Post-Retirement What I Read

This has been an interesting five years post retirement (2019). I have continued to renew my license and will do so in 2025. Two more years after that I will reassess. I am an Educator of Basic EKG and I feel it is appropriate to remain officially an RN. Who knows what the future holds? 

Also, I remain very up to date on any advances in Internal Medicine and Cardiology. It was my passion for 40+ years and I continue to educate myself. Of note; I recently attended the "Heart Failure Summit 2024" at UC Davis Medical Center on December 7th of this current year. I stayed the entire day and learned new stuff. It was a great show!

For my usual presentation of this Blog:

I had my customary "Underside" rhyme in mind but I decided to deviate and share with you my common daily reading sources which help me to keep well informed in my areas of medical interest. I know that the many persons finish their careers and just quit with the intellectual demands of that career. That isn't me, because I spent my career attempting to be the best informed. That is what made up for my lack of advanced degrees.

So I still read daily and weekly the following:

Journals I subscribe to (on-line): (All are free)

• American Heart Association Lifelong Learning 

• MDLinx: Journal summaries in Internal Medicine

• MDLinx: Critical Care / Hospitalist Weekly

• Practice Update: Cardiology Daily Digest, This Week in Cardiology

• https://qxmd.com/read-by-qxmd (this is really great)

• Medscape: Nursing 

• Medtronic Academy  (Medtronic.com)

• Pulmonary Hypertension Association News

The above list is what I have been reading for years before I retired.

And continue to do so.

I hope that those of you are who are still in an area of Nursing that you love

That you keep abreast of the changes going on.

And hopefully, you also occasionally

attend in person some kind of symposia that pertains to

your area of interest.

It is well worth it!

Suicidal Repercussions

 

Working in Medical ICU we experienced many intentional suicide attempts by persons primarily in the age group of  20 - 50. This is what I observed..

It hardly matters, the majority of those persons have had a tough time with their life stressors whether that is a result their own abuse or some kind of outside stressors that seem insurmountable. As an ER or ICU Nurse, the cause is not important. Our job is to prevent their death, stabilize them and hopefully discharge them to "home" neurologically intact. 

But there is always talk and speculation amongst us regarding these tragedies.

Suicidal Repercussions

I can see it both ways
When a person ends their own life,
Where survivors wish they could have intervened
A mother, a brother or wife,
Some of them may feel guilty
Thinking; perhaps somehow they failed,
But no, this wild, desperate decision you made
Is on YOU Ms.Suicide,,,,,,,ya, you bailed!

Now if you had been ninety years old with a cancer
I would not challenge you a bit, 
Heck, you would be older than most of us
Who are finished with all of your snit,
But NO! You had to do it
When you were loved and known by many,
Despite all of your crap that we dealt with
You were still worth at least a penny.

So, there you have it
Someone will arrange a remembrance for you,
We will all walk away
With a taste of sour wine and rancid chew,
Knowing there was a hint of a solution
At least to interfere with your wild decision,
Something to change your trajectory
Which may have offered you a sensible revision.

12-2-24

The Scolding Machine

 

In my recent hospital admission I shared the room with a completely disoriented patient who needed a Sitter. But "Sitters" need to be paid, might get injured, need health benefits and so on. The tide has turned; now the patient can have a bedside machine that watches them and Yells at them if necessary. I am not fooling. And I am amazed that I, the guy in the next bed, was not educated about the Scolding machine.

Let me tell you about the scolding machine
My disoriented room-mate had one,
The device was at the foot of his bed
To keep an eye on Jerry's type of fun,
Pulling at all of his restraints
Climbing out of bed,
It was like a game for him
Despite what the nurses said.

As his agitation would progress
First there were flashing lights,
If he began to untie things
A man-voice would read him his rights,
And if he tried to launch his body instead,
The machine would yell loudly
"Don't Get Out Of Bed!"

When I arrived to this room
No mention was made
Regarding the Scolding Machine,
I nearly jumped out of my skin
When the yelling began
Without warning or anything in between,
Well that was an oversight
On the part of my greeting committee,
I was just seven hours post-op
And this place seemed like the inner city.

I think Jerry transferred to rehab
Three days later,
His mental status did not improve
And don't call me a hater,
But having a climb-out-of-bed artist
At work sixteen hours a day,
With repetitive loud scolding?
I was feeling murderous in my own way.

Patient Room Video Technology
Tele-Sitter............https://avasure.com/telesitter/

Microbiome Trade-in

 

I don't really like writing about myself but this is a topic for our times; Microbiome. 
It seems like every week I read about some new discovery regarding our digestive system. There are billions of microorganisms seemingly working in a sort of harmony with each other (healthy gut) and influencing all the other organs in the body including the function of our brains.

However, sometimes the gut microbiome can be wiped out by some really nasty entity such as C. Difficile or Norovirus. In 2013 I had a Norovirus correction and now in 2024, Appendicitis and Ileus.............each experience gave birth to a new gut environment.

After Appendicitis
My microbiome left the house,
This has happened before
Certainly not quiet as a mouse,
These are drastic changes
In the digestive system,
It happened to me 11 years ago
And the old gut?
I really missed him.

Believe me
This has happened before,
I can tell you
It is a vigorous 
Not so pleasant chore;
Once you go down that road
It is initially bumpy,
And the end result is
Sometimes rather lumpy,

Anyway it does give one a pause 
New ramifications 
Without a rejection clause,
It is kind of like buying a new car
And having to learn 
New gadgets and controls,
Not knowing if I will really like it
And kicking myself for not reading
Any customer exit polls.

The only persons who truly have a choice
Of selecting a new microbiome,
Are those persons who receive fecal implants
And even then it is not a simple road home,
Consider it a very new 
Application of science,
The doctor will tell you, 
“We'll just let your gut
Figure out how to use this new appliance”.

The microbiome
Is uncharted territory,
A trillion microorganisms
Telling their own unique story,
Manufacturing chemical precursors
Biomarkers and agents of change,
Enough to alter thought processes
And expand emotional range.

My old microbiome exited Stage Left
Not just a minor vacation
No, a vast uncrossable cleft,
A break into a new frontier:
2024 is turning out
To be a whiz-bang New Year!

Out of Control Family

 

Crazy Foam

They said over and over

"Now, please don't forget,

If you remember this thing

We will be in your debt".

And every time after that

They said it again,

It would have been better

On occasion, now and then.

If you will, tell the doctor

The nurses and the tech,

Uncle Bob has a problem

His kidneys are a wreck,

Please measure the contrast

As careful as can be;

I said, yes I will do that

It's important, I can see.

When Hector from Transport

Came into the room,

Aunt Mary looked at him

All dire and doom,

And once again launched

The tale of the kidney,

Like a crazy old wombat

Down Under from Sidney.

Later on, after

Man, they wanted to book,

Uncle Bob and Mary

They just had that look,

Like coming down here

Was all a mistake,

A couple Wombats from Sidney

That stepped on a snake.

We bend over backwards

Primp and placate,

Give them sausage and capers

On porcelain plate,

But some of them leave

Good behavior at home,

Instead of proper manners 

They spray crazy foam.

Double Occupancy Room

 

I had 3 different roommates over the course of 13 days. The first one had a serious head injury following an MVA. He was totally disoriented, awake 18 hours a day, 4-point restraints and constantly trying to escape. The second roommate is the subject of the following story.

Stabby Roommate

He does not want a tetanus shot,
Maybe if he had been shot three times
He would throw in his lot,
To have a simple jab
That would provide 10 years of protection,
Better than a Kevlar vest
And natural selection.

He doesn't want wound dressings removed
Because that hurts,
He doesn't want blood drawn
Needles and blood spurts,
He hasn't walked yet
He is here Day #3,
But he wants food and cigarettes
Is what he asks everybody.

Stabby stomach wound
Equates to the Diet called Clears,
To advance in a couple days
He wants smokes and beers,
He was granted a Patch
To curb his cravings,
He's a 20 year old kid
Full of posing and ravings.

Stabby young punk
Brags to compatriots on the phone,
He changes his story each time
Like he is Al Capone,
Some family arrived
Three of them said he was a fool,
Going for a slugfest with girlfriends new man
You called him out to the yard
And he pulled out a sharp tool,
And oops, your rival had backup
With a knife also…………..

So you jumped in your car
Gushing blood all over,
Drove to a closed Mercy Clinic
And finally you called 911
They saved you from pushing up clover.

And still I overheard
Your secret silly recovery plan,
You’re going to hunt down your rival
And put him down like a man.

Stabby Roomate
What a kid,
Only one family praised you
For what you did,
And you get sent home with a walker
Now, that is a piece of work,
You need to go to school kid
And become a postal clerk;
Or at least, something useful.

An Unexpected Christmas Gift

 

The poem is a retelling of "The Christmas Story"

Happy Itis

That's not exactly what it seems
Itis, ambushed me,
Three days after Christmas
I got a two week vacation in the hospital
For free.

That was a present
Unpresentable,
Something inside of me
Was fermentable,
Unknown to this owner
Thinking, hmmmm
Just indigestion?
A CAT-scan said Nope
The appendix requires ejection.

Hey, I'm 70
Complications are like ripened fruit,
Ready for consumption
To a person in their birthday suit,
But my Doctors showed genius
And the nurses have no rival,
That was key
To my blessed survival.

One more plus:
I worked there twenty years,
It made me be kind of royalty
And banished any fears,
Made sure I was on my best behavior
No complaints from this bloke,
Here I'm home 3 weeks later
Ready to write the next joke.

-- -- -- -- -- -- -- --

Christmas by itself was great

A mix of family

Good times on every plate

If Putin Was A Nurse Manager

In 1999, I joined a nursing group at our University Medical center known as "Action Nurses". Essentially, this idea was to have a Rapid Response Nurse individual (or pair of) on hand in the hospital, 24 hours a day. This idea was circulating nationwide and certainly showed value as soon as it was launched. To be an Action Nurse we needed certification in just about everything: Procedural Sedation, Radiology practices, TNCC, PALS, ACLS, at least five years (preferably more) of ICU experience. Strong IV insertion skills were necessary, across all ages preferably.

Side Note: I recently returned to the Mother Ship as a patient (not planned, but serious). The second day there, much to my surprise, I discovered the Action Nurse Team was still going strong, with quite a few more team members compared to 22 years ago. Action Nurses are revered by all who need their help.

In retrospect, many of us believe a better Manager would have been better. This poem is my take on that person, whom I have named Martha Polo. 
Without further ado:

Nurse Manager Putin

Martha Polo, sure as shootin'
She was just like Vladimir Putin,
She ruled her department with an iron fist
Her laser beam eyes never missed.

A better Commander would have been better
Than having Hannibal Lecter down to the letter,
But managers last if they are frugal and frightening
Every week they brag the budget is tightening.

Managers can be dumber than dirt
When compared to their peers,
But if they stay under budget
They will keep the job for years.

Yes, Putin had all kinds of plaques on the wall
For being fiscally frugal and that's about all,
The nurses she governed had a different opinion
But those things were kept secret in Putin's dominion.
-- -- -- -- -- -- -- -- --  -- -- -


In 2004: I had an injury and Occupational Medicine would not clear me to work patient Care.

When Vlad signed the papers for me to be separated from Nursing Services department, I discovered they swapped those out with papers for separation from the University. Two months later I got a COBRA notice from UC indicating that I no longer had health insurance. It took me a mad frantic scramble to get my benefits reinstated.