Transition

Another ancient, unpublished one. The topic (death) is always a current issue, and how our industry and society deal with it.

Little Room for Hope

He suffered very long

From a well known rare disease

As he lay so still for many weeks and weeks,

There was little room for hope

And his family couldn’t cope

As his life ebbed slowly from a hundred leaks,

He had fifty different doctors

With a thousand interventions

Yet they couldn’t tame the nature of the beast,

His family suffered silently

To the depths of dark depression

Till their loved one packed his bags and headed east.

Now I know I’m very certain

That when it’s time to close the curtain

I wouldn’t want heroic measures for my mother,

Thus, the moral of this story

Is we gotta look at death

As a transition from just one place to another.

1995

Old writings, just as good

Every year, in the late Fall, I get back into sorting, collating, and supposedly, plan to publish. Today, I have sorted through about 100 old writings, and here is a good one for my pals in Neuro.

Lobotomize Me, Baby

Oh, Lobotomize me baby

I’ve got a mental pneumotension,

It’s a disease I never wanted

But it deserves an honorable mention,

I’ve got buzzing in my ears

Black spots before my eyes,

And now my doctor tells me

My cranium has flies,

They hatched from little larva

That were hiding in my brain,

Honey, please give me a sedative

Before I go insane.

1995

No Mo Thorax

No Belt Piece Prize

I had a pneumothorax

Yep, there it was,

Couldn't catch my breath,

It was because,

My pants here hanging

What a surprise,

That I had earned

The No Belt Piece Prize.

Of course, that is dumb

I blame my Uncle Mo,

He fell down on his chest

And he said, "No",

As in, "No mo thorax,

I didn't break a rib,

If you want to argue

You're outta my crib.

Leaving no more solutions

An Old Mo Thorax,

I suggest you clean it up

With good old Borax.

Legacy

Why my back hurts
On a daily basis,
Nothing to do with
Day off stasis,
No; here's a calculation
Regarding what I have lifted,
Mountains crumble
Tectonic plates have shifted,
But daily efforts
In hospital work,
Show a nurses' job
Is more taxing than a clerk.

I calculated
Thirty plus years,
How much weight
Would put you to tears,
On a year, those days
One hundred fifty and all,
Five hundred pounds
Per shift, not small.

And then, that is tallied
An enormous whole lot,
One fifty x thirty
Times five hundred and snot,
To a tune of two million
Two hundred fifty odd pounds,
Wrap your mind around that
And you will say, ZOUNDS!

That is one thousand
One hundred and twenty five tons,
A huge measure of hamburger
Tomatoes and buns,
Hauled from the farm
Way down in Modesto,
But I am not talking
Basil and pesto.

My spine discs are thinner
Scoliosis is worse,
But I am a Nurse
And that is our curse,
I'm not complaining
Just stating a fact,
If this was a stage play
I assure, it's the last act.

Yet, we soldier on
Like other service members,
Standing tall for all of those
Who missed their Septembers
Knowing they would have
Fought on like we do,
When the job is your legacy
Describing me, defining you.

Narcan Nonsense

I read an article recently that looked at one of the issues involved with overdose of narcotics; that being, premature death. At this writing, there is definitely a major problem in the USA (and the world) regarding the excessive use of analgesic substances. The author postulated that if persons known to be users of narcotics were given take-home Naloxone (Narcan) when they left the Emergency Room, this action might reduce unintentional death. To me, this seems like nonsense.

It is one thing to encourage people who are allergic to stuff like peanut butter, bee stings, and melon, to have on hand an Epinephrine injector, which can help to counteract anaphylaxis. In general, people who know about their allergy, logically and actively, attempt to avoid the substance they are sensitive to.

In contrast, when considering a narcotic overdose, we are talking about people who are intentional users. Whether they are addicted or not, is not the point; it is an illogical solution. First of all, who is going to administer it? Imagine, I’ve just taken a little too much Oxycontin, and drifted off to a pleasant dreamy state; am I going to wake up and say, “Gosh, I think I have overdosed…….where in the heck is my Narcan nasal spray?” Second, if I am addicted to narcotics, and I have an antidote on hand, perhaps I will be thinking that I can get away with taking an extra pill or two, because I have an antidote in the kitchen. Narcan, and most other antagonist / antidotes, are best left in the trained hands of health professionals.

Would the author also propose that every person who is prescribed a beta-blocker, be given Glucagon for home use, in case of overdose? Should we offer Praxbind for every user of Pradaxa, or Digibind, for those Digoxin prescribers? Of course not!

The answer is education, not medication. Whether one is addicted to something, or merely needs to take some kind of life-saving chemical, there always exists the chance of overdose. But to hand out an antidote, to every bloke out there, is just nonsense; in this case, Narcan Nonsense.

Narcan in the bathroom
For every woman and man,
Addicted to opiods
Some think, that's a plan,
For the avoidance of death
Regarding drug overdose,
Is this a sound solution?
It doesn't even come close.

Now, suppose you have an allergy
To peanut butter or a bee sting,
You actively avoid
Ever getting near this thing,
And it makes good sense
To carry an Epipen,
For that rare, but deadly exposure
You'll need an antidote then.

Contrast, the narco addiction
Some like to call it a disease,
Brain chemistry screwed up
You have pain when you sneeze,
Or a hundred different reasons
Intentional or not,
Keep the antidote on hand?
You've been smoking too much Pot.

I take a couple pills
To regulate my heart,
If I take too much
The rhythm comes apart,
Why shouldn’t I
Have some antidote?
A sensible doctor
Would never cast that vote;
Because………
The average consumer
Doesn’t know jack,
About overdose
Or heart attack,
Can barely administer
A basic eye drop,
Gets confused
When ordering at IHOP.

Too many ways
To get it wrong,
Handing out antidotes
To the public throng,
The better alternative
Is the medical approach,
Emergency responders
In the Paramedic coach.

Power Outage

When the hot topic word is "transparency" in respect to how businesses operate in the local and greater community, it is odd when an organization manages to achieve local media silence.

When Ebola showed up

Man, we got in the news,

To prove to the world

We were the place, check the views,

How we offer the best 

That branding can buy,

With moon-suits and bleach

And some good looking guy.

when the power shut down

there was nary a peep,

like the public image guys

were in a deep sleep,

and the local news outlets

ho-hummed during brunch,

but if it happened at the Arena

Friend, I have a hunch.......

That 32 Journalists

From every news station,

Would be salivating

To perform an oration,

How they got the news first

Because that's how they brag,

If you are second or third, baby

You're in a wet paper bag,

Fighting it out

To get a pink-slip warning,

To be the best reporter

You start at four in the morning.

How does a business

Suppress news in a community,

As if writing their own rules

With benevolent impunity,

We're a non-profit they say

The good of humanity, is our cupcake,

But really, if the power goes out

Isn't there more at stake?

Pretend your Momma needs a surgery

And the doctors use power tools, right?

Did they tell anyone

Why the power went out that night?

Was it shared with the public

Like the "whale shark rescue"commercial?

Quite frankly, there was a blatant silence

I know that doesn't play as well as an infomercial.

If the public was aware

Regarding the little foibles 

Of operating an old hospital facility,

If they knew about all of the steps taken

How we repair, replace and engineer with agility,

Perhaps there would be a shared

Sense of ownership and pride,

How ye olde neighborhood hospital

Was in it, for the long community ride.

But, since Big Brother took over

Millions are spent on the brand,

It's about acquisitions 

And how they expand,

To co-partner, and outsource

And run a very tight and lean ship,

While big Captain Bobolink

Has a tight grip on his gold plated whip.

Media silence

In this environment of corporate transparency,

Is clearly an outright

Anachronistic aberrancy,

When you are advertising and branding

Regarding all those touchy feely good deeds,

You better tell the public all about

The power outage, leaky pipes, the blown boiler,

And the weeds.

High Speed Train to Heaven

In general, in the year of Our Trump of 2017, modern children at age 8, are pretty much past the fairy-tale believing stage; unless of course, there is some heavy duty homey religion going on.

Grandpa's going to Jesus
That's what Auntie said,
To eight year old Jeffrey
If Grandpa gets dead,
She continued on further
Five minutes or more,
But his ears had shut down
Like a hard slamming door.

I was over in the corner
Trapped, I did feel,
It might be rude if I split
In the midst of her spiel,
Telling such a grand story
That rivalled the Brothers Grimm,
I wondered, should I clap
Or launch into a hymn?

This eight year old Jeffrey
Was wise and mature,
He seemed to understand death
Though he wasn't too sure,
If Grandpa was just resting
Would he rally in the morning?
When nothing more can be done
In of itself, that's the warning.

Jeffreys attention
Sparked brightly when I spoke,
Regarding all the machines
Without the fire and smoke,
Or the legions of angels
On the head of a pin,
I just talked about Grandpa
And the state he was in.

Maybe he'll get better?
Well, Auntie mentioned a miracle,
Indeed, that would be so
Beyond anything empirical,
Because total organ failure
Leaves little to the imagination,
Yes, his high-speed train to heaven
May have already, left the station.

Powerdown

If you work in a facility, that had its beginnings 80+ years ago, you know for sure, there's a bunch of old infrastructure, that has not yet been updated. The guys just can't get to it, because all the high tech stuff needs all the attention (to keep the dollars coming in). We all have been informed, that if there is a "brief" interruption in electricity, the generators will automatically cycle, and there will be power available at the red power outlets. But what if the generators, don't get the message?


We lost power
Just the other night,
Think, old-building blues
And lordy, what a fright,
Because for 10 long minutes
We had no juice,
Some kind of circuit breaker
Had busted loose.

But that's not all
It was really worse,
The emergency red plugs
Felt the curse,
And that shouldn't happen
Because generator power,
Should automatically trigger
For a minute, or an hour.

Meaning, that old circuit
Was isolated, dear friend,
The generators didn't know
There was no power at our end,
And when it returned
Without any intervention,
The engineers couldn't find
The cause of disconnection.

Well, that was cool
Just a little fluke,
No one knew why
If they had, they would puke,
Because three days later
The system REALLY crashed,
Five hours without power
New records were smashed.

A hospital without power
None to be found,
All kinds of devices
Fall to the ground,
Really important things
Rely on electricity,
The lack thereof
Causes spasticity.

All the bosses came running
Who run the joint,
Offering solutions
Wondering where to point,
Knowing that the blame
Would soon need a home,
Why everyone started
Shining their chrome.

One of the geniuses
Posed this opinion,
Let's fixed it with something
Right here in our dominion,
Replace that ancient breaker
With that old one in the box,
Bought back in the days
Of wind up clocks.

Yep, saving every nickel
Down at ground zero,
Make the cheapest suggestion
And you'll be the hero,
Don't look to the future
Make the easy fix now,
It's sure to work for a while
If it doesn't, disavow.

Good thing our Engineers
Are wiser than most,
Ask them, "How smart?"
And surely they will boast,
But still, in the end
They know redundancy rules,
Buy the biggest damn breaker
A whole box of them, fools!

The Gift of Giving

Be a bedside nurse long enough, and you too, will experience the gift of giving. That special patient who loves to share some precious body fluids with anyone dumb enough to come into close proximity. Be warned and be ready, kids.

I saved my BM
Just for you,
I bestow such gifts
Where gifts are due,
Because you are such
A kind caregiver,
I included a chunk
Of my dead liver.

I saved some vomit
For my best nurse,
A sweet memento
She can carry in her purse,
And as a bonus
An awesome booger,
On the lunch tray
With a packet of sugar.

I'm holding some sputum
For Dr. Astute,
When he gets near
I'll spray it on his suit,
His ten thousand dollar
Jacket from Brooks,
Just to see his precious
Hateful looks.

Yep, I am a gifter
I do it, because I care,
If you'll come a little closer
I'd love to touch your hair,
Just after I've scratched
That pustule on my arm,
A special gift for you
It's just part of my charm.

Power Break

I've worked in healthcare for 38 years now (RT & RN), and all the same dynamics are at play. Sure, technology changed, policy's and procedures were revised, diseases are better understood, and workplace interactions have improved between disciplines. What is still present, are all of the tricky interpersonal, colleague to colleague interactions. The foremost question (and answer) one needs to have in their head at all times, is; "Who do I trust?"

Lazy Nurse 16
Claims, he didn’t get a break,
When I asked the dude
He gave his a head a shake,
Seemingly saying, he had it covered
Then I’m called on the carpet
When Charge Nurse discovered,
That Lazy Nurse 16
Stated he worked all night,
Unable to stop
No one noticed his blight,
How he worked his butt off
(Except for that hour);
When I saw him on his cell phone
Attending to a higher power.

Gender Revenge

The latest news regarding Zika and mice:
"Not only did male mice infected with the Zika virus have a tougher time getting females pregnant, their levels of sex hormones crashed, and their testicles shrunk by 90%, possibly permanently".

At last, women may have their "fight back" solution, for those guys slipping GHB into their drink: just place a little Zika Dust into his drink!

Ladies, take note:
Here is your answer to the date-rape drug,
Spike the drink of your paramour
Give his testicles a proverbial slug!
Ya, see how he likes it
When he can't get it up forever more,
With the powdered dust of Zika
His romantic endeavors will be a real chore.

Dental Dana 53

Dental Dana
She's that one,
Over there in the corner
Looking dangerously fun,
The hottest hygienist
In the Dental suite,
All buttered up
Looking good enough to eat.

She looks so yummy
So gentle and placid,
But Dental Dana
Is more dangerous than acid,
She could pulverize a crown
With her nitrogen tapper,
Then catch you on the rebound
With her ultrasonic zapper.

Just play it safe
Relax and cruise,
Remember, she's crafty
And there’s a lot you could lose,
Like thirty-two teeth
Your gums and tongue,
Sliced in little pieces
And dropped in a lung.

If you get too distracted
By her tight fitting slacks,
Ask for some nitrous
To help you relax,
Or maybe something more
Some light anesthesia,
Just for you, they reserve
The milk of amnesia.

Remember, my friend
You could be easily whacked,
Do whatever it takes
To leave that office intact.

Paging the Swami

A post script to the Meth poem of two days ago.

His cardiac arrest
Took forty years off his life,
Now he's babbling like a six year old
To his mother and his wife,
At three a.m. he calls out
Will you please call my Mommy,
I respond, "Right away dude
and then I'll page the Swami".

Instantly anxious
Panicked and wheezing,
Grabbing and thrashing
I know he's not teasing,
While gasping for air
He then holds his breath,
His pulse goes way down
Turning purple, like death.

It's a two nurse dilemma
Handling this guy,
Just a couple days ago
He used meth and did die,
Revived, yes he was
But some brain cells are gone,
And quite frankly, I'm thinking
He is destined for the lawn.

Funny, but best unreported

Oh, how we love to laugh at humorous animal anecdotes; cute puppies, silly cats and romping rhino's. There are times when the our patient-population, seem to mimic those animal antics, and yet, if I say that Billy-Bob looks like a pig thrashing about in a muddy pigpen, that would likely cause offense.

Last night, changing the linen for Betty Lou, was akin to oil-wrestling with a semi-sedate wild boar. Now imagine, two somewhat elderly nurses (guys), attempting to accomplish this. Frankly, even at this moment 8 hours later, I am nearly collapsed on the floor, laughing at myself and Popeye my stalwart companion.

Things that we laugh at
On You Tube, for example,
Or those family shows
With photos to sample,
We laugh and we snicker
When Bobby falls in the trap,
Especially if it was filled
With Elephant crap.

Why do we laugh?
Because it happened to them,
Yes, anecdotal humor
Is really a gem,
We laugh while we're thinking
Thank god, that wasn't me,
While Bobby played in that crap
I was up in a tree.

Things that we laugh at
The misfortunes of others,
Jokes about everything
Even our Mothers,
We can use social media
And upload anytime,
All of us can laugh at you
Oh, isn't that sublime?

Marijuana, Meth and Myocardial Mayhem

I've discussed how at least 50% of all admissions to the Medical ICU test positive for Amphetamine. Sure, that is just a simple estimated, bystander, non-statistical guess. (that's my disclaimer, as an unqualified statistician).

But next door in the Cardiac ICU, we are seeing the same thing; the myopathies and the acute heart attacks, who also are Meth users. Henceforth, another completely avoidable disaster, Mr. Public!

The morning after
The night before,
There is writing to be done
A compulsive chore,
Ideas to expel
And words to sort,
About the cardiac arrest
Of Uncle Mort.

He's forty six
And overweight,
Marijuana and tobacco
Are on his plate,
With an after dinner chaser
Of public menace Meth,
Caused his heart attack
And imminent death.

Heck, everyone has seen
"The Faces of Meth",
If I looked like that
I would gladly embrace death,
But no one comprehends
The toxic stimulant power,
How Meth causes heart attacks
Every minute, every hour.

Good old, Uncle Mort
A sweet dude, he was,
Why did he do that stuff?
He said, because,
His life, was so damn boring
Working at the DMV,
Living in ugly suburbia
Without a single tree,
This altered reality
Destroyed all of his resistance,
Marijuana and meth
Validated his existence.

For years;
Doctors and family
Told him what to do,
Take your medicines, Uncle Mort
You'll live longer, we love you,
Kick your bad habits to the curb
Lose some weight, get exercise,
Well, Uncle Mort fell off the wagon
And it's no surprise,
Because good clean living
Is stupid boring, not fun,
While marijuana and meth
Are like facing a loaded gun,
With danger and drama
Mystery and intrigue,
Yep, it's way more exciting
Than the PTA league.

Uncle Mort had chest pain
Someone called 9-1-1,
He had a V-Fib arrest
Life support, was thoroughly done,
Got a stent to an artery
Saved his family, from mourning,
Ya, Uncle Mort, dodged a bullet........
May this be his last warning.

Dental Dana Vol II

I thought I was all done, excommunicated, exited, and never to be exhumed........but Dental Dana asked for another volume of randy, rabid, romps of hygienic nonsense.

Dental Dana 51

Dental Dana
She's so nifty,
I thought she was done
At chapter fifty,
But now I'm writing
Fifty-one,
No, Dental Dana
Isn't done.

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

Dental Dana 52

Dental Dana
Is so damned cute,
But you better duck
If she says, shoot,
Because more than likely
She has taken aim,
You've been naughty
Will be her claim.

Dental Dana
Let her do her job,
Scrape your plaque
Till your gums do throb,
Say please and thanks
You know the drill,
For the pain of pleasure
Just pay the bill.

10/7/16

Dead is not gone

I have covered this topic in 42 different ways over the years, and I am still astounded by the actions of loving families, who refuse to let their loved ones go on to heaven. Often their religious beliefs are at the bottom of this (definitely not the top). This is an old poem (2008), slightly edited.

The Work of Jesus

I'm ever more astonished

At the work, Jesus is expected to do, 

Forecasting that he will heal 

When really, death is due.

Take this patient in the corner

As example number one,

Her heart, her lungs and kidneys

Were very nearly done,

When a cardiac arrest

Knocked her to the floor,

Giving her tired soul a chance

To slip right out the door.

She had CPR

For well beyond an hour, 

Where the medical team performed 

Everything within their power, 

But they finally reached consensus 

That there was nothing more to do,

When lo and behold, her heartbeat

Went from straight-line to forty-two.

Now she’s grazing in our unit

Life-supported to the nines,

Seven vasopressors

And thirteen central lines,

An ET tube, an NG sump

And the Foley-Temp-Deluxe,

And while it seems we're doing everything

She's a DNR, oh shucks.

We finally get to Jesus

His role in this whole caper,

The family expects a miracle

According to the paper,

Written by some disciple

Two centuries post-resurrection,

How Jesus will raise the dead again

Like some cosmic lottery selection.

There are just too many people

Who need that Lazarus link,

Jesus can't heal every one

So do not even think,

That your sweet old Aunt Jemima

Is on the Jesus list today,

She tried to depart a week ago

Till epinephrine, made her stay.

The truth regarding dear old auntie

Is that she'll never get restarted,

Her body is here, and her brain is dead

While her soul has already departed,

The resident of this ICU bed

Could be likened to an empty shell,

Auntie is firmly ensconced in heaven

While her body remains here in Hell.

Technical Difficulties

Please wait, we are experiencing technical difficulties...........we've all done it at sometime or another. Accidentally did the one thing, and it caused the other thing. Solve the problem, and you're a better engineer.

I almost sent her soul
Down heavens fairway,
After I stopped
To clean her airway,
Just a little faux pas
With the suction device,
An improper position
Well, she almost paid the price.

Assessment and decision
I'm fast on my feet,
Troubleshooting with friends
At the bedside we meet,
Setting Oxygen on blast
Via bag-valve-connection,
Returned her to baseline
On final inspection.

Refreshed my memory
Old knowledge relearned,
Like Shakespeare once said
The worm has turned.

Decay and Denial

Here's a dark one.........Most folks don't recognize the amazing resilience of their bodies to counteract the battles we wage upon ourselves. I've met thousands of folks who thought they dodged the bullet of disease, cuz they smoked and drank and shot up drugs and it never seemed to harm them. And then, at age 51, BAM........collapse and misery.

In the morning
After the dream,
I remember
Last nights scream,
Or was it a moan
I am not really sure,
When we told Betty
There wasn't a cure.

There is no escaping
Our final day,
For eons we've tried
To prevent our decay,
But just the smallest peek
At our everyday behavior,
Well, it's a giant billboard
Regarding who is your savior.

Fast food for Freddie
And whisky for Willie,
Barbaric religions
With practices so silly,
And then there's the Meth
The Cocaine and shrooms,
We're all tangled up
In our lifestyle looms.

Our happy interventions
Do not prolong life,
And now it's too late
To save Betty, your wife,
She thought that her Camels
Unfiltered and rich,
Would never deliver her
Into the ditch.........
After all, there never was a cough
She could climb a mountain like a goat,
Until the cancer filled in
And plugged up her throat,
Too late for a cure
Now she's miserable and blue,
Take a look in the mirror
It could happen to you.

Cautious Ending

Time and time again, I've seen it; Ms. or Mr. Nurse counting down the last few days till they pull the plug, open the door and escape to retirement. These are the last moments for things to get dicey.........

Approaching the end
The setting of the sun,
Just 19 more shifts
And then she'll be done,
But I say, use caution
Be extremely wary,
On any given night
Things can get hairy.

Yes, anything could happen
On one of those nights,
A whacked out meth user
Knocking out your lights,
Drug addled Billy-Bob
Ramped up and squirrelly,
Ending your career
16 days early.

My worst experience
I was kicked in the head,
I had a concussion
Lo, I could have been dead,
Or the time that Barry slugged me
And Mort threatened death,
All those things happened
In the time of one breath.

Be cautious, old nurses
Don't get too frisky,
Take care of the comatose
Where violence is less risky,
Maybe, fake an illness
Or sit on a Jury,
As your days are counting down
Don't be in a hurry,
Protect your retirement
Whatever it takes,
Just a few days left
Are you getting the shakes?

Non-Compliant Croatian

Hypertension: It is so hard to convince folks the importance of taking their meds, and to talk to their doctor, if they would like to stop. No, the wrong way is usually the chosen way; just stop taking your pills because you feel funny, or maybe your BP is under control and you think the problem has gone away. Whatever; there is a life-threatening crisis hovering on the event horizon.

Once upon a time, two people stopped taking their meds. One thought she was cured by Jesus, the other didn't like the way the pills made her feel. The first one blew out her Aorta, the 2nd one had a massive M.I.

Risky business, that's what it is.

Non-compliant
Stopped her medication,
She said, "My pressure is fine"
A major violation,
With malignant hypertension
Obesity and heart disease,
Her aorta is ripping
Her family prays, Jesus please!

When she needed bypass surgery
Jesus found her the doctor,
With Pulmonary emboli?
Jesus was the Proctor,
And by golly, I'm thinking
Jesus blessed her medications,
Then the Devil, slyly told her
"You don't need meds, you're Croatian!"

One week ago she stopped
Taking any of her pills,
She must have figured that Jesus
Had cured all of her ills,
That her blood pressure was fine
When she took a walk this morning,
But her pressure was sky high
Her Aorta ripped without warning.

Now Jesus is standing
Over there, in the corner,
Nibbling his pie
Like little Jack Horner,
Pondering the failings
Of this member of his flock,
This non-compliant Croatian
May have taken her last walk.

9/18/16

Street Racing Remains

Young Jake revs
The engine with pride,
Hot burping exhaust
Let's go for a ride,
And do a little racing
At the stoplight on 2nd,
Fate and the Grim Reaper;
They must have beckoned.

From zero to sixty
And sixty to zero,
Don't get out of your car
You're not a hero,
No need to brag
That you were the one,
Racing down Broadway
Boys doing fun.

Now, maybe your Lambo
Does an easy one-eighty,
And you've got your eye on
Some sexy young lady,
You're trying to impress
With bravado, not brains,
While the audience expects
Your bloody remains,
Spread on the pavement
The tree and the wall,
As that pretty young woman
Stands poised with a shawl,
To cover your splatter
And sob at your wake,
Just boys having fun
Then it's over, young Jake.

Yes, everyone loves
A spectacular crash,
That's why we crave speed
Blowing smoke, acting brash,
But we like it best
With the front row view,
We were close to the edge
But it happened to you.

Talking in my sleep

I work odd hours now; from midnight to 0600. One of the ways I stay awake during the drive home, is to dictate stream of consciousness rhyming into a voice recorder. I have been using the method for years with great success. There I'll be sitting in traffic having a lovely conversation with myself.

Hammer Head

Just in case
I get inspired,
Even tho
I'm kind of tired,
On this 20 minute
Drive back home,
I'm often inspired
To dictate a poem.

Assembling words
As thoughts drop in,
Whispering tales
Of misery and sin,
Stories that are filled with
Disease and discord,
And all of those things
That people afford.

Stuff that is healthy
More, that is not,
Eventually discovering
Their body is shot,
And at the end of it all
They pull into the marina,
Singing songs of misery
Like a spotted hyena.

They want food in their belly
And drugs for their pain,
Warm blankets and tea
And a hot nurse from Spain,
We do our best
To bring you back from the dead,
But don't grab at Betty
Cuz she'll hammer your head

Pass the Test

I have been an Instructor and tutor of basic EKG / Cardiac Monitoring for 13 years. Our classes comprise quite a cross section of students. There are Nurses, some fresh and some having worked a number of years already, plus EMT / Paramedic students. Occasionally we have non-medical persons that work in some other hospital department, thinking of attending Nursing school, or considering being a Monitor Technician. Every year we have about 400 attendees, and a very high success rate. The class provides the student with a certificate of Basic Cardiac Monitoring, which may be a requirement at their job.
Most important, as simple and basic that it might appear on the surface, this class is not easy.

Pass the Test

Didn't pass the test?
You thought it was, too simple,
You gave it less attention
Than a recent forehead pimple,
Or maybe, you got busy
Then fell back to reason 1,
You thought this class was easy
Until your test was done.

Blame it on your study habits
Or blame it on the devil,
But this time, do your duties
If you wish to pass this level,
Then return again next week
You must repeat the test,
Don't squander your last chance
Just do your very best.
--  --  --  --  --  --  --

Here is a link to the programs offered:
http://continuingeducationconsortium.org/

A Bad Batch of Heroin

The poem tells the story, the news outlets write the nonsense.

A "bad batch of Heroin"
What a description,
"The overdoses have victimized men and women of all ages"
That is the depiction,
But I contend, they victimized themselves
Choosing Heroin, over what is good,
All heroin is bad
Let's label it, as we should.

Journalists and News outlets
Please do not pander to these kind of terms,
Heroin is heroin
No matter how many worms,
Have been used to dilute
Or to up-tox the solution,
There is no "good" heroin
Just as Coke and Meth, are deadly pollution.

We heard about this two years ago
The "bad heroin" that was killing folks,
Last year it was the disguised Fentanyl
Drug dealers, love these kind of jokes,
Although, killing off the users
Normally, would be a poor business model,
Maybe, they ought to shift the delivery mechanism
And brew it for the bottle.

Regarding the recent explosion
Of breweries, all over the land,
Why not slip a little bit of heroin
Into that ice-cold aluminum can?
Just like the legalization of marijuana
Why not blend heroin into that mix,
Just name it Red Dog Explosion
And sell it for a buck sixty six,
Pass the sales tax along to the bean counters
They won't bother to ask why,
No one will say that heroin is bad
When the money rolls in, by the by.

A "bad batch of Heroin"
What a great story,
Let's tax all that stuff
And sing Morning Glory,
Down at Reverend Joe's church
On April eleven,
Consumers will be so happy
They will think they're in heaven.

9/10/16

Self Harm

The next poem might seem
Depressing and mean,
But I can't deny
All the things that I've seen,
Over and over
On a daily basis,
The human miserable condition
Is often in stasis.

I'm not talking about
Birth defects,
Nor discussing
Society rejects,
I'm merely posing
Personal choices,
Meth, coke and smack
Not Ferrari Rolls-Royces.

Nobody force fed
The addicted user,
He looks in the mirror
And sees his accuser,
Now we paste together
The shreds of bad health,
Wasting the resources
Of our society wealth.

The typical user
Started young, immature,
Regarding any repercussions
Abstract thinking, obscure,
Just fun for the moment
They'd never bite the hook,
Instead, they become a subject
In the drug abuse book.

Yes, we're patching them up
Over and again,
This 37 year old amputee
Reminisces about when,
He was young, strong and sexy
A babe on each arm,
Now, his life is pure misery
From his own self-harm.

Every Day Occurence

Life sure was easier when all we had were Alcohol and Heroin abusers.

Maniac

Losing my foot

After fingers and toes,

I put too much Cocaine

Up my nose,

Then I moved on

To crystal Meth,

Now I'm flirting

With sister Death.

Another thing

My kidney's are shot,

I get hemodialysis

Piping hot,

My mouth is full of Herpes

I know it looks bad,

But this is my life

So don't feel sad.

I would gladly do it all

Over again,

Nothing feels so good

As Meth in a pen,

Shooting up my veins

Until they were all gone,

Then having a seizure

On Billy-Bobs lawn.

I'm a regular visitor

At your medical center,

I've got Medi-cal

So, I'm a destitute renter,

Sucking up resources

I'm unrepairable,

And I do my best

To be unbearable.

Spit at my nurses

Call them bad names,

Those are a couple

Of my favorite games,

Crap in my bed

And smear it on the rails,

Scratch Betty Lou

It's under my nails.

Act like a maniac

What else can I do?

I did this to myself

And I hate you.

I will survive

And go back to my hole,

I'll return in a month

Because that's my role,

After snorting some Meth

With ketoacidosis,

In complete Liver failure

My new diagnosis.

9/8/16

That Rhythm Again

If you read this blog, you might think that I am an officer of the KGB Rhythm Analysis group, always spying and prying into the lives of those who mis-label ECG rhythm strips. The truth is out there; this is my crusade!

That rhythm again
Fools them every time,
Prompting me
To write this rhyme,
Regarding Atrial Flutter
And Atrial Tach,
Those ectopic impulses
Doubling back,
Fooling the reader
Of the EKG’s,
They think it is Sinus
If they don’t count the P’s.

That rhythm again
Improperly read,
I told Betty Lou
But she wrote Sinus, instead,
So she didn’t tell the doctor
But what can I do?
I’m just the break-nurse
Sharing an expert view.

That rhythm again
Everybody should know it,
With proper treatment
We hope to slow it,
But that won’t happen
If it isn’t read right,
As it happened again
Just the other night.

9/8/16

Algorhythms

Here at Sister Euphemia's place (and perhaps your joint too), we are forced to participate in an employee training and education package called, "My Journey". The name alone makes me want to hurl, because it reminds me of all the "iSomething" naming of things in the future-of-now, Apple iPod-isms. We've gone from "i" to "my". It is totally pathetic. Anyway, this rant is about more superior-sounding lingo jingo, in the renaming of the same old concepts. Just say to yourself, Body Handling Algorhythm; I had to read all about it last night as I was traversing My Journey, for my annual body mechanics reeducation. Hospitals and other entities, think that if they just educate us about protecting our backs, then that will save us from debilitating injuries in the future. Sure, there is some sense to that, but you and I know, what is killing us is the fact that 70% of our clients are now morbidly obese, and half of our Nurses are over the age of 45. We are already injured (and somehow still working)... and that's the other rant I'm always harping on.

Anyway, back to the topic of Jargon.

Body Handling Algorhythms

Old methods, by a newer name,

Quasi superior importance

In the technical jargon game,

21^st century scholars

Doing rewrites on concepts and theories,

To appeal to a new younger audience

Repackaged as classes in series.

Knowledge expands

As new stuff is discovered,

Old stapled handouts

Are bound up and covered,

Add a couple fresh ideas

Publish, package and sell,

Force the workers to read it

Or consider leaving the cartel.

8/30/16

Hypoxic U-Toxic

At our Medical ICU at least 75% of admissions are designated as suffering from Sepsis. One of the issues; 50% of those will have a Toxicology screen showing evidence of Methamphetamine, with some easy going THC (marijuana). I guess the two of those, are the Yin-yang of the local street-drug supply. The end result, is that the dude's daily substance abuse issues, will severely impact the care delivered, and outcome of survival.

Hypoxic psychosis
Is the cause
Of his neurosis,
Hypercapnic
Overweight and fifty,
Says, he doesn't like C-PAP
Isn't that nifty?

Somnolent, unresponsive
In the Lazy-boy chair,
The wife can't awaken him
Get the Paramedics there,
Haul him to the hospital
On the megaton rig,
Sometimes the ambulance
Isn't even that big.

Now, it's up to us to save him
Then do it over, in six weeks,
He won't wear the C-PAP
'Cuz it blows up his cheeks,
And dries out his eyes;
Claims he can't sleep,
More likely it's the "Meth";
Is the logical leap.

His U-tox is positive
At every admission,
Methamphetamine and opiates
Affecting his cognition,
Morbidly obese
Untreated hypertension,
Weight, one-eighty kilo's
An honorable mention.

He will cuss at the doctors
And fight with the nurses,
His wife will give the stink-eye
While mumbling gypsy curses,
Then finally, when his brain clears
He pulls the breathing tube out,
Escapes the ICU;
He'll return, there is no doubt.

Uh oh, what's that on the X-ray?

No, this is not something that recently happened at work. However, the facts are out there; tools are sometimes (rarely) left behind in a surgical wound, and folks definitely do swallow ridiculous items.

Oh, someone left scissors
In Billy-Bob's gut,
They thought at the time
It will pass from his butt,
And about three weeks later
As they waited to collect them,
Scissors and a Rolex
Passed out of his rectum.

Have stranger things happened?
Oh, undoubtedly so,
Folks swallow strange things
To impress their new beau,
Like bedsprings and batteries
And cigarette lighters,
Cell-phones and coins
After drinking all-nighters,
Only to wonder
About a ringing in her gut,
She says, "I'll answer it later"
When it exits my butt.

One might consider this
The original sin,
Be it surgery, or stupidity
Be careful what goes in,
And use caution, young fellow
On the potty, don't push,
'Cuz, if you swallowed razor blades
They will slice-up your tush.

Out of Whack

On May 30th, I wrote about an instance where a Cardiac Rhythm was misinterpreted by an EKG machine, and then also, a variety of healthcare workers.
Well, it happened again, in a very similar way.

Admitted late
Ten o'clock at night,
Misinterpreted heart rhythm
Oh, what a fright,
The Cardiologist nailed it
The next day, what I'm saying,
An Atrial tachycardia
With 2:1 playing.

All nurses
Called it Sinus Tach,
But they were totally
Out of whack,
This guy
With chronic Atrial Fib,
To have Sinus Tach
Doth tickle a rib,
And a regular fixed rate
Right around one-twenty,
Screams A. Tach with block
Good and plenty.

When it finally became irregular
The nurse called it A.Fib,
Then phoned the doctor
To tickle his rib,
I proposed it was never
Not ever Sinus tach,
Whatever you were calling it
Was totally whack.

Finally, on day three
After adding beta blocker,
His rate slowed down
Atrial flutter, no shocker,
Looking exactly
Like his rhythm, 3 months back,
Had they looked at that EKG
No one would call it, Sinus Tach.

Grief

Despite the fact that many of us have been present at the death of hospital patient's (100++) , it is never anything like the loss of someone we know, or feel close to.

It is hard to express, because really, words are inadequate.

Grief

An aura of grief
Is surrounding you,
Please know, we care
And pray for healing,
We feel loss
And sadness too,
'Tis, but a shadow
Of what you're feeling.

Old Job

Four months have passed since switching the job and the hospital; I needed that much time to cool off. However, I had made it known when I left, that I might be available in the future to work some extra hours, if requested. A week ago I worked an extra 10-hour shift, and as Yogi Berra said, "It's deja vu all over again". (http://yogiberramuseum.org/just-for-fun/yogisms/).

Yep, we got crushed after 5:30 PM, because 55% of the staff went home, leaving 3 of us to thrash about. Incidentally, when I arrived at 12:30, I took over the Cardioversion patient, where I needed to administer Ibutilide (his rhythm did not convert, so he still required a shock). Then, at 1430, the patient who had undergone V.Tach (epicardial) Ablation, general anesthesia with severe sleep apnea, had in-dwelling Arterial and 2 venous sheaths in his bilateral groins; arrived, barely arousable and exhibiting guppy-breathing. Twenty minutes later, he required STAT re-intubation, and immediate delivery to the CSICU!
Yep, we were off to the races.

I returned
To the scene of the crime,
To work a rescue shift
And earn an extra dime,
My old-world job
At the mother house, mister,
I felt like
The prodigal sister.

I established some ground rules
I will only work with Ell,
She can protect me
When the scene goes to hell,
In the usual fashion
Every day after five,
Only time would tell
If we got out alive.

A close call, it was
'Twas a ten hour flog,
I felt like I was beaten
With a crusty oak log,
And at the end of our tour
At twenty-three thirty,
The two of us felt
Pummeled and dirty.

This experience affirmed
Why I left the dollar store,
I need a low-stress venue
To complete my final chore,
Working for the family
An assistant supporting role,
Make it out of this alive
Preserving sanity and soul.

Skin Deep

In lieu of the fact that I have another Dermatology appointment tomorrow (after working tonight I will have tired skin), I wrote #5 in the Skin series.

Skin Deep

What they say is

Beauty is only skin deep,

Some spend thousands of dollars

And lose a fair amount of sleep,

Attempting to keep it perfect

Thinking, it’s part of my charm,

The pills, potions and treatment

Often causing much harm.

All Dr. K, ever says

Is protect from the Sun,

When you’re playing outdoors

In the midst of your fun,

Slather on sunscreen

So you look something like Crisco,

You will fit right in

Visiting San Francisco.

7/11/16

Bloody Smell

Revisiting an ancient theme
I encountered a smell
That made me scream,
Despite the absence
I do not need,
To be reacquainted
With the G.I. bleed.

I previously
Pointed out,
How an odor like this
Is bad for one's snout,
On a scale of one hundred
It's two hundred and nine,
Sending putrid odors
Up and down my spine,
And frankly, folks
It should be unlawful,
'Cuz the bloody smell
Is frickin' awful.

Mark-5

Little preamble required on this one, as the majority of us Nurses had to deal with this somewhere in our careers (with an emphasis on rears)!

With a rapid ejection
From his butt,
He expelled all the contents
Of his massive gut,
Like a Mark-5 torpedo
At a high rate of speed,
Then he turned to his Nurse and said
"Isn't it time for me to feed?"

Skin Wager

I am a little apprehensive
Regarding my next trip,
To the Skin Doctor, because
They want me to strip,
To thoroughly examine
My skin, from head to toe,
Having previously looked
From the waist up, you know.

I must remove all my clothing
And wear some temporary covering,
While an Intern and Resident
And the Professor are hovering,
Just outside of the room
And checking their pagers,
In total anticipation
Of their most recent wagers,
Regarding the statistical totality
Of my northern pale skin,
I am sorry to say
'Tis the one I was born in.

So far, I've been fortunate
Nothing to worry about, beyond reason,
But I gotta tell you, those Doctors
Get a kick, with all their freezin',
Of any little thing
That looks remotely suspicious,
Kind of like a barbecue Chef
Where every kind of meat looks delicious.

I will walk out of that office
Having suffered over-exposure,
In conclusion, I hope
With a sense of contemplative closure,
Most likely, to return again
A yearly visit, I suspect,
And Dr. K will admonish:
Wear sunscreen and protect.

Total Rewards

There I was today, perusing the company website portal, trying to get a look at my paycheck (browser not supported from home) and pondered the terminology my organization uses to descibe the sum-total of programs covering pay, pension, retirement, insurance and so on. Our naming is, "Total Rewards". Quite naturally  I began to ponder, wander and wonder on this whole thing.

Where I work
Payroll is listed on the Company Internet home page
Under the menu "Total Rewards",
According to the dictionary, this is defined as:
Noun - "a thing given in recognition of one's service, effort, or achievement"
Verb - "make a gift of something to (someone) in recognition of their services, efforts, or achievements";
But really, how does that apply to the worker-ant hordes,
The ones that slave on day after day
Because this is just a job,
Which could be performed by just about eveyone
Even Billy-Joe, the dumpster slob.

Are we all being compensated
In the usual hourly way?
Or truly being rewarded
As the homepage, suggests, to say,
That a properly emptied waste basket
Is equivalent to saving a life,
While some might say, if I don't do it at home
I will catch Hell, from my stay-at-home wife.

Total Rewards in summation
Looks at all of every things,
Unless you work as Per-Diem
Not tied to the apron strings.

Dental Dana 49

Dental Dana is so sweet
And never ever vicious,
Quite frankly, I tell you
She looks absolutely delicious,
For seven years now
She's been working at the store,
She looks good coming in
And out every door.

Let me tell you why
I like her so much,
She is an angel
With a feathery touch,
I barely sense her efforts
Until she stabs my plaque,
Yes, things like that
Are why I keep going back.

She gave me a tingle
With her ultrasonic gun,
That's why folks
This chick is so fun,
Never a dull moment
In the hygienists lair,
Though, she has all the weapons
So it isn't quite fair.

6/16/16

Talking at Two

An ICU is a noisy place; we all know that. And we have been instructed, regarding how important it is to limit casual conversations in the presence of those same patient's and the public in general. When a person is newly admitted to the ICU, they are frightened, anxious and often, downright unstable. After we get them settled, maybe that person can relax enough to even sleep or doze. What they don't need, is their nurse to hold a palsy-walsy meet-and-greet, with a buddy or two while still standing in the room.

Talking at 2 a.m.
In the patients room,
Give me a bat
Or a sweeping broom,
To coax them along
And out the door,
A boot to the head
The winning score.

A cotton curtain wall
Doesn't block voices,
You are his nurse
And thus, you have choices,
To show respect
The fellow needs to rest,
Yackety-yak nurses
I'm not impressed.

For Gods sake, remember
He just came from the Cath Lab,
Without Emergency services
He'd be dead on a slab,
Ice-cold and blue
At the morgue out back,
But, Dr. Genius placed stents
To cure the heart attack.

So, just think about it
The dude needs quiet and rest,
You told his wife, you'd watch over him
But you failed the test,
When Bootsie came over
Just to say, "Hi",
And Joe Bob in the bed
He wonders why,
Regarding Bootsie and you
Less than 10 feet away,
Talky nurses on a break
Like it's the middle of the day.

Others noticed
Your noisy conversation,
At 2 in the morning
It's an aberration,
Talking it up
With a friend and another,
You deserve a smack
From your dear old Mother.

This isn't a tirade
Regarding women or youth,
There's a time and place for everything
That is the truth,
But it's hard enough already
To sleep in this joint,
So, please leave the room to talk;
Do you get my point!

California Hospital Prices

Worthwhile story regarding the rise of hospital prices, in the setting of giant Health-care conglomerates.

June 13, 2016 @ L.A. Times
http://www.latimes.com/business/hiltzik/la-fi-hiltzik-california-hospitals-20160613-snap-story.html

A big hospital story
And it’s kind of funny,
Despite reported low profits
We should follow the money,
A USC report
Regarding uprising prices,
Relay the real truth
Regarding profit devices.

Now, we’re often reminded
How the money can’t be found,
Yet, a story describes
There is plenty around,
With Dignity earning
A half billion bucks,
Layoffs and cutbacks
For employees?, that sucks.

To Silence the Alarms

During the most recent Break-Nurse shift, I designated myself as the alarm-silencer, as there was a situation calling for that duty (if you're a Nurse, you know what I mean). This prompted a weird idea, as most of you are undoubtedly aware of a book (and movie series), "The Silence of the Lambs". Naturally, it caused me to ponder, "The Silence of the Alarms", and here is my version.

Prologue:

There was a ghoulish
Murderous story
Regarding quiet sheep,
A serial-killer on the loose
His first victim Little Bo Peep,
His crime, so truly heinous
My thoughts, Oh, bloody damn,
The saddest thing about it was;
The silence of the lamb.

Introduction:

Now silence is golden
At least, that's what we're told,
But enter any hospital
You'll notice silence is old,
So old, in fact
It long passed away,
The cacophony in the joint
Is a tumultuous affray.

A new job position
Break-nurse, by name,
For all intents and purposes
A minor player in the game,
But there's a quiet revolution
Down on the farm,
The true reason to hire him
To silence the alarm.

Once Upon a Time:

Thus, here's a better story
About a handy guy,
He's older than Methuselah
They say his patients never die,
He's training for retirement
But still needs to fill his purse,
No better choice available
To be your ICU break nurse.

After in-depth interviewing
And resume' perusal,
Floyd Dean, said, "Dammit, hire him
We won't accept refusal",
Because, we know he is an expert
And we are threatened by mighty harms,
Who better, to take the reins
To silence the alarms.

He worked in 60 hospitals
ICU, in every chapter,
A mercenary of sorts
Rapid assessment and adapter,
But now he's slowing down
He desires a scene, less violent,
Who wouldn't want his expertise?
He can make an alarm go silent.

Epilogue:

The new guy, is really the old guy
And that's just one of his charms,
Just park him in front of the monitors
To silence the alarms.