Product Review: The Nice Voice Surgical Mask

Boston, MA --  Healthcare professionals have reason to rejoice with TLC Industry's new language  transformation filter - The Nice Voice - that promises to allow medical professionals to speak their minds without fear of losing their jobs.

Never let honesty get you in trouble again.
The Nice Voice was created by Robin Hruska, a hospital floor nurse reprimanded last year for telling an attention seeking  20 year-old female admitted through the ER with generalized weakness - after she refused to go home and take care of herself - to put down her phone, stop being a whiny little brat and get her ass out of bed.

Though it looks exactly like a surgical mask,  The Nice Voice contains hidden proprietary electronic circuitry that can sense angry, mean or cynical comments in real time and transform them into beautiful streams of poetic complements.

"I thought it was ridiculous that I couldn't say whatever was on my mind at work,"  said Robin, who never missed an opportunity to provide witty commentary after a patient-family-doctor tirade.

Now with her Nice Voice, Robin can tell it like it is. "Even though I'm surrounded by idiots all day long, I feel true to myself saying what I'm thinking without fear of losing my job." said Robin, who's colleagues actually miss her edgy attitude, except for that one little snitch in every bunch.

Robin's first post marketing test of The Nice Voice worked amazingly well.  While talking to nurses John and Brenda at a rare lunch break, Robin said, "Did you see that slutty Facebook picture of Cindy yesterday?  What a whore."  But what John and Brenda actually heard was, "Cindy is one of my best friends and I would waste Dilaudid with her anytime."

While some patients may wonder why their nurse is wearing a surgical mask, Robin says this concern is easily alleviated by telling the patient they got the flu from their flu shot and refuse to get one again.  "Patients are well aware of the flu shot causing the flu and understand that angle completely," said Robin.

The Nice Voice also works well in communicating with difficult doctors and surgeons.   Robin says she is constantly asking for orders to control her old-naked-roaming population.  She recently spoke with a Hospitalist to request wrist restraints but was told no.

Robin told the Hospitalist, "Give me wrist restraint orders or I'm going to be your sh*t storm for the rest of your life."  But what actually came out was, "I'm thankful for the excellent care you and the rest of your Hospitalist team provide day in and day out in a very difficult and challenging environment."

One surgeon going through his 7th mandatory sensitivity training class in two years tried The Nice Voice for one day and will never go back to the way life was before.  "I just put on my Nice Voice surgical mask every morning and relive the good old days,"  said the God-surgeon.

Robin gave the mask to several nurses on her floor and they too were amazed at how therapeutic it was to say what they actually want to say without worrying about hurting the feelings of some emotionally unstable patient or colleague.

Jenny Armstrong, a new graduate nurse, who is currently molting from kind and caring nurse to burned out and cynical nurse, gave The Nice Voice a try and found a new inner peace with saying what she meant.

"Go home lady.  You're driving me crazy!"  Jenny told a hovering wife who wouldn't leave the room.   But what the lady heard was, "Your husband would be grateful to know you never leave his side in the hospital.  You are his shining light during times of pain and suffering."

Down in the ER,  Dr. Frank Fillmore was amazed at how good The Nice Voice made him feel by not having to be politically correct all day long. 

When dealing with a crazy lady interrupting his football game,  Dr Fillmore said, "Your pathetic pseudoseizure attempt is giving me pseudoseizures."  But what she heard was, "I thank you for choosing our hospital for your healthcare needs.  We know you have many choices and we are honored you chose our hospital to seize with us."

Robin says she's considering using The Nice Voice in public too, especially at Walmart.  "I was in a checkout lane at Walmart when some lady pulled out 72 coupons, her checkbook and a bag of pennies. So I put on my mask and let her have it.  But what she actually heard was 'Merry Christmas.  Take your time.  I have nothing better to do.'"

Chart Attacks a Leading Cause of Death Among Nurses.

Boston, MA -- Nursing is one of the most dangerous jobs in America, but the reasons may surprise you.  Most nurses have been kicked, punched, scratched, spit on, pooped on, bit on, hit on or called names at some point in their career, but physical assault was not the reason nurses cracked the top ten list for most dangerous jobs in America.

Charting now feared as workplace hazard
An epidemic of chart attacks is sweeping through hospitals with alarming speed, afflicting thousands of nurses with deadly consequences.  A chart attack - often mistaken for a heart attack - is the collection of signs and symptoms that occur during nurse charting opportunities, defined by researchers to include any nurse at work and any nurse with a computer at home.

Symptoms include the sensation of an elephant sitting on the chest,  left arm pain, shortness of breath, nausea, diaphoresis, lightheadedness, syncope or being irritated by something.  An elevated troponin is often found with ECG changes, including tomb-stoning ST elevation and runs of VT-VF alternans.

After reviewing data from thousands of hospital EHR systems, researchers found a direct correlation between nurses who had presumed heart attacks and nurses who chart, leading journalists to  publicly declare that charting causes chart attacks and labeling chart attacks as a cute new leading cause of on-the-job injury in America.

Researchers discovered hundreds of cases where hospital rapid response teams (RRT) were called to assist charting nurses, including Ben Fester, a 47 year-old nurse with three cardiac stents last year.

"We just thought he was exhausted from documenting accurate I's and O's," said Tonya Bedder, the rapid response nurse who found Ben face down while charting that he didn't have time to finish charting.

Health and Human Services used this research to declare electronic documentation as wildly successful.   "This is the clearest example so far of the benefits of electronic health records.  If not for the heroic documentation efforts of our nurses,  we would have never known charting was killing our nurses," said HHS Secretary Sylvia Mathews Burwell, who subsequently signed an order requiring all nurses to chart their chart attack symptoms.

Some nurses were surprised at their misdiagnosis of heart attack.  "You mean I had four stents followed by a five  vessel cabbage for nothing?" said nurse John Flemming, a 2-pack-per-day smoker who always volunteers to take all the patients out for fresh air and now believes he was actually having a chart attack when his symptoms hit.

To treat a chart attack, researchers recommend nurses stop charting or stop thinking about charting for five minutes, and then try again to see if the symptoms return.  They urge against seeking medical care, as this would interrupt the nurse focus on completing all necessary charting activities.

However, nurses complained this recommendation was not realistic.  "Our hospital policy says if we stop charting, we get fired," said John, who had just finished charting a respiratory rate of 20 on all his patients.

Hospital Weights Adjusted Downward After Thanksgiving, Scoring Patient Satisfaction Win!

Memphis, TN -- A nurse at Grover Hospital struck clinical gold Monday by recalibrating hospital scales back 10 pounds, 20 pounds, 40 pounds, even 100 pounds and more - in the weekend  aftermath of Thursday's annual Thanksgiving Day bing - to try and win the third annual Most Improved Patient Satisfaction Scores Floor Contest.

Customers admitted after the holiday feast will often complain to nurses they gained too much weight gorging on turkey and stuffing.  So Brian Jamison, the good looking male nurse known hospital wide for his inappropriate comments, decided to take matters into his own hands.

"I was assigned  Gerty, a 90 year old with CHF and TOADS* who went on and on about gaining 10 pounds after Thanksgiving and lamenting about her days as a 120 pound Roxette while I was trying to enter yes-no questions into the EHR.  I could see my patient satisfaction scores declining before my eyes," said Brian, who's amazing pornstache sealed the win for his floor's No-Shave November contest among the male and female nurses.

Brian was not about to let a lodl** ruin his chances at winning another holiday contest, so he quickly zeroed out Gerty's scale at minus 10 pounds and helped her up.  "The scale says you've lost five pounds this week.  Way to go sexy!  You're ready to dance!" he said with that special murse pornstache smile.

"I don't know where I am or what's going on, but I just felt butterflies under my skin after that good looking young man told me I lost five pound," said Gerty, who somehow works her way out of four-point leathers and wanders the halls buck naked every time she gets admitted.

With Gerty's success behind him, Brian's ambitions for perfect patient satisfaction scores grew with every patient, racking up over 247 pounds of weight loss satisfaction gold in just one 12 hour shift.  "I had patients sending ME flowers before my shift was even over," said Brian who normally feels bad for the other nurses when a homeless, one-legged, drugged-out meth addict gets more flowers in the hospital than most of his colleagues get in a year.

Some doctors were mildly concerned, albeit briefly, about the effect inaccurate weights might have  on their patients' safety, but then quickly realized happiness always comes first.   "On one of Brian's dialysis patients, I had to add 17 kg of volume during his Saturday run after he lost nearly 40 pounds the day after Thanksgiving.  He ended up on a ventilator with a cardiology consult for reverse aquapheresis management, but the last thing he said was 'Give me that satisfaction survey.  You're getting all fives',"  said Dr. Henry Allensworth, a nephrologist who who normally carries his own scale with him as a substituted for hospital wide inaccurate I's and O's,  but forget it this fateful weekend.

One gastric bypass candidate actually canceled her surgery scheduled for next week when Brian informed her of a miraculous 170 pound post-Thanksgiving weight loss achievement while hospitalized for acutely chronic bilateral non-celulitic cellulitis.

Unintended consequences of weight adjustments were popping up everywhere.    Pharmacists were forced to use a modified Cockcroft-Gault creatinine clearance formula using a Coefficient of Brian (CoB) to account for his unorthodox, but highly successful, patient satisfaction initiative.
 Modified Cockcroft-Gault CrCl = (140-age) * (Wt in kg*CoB) * (0.85 if female) / (72 * Cr)
Results on Brian's floor were nothing short of remarkable.  Average body mass index dropped over 30 points, causing a loss of $600,000 in Medicare reimbursement for morbid obesity as a complicating condition and mortality rose 14% due to physician volume mismanagement in 72% of patients - a rate 10% higher than normal.  But more importantly, patient satisfaction scores were perfect in  97.9% of Brian's patients.

A retrospective analysis of the data confirmed the 3.1% failure rate was due to Brian's failure to pick 42 pounds - the desired weight of his anorexic patient - instead of the 43 pounds for her weight that he just eyeballed while also picking non-even, believable numbers to chart for her complete set of vital signs.  For that, she gave him zeros on all his patient satisfaction scores.

After winning the contest and being promoted to Inpatient Manager of Perception, Brian ordered all nurses to manage up their scales by managing down their weight and also anew dress code that included mandatory participation in No-Shave November for all nurses because he thought it would be fun.

*Too Old And Debilitated Syndrome
**little old demented lady

Thanksgiving Meme Humor Collection

Enjoy this fine collection of Thanksgiving Day humor meme's you won't find anywhere else except on The Happy Hospitalist's Facebook Page, Pinterest and Twitter accounts.  Make sure to join today and never miss another day of the humor action again!  And don't forget to check out the hospital that closed for the entire Thanksgiving weekend!

"Today we are thankful for Ativan. Oh yeah, and Haldol too."

Today we are thankful for Ativan.  Oh yeah, and Haldol too medical humor meme photo.

"Prepare yourself.  Understaffed hospital coming!"

Prepare yourself.  Understaffed hospital coming humor medical meme photo.

"Oh, so you gained 15 pounds of fluid after Thanksgiving?  Tell me more about how my dialysis orders are all wrong."

Oh, so you gained 15 pounds of fluid after Thanksgiving?  Tell me more about how my dialysis orders are all wrong medical humor meme photo.

"Prepare yourself.  Pureed turkey and stuffing is coming!"

Prepare yourself.  Pureed turkey and stuffing is coming medical humor meme photo.

"Prepare yourself! Holiday admits are coming!"

Prepare Yourself.  Holiday Admits are Coming medical humor meme photo.

"What if I told you Thanksgiving was a fowl holiday?"

What if I told you Thanksgiving was a fowl holiday humor meme photo

"I don't always celebrate Thanksgiving, but when I do I drink Wild Turkey!"

I don't always celebrate Thanksgiving, but when I do I drink Wild Turkey humor meme photo

Hospital Closes for Thanksgiving Weekend. Doctors and Nurses Rejoice!

Denver, CO -- The parking lot was empty at Piedmont Hospital today after security locked the doors, turned off the lights and erected 'No Smoking or Trespassing' signs throughout the campus.   Administrators made good on their promise to close the hospital for the extended Thanksgiving holiday weekend allowing all doctors and nurses a rare vacation at home with their families, a strategy in direct competition with Black Friday Hospital Deals.

The idea was born after Nurse Jenny, a new graduate who was upset nobody ever told her before she went to nursing school that she'd have to work most holidays for the rest of her life,  half-heartedly put the idea in the Suggestion Box last year.

ICU cleared out with patient-family-centric policy
"The suggestion box is a joke.  I was shocked when Jenny's idea became a law.  Every year I ask for a raise, better staffing and a Hoyer lift that can handle more than 400 pounds and I get nothing.  But Jenny gets us a four day holiday weekend on her first try?" said a veteran nurse who hasn't seen a suggestion implemented from the box since 1986's  idea to not have to stand up when a doctor entered the room.

The 400-bed level one trauma center became the first hospital in the country to trial the four day Thanksgiving holiday closure. Preparations began last week when the emergency department went on diversion for all ambulances and walk-ins.

"Whenever an ambulance would call requesting transport to our ER, we'd tell them all our doctors were tied up with mandatory Ebola training exercises and they would have to divert to another hospital.  We just couldn't risk having a train wreck  traveling by ambulance to an LTAC unit from another hospital divert to our hospital en route and trash our plans to shut down," said Johnny Flemming, an ER doctor who plans to read Gomerblog nonstop during his 4 day holiday weekend.

To prevent any potential walk-ins from getting admitted in the last week, an EMTALA compliant screening exam was provided in triage.  Over 98% of the patients were determined to have non-urgent conditions and referred to an urgent care center.  The other 2% were evaluated by the ER doctor but diverted to another hospital because the Hospitalists had implemented a one patient per day admission cap for the week leading up to the holiday weekend and the ER had no way of verifying if one patient had already been admitted.

By capping admissions at one patient per day, Hospitalists did their part to ensure hospital beds were emptied by Thanksgiving Day.  "A week ago I was rounding on 25 patients a day.  Yesterday I rounded on one patient and that's just because the social worker had already left for the day and the patient didn't want to go home because he couldn't find his shoes and nobody knew what to do, "  said Heather Valentine, a Hospitalist, who plans to make Oreo turkey cookies from a picture she found on Pinterest yesterday.

The intensive care unit, normally filled with chronically debilitated patients who are alive, but not really, was emptied and closed down two days before Thanksgiving by implementing a patient-centric-family-centric-extended-family-centric-non-english-speaking-centric-non-nurse-centric-no-wrist-restrain policy.  Starting last week, all ICU patients had their wrist restraints removed in favor of bedside-family-talk-down therapy for any agitation and confusion.  All sedatives were added to the list of medications in critically short supply and restricted to end-of-life patients only.  Miraculously, patient after patient self-extubated and were determined to be end-of-life, filled with compassionate Ativan and died peacefully in their ICU bed.

"It was the most glorious week of celestial discharges ever," said Dr. Valentine, who usually wins ICU BINGO at least twice a month.

Some hospital administrators wondered how Piedmont hospital could afford to shut down for four days, but an internal memo provided to The Happy Hospitalist  suggests hospital CFO Blake Banner is projecting a 30% labor cost advantage over the next 10 years by closing during Black Friday sales.

"The more indebted our employees become, the more insecure they are about leaving their jobs.  That will allow us lower annual cost of living adjustments, fewer bonuses and a larger mix of crappy benefits over time.  If this closure is successful, I recommend a trial of Christmas and Columbus Day closures to take advantage of retail sales events during those times as well."