Wednesday, August 30, 2006

Another ode to my Dentist:

A Perfectionist Driller

That devilish dentist
Always looks harried,
Is it because her last
Two patients were buried,
Or does she need extra money
For housing and food,
Since her income was garnished
Because she was sued.

I don't know, I don't care
As long as her aim,
Is steady and precise
And matches her fame,
As perfectionist driller
And cosmetic master,
With a little more coffee
She'll get it done faster.

A satisfied customer
Is a boon for the trade,
With a couple like that
Your business is made,
By word of mouth
And glittering smile,
The bucks will roll in
And make a big pile.

Fibril_late; 8/93

Thursday, August 24, 2006

Even my Dentist felt the attention of my rhyming muse.

Putty In Her Hands

I’m always fascinated
In a painful sort of way,
How I let my dentist hurt me
And then I gladly pay,
She has a special touch
And I’m sure it’s not immoral,
But she knows her way around
When it comes to being oral.

When I step across the threshold
And come into her realm,
I follow her directions
She’s the captain at the helm,
I sit down in the chair
And survey her magic tools,
I hand over my volition
And say yes, to all her rules,
I am putty in her hands
My mouth her territory,
I’ve given my permission
To do it for Old Glory!

Finally she releases me
To venture out the door,
Pain and pleasure all at once
Yes, I’ll be back for more.

Fibril_late; 8/93

Monday, August 21, 2006

Dang, I must have been ticked off with Surgeon's back in '93. Who knows what the heck was going on?!?

Nobody's Crying

I'll take another hit
About surgeons, generic,
They fashion themselves
As some kind of cleric,
In direct communication
With the heavenly father,
Who admonishes them
Do it right or don't bother.

But so many of them
Reinterpret the saying,
They won't do it right
Unless somebody's paying,
As their bank accounts grow
They feel glorified,
There is little remorse
When someone has died.

It's business as usual
In a world of disease,
Make money like crazy
As much as you please,
Who will question the need
Of a man who is dying,
If he's willing to pay
Why nobody's crying.

Fibril_late; 7/93

Sunday, August 20, 2006

Here I am, picking on surgeon's again. What's up with those guys, anyway? The ones I put in the spotlight, are usually the arrogant ones. Like anywhere in society, arrogance speaks boisterously and carries bad breath.

The Safety Of Your Parts

If you suspect you have
A colon deviation,
Be generous in terms
Of contemplation,
Because a surgeons role
Is one of keen attention,
He lives and breathes
For cutting intervention.

To talk with him you must
Resolve to shout,
Or he'll send you home in stitches
There's no doubt,
Because he rarely pays attention
To his clients,
He always gets his way
In bold defiance.

His opinion ranks way up there
With his Savior,
Who sanctions all his
Childish behavior,
Unknowingly, this God
Has just been had,
His surgeon-son says, "Thanks
Now kiss off Dad".

Tread carefully
The path of intervention,
Probe your surgeons' depth
Of sane intention,
To guarantee the safety
Of your parts,
Have a second opinion
Before he starts.

Fibril_late; 7/93

Friday, August 18, 2006

Oh, we nurses; we're just like everybody else in thier miserable jobs. So often, we sit around and bitch about all the petty stuff that complicates our days. Or, we sit around and talk about how we were smarter than some doctor, when we pulled some poor patient back from the brink of death. We're just like the TV news, always reporting the sensational stuff. The blood and gore.
Truly though, we are deeply caring individuals, who hold sacred the tenuous thread of life and the most special, secret experiences we hold close to our hearts. I call these things:

The Sacred and Healing

I listen to the tales
That my nursing cohorts tell,
After time, there's repetition
The favorite stories from hell,
But often the ones
With the most precious feeling,
Are those we keep secret
About the sacred and healing.

You see, it's hard to convey
The uniqueness of spirit,
We can talk all around it
But no one can hear it,
We attempt to describe
The subtle ways we were touched,
But the completeness of the experience
Can't be shared; it's too much.

Some call these things miracles
I call them this,
You had to be there
Or else you would miss,
The moments that no one
Could ever have known,
Defying logic and science
We were witnessed and shown.

I saw a man
Who died of lung disease,
When his heart finally stopped
No one gave it a squeeze,
But his was no ordinary death of the day
What a few of us witnessed
I'll try to relay.

The cardiac monitor showed
When his heart ceased to beat,
He was no longer breathing
It was a remarkable feat,
Then he was pronounced dead
By a doctor of good standing,
And what I saw that night
Was better than a moon landing,
After about 30 minutes
The dead man came back,
His heart began to beat
His breathing got on track,
And as he slowly woke up
We gazed at him in wonder,
There was no explanation
Nor any medical blunder,
'Twas just one of those things
Beyond the telling and feeling,
We had witnessed and been blessed
By the Sacred and Healing.

Fibril_late; 8/18/06

Thursday, August 17, 2006

Here's a grim and hardly sobering look at how some physicians won't stop their medical care, prolonging the inevitable death and so on. End of life issues, that many nurses like myself had to struggle with every day of our careers.

Still Going Strong / The Afterlife Dance

And still going strong,
Three months too long,
All for the sake
Of his surgeons pride,
Who claims that none
Of his patients have died.

On our service
You're always a code,
No matter how long
Or crooked, the road,
If your organs should fail
It's hardly our fault,
You should have laid off
The tobacco and salt.

The poor old guy
Just lies in his bed,
As visions of other days
Dance through his head,
And his fifty year wife
Looks so dazed and worn out,
She can not quite grasp
What this show is about.

The surgeon will tell her
That Fred is ok,
A little bit better
On his ninety-ninth day,
Because rumors were heard
That he breathed once, last hour,
So it wouldn't be proper
To turn off the power.

These almighty doctors
With statistical pride,
Just think about numbers
When people have died,
Because it makes it real tough
When they're applying for grants,
If too many clients
Do the afterlife dance.

Fibril_late; 7/93

Wednesday, August 16, 2006

From 1981 to 2000 I worked the night shift. I liked it, but that was a period where I learned to get by with little sleep. I think my short term memory was affected at times and I sought to find the cause of forgetfulness. I discovered my thoughts were falling into the "Bermuda Rectangle" and often lost forever.

The Bermuda Rectangle

There's a spot where I work
In one of the hallways,
Where my memory goes blank
Not once, but always,
A vacuous vortex
Like that Bermuda place,
To be more specific
It's a rectangular space.

I have several theories
That I can expound,
Till the day comes along
When the real one is found.

I think it's just one
Of several collectors,
That somehow is trapping
Invisible vectors,
From gamma ray fields
And thallium scans,
Magnetic images
And full body tans,
The morning chest X-rays
With their particle spray,
Are sucked into the vortex
Where the beams are at play.

In previous jobs
And all types of work,
I don't ever recall
This strange memory quirk,
Then one day I sought
Some workplace enjoyment,
And I went and acquired
University employment,
I trusted that foxy
Nursing recruiter,
Knowing what I know now
I should go back and shoot her,
Because each time I step
In the Bermuda rectangle,
My brainwaves acquire
A new twisted angle,
My memories are stolen
While lives are at stake,
What was planned as a broil
Turns into a bake.

I think I am done
Is this June or September,
Just what did I write about
I don't remember.

Fibril_late; 7/93

Tuesday, August 15, 2006

The ICU is full of all sorts of electronic monitors. The majority of them display their information with some sort of visual waveform or tracing that marches across the viewing screen. There are many reasons that might cause those waveforms to get crazy, such that unreliable information is displayed. Sometimes it's just a matter of interpretation. So many possibilities........

The Nature Of The Waves

Have you ever wondered
Why the waves get weird,
Falsely elevated, or
Completely disappeared,
Is it merely just a factor
Of a bent or busted tube,
Would it benefit your patient
To have a twenty minute lube.

Is it possibly apparent
That the readout might be true,
The skin is cold and clammy
And faintly colored blue,
Then the doctor wanders in
While muttering a curse,
Irate, that he's been bothered
By an "over-reactive Nurse".

Dr. Mouth has been engaged
But his mind is slipping gears,
The execution of his destiny
And fulfillment of her fears,
Will lead him to denounce
The writing on the wall,
He won't accept the blame
That he made a lousy call.

The outcome isn't always
The disaster that I render,
At times the IV tubing
Is like a salad in a blender,
When your dazed and crazy patient
Is chewing on the plastic,
The readings are erroneous
The waves have all gone spastic.

Whatever is the reason
The quandary or quirk,
If the situation's critical
You might wish you were a clerk,
Just cruising in a day job
As someone's minor slave,
Untroubled by complexities
Of the nature of the wave.

Fibril_late; 6/93

Sunday, August 13, 2006

A tragic tale about a young cocaine user.

The Echo

Chest pain for a couple weeks
On and off again,
Just a little twister
On a scale of one to ten,
Attributed to stress
At home or with employment,
There there's smoking, drugs and alcohol
To summarize enjoyment.

His brother had a heart attack
His mom has hypertension,
His daddy had a CVA
And something else, I'll mention,
He has elevated lipids
And a type "A" personality,
He was ignoring blatant signs
That he'd soon be a fatality.

He took too many hits
From that devil, crack cocaine,
Now he's screaming in the hospital
That he's dying from the pain,
Like a herd of angry elephants
Are standing on his chest,
It's tough to feel much sympathy
For his cardiac arrest.

Did he make it, no he didn't
He no longer is alive,
A sorry commentary
On a guy just twenty-five,
He had cardiomyopathy
An enlarged and boggy heart,
The cocaine tachycardia
Just blew the walls apart.

He was dead before the echo
Of his screams could fade away,
His family, in denial asked
"Is he coming home today",
And a stony sense of silence
Emanated from the room,
As a call went out to housekeeping
To bring a mop and broom.

Fibril_late; 6/93

Friday, August 11, 2006

Here's a silly one about irregular rhythm's of the heart and the many ways they can be treated; just a lot of:

Hocus Pocus

In this day of modern medicine
There's a topic and a focus,
Preventing sudden death
With a lot of hocus pocus.

Take a heart that's sick or injured
With a recent big M.I.,
You want to try to minimize
The risk of ectopie.

You might load them with some lidocaine
Procainamide, bretyllium,
Dietary fiber with
Colace and some psyllium,
To regulate conduction
In the bowels and the heart,
It's a basic fact of life,
You have to
Let the poor guy fart.

You might try a new religion
If he's blocking without capture,
And if you convert just one more heathen
You will earn divine rapture,
If you could get one hundred heart attacks
At a summertime revival,
Just think about the impact
On the sudden death survival.

Have you studied early bloomers
Or closet late potentials,
Be they early, late or never
And other fine essentials,
Does the corrected Q-T interval
Increase, despite your scrutiny,
Do you double up your bets
When you think their heart may mutiny,
With increasing T-wave ectopy
And ischemic irritation,
It may warrant intervention
Like bedside HIS oblation.

It's really very simple
Though it takes a steady stroke,
It requires a lengthy needle
Then just eyeball where to poke,
Drive the needle to its hub
And shake it all about,
If you do this hocus pocus
The ectopy comes out.

Fibril_late; 6/93

Wednesday, August 09, 2006

Peer Review: is not what it seems. Somehow to be judged or critiqued by your peers, just turns out to be something like a session where everybody and their brother has a safe forum to take potshots at you, under the guise of objective criticism. Peer, schmeer, and I had something to say about it back in 1993.

The Obedience Review

Standing for review
In a circle of your peers,
Seems like a sunrise firing squad
That's aimed at all your fears.

Amidst administrative chest thumps
The announcement is precise,
You must meet the unit standards
Or prepare to pay the price.

At first a small citation
To punish your behavior,
And if you don't correct yourself
Start praying to your savior,
Because until you tow the line
And follow every rule,
You'll have a leave of absence
Till you pass obedience school.

Fibril_late; 5/93

Tuesday, August 08, 2006

Timesheets; our place of work was "progressive" and eliminated the "time-clock" punch-card and let us peons take responsibility for attempting to fill out the most confusing, snafu piece of paperwork you can imagine. Then, payroll had the gall to threaten disciplinary measures when we failed to complete the "time-sheet" to their precise directions. I fought back with...........

The Time Sheet Proclamation

It has the makings of new history
A sis-boom-bah directive,
Designed to guide the working class
In ways that are corrective.

It involves some mild coercion
In the name of reprimand,
If you screw up two or three times
They slap you on the hand.

Should you blatantly defy
The time sheet proclamation,
You might as well stay home
And enjoy your termination.

Instead I recommend
A working class solution,
Let's have a show of solidarity
With a time sheet revolution.

If each and every one of us
Submits a daily error,
The agents of the payroll
Will collapse in hapless terror.

After firing every one of us
In a show-of-force command,
The administrators, in their glory
Will watch the hospital disband,
And the leaders of our community
Will throw them from their seats,
When they discover that the issue
Was all about time sheets.

Fibril_late; 5/93

Monday, August 07, 2006

Floating? What is it? This is where the nurse, is directed at the behest of the staffing office, to "float" to another care unit, either because their own unit is over-staffed, or another place in the hospital is under-staffed. I would contend that most "unit-based" nurses despise this, because they love working in their home unit. For me, the worse place to float to was the Emergency Room. We were a Trauma Level I hospital and that E.R. was hell in chaos. I always did the best I could under any circumstances, but that float assignment always caused me anxiety.

When Float Is The Theme

You probably won't like it
You'll feel like a turd,
You don't need the experience
When float is the word,
You'll be asked to do things
That you normally wouldn't,
And you'll be ostracized
When you claim that you couldn't.

The demons of staffing
Expect you to play,
Whether you like it or not
Just do as they say,
Or they'll mete out a punishment
That is far worse than rotten,
You'll be sent to the
Emergency-Room and forgotten.

Your life will become
A nightmarish dream,
That's the way things can go
When float is the theme.

Fibril_late; 5/93

Sunday, August 06, 2006

The Super Nurses From Hell. Right up there in the Top 10 best nursing poems about us. I was attempting to convey an image of the territorial, type-A, alpha-male/female. know-it-all (quite probably) critical care nurse figure. Naturally, I am too humble to admit being part of that group, but I knew of them. Enjoy.

Super Nurses From Hell

Well educated, yes indeed
They comprehend, what makes you bleed,
Certified to handle crisis
Justified to call their prices,
Their one objective
To make you well,
These are the super
Nurses from Hell.

Special licensing up the wang yang
A continuing educational gang bang,
Marking territories, like a leg lifting dog
Primal chest thumping, like apes on a log,
They'll jump from an airplane
They'll dive in a well,
These are the super
Nurses from Hell.

Career choice priorities, the family must wait
Wild party animals, a blast on a date,
It's excitement and danger, all in one breath
Raging a war, of life and of death,
It shortens the life span
But, the stories they tell,
These are the super
Nurses from Hell.

Power wielding icons, predators of peace
They can pull a fleeing soul back in
And then renew its lease,
If your heart shows signs of stopping
Like it's time to say farewell,
You can surely count on
The super nurses from Hell.

They know everything, they teach the physicians
Experienced at a thousand, different positions,
Cosmic consultants, they've been there and back
They don't stop to eat, because life is a snack,
They'll help you pass on
If they can't make you well,
They are known as the Super
Nurses From Hell

Fibril_late; 5/93

Friday, August 04, 2006

There was a general surgeon, very good in fact, and around the Christmas season, it seemed like he was working double-time for the money.

A Blessing Or A Bust

Surgical intervention
Can be a blessing or a bust,
Is the surgeon a skilled practitioner
Does he radiate with trust,
Does he operate in honesty
To fix the part that's lame,
Does he understand the principle
That life is not a game.

Or does he check with his accountant
Before the Christmas season,
And then perform more surgeries
For some financial reason,
Does he tend to wield his knife
Instead of pursuing a conventional course,
Does he wager his opinions
With a subtle show of force.

The poor consumer public
Has little way of knowing,
Just what kind of feathers
These doctor birds are showing,
So as nurses in the mainstream
Of the healthcare mess today,
We have an obligation
To guide the rules of play.

Fibril_late; 4/93

Thursday, August 03, 2006

Another insane rant about the doctor profession. If you are an MD or know someone who is, don't be offended, it was probably just an offshoot of road-rage on my part.

Guerrilla Doctors

Guerrilla doctors
Their brains are dim,
They make up orders
On a whim,
Strange directives
That appear insane,
Specifically designed
To boggle my brain.

Guerrilla doctors
Driving their cars,
I wish they were
Some sort of energy czars,
But they favor the gas guzzling
Party-boat cruisers,
This is par for the course
Oh, what consummate losers.

Guerrilla fantasies
Gorilla dreams,
Practicing medicine
Measured in screams,
Plaque covered walls
To display their achievement,
If you hire these guys
Be prepared for bereavement.

Darwin's bold theory
Of evolutionary rules,
Didn't take into account
These neanderthal fools,
And after several millenniums
They show little advancement,
These guerrilla types
Lack remedial enhancement.

Fibril_late; 4/93

Wednesday, August 02, 2006

Many brave nurses "moonlight" for extra money, or just because they like variety. We contract out to other hospitals, often on a one shift basis. I say brave, because often you're walking into unknown territory where you don't know the lay of the land, the policies, who you're going to be working along side of and you don't know the doctors. If the hospital doesn't know you, you're gazed upon with a suspicious eye, just waiting for you to screw up. Your license and reputation teeter at the brink. If you have your shit together, everything works out, and if you "save-the-day", you're the freakin' hero of the moment, and they beg you to come back to play again.
Certainly in all the years of my practice, 97% of the physicians I encountered, were fantastic men and women. The other 3% were either incompetent, emotional sociopaths, megalomaniacs, and so on; they should have chosen other careers, but now we're stuck with them.
On this particular night of working elsewhere, a small hospital out in the boondocks, I recieved into my care a 42 year old woman, alcoholic, who was hemorrhaging from esophageal varices, and in her case, blood was coming out both ends. She was dying, unless she could be transported emergently to the county hospital immediately. I had to call in one of the most egotistical, "don't bother me" doctors, that I ever encountered. The climax of the night was where I joined the ambulance crew (they had no critical care nurse available), on a wild, hair-raising trip in the rain, on the freeway, with the patient gushing blood everywhere. The back of that ambulance looked like murder had taken place. Anyway, that's my tale........................

My Permission

Don't call me for this
Don't phone me for that,
For acute hemorrhagia
Don't call me stat,
Because sooner or later
I'll visit my clients,
A hands off approach
Is my method of science.

I studied long years
And went without sleep,
I made my mistakes
And buried them deep,
But now as a
Royal academy guy,
You must have my permission
Before you can die.

Fibril_late; 4/93

Tuesday, August 01, 2006

One of the big infection dilemma's we face in the hospital setting, is the occurrence of cross contamination or the unwanted transport of infectious agents by a "fomite". A fomite is any inanimate object or substance capable of absorbing, retaining, and transporting contagious or infectious organisms, from one individual to another.

A Fomite Under Power

It's the early morning cough-athon
They're hacking right on cue,
And the wind of droplet nuclei
Will blow on me and you.

Though invisible, you can't deny
What's floating in the air,
A microscopic layer builds
Upon your skin and hair.

When you leave your place of work
You're a fomite under power,
Radiating organisms
That multiply each hour.

You drop them in the car
The restaurant and the store,
In a couple days they'll reproduce
To a factor of forty-four.

Don't worry or feel guilty
About the lives you place at risk,
You'll have guaranteed employment
And business will be brisk.

Fibril_late; 3/93