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.
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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.