Death of the Deadly

I haven't touched on the subject of death for a while, because I am not working in that arena any longer. Sure, people keep dying, but not in my Unit. However, the memories never go away. Here, I am contemplating a role I felt I played in the past; The one who handed off a soul to the Grim Reaper, for the journey down below.

We see disparity
And we witness pain,
I've treated a broken heart
And hemorrhaged brain,
I have administered to evil
Murderers, and more,
And still applied compassion
Because that is our chore,
Not to single out anyone
In the course of our care,
Every patient is an equal
So, let's not go there............

Until the Rigor Mortis
Is about to set in,
When the Grim Reaper
Stands, to reckon the sin,
Perpetrated, by Billy-Bob
In his moments of violence,
When nobody listened
Or penetrated the silence,
Until now, the great chasm
That he must cross, on his journey,
There is no chance in Hell
That he will beat this attorney.

As the appointed Nurse
I do stand by,
Grim Reaper awaits
For permission to fly,
Taking his charge
For the Karmic obligation,
"Billy Bob, I cast you out
For a Hellish vacation!"

9/15

Meandering Mind

Look, I'm not the go-to guy for solace and hugs; we all have our area's of expertise, and that is clearly my area of avoidance. You want technical know-how, and obscure scientific facts, that's what I have to offer.

I write more, when I'm stressed
Definitely not when I'm caressed,
And forget all the hugs
I'm not that kind of guy,
Find Linda or Lynn
If someone's about to cry.

Maybe names that begin with L
Can handle the tears that come pell-mell,
Surging from the eyes
A cataclysmal drenching,
Gnashing of teeth and
Primordial fist clenching.

That's when I drift away
It just isn't my thing,
I'd rather just shock you
200 Joules, bada-bing,
Plus a sensible dose
Of the milk of forgetful,
Whatever was the bother
You won't be regretful.

So reader, you see
I meander about,
When work stresses bother
I will not fight or shout,
But rather make words
Build a story or fable,
And with the right glass of wine
I am most certainly able.

9/12/15

Tsk, Tsk

When a force of nature
Meets a natural force,
There's no way to predict
The path or the course,
One can guess at the outcome
And calculate risks,
But when injury happens
Expect a lot of tsk, tsks.

Managers offer
Platitudes of blame,
"Well, you shoulda had more help
Now you're hurt, what a shame,
But really, you're the one
The cause of your disability",
Just talking to Momma?
An endeavor of futility.

Thus, we soldier on
Every day we are tested,
If a patient assaults me
Can I have him arrested?,
Not if he's confused
The result of anesthesia,
I got lucky once again
No acquired paraplegia.

9/12/15

No Heavy Lifting

No lifting more than ten pounds, no squatting, stair climbing and definitely, no ladders. Sounds sensible, doesn't it? Look, it is well known that I don't want to do discharge phone calls. Instead, here's how the day panned out.

A. Prep 3 patients for procedures. (1 to 1.5 hours each)
B. Receive 2 transfers, and prepare them for procedures. (1 to 1.5 hours each)
C. Handle 2 Recoveries (2-3 hours each)
D. Find time for Lunch + 2 breaks
E. Participate in a Mini Code Blue.
D. Document at least an hour on the day.
F. Start 2 IV's (patient reporting, "you better be good"...), do 3 EKG's, Assess Transfer IV sites, wounds, skin, communicate with families, provide an hour of in-depth Cardiac teaching during the shift. Answer 20 phone calls, Page 5 Doctors, and cover other Nurses for their breaks.

Actually, I didn't do the break-relief very well, as I was too flippin' busy. That meant I forgot to give Betty Lou an aspirin for a headache, and forgot to call Mr. Fonebone's daughter to come pick him up. When those Nurses returned from break, I just had to give my lame excuse of failure.

The Elephant in the Corner?; We are perpetually understaffed.
(Two lucky staff members were allowed the day off)..........however, our work load did not suggest that to be a sensible choice.

It is only the true depth of experience and moral fortitude that our team contains, that keeps our patient's safe and alive.

Shipping Out

Some say that injuries happen when we are fatigued, or just burned out; ther e is some truth in that, but in general (majority) it just isn't so. Our patient's are just too flippin' large and combative. That's it................simple.

They will wonder why I burned
When I never complained,
It's a result of my philosophy
As a High Duke from Spain,
I work for my subjects
I won't quit, if they suffer,
Hence, I never do argue
As a servant, I am tougher;

Than the ones that I work with
Because my philosphy rules,
I'm a servant to my constituents
Their demands, are my tools,
To apply my special talents
And satisfy their needs.
Get them home safely
And nobody bleeds.

The house is on fire?
I run into the middle,
The Demon is smoking
And playing his fiddle,
But I know the melody
Though I didn't write the song,
The demon is a wimp
Soon to be running along.

Frankly, I'm just a member
Of one awesome team,
We understand the wind
And the flow of the stream,
We might not be the Captains
But only in name,
Without us, this ship
Would have no claim to fame.

9/2/15

Pray-ers

I respect prayer
But I want it to be silent,
You may not like my prayer
And you become violent...............

Look, I was brought up in a Catholic family and my Auntie was a real Nun (and 2 of her cousins, also). And when it was time to perform real, focused and God directed prayers, they was done silently. So, that's why I'm so secretive.

I moved passed religion
I said every prayer,
I know about Gods
But I don't really care,
Because I did arrive here
In the usual way,
My parents got together
Back in their day.

I practiced their training
As much as I could,
Tried to make the best decisions
Just like they said I should,
And whether some god
Had a hand in it, who knows?
The world will keep turning
Because that's the way it goes.

A lot of "God, bless you's"
Are heard where I work,
We were once a Nun hospital
So, perhaps that's a perk,
But I never say it
I don't want to offend,
I might choose the wrong God
And the blessings might end.

Or maybe the client
Thinks the way that I do,
And along comes Brother Jo
Saying, Bless, Betty Boo,
Perhaps Betty is offended
Or embarrassed, to boot,
She has an allergic reaction
To this religious recruit.

I think we need to be careful
Regarding this issue,
Stop throwing prayers
When they reach for a tissue,
Pause for a moment
And ask for permission,
Perhaps a better idea?
Let's call a magician.

9/2/15

One Punch

For the most part, we don't have much trouble with out-of-control patients. It's not like we call a "Code Gray" for help, when a patient who had General Anesthesia has an adverse reaction, and struggles as he wakes up. However, one can not minimize the inherent danger to the Nurse or Doctor at the bedside. If the patient is a colossus that is six foot nine tall and weighs 410 pounds, believe me, this guy could kill with one punch. Comforting, isn't it?

Mo, didn't wake up well
After anesthesia,
I hope he didn't give me
Paraplegia,
Because my back hurts
Below my Lumbar,
Bothersome discomfort
Down my legs too far.

He was flailing and thrashing
Weighing two twenty two,
Both groins were bleeding
And what must I do,
To protect him for safety
After all, that's my job,
Let the dude bleed out?
Not this Billy-Bob.

The nurse is the one
Who walks away lamed,
Was I too aggressive?
If so, I'll be blamed,
But we had to protect him
With each wild gyration,
I could be sued
For exsanguination.

Pain down my legs
Paresthesia to my shins,
Let me explain
Numbness, needles and pins,
An unexplained coolness
And episodes of weakness,
I ain't horsing around...........
I'm not ready for the Preakness.

I'm off tomorrow
But, I'm calling this in,
Fill out the paperwork
For the Workmans Comp sin,
An Employee Health visit
And a scowling Manager,
They'll be talking and twittering
Like bright feathered Tanagers.

It was bound to happen
With the patient's we see,
Last week was a record
Four hundred and three
Pounds that is, at 6 foot nine,
He fought us, too
Now, isn't that fine?

Two good Nurses
Could have died,
One punch from that one
I would have flied,
Across the room
And out the door,
And the boss might comment -
Your hours don't score

Well, how about that?
Concerned, not a chance,
We're not doing enough
Billing hours, rule the dance,
And the party may be over
For this dedicated Nurse,
He worked as hard as the best
And for that, he was cursed.

9/1/15

Nurse 32

After a crazy, stressful and whacky week, filled with too many Recoveries and 3 nights of overtime, I just have to unwind and write my own craziness.

Nurse 32

I've been a nurse for 32 years
Working, in-hospital for thirty-seven,
Some say to me, "You must love it"
Well I do, but it's not really Heaven,
I enjoy the goodness that I can do
To the people, who are really in need,
But for all those flippin' malingerers
The ones from the toxic seed?

They are the few, that test us all
The whacky, the crazy, the violent,
We must wear our happy face
Duck the fists and keeping silent,
Because now we must pay attention
To the almighty Satisfaction scores,
The 3-day departure, little phone calls
Where they scream and declare
You're all whores,
Not realizing that Betty-Boo nurse
Had no connection to Dr. Z's mistake,
While Betty-Boo's call will be audited
And her Manager, will give her a shake.

Oh, I can hardly wait to go
On the Hot Diggity dawg retreat,
I'm hoping and praying they bother
To have something good to eat,
Because I have noticed the goodies
When the visiting Dignitaries call,
They get the best catered food
That's what I'm say, that's all.

8/28/15

Happy Whack Job

I think I had 7 patients today. It only took one to make me go postal........too bad three of them were either confrontational, argumentative and angry, and the family chipped in. Here's the winner:

Happy Whack Job

A 12 hour routine
Day in and day out,
What could be so different
To make me scream or shout?,
The particular kind of patient
Confrontational and demanding,
Where reason and logic
Have no place of understanding.

Consider this Billy Bob
3 days in our palace,
Drove himself to the hospital
With nine K dollars in his valise,
Don’t ask me why
I’d never believe it,
But in the midst of his Recovery,
He says he has to go retrieve it.

I’m telling him, “No
I will just call the Nurse,
Up on floor three
And he begins to curse,
Never telling me why
He said, “Only I can do it”
He’s getting whacky and crazy
So I said, “just screw it”;
Go ahead, go upstairs
Let me show you the elevator,
He marches off
Like one hot potater,
With his spouse at his side
And a bounce in his step,
He returned pretty soon
With his own nursing rep,
She took me aside
And told me about the money,
About 9 thousand dollars
That’s why he's acting so funny,
He wouldn’t put it in the safe
No, we had to lock it in the Med-room,
And now he’s holding his black valise
At his side in his bedroom,
Along with his Mac computer
And his jaunty baseball cap,
This 73 year old whack job
Is one happy chap.


8/26/15

In Their Place

Too busy, along with being understaffed. Now, in the past, where I came from.......If I had an ICU patient, that went out for a surgical procedure, this patient would come back to me after Recovery, and then, if he were to be downgraded, I would send him off to Telemetry, or such. Today, I received two people (from MICU and CSICU), who had a new Pacemaker insert, for their "one hour Anesthesia recovery". However, now they were going to be downgraded to Telemetry, and thus, I was not sending them back to their ICU. Well, that sucks, 'cuz, one of them ended up staying 5 hours in my Unit, waiting for the next bed and nurse. The other guy, I had to remove the Temporary Pacer, the Swan Ganz and the Arterial line, all of which had been in place for 3 days. These are not the typical duties of your General Anesthesia Recovery nurse, who at this time, has 3 patients, (one of them being the other ICU patient). My buddy was picking up a new Ablation case (general anesthesia); a guy that was leaping all over the bed, with 5 Femoral sheaths in place.........so my pal was out of the mix. Eventually, we each had 3 Recoveries a piece. Later, after lunch, I take the guy that is 410 Lbs, 6'9" tall, and had an A. Fib ablation. He has 4 Femoral sheaths in, and is flinging around, because his back / hip pain is off the charts!
Holy Bleeding Puncture, Batman! Pass me the Kerlix!

Hott Diggity, Dawg.

After nights like this
I need to empty my mind,
It was nothing like a kiss
No, 'twas a kick in the behind.

Two patients from ICU
Gone for Pacemaker
But not returning to that space,
Technically, I'm doing only
Anesthesia Recovery
But now some ICU duties, in their place,
Remove the Swan Ganz
The temporary Pacer, and the Art-line,
Do all of that stuff for CSICU
Hot damn they're happy, things are just fine,
Because TAVR Joe-Bob
Is finally off of their floor,
They have practically given his room away
The moment he departed the door.

"Me, I'm waiting so patiently
Lying here on the floor,
Just doing my jigsaw puzzle
Before it rains anymore*#.

_ _ _ _ _ _ _ _ _ _


*#Rolling Stones
"Jigsaw Puzzle"
Album: Beggars Banquet - 1968

Gut Feeling

Sorry, but I'm sorta stuck on this topic.

Gut Feeling

Gurgle Gut
Is such a bother,
I told my Mother
And my Father,
He whispered something
About stinky gas,
Mother said
Don't let it pass,
In the company
Of Nuns and Priests,
Unless they're sipping
Hops and yeasts.

Gurgle gut?
I received a call,
Number one daughter
Sometime last Fall,
Regaled me with
Her story, true,
Thank god it wasn't
Tic delarue,
But alas, 'twas something
Just as awful,
From the sugar syrup
On her waffle,
Tainted water
In the city Tangier,
A water born illness
No fun, poor dear.

I offered her solace
For her pain,
We discussed the tragic
Intestinal drain,
That can occur
When least desired,
Plus,  tips and tricks
When the gas has fired.

Not easy dealing
With this issue,
We should have invested
In toilet tissue,
Northern, Charmin
Or Kirklands best,
One million wipes
We've put to test.

Good healing salves
Are hard to find,
Herbal Savvy
The Comfrey kind,
Burts Bees foot creme
Protects and soothes,
Especialy in the
Hidden grooves.

What to do?
We continue to live,
Hoping that
Our friends forgive,
An occasional blast
Of  toxic gas,
Bursting from
Our sorry ass.

Gurgle gut
Is a major bummer,
It can put a crimp
On a fun-filled summer,
Carry extra undies
And soothing wipes,
If you accidently
Blow your pipes.

Advertisers
Have yet to address,
Specifically
The Gurgle gut mess,
They hide the details
In mumbo jumbo,
Regarding the dangers
Of Jalapeno gumbo.

A gurgling industry
Is just developing,
Soon to be
Completely enveloping,
An I-P-O
With investor options,
Rescue centers
For intestine adoptions.

Burnt sienna
Wristbands and hats,
Promotional bling
Baseballs and bats,
To gain support
And public attention,
To promote awareness
Regarding poo retention.

We gurgle guts
Are never full of shit,
That's the least
And most of it,
No, commonly
We go each day,
Three or four times
In a moderate way.

Three times a day
Is, way better,
Than once in 3 days
By the letter,
Constipation
I'd rather not have,
Although diarrhea
Requires more salve.

All in all
It's a disturbing condition,
And I've spent too much time
On this rendition,
But I just had to
Get it out,
Gurgle Gut
Deserves a shout.

8/21/15

Arrhythmia.............again

After a 20 month rest, a return for another Cardioversion (#15); is that a record? Who knows........but we have a handle on that.

Back on Your Feet

It's two thousand fifteen
And Jake never quits,
He swears that A. Fib
Is way better than Zits,
"I get much better meds
When treatment is required,
I won't feel a damn thing
That's what I call, inspired".

A twenty month sojourn
Since his last visit here,
Not a whiff of arrhythmia
Till that one, ice-cold beer,
Sent his heart stuttering
On that hot stinkin' day,
And in the realm of A. Fib
To play, you must pay.

For rejuvenation
And dynamic publicity,
Spend an hour with us
We'll turn you on to electricity,
Delivered with gusto
With the milk of amnesia,
You'll be dreaming of angels
In French Polynesia.

For sure, your arrhythmia
Is a bother, at best,
A few trips to the E-R
For an EKG test,
Until finally you tasted
The fruits from our vines,
Electricity and Propofol
Are the best of all wines.

An Ablation or two
You can try, what the hay,
Sometimes it works
Just one time, one day,
But you are the winner
At cardioversion, fifteen,
We love you, dear Jake
If  you know what I mean.

You're a part of our family
We will never give up,
When you're feeling irregular
Please come, fill your cup,
On our high-octane juice
You'll feel better, right quick,
Give your A.Fib a taste
Of our pit-viper stick.

Today you presented
With a different thing,
Atrial Tachycardia
Fit for a King,
Easier to manage
With a miniscule zap,
Just 20 little joules
Like a mosquito tap.

But still, you did ask for
A shot of amnesia,
We give it freely
Whatever will please ya,
Because you are like family
We want you back on your feet,
For a good round of golf
Down at St. Pete's.

8/19/15

Gurgling Gut

Irritable Bowel Syndrome, affects millions of people in the world. There are treatments and therapies, and causes and theories.............and bloating, cramping, Borborigmi and rumbling, and a great deal of unpredictable inconvenience for those suffering this crappy condition.

Here is Billy Bob's story:

BB's Thing

With gas and gurgle
In his gut,
Toxic fumes
Escaped his butt,
Don't stand behind him
Momma said,
That's BB's thing
He'll kill you dead.

Billy Bob will
Tell you why,
Moroccan muesli
And Danish rye,
Didn't cause it
No, dear daughter,
The problem was
I drank the water.

A grave mistake
But I was parched,
That mountain climb
We over marched,
And laughed about it
At the Inn,
I drank the water
That's my sin.

Now, seven years later
His gut rebels,
Unpredictable
Good lord, Hells bells,
When least expected
Like a cry of the loon,
That Moroccan beast
Nearly makes him swoon.

Praying for Rain

This post is a follow-up to the one below. More junk going on................

Just one week later
Complications were worse,
A string of bad luck
In search of a curse,
An Aortic dissection
From the arch to the Iliac,
Thank goodness Mr. patient
Was not a hemophiliac.

Experts were consulted
Group worry was evidenced,
Just watching and waiting
Good advice, was dispensed,
Keep the blood pressure down
Diminish Aortic stress,
Then evaluate the cause
Who to blame for this mess.

The Doctor who did it?
Oh ya, he just left town,
At the end of the procedure
After he took off his gown,
Though he stopped by the room
To mumble his regrets,
Stating, an on-call physician
Will cover his bets.

I worried and fussed
Six hours of inspection,
Five sheaths to remove
During crisis detection,
Monitor vital signs
Assess pulses and pain,
Waiting for decisions
Like praying for rain.

To the Cardiac Unit
At seven pm,
I could finally relax
Now, it's up to them,
The Critical Intensivists
Will manage him there;
My tour of duty
Was a journey of care.

8/4/15

Exceptions

It is well known that Catheter based procedures place the patient at a risk for bleeding, probably in the range of 3-7%. So of course, we the practitioners, do our darndest to minimize this. However, there are just too many variables that we can't control. And despite 37 years in health-care, I still get nervous and worried when patient's are bleeding.

Exceptions

I haven't written
In the absence of stress,
Then along came today
And Lordy, what a mess,
A complicated ablation
Her A-C-T too high,
Oozing and bleeding
I worry and sigh.

When the Doctors inform
Their delivery is brisk,
A 3 hour procedure
With a low percentage risk,
Go home the same day?
"No problem", he replied,
Leaving out the part
"Except, if you died".


7/21/15

Dental Dana 42

When Dental Dana
Has a day off,
I'll cancel an appointment
Complaining of a cough,
Or maybe she's having
Her Mercedes fixed,
That's another appointment
I have nixed.

My Dentist isn't thrilled
With my bait and switch,
Probly mumbling something like
That son of a bitch,
While grimacing with every
Unplanned rearrangement,
The whole darned office
Is planning my estrangement.

But I'm a paying customer
With a 3 month cleaning,
Though I suspect
They are pondering weaning,
Me out of the roster
And onto the street,
(No farewell party)
The contract is complete.

6/29/15

Bovine Binary

Administering to cows with heart disease
All long as they utter thank you and please.

6/8/15

Fistula

I haven't written a gross-out poem in a while, but I still have a flair for  it.

Poo & Pee
Got together inside,
Found themselves a fistula
What a crazy ride,
Poo said to Pee
"Geez, you're kind of runny",
Pee replied, "Dude,
You smell awful funny".

Together, they knew
They could cause a lot of trouble,
Let's get on with it
And do it on the double,
Poo and Pee figured
They only had a little time,  
Before someone found out
And put an end to their crime.

Poo and Pee
They made a pact,
God bless, our chance encounter
Now it's time to act,
Make a total mess of things
Inside our sorry host,
"And, after it's all over
Let's head to the coast".

6/8/15

Dental Dana 41

Deliciously dangerous............

Dental Dana
Fixed me up,
She's a little
Buttercup,
Flossed my tongue
She sliced it too,
Now it really
Hurts to chew.

Dental Dana
She's a Holy Roller,
She spoke in tongues
When she cracked my molar,
I felt the vibration
Into my brain,
I begged for another
Shot of Novocaine.

She said, Ok
And poked me in the thigh,
What the heck?
I don't know why,
Probably because
I'm so much trouble,
She said, "Don't complain
Or I'll make it a double".

As usual
Like every time we meet,
I left the office
In prickly heat,
Hot and bothered
Not feeling any pain,
Because Dental Dana
Is my Novocaine.

6/8/15

Dental Dana 40

Dental Dana
That's her, over there,
She looks real good
Just sitting in a chair,
But when she turned sideways
The view was unbelievable,
I inhaled the mondo pick
And now it's unretrievable.

Coughing and sputtering
She hurried to my side,
Because it never looks good
If your patient has died,
But I wasn't dead yet
So she kindly observed,
When I tried to grab her
She skillfully swerved.

A stylish pirouette
Dental Dana a dancer?
I should have guessed it
This obvious answer,
Why, with all of my moves
I never seem to get close,
And with her blow-dart sedative
I always earn a double dose.

5/30/15

Retirement

A long career in Nursing eventually leads to dinner-table talk, of old stories. We all have our favorites; some people telling tales, that suggest they were the "smartest" nurse at the time, perhaps showing a Medical Resident how to do something the right way. My stories usually describe some kind of gross or unusual circumstance, that I found to be sickly humorous.

Four old nurses
Sitting around a table,
Each of them states
Boy, I have a fable,
That you ought to hear
It's the craziest story,
Each nurse has
Their tale of glory.

How about the time
The 900 pound client,
Swore on a bible
"I'm sodium compliant",
I only eat pretzels
That my Momma makes,
It hurt her feelings
When I said no, to the cakes.

Oh, let me tell you
About the ascites fountain,
That fellow had a belly
Bigger than a mountain,
When his umbilical hernia
Popped open under pressure,
It sprayed me with the fluid
Oh, nothing is fresher.

Well, that made some giggles
But did you hear about Rob?
Billy-Bob Borko
Was one heck of a slob,
He sat on the commode
And when he stood up,
That commode bucket
Was one stuck cup,
On Billy-Bob's backside
And then it crashed to the floor,
The nasty, stinky liquid
Splashed all the way to the door,
Practically covering Rob
And he exclaimed, "Shit,
Someone, call Hazmat
See  you later, I QUIT".

Another favorite story
Was the disappearing man,
I met his nurse in the hallway
She said, "I'm looking for Stan",
He's been kind of confused
We can't find him anywhere,
He had a Posey vest on
But now he's not there.

I followed her to the room
The mattress was on the floor,
Stan, wasn't there
Did he run out the door?
No one has seen him
Should we call the Head Nurse?
Let's wait a little longer
Because who needs that curse?

Then we heard some muffled sounds
And that mattress did shake,
"Is this room haunted
Good lord, is that a snake",
Slithering beneath
The bedclothes on the floor,
With one look below -
There was Stan, looking sore.

He'd been thrashing and pulling
Then he mustered a lunge,
Over the rail he went
A swan-dive, a plunge,
Face down on the floor
With the mattress attached,
He appeared to be gone
But survived, yea, unscratched

We reassembled the package
And got him back in bed,
Assessed for broken bones
And bumps on his head,
He had no complaints
He just wanted to sleep,
"Sweet dreams, dear old Stan
Please don't make a peep".

And that's how the talk goes
With old nurses at the table,
Later on the, Maître de'
Will lead us back to the stable.

5/29/15

Dental Dana 39

Dental Dana 39 

Dental Dana
She's a hottie,
We went out to lunch
And shared a chapati,
I told her she was hot
Right to her face,
And then she sprayed me
With her mace.

She threatened me
Right in that booth,
Regarding a missing
Canine tooth,
And the crown to replace it
Sure, it could get lost,
And regardless,
I'd have to cover the cost.

Dental Dana
She's a wily one,
And that's what makes her
So much fun.

 5/29/15

Smartphones, Ignorant Parents

This is not really about Nursing or Medicine, but instead a reminder regarding our lack of situational awareness (a result of our fascination with streamed entertainment).

I went to a coffee house this morning, and noticed 3 persons at a table. What looked to be a Mom and Dad and their son, of an estimate age of four. The parents each had a smartphone, with the whole of their attention on the device, effectually unaware of anything going on around them. The young fellow looked my way, as I walked past the table. The parents had zero attention for their son; a trajedy in of itself, and a lure to any wacko in the audience. How easy it would be to steal a purse, or even their child.

Telephone Charades

With mom and dad
On their telephone,
I'm just sitting here
All alone,
Watching strangers
At the coffee shop,
I'm completely ignored
By mom and pop.

Lots of others
In this place,
Hold a smartphone
Up to their face,
They are unaware
Of what is near,
I could be kidnapped
Or disappear.

Stranger man
He walks by,
We look at each other
Eye to eye,
He seems to notice
My mom and dad,
Faces tuned
To phone and pad.

He looks nice
And asks my name,
Just like Charades
I know that game,
We played it once
At Grandma's house,
He whispers to me
"Be quiet as a mouse".

We'll go outside
You won't be bad,
'Cause it's Ok
With mom and dad,
They are too busy
And you're alone,
They're more interested
In their telephone.

You can come back later
When we're done,
You'll tell them how
They missed our fun,
But for now
They just don't care,
The phone is more important
Than having you there.

They'll be excited
Yesiree,
Wondering what
You did with me,
But that's our secret
So, let's not tell,
Or mom and daddy
Will go to Hell.

You can show them
Your brand new toy,
I gave it to you
You're such a good boy,
Because that's what
Mom and daddy say,
Along with please and thank you
And have a nice day.
_ _ _ _ __ __

Sure, it's creepy; but so real is the danger we are inviting into our lives when we subjugate our awareness to outside distractions. For example: Driving the car using the cellphone; walking across a busy intersection looking at the cellphone, traversing the stairway in the hospital, using a cellphone; Driving the commuter train while texting on the cellphone; performing patient care, while looking at the cellphone..............danger is everywhere.

Dental Dana 38

Trying to repair a tenuous relationship with a Dental Hygienist, has some risk. Perhaps I should review our historical reference...................or not?


Dental Dana
What's her gauge,
Measurements, diameter
I don't know her age,
I seek any advantage
To be leveraged
Towards my cause,
'Cuz I'm a serial offender
I've broken so many laws.

First, there was the time
When I said, she didn't do me,
That was so incredibly offensive
I thought she would glue me,
With my jaws tight shut
Not to eat for forty days,
And use that blue-light igniter
Set on maximum phase.

After that, I posed
That she was the bomb,
Better looking even
Than my Mom,
She said that was rude
And tasteless, to boot,
So she lanced me
Without Lidocaine,
To the nadir
Of a root.

If that wasn't enough
I mentioned the word Goddess,
How can I help it
If it rhymes the word bodice,
Referring to clothing
Low-cut, across the chest,
Heck, I'm just a writer
And she's truly blessed.

And that's the crux of the matter
In a visual context,
My thoughts in a streak
Imagining what might come next,
If reality was plastic
To be shaped in a second,
The pillows would be fluffed
And Dental Dana has beckoned.

Oh, I'm such a dreamer
An old man with 'osterone,
Still grappling with slow mail
And she's on a smartphone,
Light-years ahead of me
Planning her next move,
Where she Lasers my frenulum
While shaking out her groove.

Dental Dana is beyond
Any realm of common existence,
Thus proving, in practice
There is no point in resistance,
Just do what she says
In the context of your appointment,
Believe me, do avoid
An opportunity for annointment.

Dental Dana
She's the best
And that's my conviction,
Never mind
All her weapons
You must seek benediction,
Placate her, I urge
Or you will pay the price,
Jaws without teeth
While you're sucking on ice.

5/7/15

Dental Dana 37

Last week I was in the Dentist Office, on a Tuesday; not my usual day, and there she was, the living embodiment of Dental Delight......................Dental Dana. No, she was not my Hygienist, and in truth, our days of mutual involvement, go back about 2 years now. But heck of it all, it still plays out to be a good, dang story.

Dental Dana 37

Dental Dana

She's a wonder,

I'm trying to avoid

My usual blunder,

Where I approach

And act too frisky,

With Dental Dana

That is risky.

I can't hold back

Because she's the one,

She makes every appointment

Kind of fun,

Easy on the eyes

And always cheerier,

Iron-willed

With a soft exterior.

But when she opens

Her chest of tools,

She makes it clear

She won't suffer fools,

I'll go to Hell

Without stopping in Limbo,

If I should treat her

Like a bimbo.

Yes, Dental Dana

Rules the roost,

Misbehavior

Will garner a boost,

Out the door

And into the street,

She'll wave goodbye

And smile so sweet.

4/22/15

Hospice Blues

An old time musician in hospice; what could happen?

Hospice Blues

Woke up this morning
Pondered my dues and my debt,
Smelled something funny
Damn, my diaper is wet,
Called to my Nurse
Oh Baby, I need you,
She said,  "Make up your mind -
Should I wipe you or feed you".

Oh, that woman is so cold
She won’t cut me any slack,
Slipping Ben Franklin from my wallet
Whenever I turn my back,
But what can I do
I’m disabled and weak,
I needed a good nurse
But, this one's a freak.

My mojo isn't working
On this devilish caregiver,
She's 'sposed to cook me good meals
Not, Friskies chopped liver,
Man, she's being paid
To do her nails and watch TV,
That's all she ever does
Instead of watching over me.

Now I'm fighting back
With old fashioned voodoo,
I slipped some black cat bone
And my John the conqueroo,
Into her sugar-free Pepsi
That she drinks all day long,
Pretty soon she'll be singing
The Billy Bob song.

Oh, Billy whatcha need
My attention is all yours,
Baby, grab me a Heineken
And wheel me out doors,
Rub my feet and my back
Then cook me a good dinner,
She'll say, "Bless you, Sir BB
Thanks for saving this sinner".

Nepotic Leaders

This is a fine bit of nonsense that morphs into another look at: questionable leadership...........or lack thereof.

The Family Kara-Hiri

There be Sister Euphemia
And Auntie Euthenasia,
The younger Eugenics
And Father Dysplasia,
A motley crew
With skills beyond measure,
They can lead you from oblivion
And guide you to the treasure.

An odd, assorted team
If there ever was,
How they manage to work together
Somehow, just because,
No one ever seems to know
What this bunch will do next,
They never use Facebook
And hardly ever text.

Throwbacks to an earlier age
Before our nascent technology,
Darwinian survivalists
Of primordial biology,
How they survived to this day
Is anyone's guess,
As leaders of mayhem
They barely even stress. 

They run the ship
We hold the oars,
We're whipped if we argue
They keep all the scores,
Every day they're competing
Bonus dollars, on the line,
Peons can't touch that
We are wrapped up in twine.

Nepotism at its best
Survives because they score the test,
Stack the cards, prime the deck
They jump ship first
Should we ever wreck.

The blame always falls
On the workers at the bottom,
Each of one of us musing;
When had the chance
We should have shot'em, 
So you better have a backup plan
Just what I'm saying, Dearie,
Considering the business plan
With the family Kara-Hiri.

Never Embarrassed

After a while, particularly if you worked in an Adult ICU, every situation that might be classified as embarrassing, has come and gone. That's in regard to the patient's, in their time of dire need. Therefore, how can I possibly be embarrassed about some dumb little thing, having to do with everyday living?

I am never embarrassed
And I'll tell you why,
I have seen everything
That can make a person cry,
In the course of three decades
Of this Nursing career,
Regarding comfort and privacy
As I stood at the rear.

I will never forget
The crap blasting farts,
The cratering wounds
Like infected cream tarts,
The abdominal ascites
With a peritoneal fountain,
The blubberous bulk
Of a humanoid mountain.

You might call me insensitive
And there, you'd be wrong,
We closed all the curtains
And sang the same song,
Of comfort and care
To our suffering clients,
Along with warm blankets
The Gold Standard of science.

So, can I be embarrassed?
Not after what I have seen,
What I have smelled, touched and tasted
To get everyone clean.

5/1/15

The Burden of Wait

We have all experienced the waiting...............every aspect of life presents the opportunity to wait, longer than desired.

The Burden of Wait
Unlike the Duke of Earl,
Promotes anxiety and anger
Like a fussy, irksome squirrel.

No one enjoys
Unpredictable delays,
This kind of thing can happen
On the slowest of days,
Because we are a referral center
For Cardiac disorders,
People can become so unhappy
They threaten missiles and mortars.

A traffic jam of inefficiency
And the disgruntled client,
Waiting forever
Their hunger is a giant,
After 4 or 5 hours
It's a little too much,
Our tired excuses
Are like an old, rusty crutch,
Over and over
We apologize and placate,
Feeling like this situation
Is the worse kind of blind date,
Lame excuses repeated
Again and again,
While fuming family members
Look dangerous just holding a pen.

4/30/15

Dental Dana 36

Really now, who enjoys a trip to the Dentist office? No one I know. But what if there is a hot looking hygienist to cozy up to? Exactly! Dental Dana...........fits the formulaic fictional fantasy story to a T.

Dental Dana
Makes me itch,
When I gaze at her
I start to twitch,
Which is not advised
In a Dental chair,
But is Dental Dana
Even aware?

She's so very nice
To every one of us,
Though it's a given
Some folks like to fuss,
Generating tension
During the hygiene event,
With Dental Dana
Prepare to repent.

Dental Dana
Looks hot and healthy,
She's got some moves
That border on stealthy,
Especially when placing
Tools between my jaws,
Her aim looks deadly
Like she might break some laws.

I asked for DD
When I busted a tooth,
I wanted an intelligent opinion
And her hot-buttered youth,
But with my prior history
Of Dental offence,
It's really no wonder
She wouldn't give me two cents.

Oh, I was crushed
And begged for a pardon,
I offered a shopping spree
At the Mall on Arden,
If she would please, please
Just handle this one little task,
Oh, Dental Dana
Why won't you do as I ask?

Well, she truly is an angel
Dressed in blues and whites,
She came back to the room
And punched out my lights,
When I woke up
From Dental Dana's slap,
I had a fine looking tooth
Where there once was a gap.

I promised her flowers
And a thousand dollar check,
I blew her a kiss and croaked
"Get your hands off my neck",
She gave me such a sweet
Coquettish little smile;
Oh, how we all adore
That Dental Dana style.

4/20/15

Injured me

Slipped and fell on my butt
Dislocated my shoulder,
I'm thankful I wasn't
Perched on a boulder,
Thus, now I'm one-handed
Out of sorts, yes indeed,
A horrendous injury
And I didn't even bleed.

It hurt like the dickens
Ten of ten pain,
The Fentanyl was helpful
Like IV Novocaine,
But when they pushed, pulled and cranked
On my arm for Reduction,
Fentanyl didn't touch it
I needed Diprivan induction.

I told them in the beginning
When they answered the call,
Fentanyl for discomfort, and
For the procedure, Propofol,
But young Doctors must follow
Their protocols, to the "T",
Shoot the little guns first
To set my shoulder free.

Well, that was an ordeal
Not to be repeated,
My pain hit 250
With my shoulder still unseated,
And they did concede
Stronger meds were in demand,
Like I said in the beginning
Folks, Propofol is planned.

I've used it hundreds of times
In my Nursing career,
And now that I've had it
Man, it's monstrously clear,
That, this stuff is better
Than Cinnamon toast,
Like a cool soothing blessing
By the hand of the Holy Ghost.

When I woke up
The pain was a two,
With everyone smiling
At my shoulderly view,
Repositioned, it was
So properly placed,
Just like the Doctor said
The pain was erased.

Homebound, we were
A seven hour ordeal,
I'll need several months of Rehab
To resume my curb appeal,
A turn at disability
My initial impression,
An impromptu vacation?
Note my facial expression.

I own the Truck

Nurses eat their young........while Betty *Battle-axe, never loses the appetite to nibble away at her staff. (*an aggressive, domineering, forceful woman).

Oh, the things that I could talk about
That I rarely mention,
The subtle harassments
That would get your attention,
And what is the point of these things
I'm asking you?
When we who are smart enough
Recognize those things that you do.

It's kind of funny
And Ludicrous, all the same,
Watching your twists and twirls
In this silly bothersome game,
Where, you might claim
An Auditor, noticed a thing,
In the language of HIPPA
Where your threats can really sing.

And those persons who claim to be
In charge, and your boss,
Hardly have a solid grasp
On how the salad is tossed,
When the facts truly come out
How they didn't do their homework,
It was all an exercise
To give your chain a jerk!

What nonsense I say
That's why I keep the recording,
Every time this stupid train
Honks it's horn at the time of boarding,
And the Conductor punches tickets
Intimidating, those who they wish to irritate,
I never understand it
Because it's not my fate.

My works and diction
Don't support this kind of Fiction,
Because, over the years of my dedication
I'm the guy they call, to provide salvation,
And all those other things, when dire straits run amuck
Don't mess with the guy who owns the truck.

The Kidney Got Blowed Up

Language Sinner

I thought nothing was funnier
Than Doctor's dictation,
Until I read Nursing notes
In our grammar-poor nation,
An entry discovered yesterday
Surely takes the cup,
Regarding an Iodine Allergy:
"THE KIDNEY GOT BLOWED UP".

Yes, that's how it reads
At the top of the page,
On the EMR Chart
In our digital age,
Where spelling and grammar
And gibberish, show evidence,
Suggest a lack of education
And no common sense.

The computer-based document
Allowed me to learn,
Whoever wrote that nonsense
Needs a reprimand, stern,
An embarrassment certainly
To the likes of our profession,
Come forward, language sinner!
And deliver your confession.

4/4/15

Once is enough

The story is true, the secret is secure.

Jerry Rigged

Something happened yesterday
Never seen before,
Old man farmer
Took care of a chore,
He was out of bed unclothed
IV stretched and taut,
He seemed a little confused
At least, that's what I thought.

He proved me wrong
What an entrepreneur,
He showed me his solution
For human manure,
A sudden urge, it was
He needed to take a dump,
First he peed in the urinal
And then he added a lump.

He was careful not to spill
And his aim was pretty good,
Holding the urinal to his butt
The lump went where it should,
Not a drop on the floor
I commended him for that,
Giving him some hand-wipes
'Twas a feather in his hat.

The urinal was hanging
On the bedrail with care,
We both took a look at it
And sensibly, left it there,
Then I told him to get dressed
And gave the usual teaching,
The do this and don't do that
Our standard Cardiac preaching.

When the family arrived
He was dressed and looked super,
No mention was made
Of the jerry rigged pooper,
We shook hands and both stated
Let's not do this again,
Despite all the fun
After all, we are men.

Senior Nurse, Senior Citizen

I've been stewing for a month, and this soup is sour. We have only had a couple slow days, and otherwise so ridiculously busy and understaffed on our evening shift, that I'm about to blow a fuse. So, here's my latest ramble.

Sorry Spleen


Nothing written at all
For at least one month,
I think it happened before
Maybe just wunth,
What have I been thinking
Who in the heck knows?
The absence of all writing is as
Unpredictable, as the wind blows.

I guess I'll write about work
The never ending story,
All the chills, thrills and drama
Have overwhelmed the glory,
The Testament of this Nurse
Now at the bookend of his career,
I'm warning you, kid
Don't look stupid when I'm near.

I might write about you
And tell the story of a hack,
A Cardiac Nurse without the rhythm
That was yesterday, oh, how you slack,
Comfortable in your position
In this cool working place, what a score,
Less than 7 years experience
When you were invited through the door.

And it clearly is evident
In the way you bob-and-weave,
I worry about our clients
Regarding what is not, up your sleeve,
The patient's, they don't know Jack
Regarding what a Nurse ought to know,
So when you enter the room, they ASSUME
You are an Expert, Joe Blow.

Now truly, it's a fact
Administrators want good scores,
On the Satisfaction Survey
Or they'll be kicked outdoors,
To the curb or worse
Their reputation smudged,
"Mr. Smith, did you have a nice Nurse?"
That's how we're judged.

And please, tell your neighbors
That you had the best time,
How the staff was so friendly
And the food was sublime,
How the Nurses were best educated
They knew their stuff, each and everyone,
Knowing that, you felt safer?
Oh, you ASSUMED that, you son of a gun.

Human Kindness is a concept
We can all get behind,
Hospital standards of care
Are carefully defined,
Professional excellence
Should be demanded and required,
If you don't improve your skills
Then you will be retired.

But that is the world
Dreamed about by me,
The senior nurse, senior
Wishing I could be set free,
From this nonsensical arena
Of medical care, 2015,
It's all about the name-brand name
Not clinical outcomes, my sorry spleen.

Composure

Busy, crazy days are so common, I probably talk about it too much. Be as that may, I find my quickest mind distraction, is reading News reports on the internet. When I read all the horror stories going on elsewhere in the world, I realize my troubles and stress, are minimal and like the fluff of old Dandelions...............fly away with a puff of wind.

Flag of Composure

Friday we were slammed
But then I read the news,
Horrible happenings everywhere
Changed my micro views,
I realized my troubles were minimal
Compared to the rest of the world,
Letting go of the stress I was feeling
My flag of composure unfurled.

Repeated, again

With Cardiac Arrhythmia's, an individual might have to return for repeat procedures; such as Cardioversion, Ablation, Pacemaker fiddling, Angiograms and so on. It's just the nature of the beast.

Mr. McGinnis
Came back to our store,
He had a prior Ablation
And now he wants more,
Oh, let's do-do it again
He said with a stutter,
But this time I've come
With Atrial Flutter.

Mr. McGinnis
Is a likeable chap,
Friendly, yet stoic
He wears a jaunty cap,
Adventurous, he is
Regarding recreation,
He says, "I've had a month of rest"
Let's do another ablation.

Dr. Oneill
Reviews all the options,
Clarifying clearly
He doesn't do adoptions,
Nor suffer fools gladly
Seeking medical attentions,
"But, if the proof is in the pudding
I will apply my interventions".

Dr. Oneill, in his customary way
Articulates, with nary a stutter,
The EKG, clearly shows evidence
Of Cavo-tricuspid A-Flutter,
Quite simple to fix, in my estimation
Drop in for a day, get it done,
Mr. McGinnis, heartily replies
"Thanks Doc, I'm sure we'll have fun".

2/19/15

Catering to you

We all have had difficult patients, families, co-workers and bad days. Over the course of this job, I have worked in situations, where a patient might come for multiple visits, over weeks, months or years. I understand all the psychodynamics of how the person might feel lost, or have a sense of powerlessness, or whatever................I get it. But why act out towards the folks who are trying their best just to help you? If you don't want to be in the hospital, or you'd rather not be repaired, just go home, Ok? There are many other nice folks we would just love to attend to.

Catering

I'd rather gather bathhouse blankets
Than take care of you,
Working minimum wage
And do the best I could do,
I'd rather dig fire-pits
To roast the slaughtered pig,
Than spend another day with you
With your ego so big.

When you come to the hospital
Please leave your attitude at home,
We're doing the best we can
This is not the church of Rome,
No, we're just medical peons
At your beck and call,
I'll do my best for 12 hours
Just don't call me Paul.

I will treat you respectfully
And look for the same in return,
I'll get you juice, food and TV
Your care is my concern,
But please do remember
Your safety comes first,
If the Doctor writes, "NPO"
I can't cater to your thirst.

You didn't eat since yesterday?
It's a bother, but not critical,
Most of us are overweight
I'm just saying, not analytical,
And fasting can be a benefit
However stressful, it might seem,
When you finally get to eat
Our food will taste like a dream.

I'd rather trim forty acres
Of Star Thistle, in June,
If you ever come back again
That will be too soon.

Themeless not Dreamless

Sometimes something just sticks in my craw and I don't really understand it. But when I begin with some little idea, the concept unfolds. Here I was thinking about all the dumb stuff that Administration threatens employees with, while letting other really important issues go down the tubes. Sure HIPPA is important, but what do we do about the public whipping out their phones to photograph Momma with her pretty blue surgical hat on, or some fool Mother, let's a cellphone in the room with her intubated neonate and the picture ends up on Faceless Book?

Anyway, I'm peeved.

Hospital organizations
Threaten new members,
HIPPA violations?
We'll roast you on embers;

And other fancy rules
Laid out clearly for new-hires,
Will never be enforced
Until the statute retires.

Why do they forcefeed us all
With powerless reminders?
To impress the Regulators
Who are all wearing blinders,
To the reality of the present
Perpetual cost-cutting days,
No more free Soda
Unless the Employee pays.

2/12/15

Assuming the Reigns

Choosing to be a Nurse Manager..........well, I gotta hand it to you. It sounds like a living nightmare; until you go home, and have PTSD nightmares, of what didn't go well that day at work. It's a huge amount of responsibility  (to do it right). Good Luck!

Manager, or
Man ager,
You might feel older
I would wager,
Assuming the reins
Of that wild horse,
Perhaps, you're the one
Who can right the course.

Historical guidance
From a veteran, needed,
Professionalism
Has been impeded,
I was there and I saw it
And it wasn't good,
Perhaps you can fix it;
Our old neighborhood.

Focus your powers
And rally the troops,
Watch out for landmines
And the loopety-loops,
Who lurk in the closets
And whisper sedition,
Clean house if you must
To establish your edition.

Make fair new rules
And stick to your guns,
Establish strong protocols
For your daughters and sons,
The family you inherited
By your audacious deed,
Discover your mentors
To guide you, to Lead.

2/11/15

Bobcats & Rabbits

Good Goat Almighty............! Today was like Bats out of the Cosumnes River Preserve! 45,000 of them at once. That is what it felt like, and what other bystanders commented. It was totally demented.


Oh, my word
How busy can it get?,
Not too much more of this
I can safely bet,
With the resources we have
And that's not counting too much,
Few persons, qualify to float
And if they do, they wouldn't touch,
Knowingly enter
The region we inhabit,
Kind of like Bobcats
Who are chasing a rabbit,
All about the tributaries
Leading to the Den,
Thank goodness, this only happens
Now and then.

2/6/15

Caring Time

Today, we had a boatload of patients, procedures and recoveries. We were super busy, procedures were delayed, it was hard to find beds and we "closers" worked 14 hours total. What made it a good day, was how many good visitors we had, paying attention to their friends and loved ones. Thanks, all.

Families and friends
Who hang out for the waiting,
Are the best that can be
And I'm not overstating,
The appreciation we have
For their vigil with Bob,
Whether they are dressed to the nines
Or just a casual slob.

It's best if they talk
Ordinary conversation,
Perhaps share a tv program
Or a radio station,
I don't like it when visitors
Focus on their gadget-gear,
They might as well go to Starbucks
Because they're not really here.

Being a supportive family / friend
Showing care for Billy-Bob,
Is far more than any kind
Of lazy, boring job,
You are giving of yourself
Unselfish caring time,
Thank you, to everyone
You help everything rhyme.

1/31/15

Drought Solution

Where is all the water? I realized where a good portion of it is, after seeing a response to Lasix the other day. Perhaps our end-of-times drought wouldn't exist, if those perpetrators of Heart Failure, would PLEASE return the water!

A brilliant solution presented itself
After a standard dose of Furosemide,
In California, we're in a massive drought
The plants, and aquifiers and lakes have all dried,
The patient in the spotlight had fluid overload
Short of breath and feeling chest pain,
In the next two hours, I hereby witnessed
Two liters of urine go down the drain.

How many persons in California with Heart Failure?
Holding on to our water, in the midst of a drought,
There ought to be an ordinance, a fine, or citation
Breaking a natural law, there is no doubt,
Wildfires rage with dry tinder conditions
Fish species in danger, when they can't spawn,
And most of you with Heart Failure
Are probably still watering your lawns.

Sure, a little off the track, I will admit
But Lasix and Bumex
Just might do the trick,
To solve our water crisis
In our severe time of need,
Let Go Of Your Water
It's time everyone peed.

1/30/15

Bed Theory

After 31 years of Nursing, I stake my claim, and publish emperic, evidence-based, scientific research.

Even though our new "HIPPA" compliant, one occupant , get-ready and recover rooms are the cats meow, they are small. They are designed for a gurney, but those things are just rolling torture tables. Our 2015 idea, is to have a real bed in there, for those patients who might be with us for more than 4 hours. The following mini-research proves, that providing a comfy bed, does not guarantee patient happiness.

Bed Theory

We theorized the following:
Sometimes our patients have a long wait
For a Cardiac Cath date,
If they had a bed, instead of a gurney,
They might be less inclined
To call an attorney.

A common supposition stated
Bed, compared to gurney, might be rated,
Higher on the satisfaction scale
But still, our patients moan and wail,
Because laying on one, uncompared to the other
They don't know the difference, and the crux of it brother,
What they really want, is nicotine and food
Bed Theorem debunked, hence their bad mood.

1/27/15

Hollywood Star

This old gent was determined to need an Aortic Valve Replacement, secondary to reduction in Valve area and calcification. He had a pile of tests to support the suspected Diagnosis, and eventually qualified for TAVR. Transcatheter Aortic Valve Replacement. If you don't know; at this time, it is reserved for those persons deemed too risky for open heart / sternotomy approach. This is most often as a result of comorbidities, frailty, old-age and the like.

So, he passed all of the prep tests and today was the day of the big event...................except, he didn't really need it after all.

They thought he needed a TAVR
But it just wasn't so,
He had 14 preparatory tests
And it was all systems go,
Coming in at 5 a.m....
When you're 91, that's a cinch,
And when they started his IV
He didn't even flinch.

Transported to the Hybrid Room
Anesthesia induction, was smooth as expected,
Every monitor known to modern surgery
Insured that he was protected,
From collapsing vital signs and hypothermia
Arrhythmia's, bleeding and more,
His Femoral arteries and veins were cannulated
With everything the Surgeons had in the store.

And then it was time, for the last Aortic measurements
Before they would load that valve on a wire,
Three or four Doctors, scratched their heads and wondered
How did we get to this place, where we call a ceasefire?
And admit to ourselves, that this fellow doesn't need it
The best thing to do, is to send him home today,
Let his family celebrate, wondrous good fortune
And pray to the heavens, there isn't a Copay.

A six hour recovery, that's all he needed
Sleeping the whole time, till he walked to the car,
At 91 years of age, this was another adventure
I think he just earned his Hollywood Star.

1/25/15

Bumped Off

A couple of times a year, I find myself bumping against things to the side of me, as if my radar is busted. It's as irritating as those days, when I have hiccups about 7 times.

It's the middle of my shift
Suddenly, pain in my thumb,
I can barely bend that sucker
I wonder, what's that from?
And then I remember
Bumping the metal door,
Also, caught a finger
Pushing the handle, man, my finger is sore,
And to top it all off
Smacked my other hand,
Against a non-moving bed
I assure you, none of this was planned.

I think my proprioceptors
Are not properly tuned,
If I start bumping my knees
I might be marooned,
Trapped in the hospital
Too lame to go home,
And we don't stock toothbrushes
Not even a comb.

New Stuff Learned

I love going to Medical Education events, because I like to learn new stuff. Also, it's a great place to get ideas for jokes and new poems. I went to a little meal and eat at the country-club, back in October, and my table-mates and I learned about Neurological Disorders, specifically regarding Parkinsons and Tremor. My new pal (yes, you) likes joking around too, and here is what we came up with. Silly cocktail humor.

Chorea: A country near Japan

Leva-Dopa: When the Taxi-driver drops off the dopehead.

Bezel Ganglia - Jewelers Neurons

Parking Sons: A motor vehicle parking business.

Pre-Cursor: Middle schooler who hasn't yet learned to curse.

Vascular Insult: "Your varicose veins, are WAY ugly!"

Blood vessel to Fat guy: "Hey, lighten up, will ya?!? I can't supply all this fat!"

Parkinsonian Features: Short films, just before the Main feature, at the Parkinson Theater.

Stepwives: Exercise Program @ 24 Hour Fitness

Cardinal Rigidity: A high member of the church, and his "little" problem.

Sleep Disorder: Acting out while sleeping.

My Charge-Nurse has executive function dysfunction.

Motor-State: Detroit, Michigan

Are you moody about your anxiety, or Anxious about your moodiness?

A dancing disease vs. Advancing disease.

Don't look at me funny, that's how I manage to stay awake after drinking two glasses of country club wine. 

Smoking and Choking

I will admit, that I like ye olde fireplace fire........but now, I don't like the smoke in the air when it feels like I have Asthma.

And here in the Capitol of Californication, it hardly ever gets cold enough to freeze anything.............so, a lot of people probably don't really need to light the fire...........it's just a warm living-room homey thing.

As soon as I got to work today, I smelled wood smoke coming from the ventilation duct. As the day progressed, I was coughing more and more. Talking with coworkers later on, they too, commented they were coughing, and had burning eyes. My partner called someone in Engineering, and he dropped by.........probably thinking we were talking about burned popcorn.

Engineer of the Night, wasn't very sympathetic to our complaints of things making us cough, sneeze and burning eyes........because after all, "No one else has complained yet".


We got a heckuva response
From the Engineering dude.
If it had been Mark
He would never have been so rude,
When we called about the smoke
Piped in by our new ventilation piping,
The dude said, "It would be too expensive
And no one else complained, only you are griping".

I said, "Well, we are the healthy ones
What about those who can't complain?
Asthmatics, with C.O.P.D.
Respiratory Failure
Just struggling to operate their brain",
No, Engineering dude, once again stated
"I'm sorry, no one else has lodged a complaint",
Denouncing our legitimate concerns
Oh, I held myself back with some restraint.

I guess, maybe he is a perfect example
Of someone, who takes his job easy,
Don't rock the boat, ruffle the edges
Maybe he gets queasy,
Afraid to pose
Questions of impropriety,
Like piping in particulate-matter smoke
Intolerable to most of our society.

He talked about charcoal filters
Although, I dont know if that's a viable solution,
And anyway, Engineer said it would be too expensive
And "no one else" complained about the air pollution,
Then I begin to wonder, how much do you want to breathe
Is it as important to you, as Valet Parking?
Go find your car later, without much help
Or listen to your loved one, wheezing and barking.

Your Nurses too, are coughing
Like infected banshees, on the roam,
Where, in reality, they are suffering
From neighborhood households, burning loam,
And really folks, do you want
Your caregivers, coughing like deathrow survivors?,
Coming up from the deep-blue sea
Like gasping, deep-sea divers?

But night-time Engineer said
"Well, no one else complained",
I guess he's the wise man in the bunch;
Let's have him Ordained.

1-2-15

Some Data  regarding Smoke Air Pollution:

http://www.baaqmd.gov/Divisions/Communications-and-Outreach/Air-Quality-in-the-Bay-Area/Wood-Burning/Wood-Burning-Rule-Information.aspx

http://www.sparetheair.org/~/media/Files/Communications and Outreach/RedWoodSmoke.ashx?la=en

http://www.epa.gov/airquality/community/details/i-woodstoves_addl_info.html#activity2

http://www.cleanairplus.com/blog/activated-carbon-filters-air-purifiers.html

Our Engineers are in complete support, apparently.

Change is not Coming

Ever hear that old-timey platitude about change? One guy says, "Change comes from within". Another one says, "Become the change that you wish to see"......these are dudes who are not Nurses, working on the front lines of healthcare in the USA.............and you know what I'm talkin' about!

Fill out an A.D.O.
Oh, wouldn't that be grand,
If only I had the time
And maybe it was planned,
But when we are crushed
And fighting for our lives,
All we want is the end
And how soon it arrives.

Fill out an A.D.O.
It sounds great, when it's spoken,
And could it do any good?
Well, I think you're jokin',
Because this is a system wide
Decades long issue,
And Sister Euphemia
Just keeps handing out tissue.

Where can I find an A.D.O.?
It's on a shelf somewhere,
In the back of the break-room
Probably under a chair,
Will I fill it out?
There ain't a snowballs chance in Hell,
The facts will be ignored
Despite the stories we tell.

Because, this is more than local
It's health-care bureaucracy,
This is business, it's about money
A type of Theocracy,
With a God at the top
And she runs a tight ship,
Fill out an A.D.O.?
She'll give you a fat lip.

Fill out an A.D.O.
I can't hear you, La La La,
Union Reps claim they represent
And all that, sis-boom-bah,
No, I'd rather have the form
For an early retreat,
I need a mental health retirement
And everything sweet.

12/30/14

Too tired to think

20 years ago, I worked too much and didn't sleep enough and at the end of a work shift, I might have an addled brain. Now, I'm twenty years older working just 38 hours a week, out of the ICU, but the level of job stress is of an equal comparison. Near the end of a typical insanely busy shift, I sometimes have too many details bouncing around in my brain, like the balls in the Lottery machine. 

Circadian Calamity 

I've been known to brag

That I am infallible,

Master genius at work

Always present, ever callable,

But in the waning minutes

Of my twelve hour shift,

I'm more prone to forget

And suffer memory drift.

But I'm not alone

With this egghead fault,

A Harvard brainiac

Suffering memory halt,

Other nurses I work with

Who are half of my age,

Remark, they, as well

Lose an occasional page.

Eminent researchers

Call it Shift Work Sleep Disorder,

Decreased mental acuity

After crossing the Circadian border,

Key details and facts

Have undergone cancellations,

Call a "Memory Alert"

Block the doors, man the stations!

12-Hour-shift workers

Includes many variants,

Rotating work assignments

You could forget your under-pants,

When your mind gets so befuddled

Sleep deprived and wasted,

You feel like rotten turkey

Unfit to be tasted. 

A paper was written

Let me read it to you,

Keen observations

And a theory or two,

To correct memory drift

A recurrent event,

A simple 5-step approach

Time well spent.

The best thing I found

When my brain feels like crap,

Stop what I'm doing

Take a break, have a nap,

Find some darkness

Or simply, close my eyes,

And even if I don't sleep

I watch the starry skies,

Behind my closed eyelids

With the ringing in my ears,

I relax in that environment

My mind shifts gears,

Producing relaxation

A restful transformation,

Feeling better, I'll be

When I return to the station.

Sounds like a treatise

Delivered at the N.T.I.,

Where's the documentation?

My competitors cry,

If I don't show some proof

My claims are just fluff,

If my brain remains addled

I'll be shunned, and that's enough.

But will I remember?

Let's not presume,

I suffer memory drift

When I walk across the room,

And forget what I wanted

To do for Mr. Jones,

This Circadian calamity

It rattles my bones.

12/17/14

Terrorist Snot

I don't like coughing, sneezing, and so on..........on the job. Patients have their own problems, and I don't need to contribute to that. Every year about this time, I get my first Respiratory infection, and endure a week of feeling rotten. This year, it was a 2 week attack by Terrorist Snot. I earned enough points to score an Albuterol inhaler and 2 days of "voice rest".

Sufferin' succotash
This ailment won't leave me,
If it goes on much longer
You might have to bereave me,
Because I think it might be
One of those new-age bacteriums,
Cooked up in a lab
By some government mysteriums.

Perhaps I was chosen
At random, to be tested,
If that is the case, then
Someone should be arrested,
Because I have been sick
More days than I can measure,
And fourteen gallons of snot
Is not something I treasure.

Five nights I have coughed
For hours at a time,
And I don't just say that
To make a good rhyme,
I used antihistamines
Antitussives, anti-pain,
Still, I've coughed till my back hurts
A frickin' hacking muscle strain.

I am starting to suspect
This is a terrorist plot,
Bugs tickling my lungs
And the buckets of snot,
I am under attack
From the inside of me,
And I'm telling you, brother
It's impossible to flee.

Was it the Axis of Evil?
It’s too hard to tell,
When I’m launching green golf balls
And I’m feeling like hell,
At this juncture, who cares?
About the source of the sickness,
If the Grim Reaper wants me
He'll be here with a quickness.

Oh, miserable me
Cough-master, I be
My outcome is shrouded in doubt,
I might need a new lung
Because my Left one just flung
Through the door,  'cuz I just coughed it out.

It flopped on the floor
And now I'm feeling quite sore
Losing a Lung isn't easy,
But one thing I'll say
Things might be going my way,
Because now I am one-half as wheezy.

12/15/14

Complicit

It does no good to act like an a**hole, when the option is gratitude and collaboration. You poke your patients with sharp, pointy things, and we are assigned the duty of making sure they don't bleed. Sometimes, spontaneous hemorrhage occurs, and there is no way to prevent it, aside from paralyzing the guy for 5 hours.

Key Point:
Doctor, why not express a "Thank you", because we just saved the life of your patient. Take your nasty, grumpy attitude home and shoot it up with Vodka or something, Ok?

Doctor, dear doctor
Please, won't you calm down,
Blaming, shaming tactics
Make you look like a clown,
You're the leader of the pack
With this issue, you're complicit,
You lanced the artery
The cause of bleeding, more explicit.

I pulled out the catheter
And held pressure long enough,
Dressed the site, gave instruction
I did all the right stuff,
I checked the site often
Yes, everything was fine,
Two hours later, a leak!
Like gushing, bloody wine.

He came pretty close
To punching his ticket,
From our point of view
A bit of a sticky wicket,
A vasovagal episode
Blood pressure down to fifty,
Cut his heart rate in half
Fun to watch?; not so nifty.

Uncommon occurrence
Can happen any minute,
Billy-Jean blows an artery
Next, you're stepping in it,
With blood everywhere
On the bed, the wall
And the floor,
I said, "Holey moley!"
Grabbed a mop, what a chore.

Three nurses responded
Stopped the hemhorrhage, saved the dude,
And what did we get?
A grumpy-assed doctor, being rude,
Because he was complicit
In this bleeding event,
He should have thanked us profusely
Then gone home, to repent.

12/19/14

Way to Busy

Oh good grief! Another day of the same old sandwich.

Perhaps my perspective
Of imagined disaster,
Means I'm getting old
And no longer so much faster;

But still:

It seems like the funny stuff
Within the context of my job,
Has very little to do
With patient, Billy-Bob,
But more with situations
With my coworkers, and such,
Tired old nurses, that feel
Like a worn out clutch.

Unit Standard concepts
That don't make any frickin' sense,
We can't work as fast as they want
Even the highly trained dogs
Can't  jump that fence,
Yet, they will be the ones scrutinized
Held to the Policy intent,
And should we ever complain
They'll say we are exhibiting dissent.

I suffer intellectual overload
Some days I can barely function,
Quick; find me a Priest
Because I need Extreme Unction,
I am very nearly close
To the end of this frayed old rope,
Overwhelming nonsense
And I'm giving up hope,
In the course of this workday
Beneath this burden of need,
Oh, find me some Hemlock
To perform my final deed.

11/20/14

Mirrors and Tissues

The kitchen sink, the cyclone, and Godzilla all get thrown at us after 5pm.......

Mirrors and Tissues

Forgo the trip to Tacoland
It wasn’t very clearly planned,
Three wrong turns
From misdirection,
Stuff like this
Won’t pass inspection.

Perpetual
Understaffing issues,
Can’t be fixed
With mirrors and tissues,
High-fives!
Missing four good fingers,
The boss goes home
Our animosity lingers.

The beating goes on
Every day after five,
Sometimes I wonder
If we’ll get out alive.

12/4/14

Charades

Historically speaking, our new hospital addition required about 12 years to achieve, from an idea, a donation, a break-the-ground ceremonial shovel, knock down a school, move houses, find a place to put a new school, batter heads with local leaders............until finally, doors were opened 8 months ago. And yesterday, as I stumbled and traipsed throughout a meandering path of new destruction (while I sipped my Latte') out come this minor missive:

First came the years
Of ballyhooed construction,
Celebrated with pomp
And parades,
Now we must undergo
Years of destruction,
Exposing our Brand
Of dignified charades.

**
According to the article in the Business News Journal, the whole kit and caboodle, costs $170 million dollars!