Thursday, October 30, 2014

A Lotta Fun

Just trying to survive and continue having fun.

Thirty years from now
I could be Ninety-one,
If I can stay healthy
It oughta be a lotta fun.

I need to avoid
Getting hit by a truck,
Keep away from large snakes
And horses that buck,
Jellyfish stingers
And terrorist captors,
Giant wooly mammoths
And prehistoric raptors.

I shouldn't roller-skate
No sense in sky-diving,
Why hurry death?
When it's always conniving,
To remove just one more person
From the planet, each minute,
An out-of-control dragster?
I don't want to be in it.

Deep sea diving in a Bathysphere?
That's a possibility,
Although, I might just wait
Till I have reached senility,
Because, if a brain injury might happen
I'd rather not rush it,
And if I go down too deep;
The ocean might crush it.

Sword fighting with a Samurai?
I wouldn't know how,
I'd probably end up
Being sliced like a cow,
Not too much sirloin
I'm lean, not plump,
Barbecued, or Jerky?
And stay away from my rump.

Let's appreciate SPIKE.com
"A 1000 Ways to Die",
They pretty much cover
All the things I shouldn't try,
If my intent is to survive
To the ripe old age of 91,
Stupidity is often fatal
A not a whole lotta fun.

10/30/14

Sunday, October 26, 2014

Leader Fail

Thanks to an occasional outside contributor, I present this gem of a story:

I witnessed the stupidest
Thing today,
A Charge Nurse
Had the gall to say,
That paperwork trumped
A failing heart,
Charting, had to be completed
Before the procedure could start,
To place a life-saving pacemaker
The man was going into shock,
Charge Nurse said, "You can't take him"
She's such a cuckoo clock.

The Surgical nurse
Was forced to stand by,
A witness of this stupidity
Despite my rallying cry,
That this was an emergency
A life-threatening event,
But Charge Nurse stomped her foot
And blocked all circumvent.

I split the scene
Frustrated and fuming,
Charge Nurse is a paper pusher
A number counter, I'm assuming,
With assessment skills
That have no compare,
How can there be?
When they never were there.

Crap rises to the top
Never more true,
I wish she would stay away from the bedside
And completely out of view.

Anony-mouse

Wednesday, October 22, 2014

Soldiers of the Myocardium

The overtired theme of understaffing. My workplace, health system, corporation, conglomerate, you name it organization, will always try to run their nurses ragged, all in the hope of shifting more dollars to the top of the pyramid. 30+ years ago, hospitals stopped doing healthcare and healing, and became ordinary cutthroat businesses. Luckily, Nurses have tried to ignore all that and just do what needs to be done, for the sick and maimed.

Too many crazy days
Understaffed,
Luckily, some of our clients
For hours, they laughed,
Knowing;  waiting is a moment
Best savored alive,
One doesn't hurry a procedure
In the busiest hive.

We're the most productive bees
In the strongest of hives,
There's just no way to measure
Just how many lives,
Have been saved by our actions
Our good teachings and good deeds;
You can't hurry excellence
Or somebody bleeds.

Joe Bob in the corner
Gets anxious and belligerent,
He's missing his Nicotine
The room's too hot
He needs refrigerant,
Along with some Ativan
Let's mellow him down,
His wife leaves for coffee
With an apology and a frown.

We race around wondering
Just how can we do it?
Process so many patients
Before we totally screw it,
Or it screws us
When we refuse, for safety reasons,
12 patients, 3 Nurses?
Not in the best of any seasons.

Assuredly; we represent
Three of the best,
Throw anything at us
And you will attest,
Hot-selling, predictable
Solutions on demand,
Is it safe, my good brother?
Hell No! And be damned!

Yet, we struggle on
We are warriors of the heart,
From the very beginning
Till the end of your chart,
You command our best intentions
We will do the most we can,
As Soldiers of the Myocardium
That's our duty and our plan.

10/20/14

Wednesday, October 08, 2014

Never In Time


We're short staffed, so my time slot pulled back 1.5 hours, in the (ridiculous) theory, that we could close the shop at 2130. But it never, ever works....often, with disastrous results.


Oh, what a ridiculous
Night it was,
You ask why
Because, becuz,
Of all the silly
Things we does;

Like coming in early
When we shouldn't,
Never leaving on time
Because we couldn't,
A hematoma
On a TR-band wrist,
And late recoveries
That we shoulda missed,
But you don't keep normal
In the hospital overnight,
That won't fly
On Medicare oversight.

10/7/14

Tuesday, October 07, 2014

Research


I went to that Cardiac Symposium last week, and learned some new stuff, and here are my results.

This latest Heart Failure topic
"LCD-696",
Is the hottest new stuff
Promoted to fix,
The agony's of heart failure
Comorbidities and death,
But now my G.F.R. is dropping
And I'm completely out of breath.

High-falutin research
During experimental stages,
Where theories and data
Fill up hundreds of pages,
On 500 laptops
In 42 Labs,
Result in 3000 white rats
Dissected on slabs.

Evolutionary
Quantum theory,
Found the white rat
As the perfect model, dearie,
To experiement upon
They're much cheaper than dogs,
Although, if you need a heart valve
Set your eyes on the hog.

Dogs, these days
Have achieved a reprieve,
Owners, view them as family
Experimental death?, now we grieve,
But cut up a rat, no one cares
'Twas their fate,
Remove emotion from research
And have a heckuva date.

Fibril_late;
10/6/14

Saturday, October 04, 2014

Nursing; now it's relative


It's hard to believe that the "Nursing Diagnosis" and its companion, "Care Plan" has survived into the 21st century. I thought they were absolute effin B.S. back in 1981, but apparenly the force of evil (Darth NANDA), was more powerful than I could ever imagine. A close relative of mine, now in Nursing School, is suffering through all of that nonsense, just as I did, and millions of other suckers. I just couldn't help but write about it again.

Darth Nanda

I've been studying so much
My brain seems to hurt,
My eyes are so dry
My tear ducts can't squirt,
There's a crick in my neck
From some postural twist,
If I had a Care Plan punching bag
I'd slug it with my fist.

"Critical Analysis of NANDA
Nursing Diagnosis Taxonomy",
This gobbledygook nonsense
Might ruin our economy,
When Nursing students realize
They can't swallow that crap,
They should have studied something else
Instead of wearing the fools cap.

Is it any wonder
That a Nursing Educator,
Isn't paid as much
As your average head waiter,
So, to bury their misery
They'll write scholarly junk,
To force on nursing students
Like a bullying punk.

Just find me a nurse
Who thinks care-plans are hot,
Those are the ones
Whose skills are but naught,
Because the genuine experts
Who deal with bullets and knives,
Have no time to score care-plans
When they're out saving lives.

Fibril_late;
10/4/14

http://en.wikipedia.org/wiki/NANDA

Thursday, October 02, 2014

Seats Belts...who needs'em


Driving way too fast
For my own good,
The tree leaped in front of me
Who would think that it could?

Fortunately, for the alcohol
I didn't feel a thing,
Face first, swan-dive
And it didn't even sting.

I couldn't recommend
A better pain remover,
As they vacuumed my face
Off the pavement, with a Hoover.

1993

Hocus Pocus


Memory sure is a strange thing. Currently, I see patient's on a daily basis having Atrial Fib, Flutter, PVC, Vtach ablations, and what not. My memory does not recall, that I was writing about this topic 21 years ago (and studying it as well). But here is the proof.

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 angelic 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 simple delayed potentials,
Be they premature or missing
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 ablation.

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.

1993

Wednesday, October 01, 2014

Forensic Files

What with all of the television shows about CSI, Forensic Files, Law and Disorder, and so on, I feel like the Nostradamus of Nursing. In 1993, I posted a poem that addressed that fascinating field regarding the determination of death.

Visual Mortality Acuity

How far away
Can you determine death?,
Can you sense the subtle vibes
Of a beating heart or breath?,
Can you spot a vapor trail
At twenty-seven meters?,
Do you hear the failing heart
By the backfire of its beaters?

Can you hear the death-mans rattle
As you stand outside the door?,
Or is it like the conch shell
With the oceans distant roar?,
I suspect it's just the tailwind
Of a guy who's heaven bound,
Doing solo flying
With the wings that he just found.

Can you measure Rigor Mortis
With a telephoto scope?,
Can you guarantee a suicide
By the tension on the rope?,
Can you call a drive-by shooting
And the bullet riddled brains?,
By the ashen colored skin
As the blood pours down the drains.

When you're driving in your car
And there's a fellow in the gutter,
Can you tell from half a block
If his heart beat has a flutter?
Is he a catatonic Schizo
With a blank and staring look?,
If you've had the proper training
You could read him like a book.

When you've learned to spot a dead man
At any distance you inspect,
You must study proper timing
To be sure you are correct,
Because uniqueness is the key
When determining a stiff,
This application of your senses
May require just a whiff,
Because death is an olfactory
Experience indeed,
A body laying undisturbed
Begins to go to seed,
And the germination process
Is a documented science,
The timing quite predictable
Like a clockwork geared appliance.

What this boils down to, folks
Is a measurable skill,
It's used by Law Enforcement
At the scene of any kill,
So, if you'd like to earn your license
With a handsome annual annuity,
Train for certification
In Visual Mortality Acuity.

1993



Dental Dana 32


The older I get, the prettier things are.

Dental Dana
Got me thinking,
Every time I see her
I get rapid eye blinking,
She's so damned radiant
A pleasure to behold,
Except for one little thing;
She says I'm too old.

But I can't help it
When she peers at my teeth,
Doing a critique of my brushing
And the plaque underneath,
Amidst the environs
In my oral cavity,
Meanwhile, I'm pondering
Immoral depravity.

Oh, Dental Dana
You're the bomb, Baby Blue,
But now, I have to run
Because she's coming with the glue.

Fibril_late;
10/1/14

Rolling the Dice


The latter half of my workshift revolves around the Discharge event; having patient's walk after their period of bedrest. Their Recovery period had been anywhere from one to six hours, and usually they are impatient to get going. But we wise old veterans know, this is not a hurry-up event. Perhaps 10% of them will have some bleeding, and maybe 1% might get light-headed and bradycardic. So, I'm extremely cautious about the whole thing.

Six hours of bed-rest
An average time to wait,
Before they have
Their walking date;
So, this young fellow had
His appointed walk,
All was awesome good
When he stood upon the dock.

He was on his way out
Wife and Nurse at his side,
And there he was bragging
About his beautiful ride;
That '67 Mustang
With Holly-Carbs and Lifters,
That he was a member of
The California Drifters,
When all of a sudden
He touched his pants and said;
"I think I might be bleeding
Look, my hand is all red".

Nurse Emma brought him back
Administered Epi and Lido,
Walked him again in one hour
And he bled just like Fido,
So, we laid him again
Held pressure
And invoked the Gods;
Sandbags and D-stat
And pondered the odds.

I bet on Emma
After hearing her stories,
Simple nights of debauchery
And serendipitous glories,
In Reno or Vegas
Or maybe Burning Man,
At that point, last night
I was open to her plan.

Well, third time's the charm
When you're rolling the dice,
And sometimes when you're bleeding
You need more than twice,
When the ultimate goal
Is to send you home safe and sound,
In the future I'll feel luckier
When Emma is around.

Fibril_late;
9/29/14

Fist


The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as any physical assault, threatening behavior or verbal abuse occurring in the workplace.


You tried to punch me with your fist
To do me harm,
With your Mike Tyson grip
You bruised her arm,
And sure, you "got better"
We can blame the anesthesia,
Conveniently, you won't remember
Claiming, you seem to have amnesia.

But I know better
After thirty years of Nursing,
The drugs tear down the curtains
That hide the violence and cursing,
The evil one inside of you
That you rarely let out,
People who live with you, they know
It's not something they talk about.

Your faithful wife, stands up for you
Asking me, "Sir, are you having a bad day",
Implying, that I am the aggressive one
In the midst of this violent parlay,
Where our whole intent is his safety
In this setting, of saving his life,
But we're dealing with his hidden demons
And his ever-supportive wife.

Violence in the workplace
This is it folks, it isn't fun,
Potential career-ending injuries
Are the proverbial loaded gun,
Whether intentional or not
It hardly matters, when harm is done,
And defensive family members
Probably helped to load that gun.

9/30/14