Breath of Death

Breath of Death

I feel calmer now

After venting, to a friend or two,

To those of us in health-care

You must be one too,

I can’t discuss it with my neighbor

And not my wife, at all,

They don’t understand, life-threatening

Or the Grim Reapers call.

I have been with death

Hundreds of times,

I know him in every culture

And understand his rhymes,

I have walked the pathway

That parallels life and death,

And you can’t understand it

If  you have never felt its breath.

Fibril_late;

10/29/13

Seal of Approval

Last night...........

Seal of Approval

Cardiogenic shock

In its earliest throes,

Shallow, labored breaths

Pale and clammy to their toes,

Restless and demanding

Disorganized thought,

Classic signs of pump failure

Are those things I was taught.

Reduced urine output

A narrowed pulse pressure,

Sinus Tachycardia

We’re heading for the thresher,

Multifocal PVC’s

With Bundle Branch block,

More classic signs of

Cardiogenic shock.

Why didn’t they insert

An I A B P,

Impella in the ventricle

If it was up to me,

But no, he was sent

To our unit, for sheath removal,

Yo, Doctor, I’m not impressed

You didn’t earn, the seal of approval.

Fibril_late;

10/29/13

Treacherous

Treacherous

This is hard, hard work we do

Sometimes it bothers me tomorrow,

When yesterday’s catastrophe

Brings on hidden reams of sorrow,

PTSD

By many other names,

Is a difficult tunnel to walk thru

The most treacherous of games.

To just say that we had a bad night yesterday, is a gross understatement. We had a wild and hairy, completely unsafe three hour period, where patient’s could have died, because we were woefully understaffed. There were three nurses, covering six patients. Sounds Ok, right?

However:

1. One had a continuous groin bleed. (1:1)
2. One was post Cerebral Angiogram and he was completely bonkers, requiring four other persons to hold him down for safety reasons (requiring a Code Gray response = out of control). 4:1
3. One was a General Anesthesia recovery (supposed to be a 1:1, for at least 30 minutes)
4. One was a guy with the early signs of Cardiogenic Shock, and I was doing the Femoral sheath-pull, and he had received Plavix, Aspirin, Heparin and had an Integrilin drip. 1:1

But wait, you may notice that I mentioned earlier that we were only 3 nurses. There’s more to say, but why bother!

In the past week, each one of us has had “the worst day ever” kind of feeling. But we’re the healthy ones; the patient’s suffer too, when we don’t have the staff to give them the high-quality attention that they need.

Revision: Those were three highly experienced, GREAT Nurses.

Little Yellow Bus

I can barely

Articulate,

The daily frustration

Regarding our fate,

Attempting to satisfy

The demands of our work,

Where our leaders remove

Any kind of a perk.

To us, a perk would be

The right number of nurses,

Supportive managers

Who don't focus on the purses,

In such a manner of ways

As to believe our overtime,

We don't stay late on a whim

But we're punished for the crime.

Just play nurse for a day

And do exactly what we do,

Perform as fast as the best of us

Just to get another view,

Watch six patients with three nurses

At a moment, 4 one-to-ones,

Do the numbers, little Miss Management

When Mr. Danger, is loading the guns.

One of them a MAC Recovery

One of them was bleeding,

One of them was a sheath-pull

And one confused and needing,

Two others that were stable

But still belong to us,

This was not safe patient care

On the little yellow bus.

And tomorrow, rest assured

The question posed at first,

Why did you stay so late, girls

Our budget almost burst.

Fibril_late;

10/28/13

Fibril_late;

10/29/13

Another Tip

Another Tip

I received another tip today

The second one this year,

No one told me that at age sixty,

Nursing tips would start to appear.

Yet, retirement is approaching

Like a runaway train on a busted track,

I'll enjoy every tip I get

Without ever looking back.

A five dollar Thank you

Can buy a couple cups of Joe,

I will savor each flavorful sip

And dream about where I will go.

Fibril_late;

10/20/13

Not a Proxy

I found this little gem a couple weeks ago, jogging my memory regarding an extremely long transport involving several lengthy boring tests…………..and how it can all change so abruptly.

Not a Proxy

MRI’s and CAT-scans

Six hours in Nuke-med,

You’re feeling completely abandoned

Half-bored, and out or your head,

When the patient goes berserk

Has a seizure, then Code-Blue,

With all your knowledge and experience

You’re in charge, it’s what you do;

Bring the crash-cart, place the backboard

Prep the paddles, charge and shock,

Check the credentials of the Doctor

Before you let him lead the flock,

Recite the most important details

Of the chart you memorized,

You’re a master Critical-Care Nurse

You never are surprised.

It’s what we do, whenever we must

Experience, brains and moxy,

Critical thinking personified

You’re the real thing, not a proxy.

Fibril_late;

10/10/13

Safety Fail

Safety Fail

Once again

Another fail,

A motor-assisted bed

But the battery is stale,

Charging while at rest

Then unplugged for the drive,

Engaged the motor switch

Oh, the battery is not alive.

This labor saving device

Is the proverbial Albatross,

A 400 pound sea-anchor

And I'm at a loss,

Because I recently rehabbed

From an injury, Jack,

This load-assist device

Is like a machine fighting back.

I pushed that bed

Expecting it to move,

I felt pain shoot down my leg

In the usual groove,

Associated with the syndrome

Of the Lumbar five condition,

Another back-protection fail

A hospital tradition.

Fibril_late;

10/2/13

Disclaimer

What with all of the heavy-handed "you can't do this" internet usage crap we have to listen to, and all of that dubious HIPPA rules nonsense, it's a wonder we can even communicate anymore. I figured it was time I put a disclaimer statement at The Underside of Nursing, to protect me in the event, somebody bothers ("authority figure") to read my blog. Naturally, I had to make it rhyme.

Disclaimer

All of the names

Are perpetually changed,

If you think I wrote about you

Then you are deranged,

The quaint situations

That I write of, are fiction,

The imaginary locations

Are out of my jurisdiction.

I'm not writing screenplays

Based on true stories,

Although I've had inspiration

From hospital laboratories,

Where bodily fluids

And Lab Techs commingle,

When I visit that place

My idea's really tingle.

If you think that you recognized

Your Uncle Bob, in my story,

You most likely get sentimental

When they raise up Old Glory.

High on the flagpole

Every year in July.

When I write about Billy-Bob

He's just fiction; don't cry.

My poetry is a journal

A diary of sorts,

A multi-decade document

With rhyming reports,

Regarding my state of mind

Daily travels and deeds,

It just so happens, I have a job

Where somebody bleeds.

So, it's not about you

Your mother or father,

More likely a situation

That was really a  bother,

And later I unloaded

Another story of fiction,

Of post-traumatic-stress

A symbolic benediction.

Fibril_late;

9/30/13

Demon

It was bound to happen; one of Satan's minor devils needed a Cardiac Cath. It has been some time since I last wrestled with a demon, and although I survived, I was injured. Any nurse that works in patient care, will at some time or other, have to look a devil in the eye......touch their lucky talisman, and pray they live to see the next sunrise.

Demon

Evil demon

One might comment, “Of course”,

Slugging away at us caregivers

Without any remorse,

There is no excuse

For behavior such as this,

I didn't go to work today

Expecting a demon's kiss.

Malevolent devil

Imagine being betrothed to that one,

Said he has been married for 14 years

I suppose at one time he must have been fun,

Now he is Beelzebub's brother

Tormenting his compassionate wife,

And as he threatens and fights us

She cries out, as if stabbed with a knife.

Two of us were injured

And now I'm in pain,

I'll have a few weeks of light-duty

Physical Therapy, so I can face it again,

The chance opportunity

To meet up

With one of Satan's dominion,

But I'll just smile and wave, boys

And later post my opinion.

Fibril_late;

8/29/13

Leadership

Leadership

Reported my injury

And the Manager's Coordinator,

Said, you should have called for help

But we had to move him now, and not later,

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 beyond 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.

Fibril_late;

8/29/13