Dental Dana 45

I was getting worried about Dental Dana, having had no exciting encounters for quite a while..........until now. Here's the latest reported sighting.

Dental Dana
She's well bred,
But she doesn't let it
Get to her head,
She drives a little
Red Corvette,
Though she hasn't let me
Ride in it yet.

She tells me, Dude
You gotta behave,
You're always a naughty
Dental slave,
During dental
Dentition class,
You bite my fingers
And give me sass.

Well, I can't help it
She's hot stuff,
No amount of pain
Is never enough,
Like magnets attract
Or do they oppose?
I'm not sure
She just lanced my nose.

Skin.......the largest Organ

As a descendant of Europeans, I suffer from pale skin syndrome, and thus, am subject to sun exposure issues. Look, my skin is old, Ok? and now the medical specialists are having a look and finding new and exciting ways to remove it. It seems their favorite method is a short blast of liquid Nitrogen vapor at a cool (minus-320F, -195C, or 77K). Funny how it burns, for something so cold.


I went to the Dermatologist
To have my fortune told,
She said I looked real good
But my skin is old,
Not sure how to take that
I gave her the eye,
I said, "C'mon Dr. K.
I don't want to die,
So, just go ahead
And freeze some more skin,
I suspect they have a contest
To see who will win,
The frozen lesion award
Must be a daily wager,
It keeps everyone excited:
Why they keep checking their pager.

Just another day
At the Dermatologist,
Someone caressing my skin
And I wasn't even kissed,
They run a clean establishment
What they do, isn't massage,
No, I think they could call it
A skin remover garage.

Sis Boom Bah

The repercussions
Of a cardiac arrest,
It gives you an opportunity
To challenge the last test,
In the course of your life
To discover who you are,
Did you study enough
To at least make par?

Statistics aren't great
For immediate survival,
Not many folks
Make a hospital arrival,
About 11 percent
Live on, for more action,
But only 8 percent can claim
No brain subtraction.

Sudden Cardiac Arrest
In two thousand eleven,
More than 400 thousand
Trying to go to heaven,
That 11 percent survival rate
Is nothing to whistle about,
Unless your objective was
To become a bean sprout.

How to improve on
Your risk of demise?
Have a Defibrillator near
For the big surprise,
Strap one to your back
Or just vote them into use,
You might need one in the future
When you're playing caboose.

With a shockable rhythm
At your witnessed arrest,
Those are two of the ingredients
For passing the test,
Where the helpful Good Samaritan
Grabs the A-E-D,
Follows the idiot-proof instructions
Thinking, "I'm glad it's not me".

Now your chances of survival
Increased 300 percent,
That's nothing to sneeze at
For living intent,
Where the balance of the crowd
Will continue on to heaven,
Looking for George Carlin
At the Seven Eleven.

A-E-D
Like la-dee-da,
Increases opportunity
For sis-boom-bah,
Though occasionally not
For the moron's in the crowd,
The Methamphetamine user
No longer endowed,
With a functional brain
In his meth-adjusted head,
One more drug user
Dead on the bed.

All in all
It is best to avoid,
Because cardiac arrest
Will make you unemployed,
Your wife and kids won't like that
'Cuz even if you survive,
Everyone will wonder
How long you'll stay alive,
And consider the option called
Neurological dysfunction,
It leaves you sitting on the couch
Watching Petticoat Junction.

Cardiac Arrest
Is a life changing event,
If you don't fly off to heaven
Say your prayers and repent.

Cardiac Arrest Rant

Playing in the ICU arena again, almost every week there is another victim of a Cardiac Arrest, in lieu of a new Heart attack (STEMI). Four instances, and the victims were under the age of 60. Surprise, surprise, the 36 & 50 year old showed Methamphetamine on the Urine Tox screen. Three men and one woman, all were smokers. Mr. 46 & 57, looked at least ten years older than stated age. The 50 year old was obese, and had "just" learned two months ago that they had Hypertension, CHF, Asthma and Diabetes. I think it is safe to assume, the Asthma is really COPD secondary to smoking.

What's my point? All of these conditions are acquired and caused by personal health choices. In our metropolitan area there are billboards touting the importance of taking care of one's heart, making good food choices and stop smoking. All of us have been beaten over the head for the past 40 years, regarding what's good for us. But folks continue to do whatever they heck they want. Oh ya, out of the crew previously mentioned, only one had a job, and that was cleaning houses. Hence, not one of them had any insurance better than Medi-Cal. That means the rest of us employed folks, are footing the bill through our tax dollars. 

Deep-Sixed

Quite frankly, having no new ideas in a month had me thinking my creativity had been deep-sixed. Then I realized, I'm back working in Adult ICU territory, and that is the location of inspiration!

Not writing very much
In the most recent epoque,
Nothing so exciting
As to marvel and shock,
Though my triumphant return
To the land of I-C-U,
Is an eye opening reminder
About the words that are due.

Very little has changed
In the past five years,
Just a couple new drugs
The same sicknesses, poor dears,
Undergoing restorations
That fail the final test,
Instead of gaining new life
They discover eternal rest.

Those statistics are shuffled
Into the middle of the deck,
Sure, they learn about risks
And what to expect,
In the one to two weeks
Of anticipated post-op,
Your recovery expectation?
To home, you will hop.

Surgery was well done
A valve and two bypasses,
Up in the chair the next day
With your dentures and glasses,
But then Atrial Fib
Sent a clot to your brain,
Ninety days later
You're on the comfort care train.

The operation was successful
Your heart problem was fixed,
Unfortunately, your future
Was slowly deep-sixed.

3/24/26

Oops you're dead

Once again my NY Resolution is to better organize the writings, and I run across stuff that seems to have remained just as good as it was back in 1992.

Cruising Heaven

A mysterious event

Happened just today,

The man said, "I don't feel so good"

Then his heart beat went away.

I told him not to do that

But he didn't seem to care,

His heart rate slowed dramatically

Until it wasn't there.

With bells and buzzers ringing

We wailed upon that man,

His color went from purple

To a lovely desert tan.

He received a hit of Atropine

Some Calcium and Epi,

He replied with tachy rhythms

But his pump just wasn't peppy.

With the force of seven doctors

And the strength of twenty nurses,

Collectively their aura

Dispelled the evil curses,

That bound him to his destiny

In a room without a view,

Now he's cruising heaven's highways

With an angel friend or two.

1992

Bullying

Addressed to the youngsters and new Nurses out there, trying to fit into the battlefield of your fresh, and exciting career. Understand, that bullying happens at all spectrums, not just at the beginning. Bullying and Hazing are the power plays perpetrated by persons who feel weak and threatened. If it is too aggressive and persistent, then be a whistle-blower. Otherwise, you can do your best, to be the best, and those suckers will be trampled and wasted.

Please don't be offended
If I offend,
You were bullying me
No, let's not pretend,
The practice of hazing
Never loses its appeal,
You have shown your true colors
And earned the brown seal.

You can call me a mercenary
Yep, I'm the hired gun,
Someone high above you
Decided to give it a run,
And new ideas can threaten
The current status quo,
I sense your hostility
But I'm bulletproof, bro.

"Why didn't you do this?"
Well, babe, you didn't ask,
We mercenary types
Love to be given a task,
I'll show you my skills
You'll see nothing was missed,
But if I show initiative
You'll probably be pissed........
You're the type that would complain
"I never told you to do that"
You can't have it both ways
Now you wear the brown hat.

Each time that I work with you
I will practice my best,
And I will remember
That you failed the first test.

Limelight

Some people have extremely persistent and recurrent Atrial Fibrillation. They might have undergone several Ablation procedures, and may require prescribed antiarrhythmic medications, and still they go back into A. Fib. It is surely a drag (and expensive, I assure you). That's when we pull out the big gun in the arsenal; Ibutilide. It is a complex, and possibly dangerous option, as it is known to cause Ventricular Tachycardia at times (or worse). Typically, the patient's Potassium and Magnesium levels will be measured (and supplemented if necessary). After the IV administration of the drug, we hope to see spontaneous conversion to Sinus Rhythm, or possibly they have just been properly primed for Electrical Synchronized Cardioversion. Whatever the case may be, they will always be monitored for 4 hours, after the administration of that drug.

Ibutilide
I haven't tried,
Nor have I tasted
Dofetilide,
A shot of those
And a 4 hour viewing,
If electrolytes are off
V.Tach may be brewing.

First, a few PVC's
And then bang, it's V. Tach,
If you can't cough out of it
We go ahead and shock you back,
But who wants to do that
Maybe only Hellboy,
Lucifers spawn
Disguised as the Bellboy.

Sometimes Ibutilide
Works just like magic,
Converting your A. Fib
Avoiding outcomes more tragic;
And that's why we watch you
For a standard four hours,
So we can meet at the Limelight
And toast, whiskey sours.

2/23/16

Budget Poison

Sprayed with Mace

To clarify
My biggest reasons,
Why I left
The largest treasons,
The short shrift shift
The demand and the stress,
And the daily reminders
Of the budget mess.

Management
They should know better,
What's more important?
Than a happy client letter,
'Tis the morale of their staff
How they feel treated,
If you don't honor them
They will feel cheated.

And rightly so
Because employees do the work,
Better than a teenager
Fountain soda clerk,
But if you treat them the same
And toss them off the ship,
They will leave you in droves
My advice: Take this tip.

Four and half years
I heard about billing hours,
It was never my responsibility
To schedule or pick the flowers,
That would grace tomorrow's table
It is the nature of our biz,
Not to know, if the next day workload
Would be colossal or just a whizz.

Don't take it out on the employees
Just stop buying stupid shit,
Two-thousand dollar, lock-wires
That's the least of it,
When you could have gone to Home Depot
Bought zipties; cost a buck,
Your fancy wire holders
Surely, they will suck.

Every week I heard about
Billing hours are too short,
Close to 700 days
I am sorry to report,
The duration of my employment
Four years, it's too bad,
I did the work of many
A virtual Galahad.

The Holy Grail is missing
At Sister Euphemia's place,
When they talk about the budget
'Twas like spraying us with mace.

Happiness is............

A new position, returning to a prior hospital. This seems to be repetitive theme in my life, where I work at certain hospitals a couple of times, on different occasions, with a different job description. If you had a look at my career resume, you'd see what I mean.

Anyway, I just finished the final night of my current job, before I begin the new job in two days. I'm leaving the old job because of the way the Unit is managed, and how it is perpetually understaffed, during the final 6 hours of the day. In general, it has become too stressful to me, and I find myself angry every day that I work. So, why should I think that my last day at work, should be a walk in the Rose Garden? Well, I'm not that stupid, and sure enough, the during the final 5 hours, I experienced a major lashing.

Last night at work
And I was abused,
Visitors and family
Shoulda been excused,
Instead, they attacked
With vim and with vigor,
Almost blew my cool
And pulled the trigger.

Betty Lou had
A rabid relation,
Standing up for her
Like a Nazi invasion,
Attacking whoever
Entered their space,
Demanding name, rank and number
From every new face.

Rabid Roxanne
Said her name was Suzi,
She spoke to everyone
Like she was shooting an Uzi,
As if every each one of us
Was in some Cabal,
With verbal vehemence
She was begging a brawl.

Then there was Margaret
She fell yesterday morning,
Perhaps, it was an omen
A heart attack warning,
That prompted Emergency
To send her to us,
A Cardiac Alert
Creates a lot of fuss.

Her family was hungry
Exhausted and tired,
Fourth time for a bedpan
When my minutes expired,
And I had to settle Buster
After a general anesthetic,
The son went berserk
Saying, "Your bedside manner is pathetic".

He was ranting and raving
As I walked away,
After Rabid Roxanne
He might just "make my day",
As I pondered my inner
Dirty Harry, impression,
It's my last night at work
What's with all this aggression?

Finally, Betty Lou went home
And Margaret, got a bed,
And I went home to Merlot
To settle my head.

2/22/16

Paradigm

A dismal outlook in the nursing paradigm.

I applied
For another position,
I'm just a Nurse
And not a Physician,
But one might think
I'm a valued C-E-O,
Cuz the folks where I work
Don't want to let me go.

Come on, there's a million
Nurses, just like me,
Willing to be abused
For the same, almost free,
They have graduated
Are desperate for a job,
They don't care about a watch
With a matching fob.

Oh, the market is strange
In the Healthcare dominion,
This isn't like Law School
And someone's opinion,
Just hire a warm body
Then, throw it on the pile,
If they survive....?
Let them stay for awhile.

You have to kill someone
Four times ten,
To get any attention
And even then,
No one gives a hoot
If they're dead or alive,
You're still guaranteed a job
If you'll come to work at five.

Time to Go

Charge nurse comes to me several times yesterday and says, "Joe Bob, please don't go" (in response to the fact I had the gall to go out and find another job). Suddenly, they pretend to play nice. They say, I could just work 8 hours, would that be less stressful?

Later that day, as we are leaving at 12.75 hours on the shift, and I'm reflecting on the documentation I skipped from 7 hours ago (finally taking care of it would have cost another hour of overtime). Frankly, I'm just too damn tired to do it, and we both want to go home; I say to myself, "Quitting is healthy".

Another nurse said, "Joe Bob, you have options because of your ICU background". Well frankly, I have options, because I made a point of keeping myself current, and educated for 30 years in my field of expertise.

9 Recoveries, 5 Discharges, 3 invasive catheter removals amounting to 1.5 hours of at the bedside time, providing meals and water and fluffing, plus all day educational teaching, plus my own and others necessary break-time, and all of the side consulting like helping other nurses and doctors, and jam all of that into 12 hours.................and try to fit in the necessary legal and prudent documentation?

The other two nurses I worked with had the same experience. We're all burned out, but I'm leaving.

Because, it's time to go.

Job Fight

I applied for a job..........and they are fighting to keep me.

Sure, I'm angry
Listen, why not?
They say I can't leave
Cuz I'm too hot,
The guy who solves
The toughest of tests,
I can't help it
They think I'm the best.

Really, I'm not
I have limitations,
I have a ringing sound
In my eustachians,
It is always there
It might make me crazy,
But they know my secret
I'm not lazy.

I work harder than most
That's just what I do,
I can't help it
If I'm better than you,
I busted my brain
To get where I'm at,
I'm a non-meatarian
Without any fat.

I'm older than most
Of the other Nurses,
Which means I've endured
The brunt of all curses,
Levelled and fired
Bad aim or lucky,
Why I'm still standing?
Ask the Donners in Truckee.

Don't Blame the Dogs

I'll tell you all about my changing jobs another day; now, I have to review another batch of stupid humans. The other day, we had a transfer from an outside hospital. The gentleman had the looks of a recent heart attack, and he came to us for Cardiac Cath and possible PCI. He had the usual comorbidities, so maybe he really did need to have a pow-wow with Fi-Fi the poodle mix-something dog. What do I know?.........I'm just the Nurse specialist keeping an eye on Bob.

Stupid humans
Don't blame the dogs,
Other kinds of pets?
Let's say,
Aardvarks and hogs,
Would ya bring 'em to the hospital
Draped on your arm,
Why the Hell not
If they don't do any harm.

C'mon, don't be a jackass
Please leave them in the car,
As a Nurse, I have to wonder
Is your brain smothered in tar,
From whatever you're smoking
But no, this is the West Coast...
Where any damned kind of animal
Is like a slice of white toast.

Take them to the hospital
Carry'em to church,
On your lap in the car
In the name of research,
Say, they are a companion
They assist you in life,
You're divorced 3 times
Fi-Fi is better than a wife.

Why shouldn't it be Ok?
Fi-Fi keeps clean,
She licks her private parts
Kisses my face, see what I mean?
And I don't get sick
So why should your babies,
If Fi-Fi tries to lick them
Fer sure, they won't get rabies.

So, don't take offense
When I call Security,
When your frickin friendly ferret
Offends my sense of purity,
When I have no idea
What viruses he has colonized,
My patient with Lymphoma
Surely has been compromised.

I just can't get over it
But I won't blame the pet,
It's the owner with a pea brain
They are clearly the threat.

Death at Work

How many nurses actually die at work? I have no idea, but know it does happen. Certainly, our job contains inherent immediate danger to many of us, but what about your sudden demise in the workplace. Domestic violence is becoming a big risk I think, but in general I am pondering the health-death scenario.

Work could kill me
Just like Billy Bob,
Dying at work
Just doing his job,
He was the greatest
That's what we all say,
The best of the best of the best
Any day.

Now he's gone
And what about prevention,
Was there a prodrome
Vying for attention?
Signs and symptoms
Calling him out,
Or was the killer silent
Until his dying shout.

Tho, I don't think he shouted
He just dropped, kerplunk,
They think his aorta
Ripped inside the trunk,
An unknown condition
The dude was healthy as a horse,
The doctor's wonder, Marfan's?
He was long and tall, of course.

Could that happen to us, we wonder
Kick the frame, while on the job?
Where decay and inflammation
Reduced you to a simmering blob,
Returning to the protoplasmic
Origins of life,
Make sure ya have a good insurance
To cover the kids and wife.

Too late now, we miss him
He was a great nurse, that's for sure,
Now, he's floated off to heaven
For a thousand maidens, pure.

Excessive Ambition

This one isn't about me, although it initially looks that way. No, it reviews the actions of a physician, who clearly made the wrong decision; he chose to operate on stable patients, instead of dealing immediately with a life-threatening emergency. Maybe he figured, that merely through his psychic sense of medical mastery, he could delay, and everything would be alright. And in fact, the patient did not crump. However, the choice to postpone placement of a Pacemaker, did force an overnight wait, with just a temporary fix.

The boss won't believe it
But I'm not lying,
We worked overtime
To keep people from dying.

Joe Bob Billy
In 3rd degree,
The family is anxious
Their asking me,
Why have we waited
Eight hours in this booth,
I think I know the answer
But I can't tell the truth.

Doctor E.P.
Is shuffling the deck,
Ignoring your emergency
Thinking, oh, what the heck,
You're talking, and stable
And he's in control,
Everything will be fine
When it's time to rock and roll.

Later on, at 1030
He calls Surgery, for a room,
Saying, "This is an emergency!"
"Complete heart block, spells doom",
But Surgery can't accommodate
His late night demands,
The blame for the delay
Is all in his hands.

Now, it's time for lame excuses
"I'll place a temporary pacer",
And tomorrow, my partner
Can be the blackboard eraser,
Removing my mistakes
My errors of omission,
But the fly on the wall knows
'Twas excessive ambition.

Episodic Affliction

Another round of stress related AFib at work; it only took 30 minutes of morning chaos to set it off.

Stress at work
Caused my A. Fib,
A chaotic pounding
Beneath my rib,
It doesn't feel good
I attest,
The best thing to do?
Go home and rest.

The event this time
I suspect the cause,
Yesterday was chaos
High demand, no pause,
Now the same today
After a 10 hour rest,
Too much work stress
I failed the test.

At least 33 patients
On the morning list,
No extra Nurse
I'm already pissed,
Taking 3 reports
One after another,
And then, two more
I ran to Mother.

I said, I can't handle
The get-ready guy,
I don't have enough arms
I can run, but not fly,
So, find a solution
We need help in our crib,
Then, while taking report
I went into A. Fib.

Having done this before
Just one month prior,
I needed an instant
One day retire,
To put an end
To my episodic affliction,
Despite knowing my departure
Would cause some friction.

One hour following
Propafenone,
Rhythm converted
To the Sinus zone,
It always performs
As advertised,
Though it needs 4 hours
To be formalized.

Doctor E.P.
Had his say,
Strongly advising
Ablation today,
But I'm not convinced
Regarding that narration,
I work in the field
And see every complication.

That E.P. dude
Offered a free ablation,
But I responded
"I just need a vacation",
He turned away
And shed a tear,
Because "No" is an answer
He hates to hear.

Well, that's my story
Related once again,
A paroxysmal episode
Just happens now and then,
And when I finally choose
The invasive endeavor,
I'll find an expert doctor
With a lightning laser lever.

Anti-vaxer Barbarians

Finally, a poem regarding the practice of anti-vaccination.

Barbarians

I completely support a mandate
In favor of vaccination,
I am a health-care worker
With a moral obligation,
To protect the vulnerable citizen
The young, the old, the compromised,
With multiple health conditions
And so much research; I'm surprised,
When medical professionals
Indeed, any public attendant,
Claims a singular, personal exception
For their self or their dependent.

I'd rather allow a gun
For the greater good and everyone,
That would be safer, than allowing you
The anti-vaxer point of view,
Based on personal choice
And a dubious set of facts,
Why not bring your family to the chopping block
I'm just now sharpening my ax.

I can not fathom the concept
Public servants, sworn to protect,
College educated
With scientific neglect,
Promoting anti-vaccination
These health-care-less proletarians,
More dangerous than Genghis Khan
And hordes of barbarians.

1-6-16

Survival Decision

Obesity is an all gender issue. Luckily I don't suffer from it, nor do I know all of the causes, influences, treatments, solutions and so on. I just write about it as it affects my Nursing experience. This time I chose "he" instead of "her" to show my sensitive nature.

Survival Decision

At 5 foot 3

Three hundred seventy nine,

Even a hundred pound weight loss

Would be, right and fine,

But no, just the opposite

Since his previous visit,

He had gained another hundred

And wonders, why is it?

That he suffers hypertension

And diastolic dysfunction,

At 48 year old

He is at a crucial junction.

Moaning and groaning

And thick as a brick,

His weight is a death sentence

He needs to fix it right quick,

Because his lack of good health

Is a result of the weight,

Multi-organ dysfunction

Would like to schedule a date.

No diabetes

And no heart disease,

Pulmonary hypertension

Could kill him with a sneeze,

The cure is diet and exercise

And a stomach revision,

Survival is an option

But awaits his decision.

12/27/15

A Blogger and a Clogger

Nursing can be bloody, messy work. Oh, ya, because that's part and parcel, to some area's of the trade. Paramedics, EMT's, operating rooms and all the rest.................there is blood coming out. I'm not grossed out, or frightened, and yes, I see dead people. But, I am never cavalier about it. I'm careful and cautious...............afterall, I'm a Clogger by trade.


First I was a Nurse
And then became a blogger,
In the course of a work day
I'm an expert vessel clogger.

Folks come to us for recovery
After artery and vein poking,
When those same patients see what we remove?
They know we're not joking,
Regarding bleeding and bruises
And horrid hematoma's,
Still some will go home
Like they were in a deep coma,
Hence, they ride the motorcycle tomorrow
Up the highway to Kingvale,
Stop for gas, and fall down
Dusky and pale,
Because they didn't notice
The fifty mile groin bleed,
There's no cure for stupidity
When it comes to riding that Harley steed.

We try not to make them worry
No, it's better to be wary,
99% won't bleed
It's the 1% that's scary,
Because usually, that's Billy Bob
Doing what he does best,
Compliant taking the blood thinner
Stupid about the all the rest.