For this Christmas season, I already prepared a "review" of some old holiday themes and presented them to my mates. But that in itself, inspired me to revisit the Christmas spirit of old fashioned tunes we know so well. Take the truly beautiful song of, "Silent Night"; I admire the writing, and the format that allows me to twist it for my own selfish needs................yes, a chronicle of a haunted, Christmas night!

And for your pleasure, I advise you to sing it with the suggested melody:

Silent Night
(Sung to the tune of "Silent Night")

Silent night
Lowly night,
All of my patients
Are drugged up right,
Round about midnight
I doze in my chair,
When airborne E. coli
Drifts into my hair,
Lo, I don't know it
But it's really Grossssssss...............
I'm a fomite on this Christmas night!

Silent night
Foley night,
There's a leak in that catheter
And the linen ain't white,
I looked under the covers
It was yellow and wet,
Curses on the day-nurse
Now he's in my debt,
I'll surely repay him
For a transgression like thissssss.............
I'm rankled on this Christmas night!

Silent night
Goalie night,
If you know about hockey
You'd recognize the sight,
We were body-slammed sideways
By the night Supervisor,
She thinks of Admissions
Like common divisors,
There weren't enough Nurses
To save enough lives...........
We were slammed on this fine Christmas night!

Silent night
Guacamole night,
We brought in some snacks
And did it up right,
Then Moses, from Pharmacy
Coughed on the dip,
We all got diarrhea
On this sinking ship,
It's a night we'll remember
Too long, I am sure.............
We were cleaned out on this Christmas night!

Fibril_late;
12/21/08

At last, some new poems. Sometimes I get topic ideas but just a few juicy lines. Then later, with the assistance of some fermented grapes, the details reveal themselves.

Marketing Fat

"Anti-Obesity Drug Pulled From European Markets"
That's what I read in the news today,
It seems to me, more success might be found
If our grocery markets, would hide the food away.

Rarely is it natural for a person to become obese
Thus, it's usually a condition of habit,
But in today's society of sweet and fatty foods
With the right advertising, we all want to grab it,
And with the onset of sedentary lifestyles
With computers, video games and TV,
The demand for a pill to melt away the fat
Is an attractive concept, believe you me.

These days, it seems to be starting
As young as infancy, soon after the bottle,
Parents, just stupid, at the grocery store
Don't understand, when to damper the throttle,
When it comes to Little-junior's demands
To consume calories each hour of the day,
At five years old, and 65 kilos
I can assure you, his health will soon pay.

-- -- -- -- -- -- -- -- -- -- --

8th grade children
Larger than my wife,
Enough adipose tissue
To carve with a knife.

Not on the basketball
Or volleyball team,
Ten years from now
A gastric-bypass ream.

Those surgery specialists
Are raking in the bucks,
Screw the stock-market
This is a cash machine deluxe,
Because the obesity epidemic
Is just beginning to roll,
With outrageous statistics
Like the holiday bowl,
Because those hundred thousand couch potato's
Are future paying clients,
Thank God, America
For Bariatric science!

Fibril_late;
12/21/08
__________________

Lactulose Advice

Don't get too close
After giving your patient Lactulose,
Approach cautiously
And, I must mention
Beware of bowel distention,
If at all possible
Pad the bed,
Avoid their nether regions
Rather, pose by their head,
And if cleaning is necessary
It won't be the end,
But it's a heckuva lot easier
If you invite your best friend.

Fibril_late;
12/21/08

No medical conundrum has struck my fancy lately, and thus, no related poem. To fill space, here is my take on the leaves of my neighborhood.

Leaf vs. Lawn

While walking around
My neighborhood,
I get a feeling
For what's bad and what's good,
By looking at lawns
Garages and such,
I make assumptions
About those
Who seem to care too much;
Preening their lawns
Like a thoroughbred horse,
With a legion of gardeners
At a private golf-course,
Preparing for a tourney
Of high-stakes croquet,
While in reality
It's just my neighbor
Setting up Santa's sleigh.

He decorated the trees
The bushes and the flowers,
What's up with that, I wonder
With leisure time, for hours,
I wonder if he's working
Retired or laid-off,
Then I see a puff of smoke
And listen to him cough,
Thereby, furthering my suspicions
He has lung-disease and more,
I silently admonish him
And pity him, the chore.

With a little more attention
I compare the state of leaves,
Some lawns like mine, are full of them
And others beset by thieves,
Intent on dispatching all evidence
Via obsessive-compulsive removal,
As I relax before my blanket of leaves
I silently wave my approval.

Driving along my home avenue
I play my game, "Leaf vs. Lawn",
To the average reality-show junkie
It would barely register a yawn.

Fibril_late;
12/7/08

The Drawbacks

One of the drawbacks
Of being the man in nursing,
There are a few scenario's
Nursing school ain't rehearsing;

For example, last night
There was an elder, female, asian,
Though it looked like a peach assignment
I overlooked the equation,
Where men exit the room
In times of elimination,
They won't talk to the man
On this kind of occasion.

Every one to two hours
I entered her room,
Querying pain or discomfort
Anticipating no sense of doom,
But, with no relative for translation
She kept saying, "Ok",
Linen change at oh-five-thirty
Suddenly, hell was to pay.

This woman was lying
In a pool of liquid stool,
I was shaking my head
Like a newborn-nursing fool,
Trying to gently admonish
A lady, without my lingo,
At the same time, self-cursing
"I'm just a stupid gringo!".

But then, I understood
This is a crossroad of cultures,
As if twigs, leaves and tomatoes
Are thrown in a mulcher,
The output is messy
But fertile, there's no doubt,
She was as quiet as a mouse
While I was expecting a shout.

It all worked out in spades
I'm happy to say,
One poop for me, at the end of the shift
What more, can I say?!?

Fibril_late;
11/24/08

This is uber-ridiculous, yet funny. Actually, ridiculous doesn't begin to describe it; after all, how many times can I revisit the same old theme of Kaexalate?

K-Axle-8

I've written poems in the past
About the elevated K,
If the serum sample measures high
You have to make it go away,
And the Doctor commonly orders
An elixir; it's disgusting,
A-k-a: Kaexalate
Guaranteed for bowel busting.

But what if this was truck repair
Eighteen-wheeler, to be specific,
The differential diagnosis
Could really be terrific,
In terms of the location
The drive-shaft and its mate,
The nurse envisions a flexi-seal
And the mechanic, K-Axle-8.

So, you have to be real careful
When communicating with Patient-Bob,
He looks duller than a doornail
And he's dressed like a greasy slob,
But he has an uber-grasp of mechanics
Fluid dynamics and electrical lore,
When you tell him he needs an enema
Why, he thinks he's going to score.

Little does he know, this night
Will pass with loads of gas,
From bed to toilet, and then again
To empty out his ass,
If you can find a correlation
Between mechanics, and the way of medicine,
Instead of cussing you out, at four-a.m.
He'll be singing the praises of Edison.

Fibril_late;
11/17/08

Some things get old really fast.

Continuity

Continuity of care, is fine
When all is well and good,
But when his bowels are loose
Hardly anybody should,
Be subject to caring
For more than a day at a time,
Although an incontinent patient
Has provided many a rhyme.

Fibril_late;
11/17/08

I've mentioned it before, how I recognize it is my role to report not only what is going on in the nursing realm, but to tell the stories of those persons who present into our health-care setting.

To Write

I'm not a prophet or a messenger
I'm just a fellow, who can make a phrase,
I come to work near the end of the night
And then, I welcome in the days,
To write about these others
To tell the story as I see it,
They may never get the chance
As their agent, I can free it,
I won't divulge their sacred oneness
When I meld it with my words,
Yet I'll cast a thousand seeds of wisdom
To be consumed by many birds.

Fibril_late;
11/17/08
_ - _ - _ - _ - _ -

Recordings

Very few nurses
Read the lines that I pen,
The trials and errors
Experienced over and again,
Yet I still feel the urge
To put it in writing,
Like a night-time mosquito
Intent on its biting.

I have written for years
But very few listened,
It really doesn't matter
Regarding the verses I've christened,
These are recordings
That needed to be done,
And I surely didn't know
That I was the one,
While writing for years
In papers and in journals,
Never suspecting my topic
Might be of bedpans and urinals.

Fibril_late;
11/17/08

You have to be careful these days, when looking for a hot date!

Pseudomonas versus Pseudo-Mamas

If you're cruising the crowd
At the Autorama,
Looking for a pseudo-mama,
She might be offering a special bonus,
Candy-flavoured pseudomonas.

Fibril_late;
11/18/08

Do you like variety? Some do, while others like familiarity. Neither is better than the other.

New Patient

If you might ask a pool of nurses
Who work multiple days in a row,
Would they prefer a different choice each night
Or stick with the patients that they know,
Over the years I have asked that question
And the answers are all over the board,
Some like to see a new sunset every day
While others, like to work with what they stored,
Only yesterday, when caring for Mr. X and Y
And now today, they already own some of the facts,
It's akin to following a known path in the forest
Where you already recognize some of the tracks,
But should you query an ER Nurse
The answer is opposite and clearly understood,
That every new patient admitted on this night
Will be moving out in a few hours, as they should.

Fibril_late;
11/16/08

Some may think that I am lax, where I wait to give the bath till 4 am. First off, that leaning-over-pulling-stooping stuff that I have to do, to accomplish the bath, usually tweaks my back. Thus, I wait till the late hours of the shift. That leaves me free to help everyone else. So be it.

If All Looks Well

It's a double edged sword
When working with some nurses;

Even I may be a subject
Of somebody's curses,
Because, I guess it's well known
I don't care about the bath,
I look at every patient
And intuit their path,
In the great scheme of all things
I determine if it's needed,
With vital signs, irritation or rest
If they're alive, I've succeeded,
And after 10 hours
If all looks well, we're good to go,
It's time for my speed-bath
Because I want you to know,
That I recognize that fresh warm water
When placed against the flesh,
Has a remarkable, soothing effect
To erase memories, and refresh.

Fibril_late;
11/10/08

At Sister Euphemia's place, the proverbial wrench was thrown in (not the towel, mind you), regarding all the particulars about getting this humongous EMR system up and running by 12/2/08. Somewhere in the long chain of those-who-know, a decision was made to wait till next year. Which means, "just around the next corner after Jan/1/09". Mine is not to wonder why, but to make it rhyme with just one try. I think I've gotten to the crux of the matter: Resistance to Change. Hmmmmm, that sounds familiar...

Outstanding Duress

Why does Care-Connect pose
Such outstanding duress?
I think it's worth reviewing
Because an incredible mess,
A conundrum of calamities
Is looming in the future,
Where a pat on the back and cookies
Or a 24-carat gold suture,
Won't be adequate to patch
Our confused and aging staff,
Surely Generation X & Y
Will share a hearty laugh.

Why is change so difficult?
We confront it every day,
Never knowing for certain
How a disease dilemma will play,
In yonder victims body
After a week of rampant infection,
Change, is delta squared unknown
And we love to predict its direction.

But an aspect of our jobs
Is guaranteed regular and static,
It's the paperwork we're accustomed to
After decades, it's automatic,
We know exactly what to chart and where
The closet and shelf where they're kept,
This electronic medical record
Blatantly exposes why some feel inept.

I predict a silent rebellion
Perhaps later, an ear-rending scream,
Will be issuing forth from the multitudes
Who thought this nightmare, was surely a dream,
Then the PTO, Sick-calls and other
Will be ringing the phone off the desk,
Forty-five Nurses resigning
And swapping their jobs for burlesque.

I seriously doubt, that this disaster was foreseen
Assumptions were made, regarding the nurses,
Figuring heck, we're such resilient troubleshooters
We'll just knuckle down, muttering our favorite curses,
But, here in the waning, august years of our life
Who wants to deal, with the mother-of-pain,
Why not run with the pension and the 403(b)
And let them hire some new-grads to train.

Fibril_late;
11/10/08

Leigh, the travel nurse extraordinaire, will forever be immortalized by this touching limerick:

Eau du Leigh

There once was a nurse known as Leigh,
Who worked so damn hard, all could see,
The sparks flew as she sped
From each CCU bed,
So remarkably nimble, was she.

Fibril_late (& Ms. V)
11/9/08

Every once in a while, I have to write something so silly and nonsensical, particularly after I've been penning a bunch of true-life-stories. Enough of reality already!

Lisinopril

I’ll take most any medicine
But I won’t ever, take one pill,
To me it’s a moral issue
Regarding Lisinopril.

About the name, it sets me off
It rankles my nerves and gives a chill,
The first two syllables set the tone
Lie, sin, o-pril.

How could I possibly consider
To absorb within, this Lie,
Follow up with a course of Sin
Oh pril, I’d rather die.

I’d rather let my blood pressure
Run it’s course,
Be trampled by elephants
Or kicked by a horse,
Lay on a bed made of
Porcupine quill,
Before I’d ever consume
Lie, sin, o-pril!

Fibril-late;
11/03/08

In Nursing, when you go to work somewhere new, sooner or later you will be expected to be "Relief Charge Nurse" for your particular day/night of work. It's a dirty job, but somebody has to do it. Usually the established format is that you will receive some sort of "orientation", most likely with one of the other "experienced" charge-nurse persons. Once in a while, an error occurs in the "usual plan" and you might be thrust into the "first night as Charge-Nurse" quite unexpectedly.

In my case, everyone I worked with that fateful night, just refused to believe that I was not supposed to be assigned to Charge, yet. So I figured, "what the hey", they might have a different opinion when the dust settles. Naturally, 3 quiet hours passed and then all hell broke loose. The survivors will talk of this night for years to come.............

Charge


That was interesting
To say the least,
I entered as a lamb
And departed as a beast.

Once again
I was saved by my peers,
With them by my side
I didn't age years,
And surely, any other nurse
Would have been reduced to shrieking,
Gone catatonic
Never again speaking,
But with the help of my comrades
I limped through a disaster,
With their mighty efforts
The night passed much faster.

It was a classic example
Of a courtesy appointment,
And the word on the street is.......
I've had my anointment.

Fibril_late;
10/30/08

Don't take offense when I humor religion, ok? Let me shoulder the entire karmic debt. If you get angry, that isn't my fault.

Now let's just consider for a moment: Doesn't Jehovah deserve to have a week off now and then, to recharge his batteries (or whatever it is that he runs on)? Well, I think so. The big boss in the sky, has a heck of a lot on his plate, and deserves every little bit of peace and quiet that he can sneak in. So, I authorize at least a week off. Just call it a "prior-auth".

Jehovah On Vacation


Jesus is so frickin ' busy
Doing good works, far away,
And of course, he has the power of creation
At his fingertips, they generally say,
But surely this man of the robe
Needs to rest, like that Saturday in the cave,
He may be the ultimate healer
But frankly, he isn't our slave.

And I know for a fact he was here just last week
Saving Popeye, after a bad fight with Bluto,
Olive-Oil was there at his bedside
With her seeing-eye dog, he's named Pluto,
Mr. Whimpy came around with his hamburgers
Flirting with the Nurses; (that Casanova),
And who should he bump into in the hallway
None other, than our good Lord, Jehovah!
He'd dropped in, to have a parlay with Popeye
Bringing a case of special spinach from his garden,
He'd responded to some prayers within our chapel
Figuring someone was in need of a pardon,
And the housekeeper overheard (as he dusted)
That Jehovah planned vacation next week,
So if you should die in the next 7 days
You'll take off from this planet in a streak.

No lingering around on a respirator
No response to a shock to your heart,
When Jesus is off on vacation
It's pretty damn easy to depart,
Slicker than a whistle, slippery as an eel
Faster than you say whoops-a-daisy,
And if you're thinking, that Jesus is watching
"Good Lord", he'd exclaim, "you are crazy"!

Fibril_late;
10/30/08

If you would look at previous posts around October 7, 8 & 9, I was writing about death and families, and Aunt Mary. There was some religion thrown in also, and this piece is just a little bit of unfinished business, inspired by that previous happening.

The Crux of Departure

CPR times 90 minutes
A heartbeat, but desperately slow,
In reality, it was the end of her life
And it was time for Aunt Mary to go,
And I'm telling you, Jesus was there that day
Hell, you could hear the dude coming,
He responded to a summons by his Angels
Off-key, with their death-march humming.

As she peered down that long empty tunnel
His light illuminating, all she could see,
She had long heard his voice in a whisper
"Aunt Mary, come along with me",
But the family at bedside thought otherwise
Claiming, "We have a contract, to grieve"
Halting the process of her departure
Like a magician with tricks up his sleeve.

Yes, the crux of departure, most often
Is prolonged by a family in distress,
The patient in question is dying
While the kin are an emotional mess,
Some want to revel in each torturous breath
As if bystander suffering should be scored,
While the long endured agony of the victim
Is conveniently denied and ignored.

"God will save her", they say, "It is written"
To have faith in the Lord, our belief,
They previously disallowed any medicines
And now they are reveling in grief,
Harboring the idea that Aunt Mary is alive
As proof of her stalwart independence,
Proclaiming each blink of an eyelid
Is proof that the Lord, is in attendance.

After 30 long years of experience
I have opinions derived from observations,
I've seen hundreds of people pass on
From so many different congregations,
And those people who experience the most difficulty
Accepting the end days of life,
Are the most basic of Fundamental Christians
Who take the bible as their mistress and wife.

Fibril_late;
10/30/08

It's happening to a lot of us Nurse baby-boomers; we're providing care to a lot of 50 year-olds with horrendous health problems (and counting our blessings). And then in one short week, I provide care for a couple of really-looking-healthy guys younger than me, and I realize once again, that life is just a crap-shoot. We don't have a clue what is lurking around the next curve in the road!

Rattlebrained

A glioblastoma and a dermoid cyst
I'm telling you, brother
I would rather have missed,
These cerebral events
Inside of my head,
It's anybody's guess
How soon I'll be dead.

He was fifty-one
And the other fifty-two,
No other health problems
And I'm telling you,
As an older senior nurse
I was measuring my well-being,
Against these two guys
I couldn't believe what I was seeing.

Twenty-five years ago
When I left nursing school,
I was just about thirty
And no longer a fool,
And I think that's about average
From later observations,
Rattlebrained for 3 decades
In many derivations.

The next twenty years
Are to establish your brand,
By fifty you'll be good
And carefully planned,
So that the next half of life
Will unfold, as you thought,
After all you invested
You can see what you bought.

While I'm looking at these guys
I'm thinking, "Holy crap!",
They look healthier than me
And I realize the trap,
That all of us fall into
Sooner or later,
If you haven't met Fate
Watch out; you might date her.

Fibril_late;
10/21/08

A life is saved, the victim "comes around" and..............voila', you discover they are a classic p.i.a.
Being in the hospital, is just Part "A" of their daily drama performance. One moment they're on the phone, bragging about how they almost died (with a dramatic sob thrown in), the next moment, they're complaining that a favorite TV show isn't on, "here in this place I got moved to, and can't ya page somebody to fixit". And then there is that central line the Surgeon placed an hour ago, when the systolic blood pressure was 47/22, and this Drama Maven, will probably dislodge it in the midst of some hissy-fit!

Sometimes a 12-hour shift can seem like 3 frickin' days.

Harp and Moan

I've talked about this type before
How caring for them, is such a chore,
Drama mavens, in their own right
Their passion play is out of sight.

How they harp and moan
With a waxing whimper,
Bring attention to their cause
With a preen and simper,
Boast or cry
Whatever suits them best,
It's your compassionate attention
They like to test.

At the limit of your tolerance
They will claim offense,
Accusing you of insult
With a phony pretense,
They might demand to see your boss
Or spit at you and curse,
And like a self-fulfilling prophecy
You hate to be their nurse.


Fibril_late;
10/17/08
________________________
Big Problems

The bigger they are
The wimpier they seem,
When they’re 5’2’’
And wide of beam,
Wailing and fussing
Way out of proportion,
Maximizing complaints
Beyond all distortion.

The tiniest problems
Will initiate a grumble,
Magnanimous moaners
They hardly are humble,
Boiling over with an outburst
Of evil dispensation,
Accusing their nurse
Of prejudicial intonation.

They want a Supervisor
To reprimand that horrid nurse,
Claiming insults were flung
And her caregiver cursed,
They’ll say, “My nurse had no compassion
And I’ll write it in a letter,
I know the CEO…………….
I guarantee, that he’ll get her”.

Oh, the biggest of problems
Have little to do with sickness,
With personality disorders
They manifest with a quickness,
Irritating as hell
Some people vex and annoy,
Virtual walking inflictions
Always ready to deploy.

Fibril_late;10/17/08

Being sleepy has nothing to do with getting old. Just ask a veteran worker of the night-shift. This morning, after working a 12 hour easy shift, I could barely stay awake to drive my sort-of-short 15 mile trip home. OK, it is tough to deal with the customary morning freeway slowdown and the blazing sun at eye level, but come on, why can't I stay awake?

Let's do the instrument checklist:
Radio blasting, window rolled down, moon-roof open, slap my face briskly, scream, bite my finger.........no, that's not working..............what I really need is a 100th second mind drift, didn't notice the abrupt slowdown, brake-slamming-almost-rear-ended the guy in front of me, holy-crap!!! moment, to blast 17 micrograms of adrenaline, mainlined into my sinus-node, precipitating a burst of atrial tachycardia and HOOYAH, I'm AWAKE!
A half a minute later, I'm drowsy again. Go figure!

Can't Stay Awake

It's amazing how sleepy I am
Like I've been snacking on drug-enhanced Spam,
At some point in its creation
There was chloral hydrate migration,
And voila', I'm the stuporous man.

I'm astounded that I can't stay awake
Even during a California earthquake,
Heck, I noticed when I'm driving
It seems that sleep is arriving,
Perhaps being on the road is a mistake.

Yet when I get home, I awaken
It might be the smell of the bacon,
And when I finally lie down
I'm an insomniac clown,
I need a potion for sleep, I'm not fakin'!

No one believes me, I'm sure,
Otherwise, I might find a cure,
There is a lot here, at stake
To prove my drowsy is no fake,
And my reputation is truthful and pure.

I called upon an expert of sleep
But then I fired him, that dude was a creep,
He charged by the hour
To some exponential power,
He dug a hole in my bank account, deep.

Now I'm panhandling, at the corner of Ambien and 3rd
Can you spare me a dollar, I wonder if you heard,
My old friends run the gap
Because I look like crap,
And I'm snoring before I chance to hear a word.

Fibril_late;
10/14/08

I shudder to consider the ramifications of this; in fact, if I had not been there as a witness, thus being one of several witnesses, I would doubt the veracity of the story.

Picture this:

A busy hospital in a busy city. Beds are at a premium; patients are stacking up in the ED, like planes at O'Hare in Chicago, in the midst of a "Nor'wester" blizzard. The call from "Admitting" comes in at 0500, regarding patient in critical-care bed #A, that they may transfer to Floor bed #D. The patient in bed #A is a female, isolated for MRSA. The available bed #D, is in a room with a male patient and he is colonized / isolated for a strain of klebsiella.

Lordy be! What in the tarnation is goin' on?!? (This is where we collectively said, "Duh, why can't they see what is wrong with this picture?") The most shocking thing is this: This is Sister Euphemia's place!

Luckily, the nurse for Ms. MRSA, put her feet down, chomped the bit, blew a gasket, raised hell, and said, NO!
So the transfer fell out of favor........

Naturally to me, the whole thing had a humorous side to it:

Euphemia's Clinic

We're totally integrated
No longer segregated,
Men and women united
And finally cohabitated,
Where even infections
From different families,
Can bed to bed comingle
Like pear and apple trees.

Fibril_late;
10/9/08

Regarding the songs of death.

Singing Harmony

You were right
But I wasn't wrong,
We two, were humming harmony
In the death-prediction song.

The lyrics of this song
Are expressed in many ways,
Sometimes shreiked like a bloody banshee
Or whispered a fortnights day.

Hundreds of different cultures
With rituals and such,
Many convoluted expressions
I don't understand very much,
That's why I like to hide in the corner
Mumbling and humming a tune,
Praying the shreiking and wailing
From that family will end pretty soon.

Fibril_late;
10/9/08

Being present at the time of many deaths, one acquires a sense of the impending moment of departure..............

Death is Coming

The qualified, competent, experienced Nurse
Knows when death is approaching the bend,
We can feel the subtle vibrations
We sense where the cord will end.

It comes after thousands of hours
With practice, then mastery of skill,
Hanging around in the shadows
Close to the edge of Boot Hill.

Gleaned from years of observation
Clues of impending death,
Delicate variations
Of the heart beat and the breath;
Changes of demeanor
At times, a peaceful calm,
After weeks of fretful anxiety
Now a measurement of balm.

Rarely, are we caught off guard
It takes significant subterfuge and guile,
Though occasionally the suicide player
Goes out with a bang and a smile,
Otherwise we are the experts
Judgment Day deliverers of care,
Worry not, patrons of pathos
Upon departure, a Nurse will be there.

Fibril_late;
10/9/08

I was inspired to some degree by one of those end-of-life for "Aunt Mary" dilemma's, that cross our threshold frequently.

If only John Q. Public would get a clue: Look, when you're over 50, you have the "big-three" of CAD, Diabetes and HTN, and you're in piss-poor every-day health, and then you drop over dead, CPR x 1 hour, portends no more than a 1% likely-hood of survival. And even then, that's probably a very generous outlook. But, during that aggressive hour of resuscitation (and just why?!? did it last that long?) you do receive a boatload of powerful chemicals that just might.........initiate some last-ditch electrical activity in your heart. Well, it's tough for a physician to stand around and wait for the heart to stop (again). So, put Aunt Mary on a respirator and treat her as though she has more than a snowballs chance in Hell to survive. Believe me, even the all-powerful Sister Euphemia can't intercede at this point.

The only hope is that JESUS, will intercede, and raise the dead.

Frankly, I feel kind of sorry for that dude. There he was, hanging around in the ER, with his arms outspread to hug and welcome Aunt Mary, into his heavenly fold. And then, damn, there is that freakin' strong epinephrine stuff coursing in her nearly dead veins, and there is nothin' he can do about it! This is a moral dilemma for Jesus. He and Aunt Mary had this pact, that if she were to ever have a cardiac arrest, he would be there at a moments notice, to usher her to the other side. Now, it's as though she is being held back by some puny little humans, and it is outside of his job description to kill her, to be able to keep her, so to speak!?!

Now he is definitely between a pillar of salt and the dead sea. We caregivers are just following directions. We and the doctors have that Hippocratic Oath to "do no harm". So, we forge ahead and follow the family wishes (no matter how bizarre), because Aunt Mary, no longer can speak for herself. By this time, Jesus has split, and just maybe, he has told one of his groupies to hang around the hospital room, and keep him posted with daily updates. However, once Jesus takes off for other more pressing demands, that is when the Grim Reaper starts hanging around. Who knows what his intentions are?

And that's how I got here:

The Work of Jesus

I'm ever more astonished
At the work, Jesus is expected to do,
Forecasting that he will heal
When really, death is due.

Take this patient in the corner
As example number one,
Her heart, her lungs and kidneys
Were very nearly done,
When a cardiac arrest
Knocked her to the floor,
Giving her tired soul a chance
To slip right out the door.

She had CPR
For well beyond an hour,
Where the medical team performed
Everything within their power,
But they finally reached consensus
That there was nothing more to do,
When lo and behold, her heartbeat
Went from straight-line to forty-two.

Now she’s grazing in our unit
Life-supported to the nines,
Seven vasopressors
And thirteen central lines,
An ET tube, an NG sump
And the Foley-Temp-Deluxe,
And while it seems we're doing everything
She's a DNR, oh shucks.

We finally get to Jesus
His role in this whole caper,
The family expects a miracle
According to the paper,
Written by some disciple
Two centuries post-resurrection,
How Jesus will raise the dead again
Like some cosmic lottery selection.

There are just too many people
Who need that Lazarus link,
Jesus can't heal every one
So do not even think,
That your sweet old Aunt Jemima
Is on the Jesus list today,
She tried to depart a week ago
Till epinephrine, made her stay.

The truth regarding dear old auntie
Is that she'll never get restarted,
Her body is here, and her brain is dead
While her soul has already departed,
The resident of this ICU bed
Could be likened to an empty shell,
Auntie is firmly ensconced in heaven
While her body remains here in Hell.











Fibril_late;
10/7/08

The level of professionalism is daunting where I work, and how I suffer through it, I do not know.
And now enjoy Part - 2, "Tear Drop Tissues".


Professional

She's a professional practice
Committee nurse,
She keeps all the bylaws
In her purse,
When it's time to practice
She's the go-to lady,
She knows what's right
And what is shady.

Don't even try to pull
The wool upon her eyes,
Others have attempted
Perhaps you heard their plaintive cries,
Because the PPC nurse
Surely, never wavers,
Sticking to the rules
Is the sum-total of her flavors.

She's a pillar of our community
The lightbulb of our lamp,
Like that famous Disney movie
She's the lady and I'm the tramp,
I get a biscuit now and then
If I properly fetch and heel,
Of course, she's happier than snot
If I also bow and kneel.

Fibril_late;
10/5/08
_ _ _ _ _ _ _ _ _

Tear-Drop Tissues

When I grow up
I want to be,
A Confessional Practice
Nurse, you see;
Everyone will tell me
About their "issues",
And I'll make a buck
Selling tear-drop tissues.

As Nursing is predominantly
A female career,
(Men, don't be insulted -
Remember, I'm a peer),
And I'm covering the topic
Of the female outlook,
It reads like the typical
Romance book;
You know, "she said, blah"
And, "she, responded",
And before you knew
The two had bonded,
Taking down Mary
With a tattletale rumor,
Giggling whispers
Like schoolyard humor.

That's where the Confessional
Practice Nurse,
Pulls the teardrop tissues
From her purse,
Because, Mary the wronged
Is seeking restitution,
She's jumping up and down
Regarding workplace persecution,
And if she's not heard
She'll take the quitters route,
Find a lawyer and file
A whistle-blower suit.

As the Confessional Practice
Purveyor of truth,
It's my responsibility
To rectify the uncouth,
Behaviors and insults
And the backyard rumors,
Pluck those suckers out
Like a malignant tumor,
Then I'll offer a penance
To the goddess of nursing,
To reverse the ill effects
Of 14 females cursing,
Each other, for the petty
Day to day imperfections,
As the Confessional Practice Nurse
I'll define new directions,
For all persons and peons
Who populate this plane,
And if you don't like that
You can hop the next train.

Fibril_late;
10/6/08

I'm in that altered reality called, "worked all night, and still awake". As a result my story is all over the board, but seems to hit some high points regarding cancer, old age, Sister Euphemia, bookies and good surgeons.

Neoplasm Necromancer What could I say about a person Who seemed like a breeding ground for cancer, Was it a case of living too long Or was she a neoplasm necromancer? First, she had cancer of the colon And then there was cancer of the breast, Followed by cancer of the stomach The intestine and all of the rest. For some people, it's seen as a wake-up call And for others, you could call it endurance, But she's 78 and two surgeries later I'm wondering, the name of her insurance. At Sister Euphemia's repair shop No customers are ever turned away, Age is not a factor for dismissal You can get an overhaul and a pretty bouquet, And we'll talk about payments tomorrow If we don't operate right now, you'll be dead, In terms of mortality and morbidity It's 1000-to-1 odds, on your head. The bookies on Broadway are happy After losing their shirts on the Kings, They've been scrambling to cover their losses By wagering on Beijing's gold rings, Now whether or not that was lucrative Is hardly a fact in this story, It's just an aside, that they'll bet on who died If you live, Ms. Euphemia, gets the glory. You can't argue with her spirit And you can't knock her goodness Euphemia, has a racquet for healing, In this sleepy old town Where the Guvnor gets a frown, Health-care is the game that she's dealing, Her dice might be loaded And the cards surely marked The bookies complain, "there are rumors", But the odds seems so favorable For no chance of survival For someone, who is chock full of tumors. The jury is still out Though the surgeons did their work After seven long hours on the table, How the client survives Like a cat with nine lives Just increases the strength of the fable, The bookies were busted They shouldn't have trusted A game that was set by Euphemia, Their dreams to get rich Are now in a ditch, Instead they just left with ischemia. This neoplasm necromancer novelty While a success story, is a medical mystery, And Sister Euphemia knowingly smiles It builds her legend and enhances her history. Fibril_late; 9/30/08

When you're 83 and have a handful of nasty diseases, you really need to watch your step......literally!

Too Risky

You're too sick, it's too risky
We can't operate,
Can you imagine those words
And ponder that fate?
He broke his femur May first
And now, it's September,
He walked so long ago
He can barely remember.

Heart disease and hypertension
Diabetes and CVA,
Add a pinch of lung disease
And baby, you can't play,
In the league of operative candidates
You struck out, long ago,
But now your aortic aneurism
Is threatening to blow.

Dr. V, a vascular surgeon
Is a brave and serious dude,
He describes a very risky plan
Saying, without this, you are screwed,
Something about an endograft
He can place without an incision,
Who am I to argue?
With his death defying decision.

Now, since we'll have you on the table
We'll invite our Dr. Crip,
He used to be a gangster
Before he specialized in hip,
He'll revitalize your femur
With a carbon fiber head,
And a couple weeks from now, sir
You'll be leaping out of bed

With comorbidities like mine
I couldn't take this lightly,
I had prayed to fourteen deities
And made sacrifices nightly,
But the shadow of the reaper
Had been looming ever near,
As a veteran of the second war
I have familiarity with fear,
And the antidote for that, my friend
Springs from hope and faith in living,
Gratitude for every moment
And the capacity for forgiving.

Oh what the heck, I'll take the shot
Though it seems a risky proposal,
Without the surgery, I think
I'd be ready for disposal;
So when Dr. V, comes around again
I'll look him in the eye,
Saying, "Nothing is accomplished, sir
If you never-ever try".

Fibril_late;
9/28/08

I get pretty excited when someone posts a comment:

Trickle

I'm surprised, lo, I'm honored
When a reader responds,
I feel like Jesus on the donkey
With folks waving palm fronds,
Returning to his home town
One week before the end,
Or was it just a mistake?
They meant delete and not send.

Who knows, but I like it
Because the blog-world is huge,
Letters and replies trickle
They do not deluge,
But if one reader stops
And nudges a friend,
I'll keep writing and blogging
Till my very end.

Fibril_late;
9/28/08

It happens over and over; old age, a big MI in a beat up heart, confusion and one last trip down memory lane.

Leaping Larry

Leapin' lizards, said Larry
I feel like I'm in jail,
They've got me in handcuffs
And tied to a rail,
I can't reach my water
And I can't take a pee,
Won't somebody out there
Take pity on me?

Leaping Larry, in his lemon leotard
Slipped through the rails,
It was a move he had perfected
Escaping from jails,
During his peppery life
On the lam, on the run,
Leaping Larry robbed banks
But he never used a gun.

It was a hell of a dodge
For a man in his condition,
And for a fellow in a posey-vest
'Twas a Houdini rendition,
Yet, when all was said and done
He didn't really fall,
His legs just couldn't hold him
Like toothpicks, they were small.

Leaping Larry's condition?
He had a big, damaged heart,
He even had chest pain
Each time he would fart,
He was panting and wheezing
Just laying in bed,
But who would predict
That tonight, he'd be dead.

Leaping Larry's situation
Was really, quite common,
We discussed him at lunch
Over two cups of ramen,
Bemoaning our situation
About this crazy old man,
It's tough to be caregivers
When confusion is the plan.

Leaping Larry in his lemon leotard
Was confused to the last,
Like a retired fisherman
Who had made his last cast.
And with his body so weakened
He just sat there on the floor,
One look at his sorry countenance
At once, we knew the score;
That this was one Larry
Who would leap, nevermore.

Fibril_late;
9/24/08

Unnamed sources..............

Sister Euphemia

Unnamed sources
Close to the fount,
Lay a mighty hefty price tag
A multi-million amount,
On that shiny new cadillac
Of our CareConnect system,
Donald Trump is our advisor
I'm sorry I missed'em.

But it wasn't just a million
My sources would claim,
Sister Euphemia
Is a very rich dame,
And she's splurged on a computer
With a bundle of tools,
We'll either look really smart
Or like a community of fools.

Fibril_late;
9/22/08

Having just finished my two weeks of "super-user" computer training for the brand-spanking-new, computer charting and electronic medical record, I can foresee that there are going to be some major glitches come December 2nd, the day the system goes "live".

Right now let it be known, that I want to collect some hazard-pay for that week.

There's going to be a pile of people who didn't get enough training, or perhaps they avoided it altogether, like I avoided public-speaking in 9th grade. Come time for the final exam............meltdown!

Computer Slowdown

I took a week, off of work
For computers,
Late night keystrokes
And frequent rebooters,
Crashing the hard-drive
Every three out of four,
When I asked for some overtime
I was kicked out the door.

I entered strings of nonsense
And logged-on in code,
They said, do it this way
And stay on our road,
But I crashed all the guardrails
Like Mr. Toad's wild ride,
Good thing it was a computer
Or I surely would have died.

When the instructors slowed down
So the class could advance,
I fell asleep counting the threads
In my seersucker pants,
Until the collective complaints
Of the students in that room,
Cleaned my mind of it's cobwebs
Like the sweep of a broom.

Well, I have to admit
That I learned some new stuff,
And I understand that the Luddites
Will have it pretty rough,
When, ye olde computer system
Comes to life, December 2,
If you can't point, click and dropdown
More pity on you.

Fibril_late;
9/21/08

I'm finally getting acquainted with my COW (computer on wheels) at work. You see, although California is always considered to be on the cutting edge of many things, when it comes to advances in hospital operations, we seem to be dead last. And what gives? Here we are, in the capitol city of one of the worlds most robust economies, and we seem to be the final market in the developed world to get turned on to computer charting!

Anyway, it is providing me with a lot of fodder to munch on, as I morph into a "super-user".


W.O.W. ~ Wookiee-on-Wheels

Refresh, right-click
Read your screen,
Then you'll know
Where you have been.

Set your range
That's date and time,
Then your data flow
Will be sublime.

Change the dose
And not the rate,
If you screw up here
You'll rue your fate,
And never ever
Select Infuse,
Or your I's and O's
Are sure to confuse.

When you make a choice
You must verify,
Don't "refresh" first
Or you will cry,
Because your precious order
Won't be there,
You'll have to start all over;
The computer won't care.

The tubes and drains
And the VADS don't flow,
To the Iview
Where you'd like them to go,
Instead
They only populate,
The Quickview/kardex
Now, ain't that great?
But the Quickview is only
Good for a glance,
You can't change nothin'
Not a chance,
No, your only option
Is to double-chart;
So like a computer-
Not really smart.

All-in-all
This program is whacked,
I can hardly wait
For the day that it's hacked,
And then I can add
My own little bots,
To auto-fill the info
Into the document slots.

Fibril_late; 9/18/08
_________________________________
Cerner Learner

Perhaps you've heard, that I'm a Cerner learner
Gathering all the nuances of the system,
The program is really quite complicated
So, don't even ask me to list'em,
I've been encouraged to explore and discover
In the process I'll sharpen my skills,
I guess the idea, is when the system goes live
I'll be on top of my tasks and my pills.

Now some of us computer users
Can't help it, but we're pushing the envelope,
Exploring all the nooks and the crannies
Going, way out on the rope,
Focusing upon in-depth research
For all of the shortcuts and such,
To find any weakness in the system
And the things we're advised not to touch.

I won't claim that I'm a hacker at all
I'm just curious, and you know that old story,
There was a cat who was poking around
And he followed his nose to his glory,
So, please don't be talking this up
I know Cerner is just a tool to apply,
My goal is to find all the shortcuts
My mission? Well at least, let me try.

Fibril_late;
9/18/08
____________________________________

Click Times Three

Left click, right click
Rah, Rah, Ree,
Point your mouse
And click times three,
Open a window
Drop down a menu,
Choose a band
With a whole new venue.

Right click, left click
Rah, Rah, Ras,
Too many details
In this class,
Logoff or exit
Suspend or close,
Where your data disappears
Nobody knows.

Fibril_late; 9/18/08

Perhaps it's time to take a break from my own writing.

I present to you, Steve H. from Virginia. We worked together at the Big House in Sacramento about 15 years ago, and I'm happy to say, that he shares my unique view of health-care. Additionally, he is a fine writer who gets straight to the point in 7 letters or less.
Enjoy!

Trach

Mr. Johnson please,
If just for my sake,
Don’t cover your mouth
Please cover your trach.

I know you don’t try
To blow snot from that hole,
But, honestly, sir
You can’t control, where it’ll go.

The last time I was in here
You showed me your charm,
By blowing that green stuff
All over my arm.

I’ve suctioned and suctioned
You just produce more,
The evidence is on the wall now
With some on the door.

Yes, this is the stuff
That makes my stomach really ache.
A guy with no conscience-
A cough and a trach.

______________________________

Nurse of the Year

The patient was gasping
And turning real blue,
She was punching the call light;
So, nurse, where were you?

That call light was ringing
For fifteen minutes or so,
When finally the aide came;
So, nurse, where did you go?

She stood up in her bed,
And she tried hard to yell.
You were nowhere around;
So, nurse, who did you tell?

“Well, boss, I’m surprised,
Now, didn’t you hear?
I went to the Awards meeting;
I got Nurse of the Year”.

Steve H.
Sept. '08

Yessireebob:

Over at Sister Central, where we are transforming ourselves to digital deliverers of darn good health-care, we have to familiarize ourselves with about 175 new medico-industry acronyms like "BMDI" (Bedside Medical Device Interface). Just take a moment to think about what the abbreviation "BM" brings to mind, and you'll begin hallucinating like I did.

Don't ever forget; behind every industry that relies on a plethora of acronyms, there is an entire conspiracy at work in the background!

BMDI

Care Connect has provided us
With an incredible new-fangled tool,
Some sort of digital gadget
To handle the recording of stool,
Nurses throughout the whole system
Will be scrambling to give it a try,
After decades of measuring boatloads of crap
Three cheers, for the BM-DI.

The Bowel Movement Digital Interface
Is a highly refined type of tool,
Revolutionizing the one task we hate
Transforming it, to something so cool,
That the average nurse about town
Will be bidding for the patient with diarrhea,
In the long run, the BM-DI
Will be known as the poop panacea.

I admit I am jealous right now
That I didn't pursue this invention,
As a veteran nurse of 25 years
I have witnessed such bowel distension;
It ultimately explodes, at the worst of best moments
Such a quantity, that can not be measured,
The BM-DI, will determine a value
So each ounce of that crap will be treasured.

Fibril_late;
9/12/08

Perhaps you read the news like I did? Scientists have discovered a "fat gene" which apparently can predispose you to gaining weight. However, after a study of Amish persons who carry the fat-gene, it was found that 3-4 hours of physical activity per day/per life, can effectively inhibit the fat acquisition process.

I imagine next year, when gas prices hit $10/gallon, we might see the whole of society walking to work, and since we're such a commuting society, 3-4 hours of walking per day, will get us to work and back, and slimmer in the process.

Fat Gene

The latest scientific research
Has discovered a fat gene,
A genetic predisposition
To develop unlean,
Science further suggests
A vigorous exercise stance,
Three or four hours a day
To stay out of fat pants.

The clothing marketplace today
Caters to all sizes,
Just pick the proper store
So you get no surprises,
If you're built for the mini
Don't shop at the maxi,
You'll be kind of embarrassed
When you step out of the taxi.

Now the names for big clothing stores
Is all over the map,
The politically-correct monitors
Won't be raising a flap,
When the name of your store
Is Super-Queen Plus,
You won't be tarred and feathered
And thrown on a bus.

For those guys who are large and tall
They shop for king-size or big men,
They have lunch at Fatso's Pizza
And dinner at the Pigpen,
However, we're sorry to say
Anorexia closed,
Secondary to thinning crowds;
They got financially hosed.

In fact, it seems the worm has turned
It is the thin, who suffer discrimination,
Forget shopping at the warehouse stores
Where there is petite-size decimation,
If you are only a size 2 and thin as a rail
But you're coming up on 35 yeas old,
It seems silly to shop and downright ridiculous
Where children's clothing is sold,
So what's a person to do in these modern times
Gain weight and conform with the masses?
Super-size on a strict fast-food diet
To compete with the biggest of asses?
It's a quandary amidst culture and society
To understand which size is best,
Leave it to the 21st century scientist
Surely they'll come up with a test.

Fibril_late;
9/10/08

Luken's Trap

If you're a Nurse or an RT, you know about that simple device known as the "Lukens Trap". It is used in tandem with a suction mechanism, to retrieve specimens from the lungs, most commonly.

Over at Sister-central, in the Medical Office building, there is an auditorium called, Lukens Auditorium. Who knows? Maybe it's named after the same. But in my mind, I can only think of that auditorium, as being nicknamed, Lukens Trap. Thus, since I had to spend 8 hours there yesterday, taking in some somnolent-suggestive lecture, I penned the following observation:

Luken’s Trap

Luken’s Trap
Was filled with tired air,
The personnel who gathered
Had a collective vacant stare,
Nearly somnolent they were
Biorhythms in a trough,
When a momentary wakefulness
Was prompted by a cough.

Since I was being paid
I couldn't complain very loud,
Collective agreement
Was solicited from the crowd,
Call it preemptive education
For us EMR-users,
But even by lunch time
We were professional snoozers.

If the class was under 4 hours
With coffee and pastries and more,
Hooter waitresses and Chippendales
And bouncers at the door,
With pulse-pounding techno
Black lights and disco balls,
There'd be hundreds of employees
Cued up in the halls.

If there were reporters from News 10
Fox 40 and KCRA,
With up to the minute coverage
And the ongoing play-by-play,
The show would go on
With nary a nap,
And the facilitator lady
Wouldn't wake me with a slap!

I awoke with a startle
In Lukens saloon,
Surrounded by my colleagues
15 minutes before noon,
Where 57 bobble-heads
Prayed for a disaster,
Otherwise, there was little hope
To finish the class any faster.

Fibril_late;
8/25/08

Over at Sister-central, we are in the midst of adopting the grand-all-boomerang of the EMR; ya, that's the electronic medical record. There is a hierarchy of Trainer, Super-user and End-user participants to cover everybody and their brother, within the great big family. I decided to be a Super-user, because I figured I could get more hands on training that way, and additionally, I'd get to boss around a few other people. Little does upper-management know, that I am a stupid-user in disguise.
Now yesterday, about 200 hundred of us Super-users all got together, and had some education-expert talk at us for 7.5 hours. At the end of that harangue, I realized I had a new title:

Stupor User

They call him the stupor user
He sleeps through every event,
Some think, that he’s a loser
They’re curious of his intent,
The stupor man replies
I learn best when I’m half asleep,
I suggest that everyone try it
You’ll find that your learning is deep.

Fibril_late;
8/25/08

I've said it before, but it bears repeating: this mode of communication know as "Active Listening", is intolerable to me. Don't ever talk to me that way, because I immediately tune it out. It's down-right insulting. So, after putting up with it for about 8 hours yesterday, I had to write about it.

Anachronism

Am I an anachronism
For resisting this lingo?
An obstinate curmudgeon
The proverbial gringo?
Set in my ways
Unable to adapt,
There might be an explanation
That defines how I’m wrapped.

What’s up with the word “facilitator”
What happened to instructor or teacher,
I guess it’s all a part of “communispeak"
For the new and improved human creature,
To me, there is something odd about the presenter
Who can incorporate all this strange lingo,
When talking to me, it's offensive
But I'm just the anachronistic gringo.

These communispeak lecturers
Have such a strange way of talking,
It's like they tried to reinvent
A new way of walking,
That is so frickin' awkward
I feel like falling down,
But if I question their delivery
I'll be kicked out of town.

"I hear what you're saying"
Sounds stupid, to me,
Because you were obviously listening
Are you mocking me for free?
Or you speak in present-tense
Regarding something heard before,
I'm thinking, this chick must be crazy
As I anxiously search for a door.

By rephrasing my sentences and words
It seems like you lack any class,
In theory it improves understanding
But to me, you're a pain in the ass,
You might say to me, "you seem to be angry"
Damn right, I suggest that you leave,
I've been insulted too long by your lingo
Adios, or your family might grieve.

I gladly admit I'm a relic
Of an age, where we spoke man to man,
There was no need to invent fufu language
We could cut to the chase, and the plan,
This "active-listening" lingo is insulting
Unless you're talking to somnolent sheep,
But even those gentle farm animals
Will recognize that you are a creep!

Fibril_late;
8/26/08

The story tells itself.

A Judgement of Dismissal

Lethargic and sickly
Though not really maimed,
Where life-style choices
Can be easily blamed,
Five decades of smoking
And a lack of education,
At the end of this journey
There will be no vacation.

Depression and lassitude
Are like weights on her shoulders,
She’s only sixty-one
But she’s feeling much older.
While a deluge of stress
Has destroyed her appetite,
And with hardly any options
There’s no end to the blight,

The daughter she lives with
Is anxious and toothless,
With toddlers and teenagers
She’s probably ruthless,
Putting up with her mother
Creates a household dispute,
Like a Colt-45
Preparing to shoot.

It looked like a heart attack
But it turned out, it wasn’t,
Does she have a regular doctor?
The answer is; she doesn’t,
She has no insurance
Although she does have a job,
A discount-store cashier
She’s no heiress-snob.

There are only more questions
And not enough answers,
She had previous run-ins
With a couple of cancers,
Type-2 Diabetes
Ten years of hypertension,
Why she kept smoking
Is beyond comprehension.

It’s another sad tale
So, totally depressing,
Though the results of her heart-cath
Might be considered a blessing,
Her coronary arteries
Are as clean as a whistle,
Yet, the rest of her life
Is like a judgement of dismissal

Fibril_late;
8/24/08

Buried in frustration.

Failing

This was an evening
Best not to recall,
My patient yelling for ten hours
Regarding nothing at all,
In the hospital for 3 months
With seven organs failing,
Sleep deprived with ICU psychosis
Had reduced him to wailing,
He had legitimate issues
Like diabetic neuropathy and pain,
But the sum-total of this hospitalization
Had disordered his brain.

At any given moment
He was oriented on all accounts,
An astute observer of society
But he had lost some of his bounce,
Short-tempered, self-centered and lonely
He would yell, five minutes after I departed,
While other patient’s in our tiny domain
Thought a war had started,
Asking to have their doors shuttered
Frightened by the uproar,
Ultimately expressing relief
When they departed our floor.

This was an evening
I am pained to recall,
Marked by my supreme frustration
That I could do little at all.

Fibril_late;
8/21/08

Another look at a weighty subject.

Heavy World

I'm getting really worried

About the weight of the world today,

Over the years more people

Are getting bigger and bigger, they say,

Thanks to TiVo and VCR's

Computers and the video game,

Out the window flew exercise

And good eating habits

Extra-large is the name of the game.

Proof can be seen amidst our monster SUV's

Big Boy recliners and giant BVD's,

Double-wide airline seats for Billy-Bob the gamer

Don't block his refrigerator, unless you're

A lion tamer.

All aspects of life, all venues of business

Have expanded their capacity, and it's causing me dizziness,

Being larger than life, has it's drawbacks I say

Our kids are so large, they can no longer play,

Or safely fit on equipment

In the parks of our nation,

Instead, all those pikers

Are hooked on Playstation.

I don't blame the manufacturers

Of those fantastic devices,

Though I could argue for an hour

About their ridiculous prices,

With company research associates

Targeting Mom's and Dad's dollars,

It's no wonder we're a country

A fall-behind scholars.

I am really very troubled

About the girth upon our earth,

Strangely, it's never present

At the entrance of your birth,

It's an acquired syndrome

For the majority of cultures,

Forsaking the native diet

To become processed food mulchers.

It's a new world culture

And a new language-largess,

Poly-syllable designations

That are sure to impress,

Best known as bariatrics

The science of losing weight,

From 16,000 procedures in 1992

To 180 thousand, in 2008.

It's a heckuva way, for a Doctor career

Maximizing reductions, you might say,

Treating multi-causational body mass excess

With a snip of the scissors

A slice of the knife

And like magic, the problem goes away;

Now you might consider me flippant

Careless, without sympathy or hope,

But when BMI expands beyond 35

Puny nurses like me, can barely cope.

Naturally you might think I am whining

But I expect my employer to care,

They promise us bariatric equipment

Hefty lifts, mondo-beds and chairs,

Until the hellstorm of a foreshortened budget

Breaks the surface from the darkened depths of Hell,

Then they tell us, just do the best that you can

“Have some cupcakes, you're all doing swell”.

Well, I know that's awfully homey

It makes me feel so cuddly inside,

The weight of the world, has been lifted from my shoulders

I'm in heaven, so I finally must have died,

Until I suddenly awaken with a jerk

With my head on the desk, and I've been drooling,

There's a 600 pound patient on a thirty year old gurney

And I realize, my bosses weren't fooling.

Fibril_late;

8/19/08

There is some bad juju going on in the workplace.........watch your back!

Packing

I'm childish at times
But it's all silliness and fun,
They are immature at times
But they're packing a gun.

I make a lot of stupid jokes
To try to lighten the mood,
We're all crotchety veterans
But some are dangerous dudes.

Ready to scratch across your countenance
If you dare to live your truth,
It won't matter if you own the righteousness
They'll be lurking outside of the booth,
Waiting for you when you're walking alone
On the path to the bathroom, or meal,
A baseball bat hidden beneath their robes
Or perhaps knuckles, that are made of steel,
Attuned to hidden danger, like good nurses are
Your spider-nerves save you again,
When battle-ax Betty, leaps out of a closet
You plant a sap* on that old guinea hen.

This is clearly a case of workplace harassment
But Betty has friends in high places,
As a female member of the canine clan
She's well loved in the family of two faces,
You can't really say boo, 'cause your word will get around
And Betty will be packing next time,
'Tis better to prepare for another canine encounter
Have a Taser and some toxic green slime.

All kidding aside, the joke is on thee
The health-care arena, is not safe nor free,
Be strong thy convictions, for ethics and truth,
And beware of those persons of nursing uncouth.

Fibril_late;
8/19/08

*Sap: a piece of metal covered by leather with a flexible handle; used for hitting people.

A casual look at work.

Remember to Swerve

I come to work
To pass the time,
It's a heckuva place
To make a rhyme,
Situations
Of passion and glory,
Can change any minute
To be bloody and gory.

I come to work
For amusement, you know,
It's fun as heck
A really good show,
All sorts of gay folks
In this happy place,
A true cross section
Of the human race.

I come to work
For stimulation,
And a healthy dose
Of aggravation,
But after 12 hours
I've had my fill,
What seemed like good medicine
Becomes a bitter pill.

I come to work
For two days at the most,
Any more than that
Then I am toast,
Beat up, worn out
Every joint aching,
But no one believes me
They think that I'm faking.

I come to work
To fill a need,
Alleviate pain
It's part of my creed,
Serving humanity
With a syringe full of dope,
It's a heckuva thing
But I'm helping them cope.

Time to wrap up

This story of Nursing,

It's different every day
No time for rehearsing,
Show up and be ready
Take whatever they serve,
And when the crap hits the fan
Remember to swerve.

Fibril_late;
8/16/08

If we were paid like celebrities, there would be no nursing shortage!

NurseMart

If only we were in business
Like the local grocery store,
We'd earn a flat percentage
For every pill and chore,
Every spoken word of teaching
Every gesture of compassion,
There'd be seasonal variations
Like the latest winter fashions.

For special big events
There could be a bonus format,
It would beat the present system
Where we're treated like a doormat,
For example, we could compensate
Events like CPR,
If you succeed, and bring'em back
You win the big cigar.

Your patient was combative
He tried to stab the candy-striper,
She’s the daughter of the CEO
You win the keys to his Dodge Viper,
Or you work an extra night shift
Like it’s really no big deal,
Seven patients with infections
Every one with difficele,
By morning you’re exhausted
And finally feeling old,
Your boss comes in, says, “Way to go”
And hands you coins of gold.

There would be no nursing shortage
If these silly thoughts were true,
Pay us like celebrities
It’s way long overdue!

Fibril_late;
8/11/08

This is a summation of experiences, having taken care of numerous patients over the years, who have a family that expects a healing miracle, in the face of certain death.

Farting Rapture

A GCS of 3, comatose, near dead
No brain activity in his head,
No movement of limbs
No rise of the chest,
His heart is still beating
But it will soon come to rest,
Unless the Lord, Gawd, Almighty
Should hear all the crying,
Of the 70 relatives
Who sound like they’re dying,
With such wailing and moaning
And pulling of hair,
We’ve collected enough
To reupholster a chair.

Then all of a sudden
There arose such a shriek,
The patient wiggled a toe
And lifted a cheek,
While blasting a fart
That blew off the covers,
‘Twas a verified miracle
To those Jesus lovers;
Uncle Joe had been healed
As they had expected,
It was clearly a sign
That Joe resurrected.

A truckload of new relatives
Soon did appear,
And each time Joe farted
They let out a cheer,
While proclaiming to anyone
Who passed by the door,
Joe was just treading water
And almost ashore,
He’d be up and around
Come Easter, next week,
As if in agreement
He lifted a cheek,
And blew off the covers
With a magnificent fart,
And with that, he just died
With the last beat of his heart.

The family was in shock
And took 4 hours to leave,
They had postponed reality
Not ready to grieve,
Having ignored all the signs
Of Joe’s impending death,
Betting dollars and donuts
On each ventilated breath,
That our machines had delivered
Because Joe was in a coma,
They’d had two weeks of rapture
From his blessed aroma.

Sometimes we wonder
What our visitors have been smoking,
What they think is the voice of God
Is the grim reaper joking,
Waiting patiently on the sidelines
For the last tortured breath,
He’s the prince of all seasons
The boatman of death.

Fibril_late;
8/8/08

Whether you ascribe to a particular religion or not, I propose that most of us carry within ourselves, our own sacred sanctuary. Additionally, I believe that no particular religion, owns the market on best prayer. The power is in the intent.

So, whether you pray for your patient silently, or perhaps incorporate spiritual healing in your practice, I think we should offer an attitude of openness and acceptance to whatever our patients own spiritual needs are. In other words, we are not there to preach our own beliefs, nor judge theirs. Our role, is to console.

Consolation

Surely we deliver the best technology
To the patients, within our domain,
But many of them, have deeper core issues
How can we respond to their spiritual pain?

By being supportive, non-judging and open
We can allow a safe place for consolation,
This may be enough, in the company of strangers
To invite the healing presence of creation.

Fibril_late;
8/7/08

Another hopeless joke just came to me:

Q: Why did the Diabetic fall down?

A: He slipped on the sliding scale.

Fibril_late;
8/5/08

This was funnier than heck. Last week, Ms. B, paid us a visit for 12 hours, and had a patient in Droplet Isolation. Apparently the N-100 masks don't fit her lovely countenance and so she wears a virtual spacesuit all night long when entering the room. Damn, it was funnier than heck!

Space-Woman

I can’t say that I’ve ever seen it before
A space-woman working on our floor,
Bedecked from head to toe in a shroud
To hear her at all, she had to yell really loud.

Her backpack air-blower was whisper quiet,
But she sweat so much
‘Twas like she was on a diet.
Apparently the respirator masks don’t fit,
I don’t care
Her outfit was cooler than shit.

Fibril_late;
8/5/08

Families! Ya gotta love their screwiness, right? Bring the old man to the hospital because he's short of breath, or having the heart attack, and then begin to refuse treatments on the grounds that we don't want this or that!
Duh! Why go to the hospital in the first place?!?

Everything

They bring Grandpa to the hospital
Wanting everything done,
Then refuse the treatments ordered
Every hour, one by one.

Grandpa hates the breathing treatment
He'd rather have a smoke,
He doesn't like the Foley catheter
He's a manly kind of bloke,
And if you keep his hands and feet tied
Surely, he will shout,
And we agree with dear old Grandpa
Take those IV's out.

We don't want that Insulin therapy
It doesn't sound much fun,
But I once again remind you
We want every damn-thing done!

Fibril_late;
8/5/08

Nurses: Day in and day out, we become intimately involved in the lives of humanity (and inhumanity, I'm sorry to say). There is a story to tell around every corner.

My job is to write about it. Catharsis, might be a better description of why I do it. I have to change the names of the players, alter locations and bend the facts, primarily to get the point across more poignantly, and more often, to keep from getting shot at. I only get slapped around on a rare occasion.

Curry & Dal

You might think it’s not true
All the stuff that I write,
Well, I admit I take liberty
When it’s my time to bite,
Because a story reads better
With a passion and fury,
Like a hot spicy dal
In your favorite curry.

I pick simple ingredients
For the stories I tell,
Chosen from factories
Between Heaven and Hell,
Having walked that long road
During my current vocation,
If you've taken that journey
You'll believe my oration.

Sure, I stretch the truth
To lengthen the telling,
You can't knock me for that
And rarely my spelling,
And I use the best synonyms
To color the tale,
Delectable details
So the story won't fail.

I caution, don't take offense
It's not about you,
You might think you identify
But it's really my view,
Perhaps looking you over
And distorting the facts,
If you accuse me for libel
I'll be sharpening my axe.

It's my way of venting
Frustration and pain,
Instead of target-practice
Aimed at my brain,
And although that sounds harsh
I don't trifle with death,
I take counsel for misery
From Lady Macbeth.

Like Mulder and Scully
I'm searching for truth,
Pursuing dirty details
In my career as a sleuth,
Then telling my story
About that 12-hour night,
If I do it correctly;
My narration will ignite!

Fibril_late;
8/1/08

This is for all the great float nurses, per-diem nurses, registry/agency/mercenary nurses. The ones who drop in, perhaps having never been in your unit before, grab the reins of the wild horse, and get through the shift and the shit, no matter what is thrown at them.

The Worst Friggin Mess

You know the drill
It goes something like this,
You're a visiting nurse
Expecting a kiss,
Because you're helping your colleagues
In their time of dire need,
Then you get the worst patient's
Like a title and deed.

You know the pattern
It's the same every time,
They'll abandon you for a nickel
And screw you for a dime,
Their faces painted with relief
When you appear at the door,
They'll say, "Thanks for coming back"
Now, we'll screw you some more.

You know it's damn common
Ya, it's really a shame,
But the odds are stacked against you
In the mercenary game,
You're the knight in shining armor
For the damsel in distress,
And what thanks do you get?
Of course - the worst friggin mess!!!

Fibril_late;
7/31/08

I must have been under the weather, or mentally malnourished, or who knows what, but in my exalted opinion, I was a screwup last night. The only bright outcome was that my companions were still alive at sunrise, I did provide true compassion, and there was no measure of a shortened existence, other than the usual passage of time, that everyone is accountable for within the context of their own lifespan. I have made this intentionally vague, to protect the guilty.

Beyond Measure

I worked nowhere near my potential

Far below my possible peak,

Could I blame it on a Sunday

The proverbial end of the week?

Although I hadn't slaved or overworked

My mind was in under-drive,

If you observed me from a distance

You might wonder if I was alive.

How many things I overlooked

I am embarrassed to admit,

If you had to follow my performance

You might develop a snit,

And possibly grumble, snarl and mumble

Inhibiting perfected profanity,

The end-result of my hand off

May have driven you to insanity.

From my point of view, I failed beyond measure

But time is the ultimate reaper,

If I were to judge me, on this singular moment

I wouldn't qualify to be a street-sweeper,

But with the experience of decades of living

I've come to accept the inescapable,

Some days I'm a rip-roaring genius

And other times, completely incapable.

Luckily, imperfection runs rampant

Amidst the society that I keep,

And in time my miserable performance

Will reside at the bottom of a heap,

Of old memories, never to be revisited

Rehashed, reworked or reviewed,

Reliving such miserable moments?

Why surely my psyche would be screwed.

Fibril_late;

7/28/08

A mandatory class is coming up where one of the things we have to be familiarized with, is called "Fall Risk Management". It stands to reason that this is appropriate, because summer will be over soon, and we better be ready for the risk of Fall.

Fall Risk Management

I'm glad to see that my superiors
Are finally on the ball,
It's the middle of the summer
And the coming of the Fall,
And although it's risky business
It still happens every year,
Fall shall follow summer
'Tis really nothing there to fear.

But in business, there is caution
And in Healthcare, even moreso,
Risky yearly seasons
Cause a tremor of the torso,
You might call it intuition
Gut-feelings, sense of danger,
Perhaps a childhood experience
With a dark and sinister stranger,
Led to feelings of inadequacy
Every summer of each year,
Prompting Fall Risk Management
To mediate the fear.

Fibril_late;
7/27/08

We're also supposed to learn about the "Patient Classification System". Now if that isn't some classic office-speak, then I don't know what is. Hello!!, what in the heck is wrong with our current system. Well anyways, I think I figured it out:

Patient Classification System

Patient Classification System
Or P. C. S.,
Is another veiled attempt
To clean up the mess,
Left by a predecessor
Whom I'd rather not mention,
Uncontrolled gossip
Is bound to bring attention.

Patient Classification System
Or Pat-Class-Sys,
Is bound to be successful
No more hit and miss,
With objectives left floundering
Like a fish out of water,
All of our problems will disappear
Like lambs led to slaughter.

Fibril-late;
7/28/08

And last but not least, apparently there is "new" information about sepsis and stroke. I have made a recommendation to see that we also address the inclusion of humor, and the recognition of emotion, in regards to the needs of bedside caregivers.

A Balance of Emotion

Early recognition of sepsis

Early recognition of stroke,

Early recognition of the necessity

To accommodate room for a joke.

No matter how stressful the moment

When chaos and calamity prevail,

Medical decisions that change by the second

Must allow for the chance they might fail,

And where the long-term survival of caregivers

May be overlooked in the sea of commotion,

We must allow room for laughing and crying

As our lives hang in a balance of emotion.

Fibril_late;

7/28/08

Here at employment central, we are being warned that we have to learn about "Johns Hopkins Tool". I am totally clueless about what the heck that means, but let me show you what I think:

Johns Hopkins Tool

I don't think I want to know
About Johns Hopkins tool,
I may be a Nurse
But I'm not a fool,
To be poking around
In his business that way,
I'd rather read a report
Than see that tool, anyday.

I really don't care
About Johns Hopkins tool,
I learned all about that stuff
Way back in school,
And if he wanted us to know
Don'tcha think he'd send a letter,
Nope, I don't want to see it
'Cause it don't get any better.

You see, I don't understand
How seeing Johns Hopkins tool,
Will make me any smarter
And I'm already cool,
So what could be the point
Of this mandatory class?
It better not be something
About Johns Hopkins ass!!!

Fibril_late;
7/27/08

Flatter Not Fatter

I create some funnies at times, too:

Joke:

Question: "What do you call it when a couple of he/she Atria are hanging out, and he says:

"Hey Miss Atria, you are looking finer than fine tonight, in your new mini-skirt".





And she replies:

"Well, my man, you are pretty hot yourself. Your appendage is looking really awesome!"





Answer: Atrial Flatter.

Fibril_late;
7/24/08

Busy patient care assignments, used to be called "heavy". Now, in the century of obesity, a heavy patient is just that! Probably over 150 kilo's and gaining weight every second that we drop in another flippin' milliliter of fluid, in a futile attempt to resuscitate them. Oh boy, just weight...........

Low Budget Anarchist

It was a terrible assignment

That's all that I can say,

Luckily it doesn't happen

Each and every day,

Because I'm telling you, if it did

Hellfire would be on call,

I'm a low budget anarchist

When it's said and done, and all.

It was a gol-darned bloody miracle

That I didn't go berserk,

Because I had a premonition

On that night I went to work,

That I'd get the crap assignment

As if it was my turn,

Well, if this is a conspiracy

They've got a lot to learn,

About the possible repercussions

When dealing cards like these,

A lot of players suck it up

And tolerate the squeeze,

But if you're dealing to an anarchist

You better hedge your bets,

They do not suffer fools, my friend

Nor tolerate your debts.

It was a horrible experience

But I managed to survive,

I found a couple comrades

In the dungeons of that dive,

Lurking in the shadows

And offering advice,

They didn't have to do that

They already paid the price,

With broken bones and muscle strains

Torn ligaments and more,

After caring for similar patients

That weigh a hundred kilo's and more.

Fibril_late;

7/14/08

In the Corner

When crap is served once, I can take it

But when it's served twice, I'll complain,

I'll stand up for the others, who were dealt the same cards

And who nearly succumbed to the strain,

They are licking their wounds, in the corner

Dealing hillbilly heroin and horse,

After losing another round of “lift-law” legislation

They are about to tell Nursing; Divorce!

Fibril_late;

7/14/08

Following in that same vein, led me to this declaration.

My Caring Attention

My sympathy stops at 100 kilo's

After that you are on your own,

We'll add up the totals of various parts

Subtracting the cartilage bone,

Compartments or regions that seem to cause trouble

Will vie for my caring attention,

Beyond the weight limit, previously set

There will just be an honorable mention.

I really don't have sympathy for the weight that's beyond

You allowed yourself to get so darned fat,

I have sympathy for the Nurses

With their narcotic-filled purses,

I'm telling you, that's where my sympathy's at.

We're busting our backs, and separating vertebrae

All at your obesity expense,

Surprised we are not

You have no insurance, on the spot,

We're aware, there exists no recompense.

Fibril_late;

7/15/08

Time and Motion studies, always bring out the "fear and loathing" in America. Just ask the recently departed, Hunter S. Thomson.

Time and Emotion: A Study

(Part I)

It began with an idea, an objective

To analyze motion and time,

An innocent theory, to derive better data

It devolved, into the worst of slime.

Seasoned professionals, we call ourselves

We ought to be mature, don't you think?,

But when someone observes us in practice

Why does it, give one cause to blink?

I pause now, and ponder the question

What causes discomfort in the action?

Being observed by a peer of my own

Why does this render a class-action?

Discomfort thrives amidst suspicion

Is there an ulterior motive in play?,

Are there camera's hidden in the trash barrels

Every move that we make, on display?

Truly, that scenario is doubtful

Perhaps historical issues are the drama,

It gives one a sense of being spied upon

Under the watchful eye of the Grand Lama.

Fibril_late;

7/14/08