Clean Out

GoLytely, is not lyte! They should have called it, "Drink Soap and Crapalot"
Well, times have changed, and for the better.


Clean Out

There will come a day

When you need to empty out,

Well, I discovered a remedy

I could publish and shout,

But, if I were to do that

I would certainly lose my edge,

And the next thing you know

I could be hiding under a hedge.

Hedge fund managers

Would be chasing after me,

They want to tap into my secret

Regarding this intestinal evacuee,

It's a multi-million dollar

Investment cycle milieu,

There is a lot of shit to spread around

And it all begins with YOU.

Some things are very sensitive

One can't inform the general population,

After all, I could really profit

From bowel medicine exploitation,

No more Golytely preps

With that vague citrus taste,

Whereby, most prescribed users

Will lie about, how much they waste.

It might seem drastic

Regarding what you do,

When you need to promote

Digestive doo-doo,

It's a method and a madness

And it really works, you'll see,

If you want to know about it

Step right up, and pay the fee.

Switch back and forth

A cup of tea, a cup of beer,

After four rounds of that

The toilet you will fear,

And after seven sit-downs

Take a glass of purple wine,

Your day will be complete

When you're flowing loose and fine.

There is one more ingredient

It can not be mentioned here,

It may foment religious commotion

And rile folks, with fear,

So, if you want the complete remedy

Just send me twenty dollars,

You will receive the secret Mojo

Known to very few scholars.

We take all major credit cards

Anything debit, that’s for sure,

Food stamps, cash, aluminum cans

Any questions?, read the brochure,

Anything recyclable

Goes to a local buyer,

Together we're custodians

Our Environment, Doth Inspire!

Your G.I. Doc, will recommend

GoLYTELY, for purification,

Please think of us, consumer

For a clean-out kind of vacation,

It won't seem as crazy stupid

As drinking a gallon of soap, 

Plus, you'll get a little buzz

Along with a pleasant sense of hope.

Intra-aortic vs. Intra-erotic

Well, the title tells it all; so be careful with terminology.

Intra-aortic vs. Intra-erotic
A swap of one letter
And timing dicrotic,
Both involving position
Of a foreign body,
Regarding cardiac output
Or your favorite hottie.

Key factors, stroke work
Performance and action,
Attention is paramount
There should be no distraction,
You will achieve the best results
If  you control your design,
Those intra-aortic-erotics
Then, everything will be fine.

Bad Investment Part I

Bad Investment

What a classic case
Of non-compliance,
Stupidity
Disguised as defiance,
Anxious, stressed out
About the whole crazy scene,
When his girlfriend came to visit
She brought amphetamine.

Two days pre-op
Aortic valve repair,
This surgeon will cut anyone
That seems to be moving air,
Active drug user?
Sure, that's OK,
Used drugs while in the hospital?
Hope ya had a nice day.

Lives in the bushes by the river
Ya, he's a great candidate,
Cut him open tomorrow
There's no reason to wait,
Are we worried about follow-up?
Well, just a little bit,
He promises to take his medicines
Each time he takes a hit,
With amphetamine, marijuana
And cigarette smoking,
Does this doctor have ethics?
Come on, you must be joking.

He says, I am a surgeon
And that's what I do,
He offered a two week tuneup
Before he cut on you,
Saying that is enough for
A good surgical choice,
No one wants to argue
When he raises his voice.

Some might say
Well, who am I to judge,
That I don't like this doctor
And perhaps I hold a grudge,
But this is public medicine
And all of us are paying,
Take care, this is an investment
That's all that I'm saying.

Bad Investment Part II

Reason for admission? Benzo & amphetamine overdose. Lives on the streets, chronic drug user, and by chance a routine chest x-ray identifies a bulge at his aortic arch. Health insurance? heck no! A CT Angio reveals an Aortic Aneurism at the critical stage........Once the dude gets off the ventilator, becomes somewhat lucid, the multi-disciplinary team (lacking discipline, if you were to ask me) get together with Joe Bob and have the big discussion. Something like this:

Team: Joe Bob, we saved your life and we want to do it again, how about it?
JB:   Uh, ok. Hey, can you get me some dope first?
Team: No, Joe Bob, you're done with that stuff now, forever.
JB:   Uh, ok.........but, can't you just let me roll a doobie now, so I can think it over?
Team:  No, Joe Bob. What we are going to do is let you get clean for a couple of weeks, then we're thinking of sawing your sternum in half, rip open your aorta and put it back together with wires and staples and other shit, and then you'll be all better in about 9 months.
JB: Hmm, sounds crazy. You know, I need to go to the powder room right now.

Over the next two weeks, Joe Bob goes to the parking lot about 4 times, to clear his head. Right; how about for a little snort of Meth!

And that's why he was the winner of an Aortic Valve repair.

Age-Weight Score

Another way to measure up.

Twenty-eight years old

Weighing twenty kilos,

She weighs about as much as

Two boxes of pillows,

Which isn’t enough

To sustain prolonged life,

Hopefully a husband

Didn’t starve his wife.

Whether kilos or pounds

It rarely works out,

If it’s the same as your age

There is reason to shout,

Something is wrong

Almost all of the time,

Forty kilos at age forty

Isn’t optimum prime.

Ninety kilos at ninety

Or maybe, ninety pounds,

In this day and age

Where too much abounds,

Either unit of measurement

Gives cause to investigate,

What is Aunt Betty eating

How much is on her plate?

Protege 2

Here is the sick and twisted sequel to the original "Protege" (December, 2016). This story is pure fiction, but would make for a great hospital whodunit.

Oh protege
Look what you did,
You killed that guy
And then you hid,
But worry not
Listen to your mentor,
When the blame is cast
I will be the dissenter.

I will show you how
To make them look,
Somewhere else
In another book,
To obscure the trail
Of evidence and blame,
This is not the time
To ruin your fame.

Now, there is a pittance
A fee to pay,
So your good reputation
Doesn't fade away,
So early on
In your distinguished career,
Just pay it once
At the beginning of each year.

You won't tell
And neither will I,
What caused Billy Bob
To die,
It seemed natural enough
And it was kind of expected,
But, going out of the window
As if ejected?
That was a tough sell
And you gotta be thankful,
So, pay your fee each year
To keep my bank full.

Oh protege
I knew at the start,
He's the cream of the crop
Clever and smart,
With career potential
Clearly off the charts,
And if you do as I say
You'll be the Master of Arts.

Bye Bye MERSA

Oh boy, finally we don't have to play dress up in bio-hazard yellow, when we enter the room of the patient with MRSA. Sure, of course, we practice Universal Precautions, cuz that's what we do for everything (especially when eating in the hospital cafeteria). Since I be the achey-breaky nurse, anytime I'm helping with cleanup, I'll wear yellow, because I visit a lot of different patients during my six hours, and thus, I'm a highly developed fomite under power, so to speak.

But here's the real news, once again:

MERSA used to be the thing
Everyone had it, tra-la-ling,
We did isolate and wear the garb
And we poked your nose with a mini-barb,
But now the latest directorate
Says, oh why bother, to protectorate,
If everyone has it, then so do you
Goodbye MERSA, so long, boo hoo.

What this all means, we need a new adversary
To don the gowns and gloves, and act kind of wary,
Until we know the enemy and develop our tools
And someday our descendants will call us fools.

Dental Dana 58

Apparently an old dog, may not learn new tricks.........

Dental Dana
Prepares for duty,
She straightens her hair
And shakes her booty,
For a memorable entrance
Walking into the room,
And every time she does it
My heart goes boom.

DD took an oath
To perform at her best,
In the eye of the storm
No matter what the test,
Because dealing with the public
In a service role,
Requires finesse
And a sharp pronged pole.

Every single appointment
Is unique and fairly risky,
I try to be good
But I always get frisky,
I just claim that I’m weak
In the presence of a goddess,
(But it surely doesn’t help)
When I sneak a peak
Beneath her bodice.

Hot Diggity Outsourcing

For some reason, not shared with the general regular employees, the hospital is now undergoing a very deep cleaning. So deep, the job has been outsourced to a group of blue garbed, female tape-scrapers. Can you imagine the very unsafety of their job, that a person would employ a razor-blade window scraper, to remove tape and other sticky substances from hard / smooth hospital surfaces? Even in the Laboratory?!? I'm wondering if there is a special clause in their contract (probably denying them compensation) should one of them accidentally perform a finger laceration with a blade carrying 42 layers of resistant bacteria, when they were cleaning the Laboratory two weeks ago.
Once again folks, I am not creating fake news; this is real-time reporting!

It is super-hospital-cleaning week
Five contracted specialists
Down on the floors take a peek,
At all nooks and crannies
Including the chairs,
Deep cleaning the swivels
I ask you, who really cares?

It’s another hotdog diggity
Delirious decision,
Five cleaners at a time
An eight hour vision,
Of scraping and wiping
Tape removal and more,
I figure at twenty per hour
This is one expensive chore.

Night after night
An outsourced cleaning crew,
They didn't query me
And they didn't ask you,
If this was a sound
Clear-headed decision,
Yet, these are the ways
Of hot diggity vision.

Pain from the RASS

I am a little late writing about this, as it has been in use for a few years now. But thanks to somebody, I have now given it my attention.

Here is another Audit-glory Tool; allow me to present to you the:

Richmond Agitation-Sedation Scale.
Never, in any Nurse-to-Nurse report did Betty Lou say to me, Billybob has a RASS of minus two, positive. Instead what they probably reported; Billybob is totally whacked out, slugging and spitting at his caregivers between bouts of profound somnolence. And incidentally, I told the Doctor the same thing. So why is there a RASS? To audit us, of course, you fool! It probably fits in somewhere, on that down-home favorite, the APACHE score.

RASS

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

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

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

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

Atrial Chatter

Question: "What do you call it when a couple of Atria are hanging out, and he says:

"Hey Miss Atria, you are looking finer than fine tonight in your new mini-skirt".

And she replies:

"Well, Rockstar, you are pretty fine, yourself. Your appendage is looking really awesome!"

Answer:
Atrial Flatter.

Dog Joke

Picture this:

Sven, an honorable Animal Breeder, he raises dogs, Dachshund specifically. One might say, he is in love with these sturdy little fellows. At some point, there is a litter of identical twin brothers, which he names Huey and Louie. They are so cute, playful, fun and spirited, they become the joy of his life.

Now, they are a couple years old, and at his side day and night. One morning at breakfast, his two pals walk into the dining room, greet their owner, and then keel over together, unresponsive. Sven races to their side, and no matter what he does, Huey and Louie don’t wake up.

Sven bundles them into a blanket, and races to the Veterinary office. He yells, “Dr. Mergatroyd, something terrible has happened to Huey and Louie, what is it?”

Dr. M performs a thorough, albeit quick examination, and suddenly declares;

“Eureka, this is Pulseless Pair’o Dachsunds!”

Inflammatory

Q: What is the commonality when comparing Sepsis, and, a Nursing Staff Meeting?

A: They are both an Inflammatory Process.

Clorox Showers

Flexiseal

What a fabulous invention,

It works pretty good

For the stuff we don’t mention,

At Thanksgiving dinner

Though, it looks like gravy,

Occasionally chunky

And usually wavy.

Flexiseal drainage

Is now incontinence control,

Placing a tube

In your nether-hole,

So the drippy and runny

Won’t mess up the bed,

And the toxic smell

Won’t make us all dead.

Flexiseal

Part of your go-to-kit,

When Billy Bob Boomer

Has another shit,

For the 17th time

In the last eleven hours,

Earning you the right

For Clorox showers.

Hospital Acquired Pressure Ulcer

CRAPU

If you give me a HAPU
I’m gonna SLAPU,
Oh, don’t make such a FLAPU
It’s all because of your CRAPU.

Phones: I See You

No commentary required.

Phones: I See You

I went into the ICU;
Five nurses sat
With smartphone view,
Movie watching
Texting and games,
Would they notice
Smoke and flames?

Sure, times have changed
But I have not,
I remember what
Instructors taught,
While on the job
Please pay attention,
Reduce distractions
Honorable mention,
Spare time? study
Expand your knowledge,
Especially if
You're not in college.

In the courtroom
There is a no-phone rule,
If the Judge should catch you
Contempt, you fool!
Why don't our hospitals
Enforce, the same,
I don't know why
But it's a losers game.

Cumin Kindness

Not all health-care entities blast their branding, all over the USA, but some do. It's a little embarrassing to the employees, but what can we do? Actually, we're supposed to following our leaders, and spout the slogans too.

Anyway, Curry Bob's Taxi Service, has apparently jumped on the advertising bus too; take a look.

Cumin Kindness

At Curry Bob's Taxi
They have a new motto,
Hello Cumin Kindness
Is displayed on every auto,
We care about you
And every living being,
They spend a fortune on ads
It's all the public is seeing.

The taxi's are plush
With fake mohair velour,
It hides the dirt and debris
For the duration of your tour,
And don't even bother
To ask about pricing,
If we ever told you
It would not be enticing.

There is a passenger mini-bar
Just enter the code,
Fresh Turkey sandwiches
And pie a la mode,
With a 3-day expiration
Preservative enhanced,
Like our cutting edge attention
We are truly advanced.

No matter, your destination
You will get there, guaranteed,
For the satisfied customer
We have everything you need,
But, please fill out the survey
And give us some praise,
Hello Cumin Kindness
To the end of your days.

News Under Pressure

Lately, there has been an uproar in the news, regarding "Fake News". I am of the opinion, that ya can't trust anything on TV or the Internet, unless you dig deep. You must know where to look.
But I think there is a bigger issue at hand; news that is held back, all together. When major industries spout platitudes about how "transparent" they are, the very fact that they are bragging about, is usually an indicator, that they have been lying for years!......and will continue to do so.
\
How does Diggity
Squash the stories in the press?
Not a peep is ever written
Regarding any mess,
Now, if there is a chance for bragging
Then, we're all over the papers,
But write articles
About problems?
You must be sniffing the vapors

'Twas like a rainstorm at midnight
In Mother's caboose,
When those pipes in the ceiling
Finally broke loose,
Back in 2013
When the sprinkler system busted,
You know, old infrastructure
It just can not be trusted.

Little catch-all pans
Trying to corral every drip,
When it all busted loose
They had to abandon ship,
Water leaking down
To the Pharmacy floor,
Shouldn't the public know this?
Bad news, is locked behind a door.

And did that ever make the papers?
Why, certainly not,
Money must have crossed palms
On a story that hot,
Or how about the time
With the new ATM,
Was it stolen by us?
No, it was taken by them,
Right there in the lobby
Two men with a dolly,
A couple boys showing off
For their Aunt Polly.

Serial thieves
A family, one might say,
Although, no one was arrested
Now that's a Payday!

1/15/17

Dental Dana 56

Dental Dana is still driving me crazy!

Dental Dana
Performs such magic,
Still, every appointment
Seems to turn out tragic,
I have wondered about that
And here's what I think,
I always seem to say something
That raises a stink.

She is always
So sweet and kind,
I must be stupid
And completely blind,
Well, apparently not
As I'm always trying to touch,
Some part of her
That I like very much.

Still, she has such patience
And magnificent poise,
She gets me to behave
With very little noise,
With a sensitive jab
Of her green-Laser pen,
Which seems to work very well
On rambunctious men.

Denial and Death

The holidays are over, so I can write a depressing story. Yes, of course it's true (with a few embellishments), and took a month for me to regurgitate.

Denial and Death

The Christmas Holiday season
Is such a special time of the year,
This is where good old Uncle Bob
Will play out his dying fear,
He has a history of heart failure
And has angina every day,
Now he's faced with Christmas dinner
Fat, salt and sugar heading his way.

He's a tough old Russian Teamster
He could pull a tractor with his teeth,
But now his chest hurts a little
He's short of breath, just hanging the wreath,
Mamma says, Daddy, your face is purple
He replies, Don't worry, it's kinda cold out,
Whispering silently to himself
No reason to scream and shout.

A silent M.I, in action
Myocardial damage, during dinner,
Everybody joking about how
Uncle Bob, used to be thinner,
Then, in the family room, later
A rousing toast to a wonderful life,
Everybody bragging
About great kids and the good wife;

Then suddenly,
Down goes Uncle Bob,
And ten year old Joey
Does a miraculous job,
Performing Cub Scout CPR,
Until the Paramedics arrive
In their siren-shrieking car.

Three days later
It's a forgone conclusion,
That Uncle Bobs brain
Has undergone fusion,
Of white matter
Sulci and neurons,
About as dense as the muck
At the bottom of Lake Huron.

But that's not what his wife sees
When Uncle Bob wiggles and twitches,
It reminds her of those times
When he stumbled into the ditches,
Out on the steppes of old Russia
Drinking potato whiskey,
She sheds a nostalgic tear
Back then, he was so frisky.

This is the new world
Sorrowful last fable,
Where no medical options
Are left on the table,
Leaving old fashioned hope
Amidst old time religion,
Sending desperate prayers to Jesus
Strapped to a messenger pigeon.

We do our best
To provide logic with sensitivity,
While this family prays Psalms
Focusing on Nativity,
A miraculous rebirth
For Uncle Bob, in all His Glory,
And as the weeks drag on
Hubby, becomes a laboratory;
Bacteria, of virulent strains
Take over in his G.I. tract,
Like a festering Petri dish
Drug resistance, in fact.

Rotting away
Such an uncouth term,
Especially the morning
When a festive brain worm,
Was seen escaping
Uncle Bob's Left ear,
Erupting suddenly
With a burst of cheer,
Singing, "Oh, we're having a party
Up in Uncle Bob's brain,
Giggling insanely
Repeating the refrain.

Finally, a consensus
Uncle Bob, can be a DNR,
But no, not Comfort Care
That would be going too far,
Thus, another month drags on
While, this body decays,
A desperate, trapped soul
Silently screaming for 100 days.

Until he died.

A pigeon pooped on Mamma's car that day
A message from Uncle, as if to say:
Goodbye.

Take a Break

Doing Break-Relief Nurse for nine months now, and my satisfaction score is pretty high; here are some of the reasons.

Break-relief nurse
There’s a lot to like,
Nearly as simple as
Riding a bike,
After competing for years
In the Tour de France,
Having earned the right
To wear the jersey and pants.

Take your break, Nurse
What do you need me to do?
Start an IV
On old Betty Lou,
Carry tubes to the Lab
Then, hang some plasma,
Titrate the Levophed
And monitor Bob’s asthma.

Set up a room
For that overdosed giant,
Keep an eye on his restraints
He’s completely non-compliant,
Assist with 3 bed-baths
On the super-sized folks,
While gasping for air
And still telling jokes.

Answer the call-lights
Attend to machines,
Troubleshoot problems
Without making a scene,
Offer suggestions
Be a team player,
Ready to offer a hand
To the dragon-slayer.

A six hour shift?
Now, that’s a relief,
Don’t have to deal with
All that charting grief,
But I must read the notes
‘Cuz, each patient is a mystery,
Please, don’t be offended
If I know more about their history.

There are a couple things
That I can’t do,
Continuous Renal therapy
That’s up to you,
If there’s a Code or a crisis
Or say, a new Open-Heart,
I’ll be your assistant
I play the little part;
Then, we’ll get stuff done
More efficient and speedy,
Don’t worry about me
I’m not the least bit needy.

When I leave at Six
Finally, I take a break,
Silently, I depart
Having earned a piece of cake.

Generations

I may seem like the grumpy old Expert curmudgeon at times, but that's what you expect from old people, right? We elder nurses who care, find satisfaction in sharing with younger generations; those Great Nurses who will follow in our footsteps. That doesn't mean I think I'm some kind of superior nurse; it only means I'm a veteran, rabble-rousing individual that expects perfection, or the closest thing to it.

Generations

It may look like
I am picking on a younger generation,
Of new nurses practicing
In our good old federation,
But, don't take me wrong
I seek the best of practice in our profession,
I like to mentor........
Just step in and make your confession.

Sure, things have changed
No doubt about it,
Thank goodness for change
I'll be the first to shout it,
No more confusion now
When doctor's write orders,
I don't have to decipher handwriting
And scribbles on the borders.

Change, ushers in new ideas
Along with new situations,
That we didn't encounter before
Thus, more regulations,
Where, some will try to find
Workarounds and shortcuts,
That is all good and well
But makes Administrators go nuts.

This is hacking in its purest sense
Like the automotive pioneers in 1910,
Where many of us dream about
Those silly days way back when,
Your great-grandmother, worried
About great changes in her world,
And here we are, one hundred years later
Having our genetic code curled,
Down at the Salon
While choosing our next baby,
The current generation of new Nurses
Is always poised to say, "Well, maybe".

No more sounds of silence

Smartphones are now ubiquitous in every hospital in America (probably everywhere else, too). With over 500,000 phone applications already available, and many of them being useful in the practice of  medicine, these babies are not going away. As their technical prowess increases with every new generation of operating system, human behaviors are going off the rails, in terms of phone abuse. The careless habits of "professional" phone users (and the inability of Hospitals to enforce rules), place our patients and their families at risk.

When an employee is on break, go for it dude, whip out the phone and be entertained! Just stop doing it when your attention should be on your patient in Room X, Y & Z.

Earplug Attention

Earplug attention
Dude is unaware,
He deserves a notorious mention
Because his patient slipped out of the chair,
His mind is on his music
A mantra and a movie,
The patient had a cardiac arrest
He didn’t notice, ain’t that groovy?

Smartphone distractions
In the midst of Intensive Care,
If this one be your nurse
It’s like playing double-dare,
With his earpiece blocking sound
Your survival is in doubt,
I have noticed he’s doesn’t hear
I practically have to shout.

Smartphone abuse is out of control
In two thousand seventeen,
You can call me Mr. Grumpy Nurse
And say I’m being mean,
But with thirty years experience
I know listening, is a specialized skill,
If you don’t hear what goes on around you
You’re not worth a two dollar bill.

Chip in the Head

She talked of this incessantly, "there's a chip in my Head". According to this delusional person, it was placed in her head when she was two years old, down in South Carolina. Well, that was 50 years ago, and there were no chips, other than potato chips, (which is what is in my head, I think).

I tried some internet research on the topic because it sounds like something right out of L. Ron Hubbard, a lesser known science fiction writer. And considering the wacky ways of his legacy (Scientology), I don't doubt for a minute, that he had several in his head.

She has a chip in her head
That’s what she claimed,
They’re trying to kill me
They abused me, I’m shamed,
It happened
When I was a baby, she said,
And ever since then
They have wanted me dead.

An “accidental” overdose
Not intentional, says her daughter,
But this was number five
So, let’s call it MySlaughter,
Trying to end her life
And that demon in her head,
A self-fulfilling prophecy
After all, they want her dead.

Squeegee

Certain topics, are covered often because they are so visceral in their presentation. And honestly, each time it's old and yet reveals some unique nuance that I just have to cover. But first, I cover my clothing and my nose.

Covered in stool
It never is pretty,
Back, butt, arms and legs
It's downright shitty,
At first look, it overwhelms
"How can I possibly clean, that?"
Run to the linen cart
Grab a bunch of towels
Call the cleanup crew, STAT!

Take a careful moment to notice
Is it flowing off the bed?
That detail is so important
So you don't slip and slide onto your head,
If it's on the floor, get some shoe covers
So the crap doesn't walk home with you,
Although it doesn't smell as bad
It is way worse than dog poo.

Now, I was unsure what to do
So I consulted my weegee,
It spelled out, forty wash-cloths
And a high-pressure squeegee,
Yes, that did the trick
BB, was slick as a whistle;
Just another chapter
In the crapola epistle.

BillyBobinator

First poem of 2017:

I don't like trauma
I'll tell you why,
All those broken bones
They make me cry,
The busted heads
With swelling brains,
And a myriad
Of other pains.

A lot of trauma victims
Have drug-seeking behavior,
And they are expecting me
To be their savior,
But I am not
That kind of guy,
I can say, No
And let them cry.

Half of these folks
Did stupid crap,
Like spilling hot coffee
Into their lap,
While driving
Their brand new Maserati,
And looking out the window
At some teenage hottie.

Swerved, they did
Into a giant Oak,
Blew up that Maserati
And that's no joke,
Two hundred and fifty
Flying pieces,
Including Billy Bob
And his two nieces,
Going off in
Different directions,
Seat belts still on
But no other protections.

Where once were three
There now is one,
Put back together
With a hot glue gun,
A hodgepodge collection
Of many pieces,
Something from Billy Bob
And both of his nieces.

A Frankenstein creature
An amalgam of parts,
One head, two arms
And three beating hearts,
The rest is a mix
Of tissue and bones,
And inside the head
Two, iPhones.

We call him BillyBobinator
The first hybrid man,
Kind of weird looking
But that was the plan,
When the trauma surgeons
Looked at that box of parts,
Retrieved from the accident
In fits and starts.

He has a little girl's voice
He got that from Trixie,
She was the cutest thing
Looked just like a pixie,
Her sister Madeline
Was a gymnast extraordinaire,
Now, BillyBobinator
Keeps flipping into the air.

He's a handful
That's for sure,
But we're a Trauma Unit
With a guaranteed cure,
Where everyone leaves
Sooner or later,
Including this hybrid
BillyBobinator.

Medical Martial Arts

I am not really a sports fan, but do watch an occasional sporty thing on TV. The big, most recent ridiculous fight of MMA women, (knock out in 48 seconds), is over now and I'm glad I missed it. However, that knockout chick got $3 million bucks, so apparently it's better than a Nurse fighting it out night after night in an Emergency Room.

Healthcare workers are commonly injured when encountering confused, drug addled, mentally unstable, demented, damaged individuals. Because of this factual premise, much that I write, is an attempt to cast a humorous alternate view of what is really going on. Some have labelled my stuff as "sick humor" at the expense of the patient (and family), who can not defend themselves. Quite frankly, we who are in direct contact with the crazed and confused, are not allowed to defend ourselves. We are the ones truly being hurt, sometimes receiving career ending physical injuries.

Heck, I may as well blame all my crazy writing on the kick-to-the-head, brain swelling concussion I received in 1993, at the bedside during a Swan Ganz insertion.

Mixed Martial Arts, Cage fighting in the Octagon, Muay Thai;
this is the analogy I am presenting, to explain what it feels like to be a Nurse.

Crazed and confused
For whatever reason,
Perhaps a teen on PCP
During the football season,
Ends up in the hospital
After a victory celebration,
A dope on dope
With alcohol inebriation.

Naturally combative
Flailing about,
We try to restrain
Then he passes out,
No longer breathing
Emergency! Action!,
Shove a tube in his lungs
Much to our satisfaction.

Quick, get the Propofol
And place him in restraints,
The danger is real
Expect family complaints,
How we tied up boy Billy
Who is gentle and kind,
While his U-tox is positive
For drugs of every kind.

Yep, it's Medical Martial Arts
In the E. R. tonight,
Luckily, not one of us
Were injured in the fight.

God Knows

Leave God out of it, that's just my opinion. However, many folks believe that when they die, and go to the next heaven, they will be able to know all things. If so, maybe you can find out the true meaning of Pneumatosis Intestinalis.

Pneumatosis Intestinalis
Sounds too big to carry in a valise,
What it is; air in the wall
Of the small or large intestine, that's all,
Pathogenicity, the predominant thought
What we know about it; naught,
Is it fatal, or even a bother?
Be sure to ask, when you meet the Father.

Just Stop It

Dear speakers and instructors, go to Toastmasters or something, and learn how to retrain your speech and grammar habits. Yikes, does that make sense?

If you are unclear about what I am referring to, read this short article:
https://hbr.org/2011/09/never-ask-does-that-make-sense

Does That Make Sense 6

Does that make sense?

No, it never did,

And if I had a gun

I would shoot you, kid,

For saying that damn thing

So many flippin' times,

Although, you're keeping me busy

Writing new rhymes.

12/26/16

Sleep ain't Cheap

Discover awake
Is what I do,
Every day
At ten past two,
That's the timer
For minimum sleep,
After returning from
My midnight creep.

We medical folks
That work at night,
Have our rituals
How we sleep tight,
Black-out curtains
Or a quiet closet,
Is like a thousand
Dollar deposit,
To guarantee
Some decent sleep,
Ya, that's a commodity
That doesn't come cheap.

Shot of Ice

"Siri, shoot me some ice!"

Objective:
For the patient who is asking every 5-10 minutes for some ice to satisfy their water cravings. (typically when they are NPO or fluid restricted).

The device could be set for time intervals, or number of spoonfuls.

Mechanism:
Automatic spoonful of ice injector. Hangs from ceiling or is a shelf unit. It might look like a movie projector. Pull the trigger and it drops ice into clients mouth. Alternate delivery where a red laser targets patient's mouth, and device shoots tiny barrel shaped ice-cubes their way.

Side benefit: Range-of-motion exercise for patient's head and neck.

Best benefit: Nurse doesn't have to go in room every ten minutes to deal with whiny patient.

There's a brand new gadget
A medical device,
It will solve a problem
At a reasonable price,
A germ of an idea
That sprouted and grew,
After consulting
With thousands of you.

In the hospital setting
There are certain reasons,
We withhold fluids
Even in the rainy season,
NPO,
Except for meds,
Makes patients crazy
Jacked up in their beds.

A genius idea
Came to me,
After 30 years
Of singing la-dee-dee,
As patients whined
And threatened with violence,
Why, even an ice-chip
Would provide us with silence.

After mulling ideas
And asking advice,
I have finally released
The "Shot of Ice",
A revolutionary tool
With multiple uses,
No no need to fall back
On ridiculous excuses.

Set-up is simple
Quick and easy,
It has a high-tech look
Nothing cheesy,
Plug it in, turn it on
Just follow directions,
One minute or less
It's ready for ejections.

Have the patient hold still
To adjust aim and distance,
Or set it on automatic, for
The path of least resistance,
It can be voice actuated
With timing controls,
Adjust by the teaspoon
Or set it on, "Bowls".

The patient can choose
What they say, for the trigger,
Like, "hit me again, baby
But this time, something bigger",
Or maybe a whistle
A clap or a moan,
For the technocrats
There's an app for the phone.

"Siri, hit me up
I want to roll the dice,
Shoot me, babe
With some flavored ice!"

4 x 900

Around 25 years ago, we served a young man who was massively, morbidly obese. I guess nowadays, he could be classified, as not so big. Back then, we did not have specialty beds to accommodate persons like this, so we had two standard hospital beds attached together. Ya, go ahead and laugh!

I have observed the strange family dynamics, that are entangled with cases such as these, where the Gorilla in the room is running the show, while maintaining a semblance of helplessness. Now, I finally am writing about him.

900 pound Willie
Calls everyone a chump,
He can't fit into the bathroom
Uses his closet to take a dump,
Just stands erect
And let's it plop on a towel,
His Mama helps clean him
Holds her breath, it's so foul.

The whole entire family
Cater to his demands,
They buy him all the food he wants
While no one understands,
How to escape with any dignity
They are slaves to Brother Willie,
Though, each one of them wishes
They could bury him in South Philly.

He was a 4 pound baby
That's right, isn't that silly,
Now he's age 29
900 pounds,
A mean one, Brother Willie.

Retention Enemy

From the Crappy Ideas Department:

When there is a Flexiseal Rectal drain in place: It can be used to perform a "retention" enema, or to load some liquid antibiotic such as Vancomycin directly into the colon...........Do remember, it must later be unclamped to allow to drain.

Retention Enemy

Flexiseal Mechanics
Section Number One,
Retention enema
Is like loading a gun,
Why, you might ask?
Well, it’s locked, loaded and hot,
Time to pull the trigger
To release the shot.

Please release me, let me go
Let my diarrhea flow,
Open that thing now, or you will regret,
The explosion of crap
That makes everything wet.

Be careful where you stand
Towards the head, at the rear,
Pad the bed in layers
And yell, "All Clear",
Wear protective clothing
With a perfumed mask,
These are the necessities
To best perform the task.

Frankly, it's simple
It's just Physics, Bub,
The dude was compacted
With weeks of grub,
That couldn't get out
Because his gut had a cramp,
After last week's surgery
By the reconstruction champ.

Bowel obstruction
Is a dangerous thing,
Toxic constipation
Till you finally blow a ring,
On that old clunky engine
Of the '44 Chevy,
Gut fluids leak out
Like a flood breached levee.

Retention enemy
Number one,
If you didn’t unclamp it
Just hightail it, and run!

Protege

Many of us have played the role of a Nurse Preceptor, to a fresh, new nurse. This is to help that person, get their feet wet, get the hang of what is going on, their duties and just how they should fit in, to this new working environment. This would be a duty that an experienced Nurse would take on, in addition to their regular daily duties. Preceptor works as a buddy to the new Nurse employee and as such, the Preceptor, needs to be cool, calm and collected. We want to build confidence, help expand their knowledge base, and become comfortable in their surroundings and practice. Anyway, over the years, I belonged to the cadre of Nurse Preceptors and hope I did some good.

Last week, I had the good fortune of meeting up with the protege of 17 years ago. This guy, has gone to great heights, but who knows, if my influence had any effect. In fact, he's got the kind of job, that could have made him my boss, had we continued floating in the same boat. Yes, grasshopper; someday perhaps, the student becomes the teacher.

I visited a protege
From way back when, the other day,
I enjoyed the appointment
Immensely, for sure,
16 years of evidence
That my training was pure,
When I imparted my wisdom
Those few days long ago,
His success is the conclusion
My influence?
I don't really know.

In conclusion:
Protege
or Protoplasm,
If they don't develop properly
You might have a spasm.

Web Address

Ever see those ads on the internet that say something like, "Search you own name at this site and you won't believe what you see"?

When searching the name of this blog, I'm happy to be at the top of the list, but looking down the page, most of the selections have something to do with another kind of nursing, that being, the actual feeding of the baby by their mother. Hence, I have to be careful, not to make some horrid social blunder.

Doing a Google Search
The Underside of Nursing,
Leads me to the breast
New mothers cursing,
Their suffering and pain
Sometimes even bruising,
When baby gets a snack
While mama is snoozing.

Although I've written of breasts
It was not on this blog,
I have to watch my language
Not to be labelled a hog,
A misogynist pig
But that isn't me,
I'm a proponent of Rights
For all women to be free.

Ok, that didn't sound
Exactly how I planned,
In my effort to explain
You may not understand,
That the Underside of Nursing
Poses anti-sexist views,
And if at all possible
Avoids political news.

Stranglers

We have a couple stranglers
Gracing the ward tonight,
On their call-lights all the time
Their demands are out of sight,
Re-arrange my pillows
All ten of them, this way,
I need a sandwich, sweetie
And a little perfume spray.

Why does that alarm
Keep ringing every hour,
I didn't like my dinner
This yogurt is sour,
I don't give a damn
If you're saving my life,
Say, could you call my girlfriend
But, don't tell my wife?

This is how we go crazy
It's called TPSD,
Terrible Patient Stress Disorder
Could happen to you, just like me,
There is a shaking of the fist
While mumbling and cussing,
An explosion of breath
And a whole lot of fussing.

We run to a comrade
For strength in this fight,
Look each other in the eye
And say, “It’s only one night”,
Because TPSD
Feels like crucifixion,
I think I’ll call in sick tomorrow
With a creative affliction.

Consumption

Something I've noticed lately: People being admitted for acute conditions such as Sepsis, Heart Failure, DKA, and Pneumonia, are obese and have Bipolar Disorder. What a surprise!

Bipolar obesity
Each side eats too much,
When one is having dinner
The other side can't touch,
They don't get along
But both love to eat,
This bipolar disorder
Is a tough one to beat.

Bipolar consumption
Runs rampant in society,      
A million easy choices
Only lead to more anxiety,
To calm ourselves down
Add drugs to the mix,
Uppers, downers, etcetera
A groundbreaking fix.

Slogans

I am curious about sources of data, slogans, origins of lingo, and always wondering, "how did this thing get started". Recently, when taking a specimen to the Laboratory, I noticed a large Employee-focused poster on the wall, titled "Our True North". It was clearly a "corporate" generated, behavioral modification tool, to repair and improve our employee public image.

What struck me was the bastardization of a common term, that being "Graffiti". Sure, we all know what that means; "writing or drawings scribbled, scratched, or sprayed illicitly on a wall or other surface in a public place. (Dictionary).

The message on the poster, subjugated that term, as "Physical Graffiti" and "Verbal Graffiti", in such a way, as to have nothing to do with writing, drawing or spraying.

Internet research, brought me to the source behind all this gobbledygook:
http://www.wecreateloyalty.com/. This is "a company that creates solutions for elevating the human side of healthcare". (Improving Patient Satisfaction........ahh, now doesn't that sound familiar?) Yep, the whole hotdog,  HCAHPS (the Hospital Consumer Assessment of Healthcare Providers and Systems)

I followed this link: http://www.wecreateloyalty.com/tag/patient-satisfaction/
And discovered exactly where this "brilliant" motivational poster was sourced to.

Anyway, that's my rant for the week; and the poem to go along with it.

Graffiti on the Wall

Hello Humankindness
Is our branding theme,
Attempting to become
A virtual meme,
It's a feel good concept
But is it money well spent?
It depends on who you poll
The workers or management.

Last month I noticed
A grand poster in the Lab,
Orange and white
Near the vivisection slab,
Where dissidents are sectioned
Along with audit prone nurses,
A feel good corporate billboard
With inspirational verses.

"Our True North"
The title, the theme,
Describing forms of graffiti
That almost made me scream,
Physical Graffiti
Old magazines in the waiting room,
Clutter at the workstation
All dire and doom.

Things you can see, touch or smell
That distract the consumer,
Like your rotten egg salad
Or the C-diff, from Boomer,
Over there in room Ten
Near the patient in Eleven,
Who just had open-heart surgery
Man, it stinks to high heaven.

Yep, that's patient centered care
With hourly rounding,
Flip and flop, Q2 hours
Uncle Bob gets a pounding,
Because it's all about perception
Presented to the people,
Human Kindness News @ Five
Rescue a dog on the steeple.

Verbal Graffiti
Just what do they mean?
Not talking kindly
About Jimmie or Jean,
While standing in the elevator
Boisterously laughing,
Saying, I don't have time
Because of inadequate staffing.

I'm on a break;
No, that's not my job,
You're not my patient
And, Mary's a slob,
The things that don't add
To their overall existence,
Then we'll fail in all surveys
Yikes; reimbursement resistance.

Fake news? this isn't
Would they lie to us? Never,
And $200 million dollars
Buys a big lever,
To bring on the smiles
And feel good public relations,
While we hunt for supplies
At the nursing stations.

Elder Barry

Break Nurse, opinionator, sounding board advice solution suggester, critical decision consultant, wise old man, senior citizen elder helper. This beats Walmart any day, except for the lifting, wiping, toxic waste disposal and babysitting the psycho's.

At work
I must be shown respect,
Cuz, I'm a Senior citizen
They must protect,
They can't treat me badly
That would be Elder Abuse,
Finally, age is working for me
Yep, I've got an excuse.

Offence

Does that Make Sense 5

I learned some new stuff

At the hospital last week,

Continuous Renal Therapy

An education I did seek,

Overall, it was worthwhile

Till the 4th speaker did commence,

To end each clarification with,

"Does that make sense?"

This is the fifth time I've written

Regarding this horrible habit,

If I had a shotgun

I would have plugged that rabbit,

To put us out of our misery

At this horrible speech offense,

Let me ask you, dear reader

Does that make sense?

When spoken repeatedly

Over and over again,

I want to perform Hari-Kari

With my best fountain pen,

Because we students don't need

To be treated like fools,

By post-graduate Nurse educators

Braying like mules.

Public speakers, please stop it!

Does that make sense?

The grammar police are coming

To toss you over the fence.