Friday, December 31, 2010

Here it is December 31 and this is the last poem of the year. Because this is such an auspicious occasion, I am delivering an opus of intrigue and mystery. It’s all hush-hush, wink-wink, in-between the lines stuff. Although I share my writings with my colleagues when it is on the up and up, occasionally I address “sensitive” topics that might ruffle the feathers of the big birds. By posting on this blog, it becomes readable in the public domain, and thus, I must drop to the level of subterfuge, to disguise my message.

And I do like to dabble in nonsense, and see what comes out of it. Happy New Year!!!

Hush-Hush

This might be my last chance
To put this in writing,
I’m past the moment of boldness
But it’s time for indicting,
Exposing the infractions
Wherever they be,
It could have been you
Instead, it is me.

It’s the duty of the press
To find the rarest detail,
Which is sometimes so obscure
You might think you’re in retail,
Coordinating the castoffs
In the dressing room hamper,
Or getting lost like a rookie
In a Winnebago camper.

To dig up what’s hidden
Requires secret knowledge,
In the realm of the professional
We’re talking about college,
You can’t play in this sandbox
Without having some creds,
And the dress code is such
You can’t show up in dreads.

Details so abstruse
You need a submarine,
To fathom the depths
For the truth to come clean,
A buried conspiracy
Fourteen layers deep,
The story of the year
And we’ve all been asleep.

Money on the bottom
Money on the top,
Dollars without sense
On a roll and just can’t stop,
With reams of regulations
And adjustments to the build,
Hush-hush secret meetings
Between the masters of the guild.

Undercover gatherings
Messages in dead-drops,
Who would ever guess
They congregate in head shops,
Monthly new directives
Provided with pearls and pomp,
Wrapped in shameless packaging
And delivered with a stomp.

The story of the year
You must read between the lines,
Like you, I need to stay employed
And avoid those nasty fines.

Fibril_late;
12/31/10

Wednesday, December 29, 2010

This was the ultimate in obsessive/compulsive disorder. This 76-ish gentleman, was absolutely, astronomically fixated on his ability, or lack thereof, to have a bowel movement (bm, crap, shit, unload, have a dump behind the stump), or whatever you call it. It was the only thing he could talk about. Every conversation, led back to his bowels. Even if he was telling the story of going to Wisconsin for Christmas, he had to include the agony he experienced on the plane, where he felt “under-pressure” in the little airplane restroom, and he couldn’t take a dump. And, that was just the beginning, regarding why his visit to see the grandchildren, was a disaster. His bowels were constipated.

Yes, that might seem a little overboard, but it is the truth. Now, fit the above scenario, on a fellow with severe, end-stage Pulmonary Fibrosis, COPD, and Asthma, who needs BiPap with 100% Oxygen at all times, just to keep his saturations above 88%. And then, all he can do is talk about his inability to take a dump. Yowza!

Constipated

Collectively, a complicated psychosis
Overwhelming, was his halitosis,
Never had I met someone, so fixated
So sensational it was, as if iron-plated,
Telling his story, to anyone that was near
Incredibly, like it was his career,
Plausibly, it was a legitimate condition
After awhile, it became a long, boring rendition,
Then he revives, and tells me once more
In fourteen different ways how he just can’t score,
On the bedside throne, even though he has been thoroughly Kaexalated
Nothing seems to help, he’s totally constipated.

Fibril_late;
12/30/10
What happens at work, stays at work. We can thank Hollywood for that observation. I write about work, weaving and twisting the experiences, and then share it on this blog. Of course names are changed to protect the perpetrators.........because I don't want that bucket falling on my head. Anyway, here's the latest on the topic.

Always Fresh

I don’t write about work much
Unless I’m there in the flesh,
My mind percolates like the coffee pot
Brewing grounds that are always fresh.

The glaring inconsistencies
Are only obvious when I’m there;
Once I’m gone for three short hours
It doesn’t matter, I’m no longer aware.

So I keep the voice recorder
On hand, in my golden chariot,
To capture those thoughts that are running loose
I’m ready with my lariat.

Once I’m home and sleep commences
I cleanse my mind with dreams,
I’ll return to work another day
To write about new themes.

Fibril_late;
12/29/10

Tuesday, December 28, 2010

Just so you know, when I write about nurses, whether I use the masculine or feminine (he or she), usually is dependent on the word I need to rhyme with. So, although I previously wrote about the “3G Nurse” who was on her smart-phone too much at work, here I am once again picking on “her” because of the basic need to rhyme properly.

Now, I know that sometimes 8 hours, or 12 hours at work can seem like torture because the patient is a whacked-out crazy man, or a person with no short-term memory, but still, it's important to keep in mind, that we have a moral duty to relieve human suffering. I've had countless nights like that and you probably have, too. Try to keep in mind.......it's only 12 hours.........surely, I can remain calm and kind, for just 12 hours. Of course, it's courteous to answer the call-light promptly.

On The Moon


I’m kind of upset
About that nurse over there,
Her patients are calling
And she just sits in her chair,
Checking her email
And talking with others,
Looking at Facebook
To see her sisters and brothers,
Who remain in her homeland
Which is so far away,
Now she’s checking the airlines
To see how much she’ll have to pay,
To travel back home
Six months, next June
While her patients are screaming
It’s like she’s on the moon.

I’m answering those call-lights
And doing her duties,
Both patients are in isolation
And covered with cooties,
But still they have needs
And this is our career,
Where our clients are needy
And not always in good cheer,
They are often in pain
Or they need to take a crap,
Maybe they’re bleeding and vomiting
And it lands in your lap,
Yes, I know it’s disgusting
To have to deal with this wet-work,
But you’re paid to be here
So get off that social network.

With 12 years of experience
Her resume’ looked great,
But she cares more about her social life
Compared to the patients fate,
Now there’s an administrative edict
Regarding use of the computer,
But this chick just doesn’t get it
So, we might as well shoot her.

Fibril_late;
12/28/10

Monday, December 27, 2010

Time for that end of the year review, sort of thing. What do I remember best? What sticks out in my memory...............

Case Of The Year

Most memorable case
Of the year, who knows?
It might have been that fellow
With the dead, gangrenous toes.

I came on that evening
After a "minor surgery" in the room,
His foot was wrapped like a mummy
And there was a cloying smell of doom.

The day nurse was reporting
"Oh, by the way, please don't forget,
Send the dead toe to the Laboratory
I'll be temporarily in your debt".

I gave him a look, in the usual fashion
Right......; you could have had this done,
But why raise a fuss in the moment
When we can all share a bit of the fun.

What kind of packaging
And where do I send it?
Double-bag it, please
And try not to bend it,
It's a special collection
A pathological piece,
Don't place it on ice
And don't send the fleece.

So I got a couple baggies
The red specimen style,
Threw that toe to the bottom
Sealed it, and kept it a while,
Quite the conversation piece
"Hey, look what I've got?"
Billy-Bob's toe
And it's as ugly as snot!

Well, after all the jokes
About the toe-truck, and such,
I sent it to the lab
For that toe's final touch,
A specimen like no other
An unsightly black lump,
What does the Laboratory do?
They call, asking about the stump.

The dead toe scenario
Has a dismal outlook, indeed,
The odds are, the foot will follow
All the way up to the knee,
I've seen men lose two legs
And two arms, before it was over,
After surviving the beaches of Dunkirk
And leaping the cliffs of Dover.

Fibril_late;
12/27/10
_________________________

Revolving Door

Attack of the largest in life
2010 was memorable for sure,
Those super-sized clients of ours
Weren't coming to us for a cure.

But rather, some kind of repair
A secondary causation, due to weight,
Without reducing the underlying problem
We knew they'd be back at a later date.

Bettyjoe Bilotnik
Was admitted four times, I recall,
And it really, was quite surprising
That all of her children were small,
Her mother was built like a toothpick
While Betty's husband was shaped like a blimp,
Pushing Betty in the wide-bottomed wheelchair
Poor old Chester, had a heckuva limp.

Jimmy Johnson from Modesto
Got an ear infection, and an abscess in his neck,
Sepsis knocked him on his can
All 500 pounds of him, on last check,
“Wait, he's just twenty-eight
How in the heck, could he be so sick?”
That's what his sister said
When we had to intubate him real quick,
Because of respiratory failure
He was a smoking asthmatic, to boot,
Oh, he's always been a little heavy
But it never amounted to much; shoot.

Yes, we surely operate
A revolving door of care,
Without our frequent-flyers
I'd hardly know what to wear.

Fibril_late;
12/27/10

Saturday, December 25, 2010

Working with the super-sick people, it's easy to lose sight of the breadth of the healing process. Additionally, when working my typical one day on-two off, it's only the one out of twenty patients that sticks around more than two days. Now, as I ponder the dichotomy of my existence, sitting here with a boot on my leg for 8 weeks, the life-cycle of the healing process, unfolds before my eyes.

Healing

Healing progresses
In its own good time,
More than a nickel
But less than a dime.

The days go by
Kind of slow and boring,
Like the baseball game
Where nobody’s scoring.

Hit the ball, catch the ball
Beat the runner to the bag,
Like a double dose of Ambien
Or Chloroform on a rag.

But who needs excitement
When bones are on the mend,
It’s like the new Spring garden
With little vegetables to tend.

Watching them grow
If you sat there all day,
Would be slower than snot
Is all I can say.

The mending of bone
Takes much longer than expected,
You can’t really feel it growing
But it must be protected.

In that respect, my foot
And lower leg, as well,
Should I fall over or stumble
It will surely hurt like hell,
So I keep it secure
Like hiding my loot,
What used to be a cast
Has now become das boot.

So I busted some bones
To earn an eight-week sleeper,
But I’d rather do that
Than meet the grim reaper.

Fibril_late;
12/25/10

Thursday, December 16, 2010

I admit it, I haven't been very productive lately. Part of the reason is that I joined the ranks of the injured, when I walked into an open drain hole in a sidewalk, in the dark. That's right, so lay on the sympathy please. Anyway, that story is being told over at (http://odarepsed.posterous.com/) which is my altered ego site. Anyway, it could have been worse.

Hummer

Getting injured
Is a bummer,
But, better to fall in a hole
Than be thumped by a hummer.

Fibril_late;
12/16/10

Wednesday, November 24, 2010

How many shifts in the past week where I have not had time, nor have there been enough staff on hand, to have breaks at work? I talked to a family member of a patient one night, who couldn't quite understand, how a nurse could be so busy, as to not have time for a break. She said something to the effect, that break-time was "mandated" in California, so of course, we must certainly always have time for a dinner-break. I think I finally got through to her, that an unstable patient, might trump my need for a food break, if there were no other nurse available to fill in.

Well anyway, this job is horribly stressful at times, despite my training in spiritual enlightenment practices and black magic.

No Immunity


Encountering another ridiculous
PTSD opportunity,
I'm once again reminded
I have no professional immunity,
To protect me from experiencing
Overloaded situations,
Despite my secret talismans
And psychic affirmations.

Like a passenger in a canoe
In some Class-5, crazy water,
Some nights at work I feel the same
As a lamb led to the slaughter.

Fibril_late;
11/24/2010

Monday, November 01, 2010

We all know by now, that Nursing is not getting any easier. It is way more complex than when I touched my toes in this turbid pond, 27 years ago. Heck, back then I had been an RT, and that discipline is incredibly more complex too.

I know so much more now, but I am ever the more frustrated with all of the crap we have to put up with in terms of management policies (or lack thereof), bureaucracy and regulatory agencies, medical equipment designed by cloistered lab engineers who don't know Jack about real-life usage, and so on. There is plenty to bitch about.

At the same time (and all wrapped up in our daily experience), I know we perform amazing feats of caring and healing, which are interwoven and incorporated into the very fabric of our lives. And that's the clincher; it's difficult to “come down”, after successive days at work, to process all of the experiences, frustrations, successes and losses, and merge smoothly into the ordinary home-life. I believe that this is a common theme among the public service industries like Nursing, Police, Fire, Military and the like.

Sometimes just a bitter cup of coffee, helps me to cross the bridge back to reality.


A Cause and a Curse

It's my usual way
After two crazy days
To unwind at the local brew shop,
Skimming the papers
While jotting down words
Disengaging my feelings with a chop.

It's that Karate killer instinct
Trying to sort, slash and bury
The experiences of this overworked nurse,
Saving people who are dying
And babysitting the rest
It's a career with a cause and a curse.

Fibril_late;
11/1/10

Tuesday, October 12, 2010

Working in a Medical ICU these days, it seems like 45% of our patients are admitted with Sepsis. That means that almost every day we are fighting to keep up somebody's blood pressure with Levophed and generous IV fluids. True enough.

However, there are people walking around with some sort of autonomic disturbance, where their blood pressure is dangerously low, and they need daily medicine to somehow support and sustain, cerebral perfusion. You might be thinking, hmmmmm, it seems like I've heard of that, but what the heck, is the name of it? Well that's the crux of the matter; it has never had a good, catchy name. That is, until I discovered it!

Hypertension Deficit Disorder

I have named a new disorder
According to my think,
We were discussing low blood pressure
And it came to me in a blink,
As if a cursor were brightly flashing
Within the deepest recess of my mind,
Several concepts were bouncing around
When all at once, it was clearly defined.

Rarely do we ever examine
That hypotensive son of a gun,
There are a lot of good reasons a BP is low
Like the planets revolving the sun,
But more commonly, our major statistics
Are driven by those hypertensive fools,
Yes we know these bloody freaks so well
They're the drivers for all of our tools.

And as a result, the naming
Of this barely known, uncommon disease,
Has gone for eons without its own title
It's more like a sniffle, than a sneeze,
So let it be known, upon this day
October twelve in the year twenty-ten,
Hypertension Deficit Disorder
Has now been transcribed by this pen.

Wielded by this one very author
And posted on this world-wide-web place,
If you wish to hijack this naming
I'll throw my copyright into your face,
You see, I need to rake in some royalties
My autumn years will come quickly to hand,
I'm open to grandiose ideas and schemes
It's a part of the future I've planned.

Hypertension Deficit Disorder
Is a well-defined disease, to a few,
In the many long years of this nurse
I remember just a couple I knew,
Who were prescribed high-salt in their diet
And proposed to render higher emotions,
Because we know in retrospective analysis
These are evidenced, and reliable potions.

I am thinking of publishing my data
Though it's a narrow, small selection research,
I'll set up a booth and a table
On Sunday, outside of your church,
When it's one-hundred degrees 'neath the shade tree
The parishioners will be dropping like flies,
Hypertensive Deficit Disorder
Will be easily proven, no surprise.

Fibril_late;
10/12/10

Monday, October 04, 2010

Here comes the holiday season, lot's of good eatin' and sure-as-shootin', there will a bunch of choking going on at the dinner tables across America. So, I got to thinking about what the statistics might reveal.

Choke

Who chokes more
The woman or man,
Fat or skinny?
Ask the statis-tishan,
Anecdotal evidence
Is a bit unreliable,
While restaurants worry
If they will be liable.

The Heimlich maneuver
Will save quite a few,
But some choke so bad
There’s not a thing you can do,
While they retch and they rasp
With hands clutching their throat,
The medical examiner will say
“Buddy, that’s all she wrote”.

Fibril_late;
10/4/10

Tuesday, September 21, 2010

Cell-phones, smart-phones, etc. People are creating complications in their lives, and the lives of others, with the out-of-control, ubiquitous usage of these gadgets. Sure, I own one, but I don't take calls when I'm driving, and I leave it in my locker at work. We all know how mentally distracting they can be if used while driving, but what about "constantly" checking your personal phone at work (plus all of the network distractions too).........could that have a potential downside, say, like the car accidents attributed to cell-phone use? Of course!

3G Nurse

The 3G network
Keeps him connected,
He feels so special
As if he was selected,
From a multitude of many
One of the chosen few,
Without his ever present iPhone
He wouldn't know what to do.

Like Adam of the Bible
Tempted by the fruit,
This electronic gadget
Is his tether, his root,
He can't seem to be without it
It's always close at hand,
What's the problem with that?
He can't seem to understand.

At work in the midst
Of the dying and infirm,
His iPhone is his master
It dictates the term,
Of his short attention span
For critical thinking,
He's woefully unaware
When the ship is sinking.

Like the cigarette smoker
And the alcohol sipper,
The airplane-glue huffer
And the heroin dipper,
These always-on gadgets
Of our modern age,
Are just another addiction
And the latest rage.

Do they belong in the workplace?
Not really, because,
Just like drinking Jack Daniels
It would violate the clause,
Of, no intoxicants at work
It just isn't allowed,
To have one's mental acuity
In an alcohol cloud.

What is the solution?
Disconnect from the grid,
Have a policy in place
Enforce and forbid,
No use of these devices
Unless medically related;
That you can use it in the break-room
Is understood and clearly stated.

There are issues of privacy
So we must set the tone,
Big Brother is watching
Some will argue and moan,
HIPPA laws are clearly posted
For us and our clients,
So, enforce and forbid
To create workplace compliance.

The 3G network
Keeps him disconnected,
From bothersome vital-signs
After the drug he injected,
Into Billy-Bob’s PICC-line
In room eight-twenty-eight,
Yes, his attention to Facebook
Will seal Billy-Bob's fate.

At first bradycardia
And then hypotension,
An allergy to Toradol
That the wife didn't mention,
And while his buddy on Facebook
Had the greatest surprise,
Billy Bob Brady
Took a trip to Paradise


Fibril_late;
9/21/10
_ _ _ _ _ _ _ _

Further thoughts on the matter, after "sharing" the above poem..............

The Lottery of Babylon

Raising junior
Raising shackles,
A barn-raising community
With hens that cackle.

Rules broken by few
While shared by the many,
I could get rich I suspect
If evil thoughts paid a penny.

Statistical analysis
The power in data sets,
In time, will identify dangers
Are you willing to place your bets?,
I’ll take wagers on inattention
While we hold our collective breath,
Who will win the lottery of Babylon?
Where the reward is a negligent death

Fibril_late;
9/24/10

Wednesday, September 15, 2010

Why haven't I written for almost two months?

Injured

I injured my arm
But I wasn't bitten,
So that doesn't explain
Why I haven't written,
In over a month
In this Nursing journal,
I can blame my trauma
On that hundred-liter urinal.

I busted my bicep
A strain in my arm,
The patient was OK
'Twas the nurse who had harm,
Now I'm in recovery
It's a twelve-step regime,
With my own Physical Trainer
She's so hot, I could scream.

No, unfortunately, I'm joking
This isn't 24 Hour Fitness,
These Trainers are pit-bulls
As god is my witness,
And returning to work
Will be a welcome event,
They're prepared to release me
When I apologize and repent.

I was damaged
(Some would say, long ago),
But the future is hopeful
I'm letting you all know,
My advice, for those considering
Having an injury, too?
Make sure it happens on the job
So Workmans' Comp works for you.

Fibril_late;
9/15/10

Sunday, July 25, 2010

You know it's organizational when the attack of the acronyms is underway. Here's just a sampling:

It’s 2010 and we have been informed about the following program (guided by the Guru’s of Pharmacy):
M. E. R. P. – Medication Error Reduction Plan

Now, other Departments want to jump on the acronym bandwagon too. Thus, consider the following other M.E.R.P. renditions:

H.R. Employee Benefits: Mandatory Employee Rest Period

Finance: Miscellaneous Expenses Rarely Paid

Respiratory Therapy: Mucus Extraction Raunchingly Putrid

Dietary: Meal Enjoyment Rendered Promising

Physical Therapy: Manipulating Extremities Really Painful

Cashier: Money Extraction Realized Profit

Neuro-Surgery: Mental Excavation Risky Proposition



The folks in the G.I. Lab figured they should have a B.E.R.P………….
Barium Enema Rectal Pain


No doubt the rest of the hospital will soon follow suit!

Fibril_late;
7/25/10

Wednesday, July 21, 2010

Did you ever use the Nerve-stimulator for testing the "Train-of-four", in respect to the use of neuromuscular blockade agents?

The latest teaching tool at work prompted me to think hard upon this topic.

Nerve-Stim

Hanging on the wall at work
We have a brand new poster,
It describes the nerve-stim test device
And it works just like a toaster.

It runs on 9-volt batteries
And you clip it to the skin,
Then turn it up to level-eight
And take it for a spin.

One twitch of yonder finger
Is a hit, but you want more,
Double up the milliamps
And tally up the score.

It's fun to use at parties
To check intoxication,
Or a prod to wake up Nurses
When they're sleeping at the station.

And also recommended
By the manufacturer,
For the dysfunctional erection
It promises a cure.

With the nerve-stim applicator
Success is a guarantee,
Promotions will come easy
Zap the boss, and he'll agree.

Fibril_late;
7/21/10

Saturday, July 17, 2010

I'm on a memo theme...........because we are inundated with them in our workplace. Here's the latest rant.

Crispy Paper

A remarkable notation
Of a memo, just last week,
Was released before officials
Had authorized a peek,
Regarding tons of wasted paper
Found by stealth and bold intent,
Enough reams of stored reminders
To cover the walls of a circus tent.

Agenda's on a rampage
A diarrhea of dispatches,
All that crispy paper
And I forgot my matches,
It's a travesty of a sham
A plethora of waste,
Hell, if this was a 5-Star restaurant
Then baby! We've got the taste!

Every month a Doctor Roster
Is posted on the wall,
So we can spot a bold impostor
And exactly, who'd we call,
It's the nature of our business
Where deceivers in our ranks,
Are selling fancy cures and potions
And collecting all the thanks.

But that Doctor-Roster, who's the impostor?
Is also posted to the computer,
If we had their monthly photo's
We would know if we should shoot her,
Because it's easier to match a face
Compared to names with vowels and letters,
Imagine a crowd of Beagles
And amidst the group: an Irish-Setter.

We could save those reams of paper
To pass it on to our CEO,
He could use it to print more money
To bankroll this golden show,
Replace the wallpaper with moving video
And save some blessed trees,
And with a handshake and his smile
Collect some tidy kickback fees.

I'm expecting some of that chump-change
After all, it was my brainiac flash,
And I know there's factual evidence
Our CEO has lots of cash,
Buried, in deep pockets
Of the man who would be King,
I'll share it with my team-mates
And you'll hear our hallways sing;

"Oh, it's wonderful to be here
Just twelve-hours at the most,
Don't clock in any overtime
(That's according, to our host),
Keyboard-stroke those digital documents
Till carpal-tunnel cramps your style,
Then punch that waiting time-clock
And join the rank-and-file."

There will be raucous celebrations
When we rip them from the walls,
The last memo's of the millennium!
And dancing in the halls.

Fibril_late;
7/17/10

Friday, July 09, 2010

Our Staff-Restrooms and our break-room are becoming plastered with memo's, reminders, administrative directives, notes from the CEO, etc., ad nauseum. There is no haven of repose anywhere in our unit. This is an outrageous case of invasion of privacy, and I'm fighting back!

Memo's Forever

Memo this
Reminder that,
Document new stuff
In fifteen seconds flat,
Over and a'over
And let's do it again,
Have no doubt, there's always more
Don't ask why, nor query, when?

Memo this
For recording that,
The charts became thinner
But they're digitally fat,
Layers upon layers
Of drop-dead menu's,
The Ad-Hoc dominion
Is like a Grand-Central venue.

Memo's forever
In the throne-room on the walls,
You can count on stuff to read
When Mother-Nature calls,
Worry not about the dilemma
If the toilet paper was swiped,
Just grab the latest memo
Or a couple, and you'll be wiped.

Memo's on a rampage
We're still killing trees,
The paper chart is history
With memo's flapping in the breeze,
It's just a game of substitution
We're still cranking out the copies,
And don't imagine that it's safer
It's on the hard-disc and the floppies.

Memo this
There is no purity,
PHI is found on Google
It's a joke, our famed security,
Despite threats of wagered fines
Financial damages and the like,
Take a note, it's the 21st century
Cracking the code, is like riding a bike.

So read the memos, take your notes
Tell your family, friends and neighbors,
We swear to honor your secrets;
But we're rattling hollow sabers.

Read the reminders, scribe the details
Every day there's something new,
And for fun, describe our memo's
When you float to ICU.

Fibril_late;
7/9/10

Saturday, June 05, 2010

I think you'd have to be living in a cave, if you haven't heard about the "Rapid Response Team". The concept has been around for at least 10 years, and has been proven to be an effective mechanism to help prevent bad things, from happening to good people. It works for bad people too, but anyway, intelligent hospital leaders, know the "RRT" can be utilized to intervene when a patient is going south, in the direction of respiratory or cardiac failure, or a similar dire situation.

Here at Sister Euphemia's joint, there was a task-force, some committees, and a few meetings..........and then there were dollar signs. The upshot outcome of all this headbanging, is what I call the Rapid Response Unpolicy. Just overhead page, "Rapid Response in Room XXX and an ICU RN and Respiratory Therapist will show up. Of course, why ask the Hospitalist to respond, he's probably catching some zzz's. Oh, by the way, the Nurse is not authorized to give any drugs, (oops, isn't Oxygen technically a drug?, the RT can't intubate..........No, we're just the arrive in a hurry and observe team (AHOT).

Enough blah, blah, blah.

Won't you please welcome...........

The Rapid Response Unpolicy

A nurse will respond
But not a doctor,
That's like a take-home exam
Without the proctor.

Along with the R-R-N
The Rapidly Responding Nurse,
Will be the R-R-R-T
Oops, I stutter when I curse.

Yes, the Respiratory Therapist
And the Rapidly Responding Nurse,
Will make a determination
Call the Coroner, or a hearse;
Because Billy-Bob Borko
Is icy cold with rigor mortis,
At least that's my first impression
Of this stone-dead old tortoise.

A differential diagnosis
Might reveal some hidden truth.
Maybe he's been like this
Ever since he was a youth,
Reportedly he was a hard man
That was according to his wife,
She tried to stab him seven times
But she always broke the knife.

In the end, as in the beginning
He was deader every minute,
We got the ziplock custom morgue bag
And put that gomer in it.

So you see, it's not too bad
The Unpolicy works, just like always,
Please tell us if it's Isolation
And keep the equipment out of the hallways.

Fibril_late;
6/5/10

Friday, May 28, 2010

I've worked nightshift for the majority of my Nursing career. Under some circumstances, family members/visitors are welcome to stay, particularly when the patient in question is confused or anxious. Often though, when it's a family member who just wants to stay over, for their own unexpressed emotional vacuum, it's usually more of a bother to the Nurse, and ultimately, the patient recieves less rest.

Sometimes the visitor just won't listen and won't accept, that it would be better for all concerned, that they go home! Critically ill people need defined periods of zero stimulation. I, as the nurse, can control my actions and activities, but having family there 22 hours a day, is usually a detriment.

Visiting Hours

Visiting hours are over
So, get the hell out of Dodge, we do ask,
Nothing is easier than leaving quite promptly
Do I need to explain this simple task?

Visiting hours are over
We've had quite enough of you now,
Leave now or suffer the consequences
Or I think, I just might have a cow.

Visiting hours are over
We overhead paged so politely,
We would like you to leave in a hurry
Or suffer a night with Golytely.

Visiting hours are over
We anxiously await your departure,
This is our one last sweet warning
Vamanos!, or we're calling the archer.

The memo was sent, the rulebook delivered
We explained it all clearly, I'm sure,
Leave now, you're no longer welcome
You're like a disease with no cure,
A thorn in our side, you're causing us pain
Your presence unasked for; uninvited,
The faster you leave, isn't quite quick enough
Disappear and we'll be so damned delighted.

For Visiting Hours, we flex our powers
Leave our building at night, or you'll pay,
We'll honor your return in the future
You're welcome to return, the next day.

Fibril_late;
5/28/10

Friday, May 14, 2010

Sometimes I get a little too proud regarding my poetic endeavors. And then I'm shot down by my buddy Steve, and his hilarious tales of Nursing mayhem. If you don't laugh and fall to the floor with this poem, you're a stone-cold chump!

Holy Senokot!
 
His abdomen was large,
His pants fit tightly,
The doctor had ordered
A jug of Golyteley.
 
After drinking a few cups
 He loudly proclaimed,
“I can’t drink any more
And I’m not one bit ashamed.”
 
“This stuff tastes like seawater,
 And it’s making me sick”,
So, I got on the phone
And called really quick.
 
“Hello Doc, about Mr. Johnson,
He can’t drink any more,
His belly is hurting
And he’s sick to the core.”
 
"He says there’s no reason
 For him to stay,
If to clean him out
There’s no other way."
 
“Can he swallow a pill?”
 The Doc asked with a snicker,
A pill would work I thought
And be a whole lot quicker.
 
So he ordered Senokot
A good drug indeed,
“15 Senokot PO now”
Just how much did he need.
 
Yes, I gave the patient
Those fifteen little pills,
Then I got some towels
As I knew there’d be spills.

And I called the pharmacist
“Did you do the approving,
Of fifteen Senokots
To get this man moving?”
 
 She said, “Holy crap”
I said, “That I will second”,
She replied, “That is a lot”
I said, “That’s what I reckoned.”
 
And the fireworks began
It was quick and abrupt,
The diaper bulged out
As he began to erupt.
 
The elastic in the legs
Didn’t hold it at all,
Poop shot from the diaper
All over the wall.
 
Mr. Johnson ran in circles,
He became all confused,
He looked like a sprinkler
I wasn’t amused.
 
Poop flew from his diaper
Til it finally blew off,
The smell was ungodly
I choked and I coughed
 
With a very loud sputter
In a big lake of brown,
I just about screamed
When his bowels settled down.
 
I wiped off the toilet,
I wiped off the floor,
I wiped off my scrubs
And I wiped even more.
 
I sat him on the toilet
And he kept on going,
In a boat with no paddles
Somehow I kept rowing.
 
So I called back that doctor
Just to say thanks and such,
“Doc, about that Senokot
WELL, 15 IS TOO MUCH!”

Steve Huff
5/9/10
Reading the previous post (below this one), you'll understand that I endure a stressful job. Sure, you say, tough luck, that's life. But I think it contributed to my current condition, the allergy attack that became a sinus infection. This story is about a little lump of mucus.

Lumpy Mucus

A lovely bit of lumpy mucus
Launching from my lung,
Came bouncing through my oropharynx
And landed on my tongue,
Its' origin, a putrid particle
Inhaled in room eighty-eight,
Has been festering for a week now
Near my laryngeal gate.

The taste is indescribable
The smell upon my breath,
As if two million viruses
Met untimely death,
And rotted in the warm and dark
In regions moist and wet,
Infectious mucus, I am thinking
What do you want to bet?

A lumpy glob of mucus
Is flying through the air,
I launched it with some gusto
As bystanders gasp and stare,
They're reaching for their cellphones
Snapping pictures of the rube,
Spitting nastily in public
Check it out, on “Mucus-Tube”.

Fibril_late;
5/14/10

Thursday, May 13, 2010

This is the last poem for the day, which includes the post's you can read, further down the page.

Our "new" 20-bed unit just gets crazier every day. I willingly step in as "Relief Charge", because I'm a closet-megalomaniac. Ya, right....in any rights, I'm technically a masochist, because this place is nutso. In the first four hours last night, we admitted 5 ICU players, transferred another, and sent another to a buddy hospital, and the northwest corner player had to get emergently intubated. I took about 50 calls on my Commander phone during the shift. Sure, I got a little testy at times; who wouldn't.

During my 20-minute drive home, I dictated the following tale:

ADUD

It was a dud, again
It was, it was,
And I ask myself why?
Because, because.

Assignment Done
Under Duress,
No matter how much I scream
It doesn't impress,
The powers that be
And the powers that don't,
It's a dud again
And I wish, but I won't

We were slammed
Pinched and scrambled,
I made some side-bets
But I've never gambled,
With odds such as these
Who could possibly win?,
It's a dud again
And I lost some skin.

An Assignment Done
Under Duress, I swear,
Twelve hours go by
And I've lost some more hair.

While the Boss in her bonnet
Is asleep in her bed,
Twelve, over-worked nurses
Are raising the dead.

And a dud is developing
On yonder north corner,
After raising the dead
We've discovered a mourner.

The Night-Supervisor
Calls me seventeen times,
With fourteen ideas
I can turn into rhymes.

An unwitting accomplice
To the power of words,
Creating seven new stories
About chattering birds.

A dud by another name
Is a dud by the same,
Assignment Done Under Duress?
Is the same cheatin' game,
I'll do all that I can
For the mission and the plan,
Just know, that I was under duress
And I'm not Peter Pan.

Fibril_late;
5/13/10
Every once in a while, it all comes together in just four, short lines. I thank a current Medscape highlight for the inspiration.

Taste It Before You Waste It

"New Targets For Pre-Diabetes Treatment"
That's what I read today, in the journal,
Measure the sugar in the urine
"Taste it, before your waste it"; your urinal.

Fibril_late;
5/13/10
I think I discovered the source agent of "restaurant syndrome", that all-to-common, food born illness.

Special Ingredient


If they ask for the special ingredient
We include it, for a thank you and please,
They don't know that the special ingredient
Comes from a cough and a sneeze.

Fibril_late;
5/13/10
A few weeks back: this patient was 55. She was an osteopathic mess. Multiple back surgeries; arthritis, some chronic inflammatory problems, and plenty of reasons for pain. She had become addicted to multiple medications like Norco, Dilaudid, Methadone and so on. She might not classify it as an addiction, but she had clearly developed a high narcotic tolerance, and the number of meds required to reduce her pain (“as stated, according to the patient”), was mind boggling. She was incredibly debilitated, and I suspect it was somewhat self-induced.

But, oh well: I don’t judge the pain or the victim. In ICU, pain is the 17th vital sign, and by golly, I’m like Robin Hood with his arrows. Where there is pain, I shoot the drugs.

Brittle and Broke

She's busted and rusted
She's brittle and broke,
She's on so many pain meds
It's almost a joke,
She has morphine for breakfast
For lunch and for dinner,
With a methadone side-dish
Baby, that is a winner

She has a long list of meds
It's an alphabet soup,
There's a bucket of pills
She keeps on the stoop,
And every year on the holidays
She gives them away,
Plus a few for little Bobby
To go out and play.

She's broken from pokin'
A needle into her arm,
She believed her first dealer
He said it would cause her no harm,
Now as a regular customer
It doesn't matter any more,
Being hooked on narcotics
Is the name of the score.

Fibril_late,
5/11/10

Wednesday, May 05, 2010

On the journey to work, traffic patterns and snoozy, smart-phone owner addicts, test my emotional barometer. Why can't "they" pay attention to the task of driving?

Places To Go

I can go from complacent to impatient
In the wink of an eye,
If you stall at the green-light
I'm thinking, "Buddy, you're about to die",
I know that seems a little harsh
But I've got places to go,
Get out of my way and off of the road
You don't belong here and that's what I know.

I'll beat you off the starting line
Nine times out of ten,
I've got places to go
And I know exactly when,
The light is about to change
I watch the other traffic, you see,
So don't wait on the green light
If you're the car in front of me.

I'll lay on my horn
Before you can gasp a single breath,
I've got places to go
And things to see before my death,
I don't like waiting at traffic lights
While you're yakking with Bobby, on the phone,
Pull off the road into that parking lot
And take care of your personal life, alone.

Sometimes I really wonder
If the guy in front of me is sleeping,
The light just turned green, it's a simple machine
But his car hasn't even started creeping,
No forward motion
And no acceleration,
If he doesn't get moving soon
There may be an assassination.

I'm heading to work
The traffic flow is quite unreliable,
I can't waste my time going slow
Arriving at work late, just isn't viable,
So I expect that all other drivers
Should be awake and alert just like me,
I've got places to go
And that's the most important decree.

Fibril_late;
5/5/10

Monday, May 03, 2010

I don't know about you, but sometimes all the flippin' memo's, decree's, announcements, reminders, JCAH crap, rules and regs, P&P's and so on, end up plastered all over every spare freewall in either the employee restroom, conference room or break-room! Enuf, damn it! We deserve some friggin space where we're not being reminded to do some new, stinkin' thing! Sheesh.

Restroom Repose

The restrooms of our unit
The private, employee loo,
Should be a place of repose
Not a forum of, "You must do"!

Let's save the professional memo's
For the walls of the conference room,
Where we gather Q12 hours
For the daily groom and doom.

A recent Reuters readers poll
Affirms by group opinion,
Leave the memo's off the walls
In the loo-dominion.

Dear leaders, don't find insult
With the comments I opined,
They are but ramblings of my repose
In this room, where all unwind.

*(Loo = Toilet or Restroom)

Fibril_late;
5/2/10

Thursday, April 29, 2010

Regarding floating to another unit.

The Luck Of The Draw


I was floated
And it was all good,
As any old, unexpected float
Really should,
Two patients were mine
Of the genre' I know best,
My float didn't have to be
Some kind of crazy test.

It could have been worse
Oh yes!, it surely could,
The Charge-nurse in this place
Was actually good,
Because everybody knows
What is the baddest of the bad,
When 12-hours goes by
And you depart really mad.

Now sometimes the float
Turns into a real whopper,
When the nurse that floats in
Is an undercover copper,
And they warned me about this
But I already knew the score,
I would never reveal secrets
Like that undercover whore.

Because I know, that when I'm floating
I'm like the cousin of a guest,
It's my whole hearted duty
To perform at my very best,
And I know that assignments
Can be sour, sick or worse,
Because the luck of the draw
Can mean you're a winner, or you're cursed.

Fibril_late;
4/29/10

Friday, April 09, 2010

Several days ago, and 3 poems down, I wrote about the cardiac arrest victim, who looked like she had an anoxic brain injury, but really, she was just in alcohol withdrawal.

Here is another look at the treatment:

Beelzebub's Bride

After so many days
Of craziness, that chick,
Finally convinced someone
She was legitimately sick,
And the sickness was alcohol
Or the lack, there of,
She might straighten around
If we provide her with love,
Absolut-ly said her mother
That's just what she needs,
Supply her with vodka
Before somebody bleeds.

A fountain of nastiness
She flung four-letter words,
With every breath that she took
She was spitting out turds,
But now that she's medicated
On Vitamin V,
With a shooter of Paxil
She's as happy as can be.

Sometimes we have to surrender
To the demons inside,
Or face up to the consequences
With Beelzebub's bride.

Fibril_late;
4/9/10

Thursday, April 08, 2010

Maybe because it is Springtime and allergies are in full bloom out here in the Golden State, that I was once again inspired to write one of those slimy, adolescent anthems.

Be what it may, I have a special talent for making rhymes of the grossest things.

Yes, I think I will read it at dinner, sometime this week.

Slimers on Wheat

After working with snot
With mucus, and phlegm,
You can easily tell the difference
Between a rock and a gem,
It is similar to the contrast
Comparing slime and a booger,
One is like Nutrasweet
And the other, pure sugar.

At our delicatessen
Called the Slime Sucking Snorter,
Our favorites menu
Tends to be shorter,
Than those jolly good offerings
At Billy-Bobs Booger,
Because we specialize in flavor
Without all the sugar.

We're open twenty-four hours
You can come day or night,
Get a beverage and pretzels
While we cook up a bite,
Of your favorite entree'
Perhaps “Slimers on Wheat”,
With a side dish of loogies
It's way better than meat.


Fibril_late;
4/8/10

Sunday, April 04, 2010

Getting old, up in the big years, life can be a slow, downward spiral; particularly, if you were in such a hurry during your adult years.

Getting Too Old

Getting too old
With so many diseases,
Nothing feels good
It only displeases,
Piece by piece body parts
Fail, one by one,
Getting too old
Doesn't seem very fun.

Approaching the grave
Can be a slow painful creep,
If you hurried while living
This hill will be steep.

Fibril_late;
4/4/10

Friday, April 02, 2010

These days, it seems like some people survive a cardiac arrest, much better than one would expect.

Take the case of Betty Boop; age 67, normal bmi, not diabetic, no history of heart disease or hyptertension. Retired, active volunteer, loves to play tennis. Mild COPD, and asthma, retired smoker. She's playing a round of Bridge, and wham, has a V. Fib arrest. Down-time at least 4 minutes with no CPR. Post-code first 12 hours, unresponsive, comatose, on a ventilator. But within 6 more hours, she's following command and nearly ready for extubation. She had another short episode of V.tach, but we shock fast and clean.

But the kicker is, that 2 days into the ordeal, she is so far out in left-field, that she's on the exit ramp outside of the stadium, in full-blown delirium-tremens, courtesy of her daily vodka routine. Totally loopty-loo. She'll probably go home in a week, and claim she met Jesus on the other side.

Loopty-Loo

V. Tach, V. Fib
Get shocked and bust a rib,
No oxygen, a four minute wait
And now she makes a heckuva date.

She woke up lucid
Like a lucky charm,
As if, V. Tach, V. Fib
Could cause no harm,
But now she's seriously
Loopty-loo,
Because she sucks down vodka
Like Mountain Dew.

Fibril_late;
4/2/10

Monday, March 29, 2010

As the nurse ages, he sees more and more patients of his generation lying or dying there in the bed. It does give pause to ponder.

Bad Habits Deluxe

Lately I've been pondering
My own mortality,
I've been taking care of the morbidly sick
Who are just as old as me.

I imagine that I own
Some magical health protection,
A barrier to sick and evil diseases
Courtesy of divine selection.

I purport that my meatless diet
For 30 years and more,
Is the secret to my longevity
My key to the healthy door.

And I'll claim that the genes I inherited
Don't stack up to the usual condition,
Of diabetes, heart disease and stroke
I'm protected by selective rendition.

But who am I kidding with this ridiculous story
Each one of us thinks, it will be the other guy,
Either bad habits deluxe, or a squeaky clean life
Flip a coin, I could be the next one to die.

Pondering my immortality
Is a better wager I think,
So many lifetimes of adventure
Gone in the eye of a blink.

Fibril_late;
3/29/10

Thursday, March 18, 2010

I recently interviewed for another classification and apparently there were three other applicants too. We all got the cut, so I guess it's back to the Minor Leagues. Anyway, I wasn't very attached to the outcome, so I'm not really disappointed. I know I'm going to stay in the position with less stress, so that's probably a good thing.
But essentially, I'm off the bus.

Off The Bus

We interviewed
The four of us,
And then they left us
Off the bus;
It wasn't moving
So, it was gentle,
But I guess, too much talent
Can be detrimental.

I interviewed
'Twas a lengthy affair,
Two separate times
In the victims chair,
The jury's decision
Was just executed,
And like a computer
I've been rebooted.

My grandiose dreams
Of wealth and power,
Lasted for only
About one hour,
Now I must return
As the horse with no fable,
Just chewing my oats
In the Nursing stable.

Fibril_late;
3/18/10

Wednesday, March 10, 2010

The story tells itself.

Dubious Science

I'll gladly be a trumpeter of evidence based practice
But come on baby, light my fire, it has to make sense,
If you show me statistics, and meaningful methods
I'll jump on your bandwagon, and gladly play defense;

But show me a policy, with the most dubious science
Like stopping the tube feed, when I lower the bed-head,
There's no single iota of technical value
Unless you're smoking some reefer, with Jerry the deadhead;.

A tube-feed that is running, at even 60 mils per hour
Is only dripping, at one mil per minute,
How will that alter the outcome of head-down
This policy has no sense within it;

Let's say, we laid him down, for 10 minutes of bath
That's tube-feed times ten mils, that we added to his gut,
There's no kind of physics, to predict any peril
Except to those of us standing, at the back porch of his butt;

The aspiration risk, to Snoopy Dupe Jones
Has nothing to do with a dripper,
This is dubious science to the maximum mondo
It reminds me of reruns of "Flipper".

On one hand we practice, some hot-damn good science
While in our books we brag about more,
If the policy date, is more than 10 years late
I don't advise that you bet on the score.

Fibril_late;
3/10/10

Tuesday, March 09, 2010

There is a flier on the wall, indicating that the good Doctor D. would soon be performing some cutting edge surgeries. I was wondering if that meant, that only some of his surgeries are cutting-edge, and then he has another side, where he performs say, some blunt dissection surgeries too. It's that word some, that is throwing me off.

So naturally, I had to write "Cutting Edge".


Cutting-Edge

Some of his surgeries are cutting-edge
While others are strictly smash and grab,
Historically, a few are just a nip, tuck and slice
For the removal of moles, scars and flab.

Cutting-edge surgery, is the name of the game
Blunt dissection, is a thing of the past,
With the help of a couple of robotic arms
Good golly, Miss Molly, he's fast.

Hardly anyone bleeds more than one pint of blood
He cauterizes with the light of a laser,
And if you complain, about your half-missing brain
Watch out, he is packing a phaser.

He's a cutting edge surgeon, with the sharpest of edges
He acquires his knives, by the crate,
Don't wiggle or squirm, he might cut off your worm
He'll declare, it's your cutting-edge fate.

Fibril_late;
3/9/10

Thursday, March 04, 2010

I've written about good and bad doctors. Fortunately, most are good characters, both personally and professionally. Here is my latest story:

He Rules The Roost


Dr. Murphy.......
He still rules the roost,
I think, our move to the new unit
Has given him a boost,
He arrives in the morning
By the crack of oh-seven,
Like he just dropped in
From his corner of heaven.

He regales the nursing staff
With his plans and his dreams,
He encourages the patients
Despite their moans and their screams,
In his spotless white coat
And his tidy, trimmed hair,
Why, no one has the nerve
To occupy his chair.

We all leap, jump and scramble
When he utters a suggestion,
He won't harbor fools
If you respond with a question,
And, pre-gather all your data
And pertinent facts,
If you can't be concise
Baby, you'll get the axe.

He's a good natured sort
And his humor is bent,
But don't tarry or lag
Because his time is well spent,
Not to be frittered or frattered
On frivolous fluff,
He may humor you for a moment
But enough, is enough.

Dr. Murphy...............
He still runs this joint,
If he ever departs
Who will we anoint?

Fibril_late;
3/4/10

Sunday, February 21, 2010

Times have changed over my career. (30 years)

There was a day when one might work in a "pure" Cardiac unit, where one saw primarily persons with just Myocardial Infarcts, Heart Failure, etc., and their various treatments. Now, those places are few and far between. Sure, the patients had other problems, but most just dropped in for 2 or 3 days, to receive treatment, for just their heart problem. Thus, all the nurses in the unit became Cardiac experts over time. Fast forward to now, with people living longer, getting more health problems over the years, with a greater degree of complexity, and we critical-care nurses, must become near-experts in whole-body medicine.

Essentially, what I described above, undoubtedly represents the maturing of the nurse-individual over a long career. I guess I share that distinction, yet I remain highly interested in the diseases, therapies and arrhythmia's of the heart; that's what I bring to the table. Luckily, I work with many other highly educated and vastly experienced nurses, and together we form a powerful force of good, for the patients that we care for.

But still, I poke a finger at us and try to make it funny.............go figure?!?



The Battle Of The Brady's

'Twas the battle of the Brady's
Jousting in the corral,
Was it caused by poisoned water
Like the famous Love Canal?

Were they age-related impulses
Unclear just how to work it?
Or knotted myofibrils
In the conduction system circuit?

Was the SA node too sickly
Or the AV node too slow,
Were the atrial motor pathways
On the stop and not the go?

Well, I opened up a chart or two
And discovered other answers,
There was a Digitalis suicide
And the other, a heroin dancer.

He was a boyish seventy-fiver
She, an ancient forty-sixer,
She'd mix heroin, cocaine and crank
Thrown together in her KitchenAid mixer.

He was despondent and lonely
His investments had gone down the drain,
So, why not take thirty Digoxin
And say "Goodbye, bon voyage", to his pain?

Now parked in a critical-care place
Where cardiac experts are few,
It's ho-hum when the heart-rate hits thirty
Quite frankly it interferes with the view,
Of Bobby-Joe showing his photo's
On Facebook, Picasa and Flickr,
"Oh look now, there's Bobby-Sue's baby"
And the local chums, giggle and snicker.

But here in the 21st century
We juggle mysteries like the jesters of old,
Knowing that illusions are paramount
For selling the goods in the hold,
We manage such multitudes of misery
Looking like mavens of medicine,
Caffeinated nurses got it covered;
We'd be the envy of good Thomas Edison.

Hence, the battle of the Brady's and Boomers
Neck and neck, at the end of the night,
The Brady's were beating at twenty
While the Boomers were ready for flight.

Fibril_late;
2/21/10

Saturday, February 20, 2010

Either we're getting really good, or some people don't die easily. This patient was a Type 1 Diabetic. For lack of insurance, she hasn't bought Insulin in 2 months. She was found down at home. Upon admission her pH was 6.8, a glucose over 700 and an unmeasurable bicarbonate. In any population, that is considered so near death, as to be considered as virtually waiting before the pearly gates. Now it's 24 hours later and she's talking about little Muffy her dog. Like I said, some folks just don't die easily.

Diabetic Curse

The diabetic patient, can
Be their own enemy, my man,
If they don't follow their diet orders
Their blood sugar will go beyond the borders.

Or say, they're on the Insulin shot
Two times a day, whether cold or hot,
But then they stop for a month or two
Surprise, surprise, their death comes due.

We try to save that unfortunate mate
Whose blood pH is 6.8,
And a glucose of one thousand two
Of the many we treat, we save but a few.

It's a foolish death, but survival may be worse
And that's the diabetic curse.

Fibril_late;
2/20/10

Wednesday, February 17, 2010

There is a job opening, and I figured, better to hire the local guy who knows the ropes. Too bad, I can't tie a decent knot.

Interview

I was interviewed
And it was good
Like any righteous grilling should,
Interrogated
By, just the Boss,
I had prepared myself
With mental floss.

It took place
In the hospital venue,
And followed the tried and true
Interview menu,
To pose ten questions
About this and that,
To find out where
My head is at.

To ascertain
My sanity,
Did I seek the position
For vanity?
Do I want to rule
With an iron hand?,
And will I do
What the boss has planned?

All in all
I think it went well,
Like a well cooked pot-roast
With that barbecue smell,
And now I must wait
On bended knee,
Wondering, "Who will be chosen
That other guy or me"?

Fibril_late;
2/16/10

Friday, February 12, 2010

Am I a Nurse or a Waiter / Waitress? Last night it seemed like I was a Waiter, but I sure didn't get any tips!

I'm A Waiter

Tonight, I'm a waiter
Tomorrow, I'm not,
What is the difference?
I won't be here in this spot,
Catering to
That man with a switch,
He makes an announcement
"Hey Buddy, I've got an itch".

But he's not really helpless
He worked 5 weeks ago,
He didn't break any bones
He had an earache, to show,
But it morphed and it broiled
And seeped into his neck,
Now he's landlocked and bedded
The train crashed, he's the wreck.

Twenty minutes times three
That's 3 calls an hour,
He's 27 years old
And he must have more power,
Than the strength of his thumbs
Dancing Salsa on the call-light,
"Yes sir, what do you need"?
It will be a long night.

Fibril_late;
2/12/10

Wednesday, February 10, 2010

The world is so weird, that I have an endless supply of ideas to tap into. Take the story I read that was posted in the newspaper, "Telegraph" from the U.K. The writer reported how in China, there are unscrupulous vendors who are marketing a diet pill, that actually contains viable eggs of the Ascaris Tapeworm. Well, hot damn! I guess that will cause you to lose weight......among other things, especially when one understands that they can produce 200,000 eggs per day. Yowza! That's gross.In fact, it makes me squirm.

It Makes Me Squirm


Because it's in China
It's the reason I believe,
I've heard they'll eat most anything
What an accomplishment to achieve

Yet, despite this foreknowledge
These things that I learned,
I'd think there'd be limitations
That even Chinese, would have spurned.

So imagine my surprise
That turned to horror
When I read it,
There's a brand new crazy supplement
You can buy with cash or credit,
To assist the overeater
Shed those pounds
They need some help,
After failing with the Exlax
The Colace and the Kelp,
The concept, the idea
It really makes me squirm,
What kind of crazy dieter
Would swallow a worm.

A tapeworm at that
The Ascaris parasite,
They lay a hundred thousand eggs
Every day and night,
But don't worry, it's safe
If it's on the Internet,
Guaranteed truth in advertising
Are you willing to take the bet?

The Ascaris tapeworm diet pill
Is a winner, there's no doubt,
Don't believe the medical experts
They don't carry any clout,
And don't worry about nasty side effects
The worms are always pure,
Infestation is the way to go
It's the latest obesity cure.

Fibri_late;
2/10/10

Wednesday, February 03, 2010

Young, large, seemingly getting along ok. He holds a job, still lives at home, drives a car. What could go wrong? It's not unusual to have Otitis Media, but an abscess in the neck, can cause swelling and compromise the airway of just about anyone. However, if one weighs close to 500 pounds, the potential sequelae of an invasive infection, well that's quite another story, indeed.

500 Pounds

500 pounds
With an infection in his neck,
It swelled his airway
And what the heck,
He couldn't breathe
And all hell broke loose,
Now he has a trach in his throat
And his bowels are loose.

500 pounds
27 years of age,
His weight is a shackle
In the obesity cage,
He thought a simple ear ache
Was just a bother, with some pain,
Now with respiratory failure
He might be easily slain.

500 pounds
His skin is wearing thin,
Septic emboli and toxic shock
He's rotting deep within,
His gut is sloughing out
Drained with a tube and bag,
His family hang by the bedside
Waving their hopeful flag.

500 pounds
It's a horror and a curse,
It's a premature invitation
For transport in a hearse,
Not a typical expectation
For one so young and in their prime,
Trapped by morbid obesity
Is the sentence, to the crime.

Fibril_late;
2/3/10

Friday, January 29, 2010

I was out of work for 3 weeks because of some alien organism that seems to have taken up residence in my right throat and ear canal. It's still there, but I've gone back to work. A lot happened at work during my missing weeks. Our "Cardiac Care Unit", has morphed into the Medical Cardiac ICU. Now I'm really more than glad that I work night shift, because most of those surgeries are recovered on Day-shift. That's right, and we stlll get paid more on the night shift. Talk about hidden benefits!

Anyway, going back to work after the unit has been broken-in a bit, has revealed new topics of business that I can write about, so I hope you enjoy this new journey.

Here again, I address a big topic; bariatrics. It's just a ruse. It's really about corporate spending on big projects, and the end-user impact.

Slalom Sleds

These hot new Bariatric beds
Are like super mondo slalom sleds,
We pull the patients up Q1 hour
They slide right down under gravity power.

The hydraulics seem a little weak
I'll explain it now, just let me speak,
When we lower the bed, head-down under feet
It's easy to reposition, all slick and neat,
But to return the head, upright beyond 30
We strain our backs, lifting down and dirty,
By physically hoisting the head of the bed
Another “safety” device, liable to make me dead.

These are new tech beds for the super heavies
Supposedly better than Sacramento levies,
Holding back the 100 year flood
But I'm not sure about Billybob's bud,
He weighed in at 225 kilo's
And we weren't even weighing the pillows,
On beds that are rated to 500 pounds
We're approaching that number in leaps and bounds.
Beds with all the bells and whistles
Not suitable for an ICBM missile.

The beds can rotate side to side
It's really quite a pleasant ride,
But here again, this weight thing irks
If you're really heavy, it barely jerks,
There's a tendency for big boy Jimmy
To get stuck on one side while the bed just shimmies,
Wiggles and strains, to pump air through the bellows
I wonder, “where is the lift team, I really need those fellows?”

There are lifts on the ceiling, with slings down below
When Jimmy's feeling better, we can swing him real slow,
Into the chair by the window to improve his outlook on life
Then the bed will be vacant, for his long suffering wife,
Her kilo's are many, her cankles are like stumps
I'm praying to Euphemia, “Dear Sister, bless these chumps”
Don't let either the one of them, have a cardiac arrest
Our defibrillators aren't prepared for that test.

We've got negative airflow, isolation rooms
And those lifts on the ceiling, on super-strong booms,
But honestly, I'm wary about the safety of it all
Bad things happen, when big people fall,
Caregivers damaged, lawsuits are brewing
When the dust has all settled, corporate is screwing,
Around with the numbers, statistics and more
The science of big, is a titanic chore.

Please, don't misinterpret my harangue on what's big
It's really an expose on the bureaucratic jig,
Million-dollar decisions, from dubious advice
High cost vendor contracts at an unbelievable price,
End-users suffer, at the whim of corporate decisions
Are Workmans' Comp injuries, in the provision?

This light-hearted muse, ended heavy and dark
But the business of healthcare, is no walk in the park.

Fibril_late;
1/29/10

Thursday, January 14, 2010

I worked in the new tower for 3 days and then I came down with some weird illness, where the right-side of my face feels like I got too much Novocaine at the Dentist office. Also, some of my taste buds quit, so food tastes really weird. Hey, maybe I could blame it on "sick-building syndrome"?

Anyway, I get a bunch of days off, and I figured I better prove that I can still pen nonsense.

Like Cancun

Any one of you with Addisons
Come on down to Auburn and Madison,
Check out our billboard
Take a look at our sign,
Glance at our fine menu and
How you will dine.


We have a shiny new tower
And a new Chef, to boot,
We welcome the gang-bangers
Who maim, stab and shoot,
We are non-prejudicial
Because everybody bleeds,
We're ready to serve
Our community's needs.


It's a fine looking billboard
Yes, it really caught my eye,
I'm thinking, that's where I want to be
When it's a good day to die,
And maybe Sister Euphemia
Will comfort my soul,
With her help I can avoid
That fire-belching hole,
Where I'm probably heading
After writing poems like this,
Poking fun at the nuns
Is like a sacrilegious kiss.


This is all about expansion
Up, sideways and down,
We're one hundred beds bigger
And in this hospital town,
It certainly is necessary
To appeal to the living,
As a non-profit joint
We depend on them giving,
Bundles of dollars
And cases of cash,
Or Sister Euphemia
Comes down with a rash.


It's a heck of a sign
On the outskirts of Carmichael,
If you're in a plane or a car
Or even on a bicycle,
It seems almost as big
As the real thing, I swear,
And if you look at it long enough
You'll crash and end up there,
As a bonafide patron
A victim, per se',
Where you had planned for a visit
And now you will stay.


New rooms and equipment
New Nurses and more,
Shiny, bold elevators
And locks on the door,
Beefed up security
And an incredible view,
You'll feel like you're in Cancun
With nothing to do.


Yes, our ambience was tested
By professional slackers,
Free drinks on the veranda
Toasted oyster on crackers,
And they gave us high-fives
Back-slapping and more,
The new McCauley tower
Got the highest darn score,
Way better than Sutter
UC Davis and Kaiser,
If you bring your business to us
You'll prove that you're wiser,
Than all the other folks
Who catered to our competition,
When they get their bills, they'll suffer
Extraordinary rendition,
Yes, buyers remorse
The equivalent or worse,
They know they should have chosen Mercy
And now they are cursed.


We have the coolest billboards
Plastered all over town,
If you give us a call
You'll get a free gown.


Fibril_late;
1-14-10