had (and will have) offer me a healthier and better life. I won't argue differing opinions......I'm not in charge of you. But still, I can write whatever the heck I want. 

Chemicals: What Not To Like?

One of the complaints of some anti-vaxxers
They don't want to put some "unknown" chemical in their veins,
All the while the chemicals eaten, wiped on skin and soaped
Are insidiously rotting their brains, 
These are the folks who don't bother to read labels
Or study a chemical database regarding what they consume,
Brother, an MrNA vaccine is far simpler
Than most of the chemicals in your bathroom. 

Bloated Belly Bleeder

I was in close proximity to bleeding throughout my critical-care experience. My hospital dreams are commonly associated with that. This poem relates to an incident I faced when I was moonlighting at a local hospital ICU.

Bloated, a balloon-like belly
A premonition for disaster,
I called the Doc for an NG-tube
As quick as I could, only faster,
To avoid an explosion of gastric contents
Who knows what's contained in that cavity?
But I guarantee one-hundred percent
Whatever it is will meet gravity.

I place the tube in mild warm water
Then coat it with Surgi-lube slime,
I favor the stuff with Lidocaine
But Doctors don't order it all of the time,
Because some folks might be allergic
And develop carboxyhemoglobinemia,
And take it from me, old friend
That is way worse than hypoglycemia.

Call it bad luck or just my fate
The dude has a G.I. bleeder,
Blood clots just clogged up that tube
And when he vomits it smells unlike cedar,
In fact any of you working Internal medicine
Know what I'm talking about,
Blood erupting from Billy Bob's belly
Is best avoidable, there is no doubt.

Creepy Crawlies

 
Sometimes our patient's were seeing bugs (common with alcohol delirium) and sometimes the creepy crawlies were real. And of course the worse situation was when the admitted individual, brought along their own personal infestation. Yuck!

Creepy Crawlies

We had an attack
Of creepy crawlies,
Worse than any of
Sigmund’s follies.

Scooting around
So low to the ground,
Favoring darkness
Without people around.

Sneaking through cracks
Keeping close to the walls,
I did the squish’em dance
In my coveralls.

Little black ants
Crawling on the sheet,
In ICU-7
Well, that’s hard to beat;
But it was an old hospital
Down on Engle Road,
Shuttered twenty years ago
That healthcare abode.

Cell Phone Use Abuse

 

Yep, this here is a new poem about a topic that is forever bugging me.

Cell Phone Use Abuse

Cell Phone use at work
This is what I saw,
So many gross transgressions
That really stuck in my craw,
I'm talking about the bedside hours
On break-time, you can do as you like,
But if you're in charge of my dear Aunt Betty
Your cell phone needs to take a hike.

I saw nurses watching movies
During their hours of work,
In an ICU with 14 beds
And the Charge Nurse acting like a clerk,
I witnessed nurses standing at bedside
With a 1-to-1 critical dude,
Three or four life-support devices
With the nurse in a Facebook mood.

I watched Big Tom in action
Handheld pressure on a bleeder,
Cell Phone in his other hand
He’s a gun collector reader,
Reviewing the latest pistol loads
Checking on the competition,
His patient favors rifles, he says;
No word on the bleeding condition.

Then there are the photo snaps
Innocent in their intent,
Immediately posted on the web
Too late when it comes to repent,
Regarding the failure of permission
Protected information and image,
Massive punishment and fines
And your license was lost in the scrimmage.

I attended the same Orientation
Which employees must all endure,
They emphasize safety and infection control
And go on a hospital tour,
Credentials are checked, experience reviewed
And a session on Cell Phone Use,
Clear and bold is the statement
No tolerance for cell phone abuse.

Well, that is a policy rarely enforced 
Much to the detriment of many institutions,
Punishment should follow two warnings
That is the only solution,
Yet there is an occasional hospital
Where cell phone usage is under control,
That is where my Aunt Betty
Has a better chance of becoming whole.

The Blade

 
I meant to do a write-up four years ago when I attended Workplace Violence Training. The first time I went to the class I arrived 20 minutes late because I couldn't find the education building. The instructors actually had the door locked and they told me I would have to reschedule even though at the time, they were merely yacking it up with the class. I couldn't attend until three weeks later, because I was working night shift and it wasn't very convenient.

Workplace Violence Prevention and Awareness
Of course it's important, doubled down and in fairness,
But to force it upon us, a requirement every year?
They won't offer a refresher; it's a do over, I fear.

The first time I went I couldn't find the school
I arrived twenty minutes late
They said, "You're out of here, fool",
Which nearly brought me to violence
But it wasn't the best time,
If I pounded the instructor
And reduced him to slime.

The second time I went
I behaved the best that I could,
Now that's not saying much
I'm like a piece of bent wood,
Making silly jokes
And talking out of turn,
But when all is said and done
There's always something that I learn.

It was a coed class
So I needed a fun partner,
Little did she know
I act like a kindergartner, 
With a bunch of silly nonsense
But I think she even giggled,
While she was choking me out
While I gasped and wiggled.

On the next exercise
I pretend I have a knife,
Imagine that I’m stalking
Number one wife,
My partner took a stance
That the Instructor’s called ”The Blade”,
Dodging my advances
And then she hit me with a spade,
I guess it was in the closet
With the gardening tools,
And like that first wife of mine
She wouldn’t suffer fools.

Yearly workplace training
Well, at least we get paid,
And I learned a new dance
Which they call the Blade.

Leg Mixup

History repeats itself everywhere and in the field of medicine too. In 1995 I wrote a poem that was inspired by those unfortunate persons who had a wrong-side amputation of a limb or a kidney. Just last week I read about it again somewhere in Europe. In the recent event the marking of the surgical site had been incorrect and unfortunately, the individual was then forced to have the "correct" surgery performed a couple days later because of advanced vascular disease. 

Leg Mixup

They cut my wrong leg off, oops
Well I guess I won't be shooting hoops,
And there was a mix-up with my right hand
But they explained it pretty good and I understand,
That sometimes mistakes are made
In the best of situations,
I really ought to be glad
There were no post-op complications.

My wife said I need to sue them
But I said no, I think they tried their best,
They performed the operation
At my behest,
So even I share 
Some of the responsibility
And my mother always told me
Be kind and use civility.

2021
- - - - - - -- - -
Undefined Compensation

Amputated the wrong leg
Cut off the wrong breast,
If life is lesson
Then this is a test,
We'll proceed with forgiveness
As we march to the court,
They took off the good parts
And now they're selling us short.

Removed the wrong hand
Took out the wrong eye,
You might call this living
But we want to die,
We'll proceed with forgiveness
But these doctors must pay,
They took off the good parts
And that's not okay.

Each side will gather lawyers
And medical scholars,
To define compensation
In a matter of dollars,
But you can't say we're happy
With the settlement planned,
It's tough to applause
When you don't have a hand.

1995

Agents of Chaos

 

This is an epic poem regarding the chaos of confusion that sometimes overwhelms patient's in the hospital in the midst of their illness. Nurses are the safety net and in the midst of providing that critical protection, they often brainstorm with their companions to come up with a safe solution, that will hopefully defuse the moment of delirium. 

Agents of Chaos

The unforeseen consequences
Of unraveling spirals,
I am telling you it's more than
Bacterial virals,
When your patient gets up
And whirls like a dervish,
It's crazy, whacked out
And makes me totally nervish.
 
Kate was with me that morning
And so was Ms. B,
When way over yonder
In room 893,
Mr. Whatzit got up
Spun in circles and cables,
Wound up like a top
In old Aesop's Fables.
 
He killed six with one blow
He fired mortars over the wall,
And our biggest concern
Was that he would fall,
Because his left-arm was missing
And his right-brain was bonkers,
And I'd heard some big lawyer
Was driving up from New Yonkers.

The worst of our fears
Like whirling twisters,
Bosses from the big house
Were developing blisters,
From the tickets they'd written
Regarding the fouls of this case,
What a collective embarrassment
On the corporate face.

Our careers were on the line
Our licenses in peril,
This whirling dervish
Had us over a barrel,
And collectively we three
Had a hundred years of knowing,
Cyclonic phenomenon
Like an ill wind were blowing.
 
We gathered our thoughts
And pondered each option,
We knew if we failed
We'd be up for adoption,
Three orphans of nursing
Tossed out with the trash,
When suddenly, Kate
Had a powerful flash,
Of woman's intuition and
Her Feng Shui power,
She said, this agent of chaos
Needs a bath or a shower.
 
Ms. B gathered towels
While I warmed the water,
We all prayed to Gaea
And Chaos, her daughter,
To reveal to us the means
To find peace amidst fury,
Then we soaped up our washcloths
And bathed in a hurry.
 
The spirals unraveled
The twisters tore down,
The cyclones collapsed
Into fairytale town,
While the bystanders cheered
And authorities arrived,
Ms. B, Kate and I
Well, we just high-fived!

Heroes of Nursing
They called us that day,
Be we all knew better
With a smirk, as if to say,
Our backs will be stabbed
Before the sun goes down,
Because heroes are orphans
In fairytale town.

Over Branded

 

As I recall, during the 1990's Hospital Corporate management began to take advertising campaign's seriously and learned about branding and image from the traditional business sector. This was also the period where the idea of guiding the language that employees should use to promote that image, came into play. This practice is known as scripting and for the next twenty years, Nursing had this junk thrown at them on a regular basis.

And then came the over-the-top branding.

At Hospital X
Almost everything is branded,
This overt attempt at public awareness
Is decidedly overhanded,
Pencils, pens and notepads
Facial tissue, hats and flags,
Everything shows the logo
Except the vomit bags.

Sanitizer for your hands
A sweatshirt and a baseball cap,
If you're heading out to the stadium
A logo blanket on your lap,
The mascot for the team
Is an orange Humpback Whale,
Yes, everything is branded
Except the potty pail.

Advertising contracts
Consume a lot of money,
Do they guarantee the best of care?
It's hard to prove that, Sonny,
It's all about the image
And how that makes you feel,,
Yes, everything is branded
But not the Flexiseal.

Blow your nose with our namesake napkin
Dry your eyes with our branded tissue,
If you need some kind of assistance
Code-Orange can solve your issue,
Imagine ducks and deer lost on the road
Puppies in wheelchairs and saving whales,
It looks we're running an animal hospital
Yes, our branding campaign has gone off the rails.

Attack of the Variants

 

Coronavirus; it's been a long tough 15 months. I believe this bugger will stick around like Influenza, and we'll be prompted to do booster shots every year, just like the Flu shot. That's okay with me; I've had plenty of other vaccinations and appreciate the work done and the protection they have offered me. 

The variants are attacking
That's what the experts say,
I guess old coronavirus
Isn't gone yet today,
And I'm telling you I'm thrilled
That I've been vaccinated,
My odds are lesser now
That I'll be deactivated.

We should have kept the memory
Of the 1918 flu,
But I wasn't born yet
And probably not you,
Plus, I didn't like history class
During my high school years,
The teacher was a tough nut
Willing to suffer students to tears.

I must have heard about that flu
I have read a gazillion books,
Avoiding history of course
I cater to the fictional cooks,
Writing delicious make-believe stories
About plagues and biologic disasters,
What we need are some folks
Who are prognostic forecasters.

Every week I hear about
Another variant piece of virus,
Maybe it's time to review
The Osiris Papyrus. 

Changes of Absence

Retirement brought some changes that I enjoy:

Now two years from leaving the workplace my hands have healed. All those alcohols, sanitizers and skin strippers kept my finger tips in a perpetual state of cracking and shedding. No longer am I exposed on a daily basis with all the toxic cleaning products found in hospitals. The worse stuff was the product used to strip the floors and carpets; it made me nauseated and caused my eyes to burn. On a similar topic, no longer am I continuously assaulted by the detergent perfumes off-gassing from my fellow workers clothing.

What I miss are all my work pals especially because the pandemic has truly separated us; I can't make an occasional visit to them. That's a bummer. Secondly, without working in the joint I have lost contact with all of the daily irritants that influenced my years of writing. 

Anyway, here is a silly attempt at humor:

ABS versus IBS
If you study this
Don't make a mess,
One slows the car
In a uniform way,
Whereas IBS
Can ruin your day.

Automatic Braking System (ABS)
Irritable Bowel Syndrome  (IBS)