Monday, September 28, 2009

Who doesn't love the idea of walking up to a dispensing machine, and being able to withdraw, whatever drug sparks your fancy? It's a thing of genius; almost.

Drug Dispenser

The computerized drug
Dispensing machine,
It's a thing to behold
And must be seen,
Just enter your password
And a special code,
Open the door
And collect your load.

Choose the drug
That fits your mood,
Like a restaurant
With your favorite food,
Come back for seconds
If you need some more,
There is an endless supply
At the drug-dispenser store.

If there is a queue at the machine
Take a number and wait,
Come back in a while
For a drug selection date,
You won't be disappointed
It's like the candy shop,
Get some extra samples
Your friends might want to swap.

There are many clever features
Like keeping track of your transactions,
Though I suspect the obvious
Big Brother, knows our actions.

But there are always ways to cheat
Though I can't reveal them here,
Meet me after work, with a case of Bud
And I'll gladly bend your ear.

Sometimes I'll write nonsense (or something close), just for the fun of it. There might be some fact, but this is more for the sake of the rhyme.

Don't Like

I don't like wounds
And I don't like youth,
I don't like severe pain
And that's the truth.

I don't like big
And I don't like fat,
I have likes and dislikes
And that is that.

I don't mind pee
But I don't like poop,
Whether teaspoon size
Or one large scoop
And I don't like snot
Nor boogers, nor phlegm,
I'll gladly leave it
For the rest of them.

I don't like anything
That ends with ostomy,
Because I always find
It has to much cost to me,
I'll like your language
If you know what's common
Pain, money and toilet
Water and Top Ramen.

I don't like opinions
Other than mine,
I don't like disagreements
Or if you whine,
I don't like arguments
Unless I win,
And please don't tell me
What you think is a sin.

I don't like religion
Unless you keep it in your blouse,
If you would like to reveal it
Just come over to my house.

I don't like this poem
But it was fun to write,
I don't want your feedback
That's my undivided right.

Fibril_late; 9/28/09

Sunday, September 27, 2009

So memorable are the times, where Mr. Patient, uses the call-bell at least every 15 minutes, for the littlest thing, even though each time before I leave his room (again!), I ask him, "Is there anything else I can do for you?". No, he says, and "thank you so much". Just minutes later, after disrobing the isolation garb, scrubbing my hands with hand cleanser, and I'm trying to sit down for a teensy bit of charting,
ding-a-ling, I hear his call bell again, he wants his pillows adjusted. I redress, enter the room, and there is his brain-dead brother at the bedside, asking me to fluff the pillow. Two pods from the same pea, I guess.


How polite you claim to be
But polite, you're really not,
You're on your call light every minute
For a drink, a wipe, and a shot,
You told me how your parents
They raised you properly,
But for a guy who's 62 years old
There's no evidence to see.

You say that you're so thankful
For every bit of our care,
But you claim you're too damned weak
To even part your hair,
You can't even hold the urinal
So you pee into the bed,
But you can find the call bell 50 times
And cry, "I'm almost dead".

I just left your room 2 minutes ago
And before I left, I queried,
If you needed any pillows, food, or
Medications carried,
No, you thanked me from the bottom of your heart
While I shed my isolation gown,
Then you nailed that call-bell 15 times
Before I made it back to town.

Your sibling came to visit
He treated you like the royal brother,
He even used the call-bell
For a pillow, a blanket and another,
"Cup of ice, please, can't you bring it
When you come back to the room",
Then he nailed me with a nasty attitude
When I failed to bring a broom.

I should thank your blessed parents
That you were raised the proper way,
Because, after visiting your room those 50 times.......
It really made my day!

These days, we're constantly bombarded with "celebrity" news. Even if you're not the slightest bit interested, you just can't avoid knowing about all the idiotic antics of the temporarily rich and famous. Take Peter Pan for example...........

Like Peter Pan

When I'm irritable, aching and tired
And feeling down like a double-deuce,
I know exactly what I need
Some of that celebrity MJ juice;
Some prefer to call it Propofol
And others Diprivan,
Just please inject it into my vein, right now
And I'll sleep like Peter Pan.

When my little ones were babies
It helped them when they were teething,
Despite the fact, that I had heard
It might affect their breathing,
Then I began to use it
When I couldn't get to sleep,
My private doctor delivers it
And frankly he ain't cheap,
Which proves that he has ethics
At least one or two, I'm sure,
For a one hundred thousand bucks a month
He guarantees a cure.

It reminds me of my mothers milk
As a baby, I drank it often,
Now, please don't bother me, I need to sleep
In my hyperbaric coffin.


Thursday, September 24, 2009

I went to a well-attended meeting a couple of days ago, and when I left, I felt like I was the only guy going home with a sunburn. And that's tough to accomplish, in a room with no windows, in the evening, just past 8pm. I'll take my parasol next time, along with my bug spray.

Ponder the Consequences

I went to a staff meeting
Dominated by a speech,
Regarding a new fangled program
Someone wanted to teach,
And I guess my body language
Conveyed my doubts and concern,
Thus, that lecturing nurse
Figured I had something to learn.

She halted her dissertation
To bring attention to me,
Directing every one
To take a look and see,
Recognize that his body language
Signals objection and disbelief,
So succinctly laid out
In front of our Commander-in-Chief.

How fortunate she was
That I forgot to bring my pack,
With my favorite weapons
For an unexpected attack,
My cat-of-nine-tails
And the latest new Taser,
The brass knuckles, and sap
And my straight-edged razor,
Typical tools
For streetwise protection,
If you're going to call someone out
Be cautious with your selection.

On my way out the door
She loudly asked for my suggestions,
If I were a fly, I’d set her up
For enzymatic digestion.


Wednesday, September 23, 2009

Gordy, Lordy! WTF?!?

We, (all nurses, in this singularly broad arena of a particular organization) must assimilate, into our already, highly-demanding and the-plate-seems-too-full-and-I'm-stuffed-with-27-things-that-should-never-happen-in-the-hospital events, faced with but another way, that we the bedside nurses, are supposed to increase the odds, that Mr./Mrs./Ms. patient, will be happier than a pig in shit, to recommend our hospital to others, and bother to come back here again.

Look folks, our town is at the "ground-zero" of Managed Care and Capitation. Our clients/patients don't really get a choice regarding where they get care. Who are the powers-to-be, trying to fool. In this community, we have about 5 predominant Health-care insurance providers in place, and if you belong to them, you essentially have been assigned to Hospital A, B, C, or D, whereupon, you will be delivered, to get your infected Gall Bladder removed. This is not about satisfaction and choice.

But perhaps it is all about reportable statistics? Hmmmm, that has a nice sound to it, n'est pas? Oui!

But, because of the way the "business" model works best, there is a filtering down of ideas, to the basic level of care. Thus, the collective we, are faced with, "The Nursing Bungle". Sure, I know that seems a bit odd for a name, but.......well, in fact, that is truly my derivation of what is being passed off as the greatest thing since french-bread with snails, "The Nursing Bundle".

I know this was along harangue, but I'm just letting you know, there will be a bunch of poems to follow, that will address this topic.

Stay Tuned

I’ve got a slew of poems
About the Nursing Bungle,
Stay tuned for the latest
Coming out of the jungle,
The morass of misfired management
It goes all the way to the top,
The hot topic this year?
Patient satisfaction slop.


The Nursing Bungle

The Nursing Bungle....
We heard it first,
From the very mouths of babes
Man, it made me really thirst,
The refreshments were okay.
Crackers, cookies, and cheese,
I kept going back to the chef
And begging, “Mister, please”,
Do invite me again
To the next festive event,
I swear, in the meantime
I'll do my best to repent,
For my overt body language
Silently screaming, without a sound,
As I sat pondering all that information
Joe Studer discovered and found.

Look, it's the same old data
Repackaged and pretty,
Shiny mylar balloons
And a parade in the city,
With new benchmarks and measures
Lengthy checklists and more,
Observations by the charge-nurse
Who will stand by the door,
Observing our behaviors
And making check-marks on a paper,
Yes, these are the hallmarks
Of another questionable caper.

The Nursing Bungle it is
The name is so apropos,
Educate ye olde bedside nurse
As if they don't know,
About care and collaboration
Critical illness and more,
Now, it's all about “satisfaction”
When Mr. Patient leaves our floor.

Let's recognize the fact
It's just old stuff renewed,
And management has emphasized
Follow orders, or you're screwed,
Because we have to be compliant
And take on new behaviors,
Avoid 27 new bad things
Then all is well, proclaim our saviors.

It's old and it's new
And we get tired of this,
Every five years, or so
We're told something's amiss,
But the problem really isn't
On the street of our action,
It's just a management perspective
And I call it, distraction.

Someone way at the top
Looks around at the horizon,
Some study results tell him
You're losing money, it's not surprizin',
The economy is down
But you must blame it on people,
Find the guy at the bottom
And impale him on a steeple.

The dollars float up
To the top of the pond,
Mr. ground-cover boss
Wants to wave his magic wand,
And ensure that the fiscal
Prosperity of his being,
Remains all omnipresent
Instead of his salary fleeing.

So the shit slides down hill
To finally find the plateau,
We're inserviced, “The Nursing Bungle”
It's the same old stuff, don't you know?


Doubtful Old Man

Call me a conspiracy theorist
Call me a fool with a pen,
Whenever there is a new fangled program
I want to know why, where and when.

Call me disruptive and cynical
Call me a doubtful old man,
Laugh when I'm doing the research
Following the trail of the plan.

I want to know the cause for new action
When management demands our compliance,
When rules and directives are jammed down our throats
Under the guise of some evidence based science.


Friday, September 18, 2009

Oops, I stumbled on some toes, and underwent some body blows.............

Scathing Words

What an experience that was
The power that sits, sat down with me because,
I had ruffled some feathers
Last evening by phone,
I called, old Doctor what's-his-name
And struck a funny bone,
He rattled his saber
About missed communication,
So this morning, I got an earful
In the middle of the nursing station.

I apologized to yonder doctor
And I acknowledged my error,
There was no intimidation
Not a shred or whiff of terror,
Just an agreement of sorts
That our computer documentation,
Leaves a lot of buried orders
An unintended complication.

Last night he was so busy
Over-stressed by demands,
I sought simple clarification
And bought a reprimand,
Uninvited scathing words
Where a simple sentence would suffice,
On-call, is a professional obligation
A pleasant deportment, is my advice.

A couple of salient points
Were hammered home to me,
Be careful whom I call at night
And keep the blaster, on setting #3.


Thursday, September 17, 2009

Another stab at our digital medical record. Why? Because there are some screwy new terms, that seem like they originated in some foreign country. "Bedfast / Chairfast"...what in the heck does that mean??

Flatus Findings

I've already told the story
Of our new charting ways,
A preponderance of data
Absorbing our days,
Removing us from the bedside
Although our patient's need us more,
The boss of the bosses
Demands adherence to the chore.

There are new terms to contend with
That I don't understand,
Bedfast and chairfast
Initiated and planned,
And other strange items
That demand some rewinding,
Just what is the meaning
Of a Genital Finding.

Am I supposed to chart, "Yes"
I found the appropriate organ,
Or maybe, Miss Betty
Is endowed more like Morgan,
I can't seem to find the answer
And I'm embarassed to ask,
I didn't think that my charting
Would be a sexual task.

Perhaps I'm too old
For this digital charting,
Because, I also noticed
There's a query on farting,
A delicate subject
Regarding flatus of the gut,
In summary, I tell you
It's a pain in the butt.


Tuesday, September 15, 2009

Someone was telling me about the latest diet, and then we had a laugh about the "obesity chain letter" that you would have to send to 3 other people so the secret magic worked. I enjoy silly ideas like that; they stimulate my writing.

The Diobesity Chain Letter

When the letter first came to me
It almost made me cry,
It said, "You better lose weight
Or you will surely die",
Your cholesterol (Oh, lordy)
Is so high it can't be counted,
Your HDL is puny
And your LDL has mounted,
To a level never seen before
In the annals of Cardiac medicine,
"Beyond a chance of survival"
Said (the famous), Dr. Edison.

I was on the verge of tears
Because I didn't know what to do,
So I grabbed a tasty side of beef
For a 14 hour chew,
While my triglyceride's kept leaking
From every available pore,
(They help me slide out sideways
Out my Winnebago door.)

After reading all of that letter
Every chapter, page and verse,
I felt that I was doomed
By my genetic family curse,
Those generations on the prairie
Raising cattle, sheep and swine,
With deep subliminal messages
That said, "Baby, you must dine".

Genetic memory eaters
Can't be blamed for their bad habits,
When we consume a couple calories
They multiply like rabbits,
Pretty soon we've grown some haunches
That have no rivals anywhere,
One day we balance upon a stool
And tomorrow we bust the chair.

After several rounds of reading
I knew the message was a beast,
My health was heading south
While I continued driving east,
To get as far away as possible
From the evidence in that note
I was convinced that "fat and happy"
Was baby, "All she wrote".

I crumpled up that paper
And headed for the shredder,
But I slipped upon my lard
And nearly took a header,
Finally noticing a post-script
That offered me some hope,
Would it be enough to save me
Here, at the end of my rope?

The instructions were so simple
"At least that's the way it sounds",
What have I got to lose
Other than 150 pounds,
And one more thing, it mentioned
I must forward the letter to others,
Similar folks, of similar means
Diobesity sisters and brothers.

I'd be cutting back on eating
All my favorite types of food,
The thought of that, was so heavy
I had a 17 hour brood,
But the alternative, yea the options
Stared me boldly in the eye,
Remember what I told you, chick
"You could surely die".

My family had already been down this road
Sisters, brothers, and cousins too,
An inch would come off, then add an extra pound
Just stand in the mirror, and there's more of you,
It's a vicious cycle and around the bend
Diseases are waiting to pounce,
In for a penny and out for a pound
Over the years gaining ounce by ounce.

That Diobesity chain letter?
I sent it to three people, in a hurry,
I guess it really comes down to me
Cut back on the calories and curry,
But what have I got to lose
Other than one hundred fifty pounds,
Get buried before death is due to me?
Or lose all my heaps and mounds.


Wednesday, September 09, 2009

I'll be hitting 60 in quattro years. Thanks to the almighty Pixie, I'm way healthier than all of the clients who roll through the doors. Take the 39 year old guy who was in for Acute MI #3. The deal was, that 10 days ago, he had an elective Cardiac Cath with Stent placement to his Right Coronary Artery. After his free-7 day supply of Plavix ran out, he didn't order anymore. Somehow that pack-per-day cigarette habit, seemed more important. This time he returned with full blown acute Stent closure MI with cardiac arrest, Intra-aortic balloon pump, Hypothermia protocol, etc.
When he finally got extubated 4 days later, he seemed to have lost a few brain cells in the flux, but did finally discharge home, with the S/O he now wants to marry. She's the one that deserves a medal for sticking by his lame and lazy side. Anyway, I'm healthier than he is.

Still, even old warriors get punked out a little. To go to work, feeling like maybe I've got a touch of the piggy flu or maybe I'm suffering from California wild-fire smoke pollution, I wore out fast during the two nights I spent at work. We have a running joke in the ICU where I hang my proverbial hat. If there are any whacked out, crazy, on the call-bell every 15 minutes, or totally psycho nutcase patients, you can bet that either Jerry or I, will automatically have that assignment, if one of us is working. That's how it was last night.

Hello Shanna, I'm your Nurse for the night. Shanna responds, "Why do you want to kill me?". She says this over and over, for the next 15 minutes. It only got better when she started yelling obscenities. And that was just the first hour. The Morphine and Ativan sort of helped, but then again, maybe not. Ms. L. was as usual, somehow helpful with her calming presence. Thanks, K.

The night ended with my following thoughts around the theme of Going Home:

Go Home Now

I have to go home
When I'm tired of the bull,
All the idiotic innuendo
I eventually get full,
All the Care-plan duplications
And the unrelenting charting,
I have to go home now
Goodbye, I'm departing.

I have to go home
When my inertia is lost,
It was stolen by someone
Or maybe it was tossed,
Into the trash by mistake
By the legally blind,
I have to go home now
I hope you don't mind.

I can't stay any longer
Unless you're willing to pay,
Double-time for my troubles
There's just no other way,
That I can put up with this garbage
That I shoveled all night,
Don't threaten to keep me
I'll put up a fight.

I'm home now, and happy
Just typing this note,
A glass of wine in my hand
While my thoughts drift and float,
On the stream of contentment
Amidst bubbles and foam,
I'm so glad I left work
Because now I am home.


Sunday, September 06, 2009

Some doctors seem older than dirt, still keep practicing, and have great results, regardless of how archaic they may seem.

He Cuts and Slices

The olde-time surgeon
He's the one,
He cuts and slices
Until he's done,
He might even dabble
In ways of the occult,
Whatever it takes
To get the best result.

He'll follow-up every morning
To see the result of his work,
He had a personalityectomy
So he's kind of a jerk,
But you just can't argue
With the results he gets,
If you need something cut out
He wins all bets.