27 February 2023

how to be a psychiatric nurse


Not much has changed,
It seems, in Psychiatric Nursing 
Since like the 1950s. 
It can be a real Snake Pit. 
What has changed, is that 
We’re moving away from 
Old Institutions- with indefinite stays. 
The stigma is being challenged. 


Psych Nurses wear street clothes 
Usually- I worked adolescent psych
When Kurt Cobain killed himself. 
I worked so much it was “crazy “!


In the Mid Century, Doctors 
Thought they had it right. 
All new treatments, medicines.  
But now, those things seem barbaric. 
Most of those first-generation 
drugs are now discontinued. 


John Nash, mathematician 
(A Beautiful Mind)
Is seen here receiving Insulin Shock. 
They inject large amounts of insulin, 
The patient goes into a coma,
And glucose is given to revive them. 
It’s often used with ETC
Electric Shock Therapy. 


The Frontal Labotomy  
is never used nowadays. 
Thank goodness. 
Wikipedia say this era represented 
“The moribund and demoralized 
psychiatric profession at the time.”
The Glory Days of the Sanatorium. 


What the hell did this ever accomplish?
My first “real job” was at Timberlawn
Psychiatric Hospital. Here in Dallas. 
Every summer until I was old
 enough to be a Nurse Aide. (18)


I worked in Medical Records 
I worked in a literal basement,
Re-jacketing the old charts from the 1800s
And early 1900s. Cool history. 


People want their loved ones home. 
Placement is falling out of favor. 
Except for short term stays 
And emergency situations. 


Lots of new drugs. 
Anti-depressants,
Anti-anxiety meds,
Anti-psychotics. 
Lots of side effects, most mild. 
It’s interesting to note that most
Psychotropic drugs are only
tested for a few weeks. Or months. 
Yet, many people stay on them for decades. 


Then, there is “Dual Diagnosis”
Which is a chemical addiction 
Coupled with a chronic psychiatric condition. 
The gentle idea is that people are 
Looking for a way to self-soothe. 
And they get into all kinds of drugs. 
And why not? If doctors can’t help,
People turn to anything that will. 


Regular Rehab is a good career option.
Lots of people just wanting to quit
And they don’t want to go Cold Turkey. 
Most people are there voluntarily. 


It’s definitely a reflection 
of how society is changing. 

Not too long ago, the DSM 2
(Diagnostic and Statistical Manual)
-The Bible for psych - 
Listed homosexuality as a mental disorder. 
The transgender community used that model
To destigmatize and decriminalize 
Their perspective. 


Trends come and go in psych. 
Multiple Personality Disorder, 
Personality Disorders, 
Schizophrenia,
BiPolar Disorder,
PTSD,
ADHD, OCD,
Suicidal Ideation,
Even Eating Disorders. 
Geri-Psych, Memory Care 

My heart goes here 
Because of the possibility of change. 
We’re poised to make a difference. 
Will this be the generation 
Who finally embraces change? 

Psych Nursing is real Team Nursing
You’ll never walk alone when you’re 
On a psych ward. Amen. 

testing days


The sky matches my mood. 
Non-descript. Bland. Ugly. 
With a hint of anxiety and a 
Side order of WhatThe Hell. 


Nothing is worth this. 
Actually it only took a few minutes 
When you’re upset, 
It changes how you perceive everything. 


This is a broom. 
Like just twigs. 
This is what we have at work. 
It’s short, too. 
So you have to stoop to use it. 


I took out all the furniture 
(from work) and cleaned. 
Swept, mopped, cleaned. 
It took a few hours with help. 
This has to be done a few times a year. 
No other Nurses clean. 
But they all want to work on a clean place. 
Go figure. 


It’s not my job per se-
But it really is. 
We’ve gone from “Quicquid Quae”
“Quidquid Necesse Est!”
(Whatever it takes)
To “Capit Semper!”
(Whatever…)
Ease-play excuse-ay my Atin-lay!
(Lol) 


In so doing, one of the plugs 
came unplugged. They do that now and then. 
We have many many machines here. 
And in the old days, one power outlet per wall
Was the norm. Cheapskates! 
So we use HD power strips. 


I get a call in the night
that one machine didn’t work. 
Well, is it unplugged? 
“I don’t know. It just won’t work.”
No treatment. None. 
Also the suction was unplugged. 
This is the 3rd week in a row. 
No- it’s the fourth week in a row. 
So no suction happened. 


When you can’t cough, can’t swallow,
The snot snot goes to the 
poop poop and the boom boom 
of the dada googoo gaga. 
Aspiration pneumonia. 
No wonder the kid isn’t getting better! 


Still picking up groceries curbside. 
WalMart messed up my order. 
I told them this wasn’t mine
But they put it in the car anyways. 


Now I can’t say I never catch a break. 
At least it’s something cool. 
Of all the things to fall into my lap. 
Quest products ! 


I feel a wee bit guilty. 
Kinda like in Les Mis 
How 24601 stole a loaf of bread. 
I guess now I have to go 
on the run for 20 years! 


7 scrubs for 7 shifts. 
Once this nurse clears this week,
I’m back to mega shifts. 
I dread it, actually. I’m tired. 


I reached my weight goal. 
Back to my baseline. 
Plus- No more heartburn! 
After TWO YEARS post covid vaxx 
And I’m healthy again. Yay! 
Full of energy! Able to clean. 
Able to bend down. Able to endure. 
No more Hiatal Hernia flare ups! 
No ulcers. No reflux. No PPI!
No anemia. Good iron levels!
Instead of taking my Victory Lap,
I’m mad because there is an adult 
That can’t plug in a machine. 
There’s an adult who won’t help 
With his own trash or his own cats. 
I guess it’s irrational to expect perfection. 




3 nights now. 
Kratom is not for sleep. 
It’s too energizing. 
And pulls so much fluid! 
Up to pee like 4 times last night. 


My solution- put on some Mozart. 


My lunch. 


My Kratom. For pain. 



Spring Is Here! 
Tell it to go fuck off for me, will ya? 
(Just kidding. I’ll tell it myself. )



26 February 2023

how to be a pediatric nurse

Pediatric Nursing is its own entity. 
It’s rough to see pictures of sick kids. 
But this is what we’re all about. 
We focus on the healing. 
Not just the pain. Disclaimer. 


Antley Bixler Syndrome. 


Omphalocele
Liver or other organ 
Is external at birth. 


Tracheotomy (pronounced traak) 
Is common with kids. 
Kids aren’t very good breathers sometimes. 
Think about it. Snotty noses = kids. 


Kids with trachs don’t always have a vent. 
But some do. 
Some just use it at night. 
Some - all the time. 


We think quadriplegia is total paralysis. 
Or that you have no feeling in your limbs. 
Not always. 


Functional quadriplegia, spine issues, 
Kyphosis, scoliosis, lordosis…
Subluxation of the hips…
Joints dislocated…


Lots of Ortho. 
Lots of Speech Therapy. 
We ❤️ Scottish Rite Children’s Hospital. 
Dallas is lucky. People come from 
All over to get treatment from the Shriners. 
They have never charged a dime 
For any service provided to any child. 

Little hands need lots of love. 
Kids don’t know they are sick! 
They don’t know what comes next. 

Kids need extra movement 
And range of Motion (stretching)
Because the bones can grow faster
 than the muscles- which pull-
And contractures develop. 


Kids should not have to face such things 
And yet- here we are! 


Kids with burns. 
Kids with cancer. 
Fat kids. Skinny kids. 
Kids that climb on rocks. 
Munchhausen By Proxy. 
Child abuse. Even terrorist attacks. 
Kids that are trafficked for sex. 
Kids that give birth to babies. 
Kids with COVID- HIV- etc. 
We stand beside them all
And protect and guide them. 

*Clara Barton. Nurse during the Civil War.*

Into this terrifying mix, 
the Nurses go-
Because we know we 
Can and DO make a difference. 
Even a wee difference. 
No life is too wee to have love.