Non-Compliant Croatian

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

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

Risky business, that's what it is.

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

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

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

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

9/18/16

Street Racing Remains

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

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

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

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

Talking in my sleep

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

Hammer Head

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

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

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

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

Pass the Test

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

Pass the Test

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

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

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

A Bad Batch of Heroin

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

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

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

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

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

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

9/10/16

Self Harm

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

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

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

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

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

Every Day Occurence

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

Maniac

Losing my foot

After fingers and toes,

I put too much Cocaine

Up my nose,

Then I moved on

To crystal Meth,

Now I'm flirting

With sister Death.

Another thing

My kidney's are shot,

I get hemodialysis

Piping hot,

My mouth is full of Herpes

I know it looks bad,

But this is my life

So don't feel sad.

I would gladly do it all

Over again,

Nothing feels so good

As Meth in a pen,

Shooting up my veins

Until they were all gone,

Then having a seizure

On Billy-Bobs lawn.

I'm a regular visitor

At your medical center,

I've got Medi-cal

So, I'm a destitute renter,

Sucking up resources

I'm unrepairable,

And I do my best

To be unbearable.

Spit at my nurses

Call them bad names,

Those are a couple

Of my favorite games,

Crap in my bed

And smear it on the rails,

Scratch Betty Lou

It's under my nails.

Act like a maniac

What else can I do?

I did this to myself

And I hate you.

I will survive

And go back to my hole,

I'll return in a month

Because that's my role,

After snorting some Meth

With ketoacidosis,

In complete Liver failure

My new diagnosis.

9/8/16

That Rhythm Again

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

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

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

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

9/8/16

Algorhythms

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

Anyway, back to the topic of Jargon.

Body Handling Algorhythms

Old methods, by a newer name,

Quasi superior importance

In the technical jargon game,

21^st century scholars

Doing rewrites on concepts and theories,

To appeal to a new younger audience

Repackaged as classes in series.

Knowledge expands

As new stuff is discovered,

Old stapled handouts

Are bound up and covered,

Add a couple fresh ideas

Publish, package and sell,

Force the workers to read it

Or consider leaving the cartel.

8/30/16

Hypoxic U-Toxic

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

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

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

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

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

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

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

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

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

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

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

Out of Whack

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

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

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

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

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

Grief

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

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

Grief

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

Old Job

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

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

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

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

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

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

Skin Deep

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

Skin Deep

What they say is

Beauty is only skin deep,

Some spend thousands of dollars

And lose a fair amount of sleep,

Attempting to keep it perfect

Thinking, it’s part of my charm,

The pills, potions and treatment

Often causing much harm.

All Dr. K, ever says

Is protect from the Sun,

When you’re playing outdoors

In the midst of your fun,

Slather on sunscreen

So you look something like Crisco,

You will fit right in

Visiting San Francisco.

7/11/16

Bloody Smell

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

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

Mark-5

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

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

Skin Wager

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

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

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

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

Total Rewards

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

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

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

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

Dental Dana 49

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

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

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

6/16/16