Senseless

As a parent of 3+3, and as a Nurse of thousands, I am shocked, appalled, and deeply saddened by the recent death of innocent's at Sandy Hook School, in Connecticut. There is no such thing as closure, to those directly affected..........but sadly, we will hear that term bandied about in days to come. There is merely recovery, and moving on. That is what one does, when your child or loved one is abruptly taken away.

Not being one who is directly involved, but only a person over-inundated with what we pass as "news reporting", I must speak out in the way I know how.......and I will continue in this theme for the week.

Senseless

Another day of tragedy
East Coast, West Coast
And in between,
Horrific stories
Rapidly unfolding
One more bloody
Media scene.

NPR, jumps on it
"Substitute all our programming today",
The sad and somber music
Appears so scripted and ready to play,
And I wonder, are we so inured
To the senseless tragedies
That unfold, with such regularity,
That even NPR
Already has a musical score
To accommodate solace and clarity.
;
12/14/12
_ _ _ _ _ _ _ _ _ _

Children

Children, as reporters
Of tragedy
In the aftermath,
Victims of media
Those vultures
Of a bloody bath.....

Children, the innocent
Victims
Of disaster,
Reporters will
Rape their souls
To collect the news, so much faster.

"How did you feel
Were you frightened
And scared?",
"The monster
Was hunting us
I wondered, would we be spared"............

But these are not the words
That a six year old speaks,
No, he was prompted by adults
Who are media freaks.

Six year old children recorded
On YouTube and Twitter,
Their words and faces remembered
Amidst the gore and the glitter,
Of newsworthy lights
And Connecticut mayhem,
Stored on distant massive servers
In society's brain stem.

What are we creating
With our instant-news mentality?
Just more photo-op disasters
And some over-the-top fatality.

Children as reporters?
In of itself, a style of crime,
They need love within a cocoon
Not celebrity and prime-time.

12/15/12
_ _ _ _ _ _ _ _

Days of Mourning

Days of mourning
A nation at a standstill,
Soul searching silence
Like ghosts in a landfill,
Wondering, "Why are we here
Amidst garbage and decay?",
These are the ways of guns
And their time-fuse delay.

Bought for protection
Purchased for fun,
Even I do remember
Being in the woods with a gun,
But now, as an adult
I'm aware of their danger,
Held in the hands
Of an unpredictable stranger.

Just who is unpredictable?
That is the crux,
What should be done about it?
Answers that would fill trucks.

There is no pure solution
Our Constitution allows,
For each and every one of us
To bear guns and not plows,
As crazy as that might seem
The 2nd Amendment, declares it so,
A guarantee for times of mourning
And burying on the plateau.

Odarepsed;
12/16/12
_ _ _ _ _ _ _

Eulogies

Eulogies for the children
And the school staff, who died trying,
Moved me to tears
Like my own family dying,
In essence, this truth
Is one I wish to embrace,
Children and their teachers
In innocence, show their face.

Innocence, what is it?
'Tis but, purity in action,
Surrounded by complexity
Where innately, those distractions,
Cloud our vision and purpose
Till our children show the way,
Innocence is their guiding light
Let's not forget this precious day.

Odarepsed;
12/17/12

Mandates

I couldn't make this one rhyme; just consider it prose.

Staff Mandates

This week at work we are advised of the new policy regarding the recording of IV Infusion Start and End Times:

1.) Safe Patient Care Mandates That We Document Our IV Infusion Times.

**: This is confusing to me, as it is not clear whether "mandate" is being used as a verb or a noun. Is "Safe Patient Care", in of itself, the name of some policy, or what? It seems to me, there might be some important punctuation missing in the above statement; perhaps a comma after Care.........who knows?

2.) In Order To Receive Payment And Credit For What We Do, IV Start and Stop Times Must Be Documented.

**Ah, now I'm less confused. This memorandum is less about safe patient care, and more about BILLING. And we sure know by now, that Billing is a true reflection of safe care, right? (hardly). In other words, we take your money and now you are safer? Furthermore, this suggests that our patients are less safe, if we didn't document, and more safe, if we Bill them.

3.) We Are Currently Losing > $1 million dollars in Revenue, Per Year, By Not Documenting Our Stop Times.

**Further proof, that this policy is not about safety and patient care; it is all about the Revenue.



Mandate:

• noun:   the commission that is given to a government and its policies through an electoral victory
• noun:  an authoritative command; especially : a formal order from a superior court or official to an inferior one.
• noun:  a document giving an official instruction or command
• verb:   assign authority to
• verb:   make mandatory

Fibril_late;
12/15/12

Morale

I was trying to read the latest monthly satisfaction scores, posted on the wall in our break-room, but it was like Greek to me; too many acronyms, avatars, percentages and mumbo-jumbo. Who cares anyways? The "boss" (who?) always highlights with a yellow maker, the score that shows how we're screwing up. Boy, that sure is encouraging isn't it? What a morale booster!

Morale

Medicare won't pay us
Because you didn't smile,
Mrs. Smith said you were grumpy
When you were wiping her piles,
Because it just doesn't matter
That we cured her Leprous sores,
Reimbursement rules hospitals
With satisfaction scores.

Medicare won't pay us?
Quite naturally, our Chief,
Knows his bonus is in question
Along with the Chardonnay and beef,
Anxious and worried
He sends out letters forewarning,
Let's improve those satisfaction scores
Or careers will be in mourning.

With numbers to guide us
One might think we'd be the best,
But personally, I don't understand
The breakdown of the test,
Percentages and Avatars
Of statistical reporting,
After sniffing at the details
I'm left sneezing and snorting.

How is it good for morale
To keep reporting how we fail?
Highlighting the low scores
This news, soon goes stale,
It might be better to emphasize
All those things we do best,
Proud and happy warriors
Work stronger towards their quest.

I know this represents
A paradigm shift,
And it's obvious that health-care
Hasn't adjusted to the drift,
Where employees are honored
Each and every day,
Instead they threaten and bully us
And it just doesn't play.

Most certainly unwanted
Reprimands and scolding,
Reminders of our failures
Praise and bonuses, withholding,
Telling us, that we're the cause
Of reimbursement losses,
No, our highly paid leaders
Just aren't the best bosses.

Medicare won't pay us?
I don't give a damn,
But I'll do the best in my job
Because that's who I am.

Fibril_late;
12/09/12

Streamline

Editorial:

Streamline

Sustain our Mission
That's what the CEO says,
Celebrated by streamlining reductions
Please take a complimentary PEZ,
On your way out the door
We'll miss you, Honey-Pie,
Have your family send us a memo
When you shrivel up and die.

Employees are expensive
Cull the ones that are trouble-makers,
Keep the ones who generate income
The movers and shakers,
Those young Nurses
Friendly, attractive and skilled,
Sell them on our family value benefits
Family-leave, a free car-seat; they'll be thrilled.

Retire the old curmudgeons
Yes, anyone over fifty,
With twenty years in health-care
They are unpredictable and shifty,
Troublemakers, each one of them
They could rip us to shreds,
Sending letters to the local news
Regarding short-sheeting our beds.

The takeaway message as always; trim the sails
Tighten our belts, let's get more efficient,
Always spoken by the man in the pulpit
The guy at the top, he's omniscient,
With a compensation package
Pushing nine million, well-paid leader,
Urging austerity with a twinkle in his eye
Light some candles; burn the incense and cedar.

Fibril_late;
12/2/12

Stepped in a Puddle

Patient's acting badly; yelling, screaming, cursing, hitting, biting, scratching, downright dangerous. And then, thirty minutes later apologizing, as if their scientific medical diagnosis is to blame. Give me a break; that's just a very lame excuse to accommodate bad behavior.

Stepped in a Puddle

Dementia
Just ain't what it used to be,
You scream, bite, scratch and snarl
I can charge you with assault and battery,
Then, later on, you come around
And apologize for your bad behavior,
Telling me, "It's because I have Alzheimer's
I'm a sinner, I'm nobody's savior".

Twice in the past month
Patient's acting like nasty creatures,
Post-operative ugly, rabid attitudes
All kinds of undesirable features,
Then later on, sweet as a peach
Apologizing, pandering for my attention,
Declaring, "I've got mental illness"
As if they deserve some honorable mention.

It's all too touchy-feely for me
I'm supposed to say (per the Huddle)
"Thank you, for letting me be your Nurse",
Sure, I smile and wave, even though
You were a mofo-monstrous, Godzilla curse,
While your outside-caregiver shrugs shoulders
Sitting there at the side of the gurney,
If I could satisfy my secret thoughts
By god, I would need a cidal-attorney.

They don't talk about that in our Huddles
It's just as well, how I hate that whole construct,
Although I love the words that might rhyme
With chucked, plucked and bile duct,
Which coincidentally, reminds me of last night
Where I was subjected to your spitting and cursing,
Huddle me, fuddle, I stepped in a puddle
This is the bane of good Nursing.

Fibril_late;
11/28/12

One Forty-One

One day recently, at about the 8th hour of work and just before my dinner break, I had an episode of Atrial Fibrillation. Newsflash: this doesn't go well with work No, I pretty much had to sit down, and wait for it to go away...........which it did about an hour later.

One Forty-One

Atrial Fib at work
It isn't much fun,
Doubling my heart rate
To one forty-one,
I took a Toprol
Drank some fluids, took a seat,
But as soon as I got up
The same irregular beat.

It's not conducive to working
When it's banging away,
Blood pressure shoots up
I need a break and delay,
Hoping the medication
Will kick in and perform,
Then maybe, after dinner
I'll return to the norm.

What was the trigger?
I'm not really sure,
A long busy day
It went by in a blur,
Some aggravating encounters
Contributed, I suspect,
Of these modifiable risks
I must shield and protect.

We educate our clients
"Take your pills, exactly how",
Because ninety percent of them
Don't know Pepcid from puppy-chow,
Whereas, I adjust my meds
To keep my pulse regulated,
The value of that
Can not be over-stated.

Fibril_late;
11/17/12

Sick Cat

Virus vs. Bacterial

At home, everyone has the usual first-of-the-season viral cough and sneeze. Several of those guilty, are not so careful with their hand washing and what not, despite my observance and counsel. What can ya do?

Me, I managed to capture my own, nasty bacterial bug, (probably at work), and lodge it in my lungs. Subsequently,  it fermented and percolated for 3 days, and then KaPow!!! it slammed me down with a vengeance. Three days of fever, short of breath, wheezing and malaise. I've had to endure the nastiest antibiotic ever, Doxycycline (very tough on the GI tract). Oh well, it actually works, so I can only whimper.

All in all, I was one sick cat.

Sick Cat

Oh, woe is me
How ill, I was,
I hang with sick people
Just because,
I chose healthcare
In the unemployment line,
Now thirty years later
I'm spitting up brine.

Causality
A case in point,
Stories begin
At a universal joint,
A bend in the road
Allowing straight, to twist,
Now I'm hacking up loogies
As big as my fist.

I saw the Doctor, after that
Quite frankly, I was one sick cat,
It felt like fur balls in my throat
He said it looked, like a cashmere coat,
He asked if I was purring
I stated, I was wheezing,
Although, I didn't have
A runny nose or sneezing,

I had a 2-view X-ray
Which naturally was clear,
But luckily my doctor
Reads the literature each year,
He nailed it on the head
A need for antibiotics,
I wasn't one of those malingerers
The sinus psychotics,
They ask for "just a Z-pac
Because it always works",
Of course it does, you fools
That's a simple clean and jerk,
The remedy didn't do a thing
Placebo, that's the name,
Appease the masses with a pill
That's the pharmaceutical game.

Sick cat feels a little better
Day after day,
No more fur balls in my throat
But too tired to play.

Fibril_late;
11/9/12

Persistent

Persistent

Atrial Fibrillation is the most common arrhythmia in persons over the age of 50. Current practice addresses either rate control or rhythm control, meaning that some people are relatively asymptomatic, and if they can't be converted to Sinus rhythm, then, keeping their heart rate below 100 is seen as a reasonable approach. However, they require anti-coagulation. Anyway, there is a small subset of patients who are very symptomatic, fail drug therapy, and are referred for an electrical ablation procedure...............sometimes over and over and again. No fun when you are only 58 and otherwise, extremely healthy.

Persistent

Hail to the man
With the most persistent A. Fib,
He returned once again
To visit our crib,
He missed us, he stated
We're like family, so dear,
The best place to be shocked
Yes, that's why I'm here.

Dr. O'Neill is so happy
To see you again,
He loves a good challenge
Which is common in men,
Of the Irish persuasion
From the Emerald Isle,
He resides as the Judge
On this most tedious trial.

Handmaidens and bards
Stand by, as you beckon,
They are all placing bets
On that shock, I do reckon,
Such consummate professionals
This likeable crew,
Saying prayers, fingers crossed
Hats off, saluting you.

Fibril_late;
10/25/12

Halt the Queries

Admission Data-Base

I bet that a lot of nurses just hate having to fill in / data entry / interrogation forms, whatever your hospital calls it, ours being the Admission History. Tedious, tasking, and terrifically boring questions...............oh wait, I think it's a Demographic Survey, now days..........My advice...........just get creative as all get out!

Halt the Queries

Our clients typically visit
For a twelve hour time,
Yet, we interrogate their lives
Like they committed a crime;
How many times do you pee
Do you dribble or leak,
Did you have a "BM" today, sir
Or was it, way back, last week;
Who really needs to know this
Yes, what is the rationale?
That I have to question what is leaving
Every bodily canal?

Many cultures, are offended
When we pose these inquisitions,
An embarrassing interview
Regarding sensitive positions,
So, I make the answers up
And document what I wish,
Does it matter if his BM
Was today, or yesterish?

And then, we have to document
Medicines taken, time and date,
I ask them, what the day was
And I choose the hour eight,
Whether morning or night
Once a day, or more,
This saves me a bunch of time
In this grossly, boring chore.

And half of the time, these folks
Don't have a clue about their meds,
The stress of needing an angiogram
Is screwing up their heads,
And yet, Bob and Betty nurse
Will perseverate and persist,
Confusing this octogenarian
Until, he slugs them with his fist.

Did you have the death of a loved one
Are you suicidal today?
How would that adjust my care?
Are you packing, I might say,
We don't want an angry wing-nut
Shooting up an operation,
Although that clearly does suggest
That we deliver good sedation.

What's the point of all these questions
I don't know, so I modify,
Your bowel status hardly matters
If you're about to die,
And I shouldn't waste your precious time
Delaying care and intervention,
There are times to halt the queries
And really pay attention.

Fibril_late;
10/24/12

Don't Call Me Jacqui

Just a little silliness................but, I'm thinking even you have had a patient that was just a little attractive......isn't that so?

Don't Call Me Jacqui

In the 11th hour
On the eve of the 11th day,
We still had too many patients
And that means double-time pay;

A woman admiring her Pacer incision
A guy, preparing for home,
One fellow waiting for heart-cath
And Betty with mirror and comb.

"It's important to always look good", she said
After lying all day on this frickin' hard bed,
I hope my arthritic knees and titanium hip
Don't lock up when I stand, and cause me to slip;

That would delay my departure, my driver would hiss
He's a snake of a man, but he has a good kiss,
So, please let me up, and sooner if you can
I like you as a Nurse, and hope you're a good man".

I did all that I could, to please that fine lady
I escorted her to the Ladies room, despite Sinus Brady,
And when we were finished, her heartbeat was tachy
She said, "Thank you young man, just stop calling my Jacqui".

Fibril_late;
10/18/12

P

I think this is how quite a few of our patient's feel, when they have just received the news that they have Left Main disease, and they might drop dead if they go home................

P

Urgency vs. quantity
That's the cat in the bag,
Like the K-Mart blue-light-special
When you're waving the yellow flag.

Six hours of bed rest
"Are you crazy, that's insane?"
I can't pee lying down
That's not how they do it in Spain;
Yes, I should have just stayed there
And not come to visit my daughter,
I'm telling you, I feel just like
The lamb led to slaughter.

I raised them, way back when
Times were different, and that's a fact,
I'm just on a three month visitation
It hasn't been all that it's cracked,
Up to be, I'm telling you
Aren't you listening?
I only came to the United States
To see a Grandson, to attend his Christening.

And now, here I am
In swaddling clothing, in this hospital bed,
The team of doctors are telling me
I need surgery, or I'm as good as dead.

Urgency vs. quantity
It takes on a whole new meaning,
I'm told my options are limited
And that's kind of demeaning,
For a visitor in this high tech country
A leader in so many parts,
I would think that by now
They could just give me a new lambs heart.

What a predicament
I can't make the decision,
I'm going home and screw all my risks
I'm not interested in an incision,
But I still have to pee
So bring me that container,
I don't want to pee in the bed
And that's a no-brainer.

Fibril_late;
10/18/12

Whistle-blower

What does it take to be a Veteran of anything? As a soldier, you've gone to a battlefield, and put your life in harms way. As a nurse, what is it? Some sort of other badge of courage, or perhaps a number of years in a type of specialty? I think that is a possible answer, but how many years, I don't truly know.

One thing that I do know, is that Veterans can see through all the flak and find the truth immediately. This is why Nursing, can become more difficult over time. Morals, ethics, good vs. bad practices and all of that other, "it might affect somebody's life" information, becomes readily apparent and obvious. 

Ethical Committee's..............phooey! The RN at the bedside can tell you what's right!

Unethical

The unethical Doctor Z
Will never get close to me.

With his dubious results
Of cardiac stress,
90% normal Angiograms
And 10% are a mess,
Whereas one of the normals
Will have a serious complication,
This immoral practice
Demands elimination.

Another questionable Heart-cath
The outcome?, disaster,
Dr. Z departs quickly
Nobody, is faster,
Turning over his "care"
To a backup practitioner,
A man with morals and ethics
An old-fashioned Commissioner.

Dr. Z has some issues
Personality, is deficient,
He postures and pretends
As if he, were omniscient,
Claiming all that is worse
From the Lexiscan test,
And with so many normal Angio's
He looks like the best;

Caretaker of constituents
In his tidy territory,
He drives a short Mercedes
Auto-collector?, not his story,
No, I think he's just amassing
The usual dollars, to line his pocket,
If he was an Orthodontist
He'd want to fill your dry-socket.

Do I have the power to challenge him?
Probably not,
He attended good training
But he was no hot-shot,
Knowledgeable, very certainly
He has it all figured out,
The tests he orders, suggest problems
"You need a Heart Cath", he spits out.

The average consumer, won't question
Heck, the information is scary,
"There's a problem with my heart?"
That's like a dead Canary,
Found in the Gold-mine
Down on level 13-C,
Doctor Z suggests an Angiogram
"Heck yes, I want it for me!"

But if the supporting diagnostics
Had been considered in the most thorough light,
Mr. Billy Bob Jorgenson, would have stayed home
But instead, he stroked tonight.

Fibril_late;
10/17/12

Once again they said, "Oh heck, you'll both go home early...........there's not much going on today". Of course, they are the ones that go home at 5pm. Had I worked my normal 10:30am shift, it wouldn't have been a problem. No, because it was a slow day, two of us came in at 9am....................but we didn't leave till 23:30pm. - that's 14.5 Hours on the books.

Blunder

Oh, I wonder
How they blunder
Born asunder
The leaders of our room,
When billing hours are weak
They endlessly tweak
Talking double-speak
All dire and doom.

Home early, you’ll go
Because it’s kind of slow
But what do they know, they go home,
We have patient’s, we stay late
It’s less exciting than a date
I’m a nurse, it’s just my fate,
Looking forward to a drink with foam.

Fibril_late;
10/16/12

Bleeding Janet

Late again
But we didn’t plan it,
We had another
Bleeding Janet.

She stood up and wavered
Sprung a leak and made a puddle,
You know you can’t fix that
With a 5-minute Nursing huddle.

Barring no other
Unexpected complications,
Bed rest for an hour
Delayed our vacations.

Fibril_late;
10/16/12

In the Lurch

Once again
We were left in the lurch,
Prayers don't have much power
In Sister Euphemia's church,
She keeps stoking the boilers
When there are no hands on deck,
And tomorrow morning, on inspection, asks:
"You stayed late, what the heck?"

So, I always pen a note
Make it rhyme, that's my motto,
Though not grossly intelligent
When I'm whack-tired and blotto.

Fibril-late;
10/17/12