After His Death

This is a new writing about an old event. Grieving can take on some bizarre practices. We nurses have heard wailing, moaning, crying, speaking in tongues, shrieking and all kinds of unusual requests, to take place at the bedside. To me, this was the pinnacle of a real freakout! These survivors were kneeling on the floor and bashing their heads on the linoleum! Also, they were shrieking and wailing. Look folks, this might be Ok at home or at the Funeral Parlor, but there is no frickin way that it is suitable in the Hospital. Yikes!

After he died
The congregation shrieked,
We were forced to close the door
So no one else freaked,
And we had to offer blankets
For those mourners wailing and keening,
And towels for their heads
Bashing them on the floor
Some sort of sacrificial beaning. 

This went on for three hours
But, folks this is the ICU,
There are other still alive patients in the E.D.
Who are dying for a room with a view,
So wIth tact, finesse and mercy
We had to carefully coax the grieving,
To get the heck out of our Unit
‘Twas high time they were leaving.

Even in our wide mouth American melting pot
Some grieving practices are weirder than snot,
And perhaps, would be better practiced at home
If you want to bang your head, flinging spittle and foam.

Death of the Deadly

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

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

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

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

9/15

Meandering Mind

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

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

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

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

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

9/12/15

Tsk, Tsk

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

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

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

9/12/15

No Heavy Lifting

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

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

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

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

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

Shipping Out

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

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

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

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

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

9/2/15

Pray-ers

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

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

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

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

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

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

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

9/2/15

One Punch

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

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

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

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

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

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

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

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

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

9/1/15

Nurse 32

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

Nurse 32

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

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

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

8/28/15

Happy Whack Job

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

Happy Whack Job

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

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

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


8/26/15

In Their Place

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

Hott Diggity, Dawg.

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

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

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

_ _ _ _ _ _ _ _ _ _


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

Gut Feeling

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

Gut Feeling

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

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

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

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

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

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

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

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

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

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

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

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

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

8/21/15

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

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

Back on Your Feet

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

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

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

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

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

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

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

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

8/19/15

Gurgling Gut

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

Here is Billy Bob's story:

BB's Thing

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

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

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

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

Praying for Rain

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

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

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

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

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

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

8/4/15

Exceptions

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

Exceptions

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

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


7/21/15

Dental Dana 42

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

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

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

6/29/15

Bovine Binary

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

6/8/15

Fistula

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

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

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

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

6/8/15

Dental Dana 41

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

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

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

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

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

6/8/15