After Dinner

To share the experience of an arrhythmia, somewhat common amongst the clientele that we serve in our Department, is quite the conversation piece . However, I think it helps Billy-Bob when I commiserate with him, regarding his Atrial Fibrillation.

About half of all persons with A. Fib are unaware of it, often discovering the problem, when they go to a doctor for some other issue. Not only do I have an in-depth grasp of the phenomena, and I teach Cardiac Monitoring, but I am aware that I'm in A. Fib, within 5 seconds. I am thankful that my Cardiologist, tested me with Propafenone about 3 years ago, when I had a prolonged (16 hour) episode. I was given a megadose of the medication, and avoided electrical cardioversion. Since that time, every episode of Paroxysmal A. Fib, has successfully converted with a "rescue" dose of 600mg.

And, on the night before Christmas:

After Dinner

A Fib after dinner
On a family Christmas Eve,
Was not the present that I wished for
'Twas like a snake inside my sleeve.

A Fib after dinner
Fixed it with dessert,
Propafenone 600
And it didn't even hurt.

A Fib after dinner
Not something I condone,
Everybody took a walk
While I stayed home alone.

A Fib after dinner
Three times this year,
All the foods were different
Without wine, or even beer;

In fact, that familiar trigger
Doesn't seem to be the cause,
A Fib after dinner?
I place the blame on Santa Claus.

Fibril_late;
12/24/13
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Fibbing in Feb

Fibbing in February?
I hope it isn't me,
I have it down to a science
I only do it quarterly,
I'm not due till March
At least that is the plan,
Fibbing in February?
Not once, if I can.

Fibbing in February?
I don't think so, my friend,
I have a birthday
That I must attend,
And it wouldn't be right
To disrupt any parties,
You see, I only invite
All the hale and the hearty's.

Fibbing in February?
That must be you and not me,
Irregularity
Is not in my family tree,
We are stalwart and solid
Dependable and sure,
So, it's no Fib in February
Because we always endure.

Fibril_late;
12/25/13
_  _ _ _ _ _ _ _ _ _ _ _
Let It Be You

February fibbing?
Oh, let it be you,
It's something that I
Would just rather not do,
Four times a year
On the quarterly plan,
Is, quite enough
For this A. Fibbing man.

December and March
June and September,
Is quite enough detail
For me to remember,
I just can't adjust
To more episodes; friend,
A Fib now and then
Is where it must end.

Fibril_late;
12/25/13

Volunteer

Everybody knows a volunteer (I hope). We hear about them, read about their service, but if you're not paying attention, they go unnoticed. In a hospital, they are indispensable; so much work is done by them and their only compensation is our thanks and perhaps an "Annual Volunteer Dinner". In our crazy department, we have had a few helpful volunteers over the two and a half years that I have been there. Quite often they are Nursing students, both male and female. They often appear shy and uncertain in the beginning, but I think we help them to feel welcome and appreciated, and when they leave, I know that everyone has benefitted from the arrangement. Currently, we have just one volunteer, and although my memory is like Swiss cheese, I think she's been coming almost every Friday night for a year or so. She exists in the land of post-college, and working on what's next. I can best define her value, with a poem:

Michelle

Michelle, Michelle
Yes, she's the one,
On Friday nights
She gets things done,
As a volunteer
She's beyond compare,
Without her help
We'd still be there.

Michelle brings goodness
Every Friday night,
When we're feeling beaten
She brings her light,
Her energetic
Enthusiasm,
Builds a shining bridge
Across the chasm.

Michelle, Michelle
Has lasted longer,
Than a league of volunteers
Because she's stronger,
She can stock IV trays
And prepare ten gurney's,
She's more valuable than
Edmundo's attorneys.

Michelle will do
Whatever we ask,
She's confident
No matter, what task,
And whatever it is
She does it well,
At the end of each week
We are saved by Michelle.

Michelle has earned
Our gratitude,
A bag of blessings
For her attitude,
Her willingness
To volunteer,
We hope and pray
She returns next year.

Fibril_late;
12/9/13

Myna Birds

Our hosses are like Myna birds……...repeating the same things day after day, without seeking workable and efficient solutions.

Sociology

There is sociological theory

A good King protects his minions,

Assembles an army

To fight opposing opinions,

Stands up as a warrior

And is a benevolent leader,

I guess it is obvious;

I’m a fiction-loving reader.

Our hosses complaints

Went something like this,

Don’t work so late

Or the budget will miss,

But, why did you refuse

That Recovery, yester-eve?

Joe Bob in the Cath Lab

Complained; now you’ll grieve.

No, our hosses don’t support us

We are attacked from within,

There is no rhyme to their reason

This is Corporate sin,

And this poison dribbles down

Through every crevice and crack;

I have a smile on my face

And a target on my back.

The psycho-babble of the 90’s

Would say, every family has it’s issues,

But where I work we wipe our tears

With pepper-spray tissues,

And no matter what they claim

About dignity, safety, and caring,

The inner workings of this machine

Are way beyond repairing.

Fibril_late;

11/23/13

Master & Novice

A historical romp regarding this old master; prompted by the recurring theme: Only a very few, super-bright, new RN's are ready for hospital Specialty Units. We veterans hope those new nurses understand the giant step they are taking..............and that their education is about to begin.

I enjoy being a mentor, but I can get grumpy real easy.

Master & Novice

I had so many writings

Five years ago,

I had reentered the field

After hiatus, you know,

Yet, I was still rockin'

That ICU persona,

Fifty five years old

And still a prima donna.

The old master returned

Just a little bit rusty,

Some engineering issues

To brush off, they were dusty,

But the knowledge-base wooed them

I was a heckuva catch,

An old relic of the eighties

The best of the batch.

Nursing is a difficult

Job to recruit,

You might carry weapons

That you're afraid to shoot,

Or maybe your shooting

Was twenty years before,

But you put it on your resume

Just to get in the door.

I'd been off a few years

But remained educated,

Symposia and journals

I wasn't outdated,

With my previous experience

With teaching and education,

Getting back into the game

Was just another train station.

That year my writings

Were completely off the charts,

Revisiting hemorrhage

And C-difficele farts,

The ICU drama's

And meeting old friends,

'Twas well worth all the angst

The means justified the ends.

Now, I work in a puddle

That's how it seems,

It’s not the kind of job

For a person with dreams,

It's a place for experience

For persons tired of the race,

Where you need to pay attention

And have the knowledge of our place.

No, you just can't wing it

In Cardiac Care;

There's too much at stake

Death is lurking everywhere,

Yet, we make it look easy

To the novice standing by,

They love the awesome schedule

Bankers hours?;  yes, they'll try.

New nurses don't know

And I remember, yes, I do,

A lot of overlooked mistakes

I wanted to slip past your view,

And instead of admitting

That I screwed up again,

When a Doctor called me out

I wanted to swallow my pen.

We veterans worry

About mistakes that might occur,

Allowing new nurses in

While they're still learning to stir,

A minestrone of diseases

With Cardiac at the top,

In the absence of a foundation

This house of cards could flop.

Assessment skills are so important

They are refined by repetitive actions,

One needs to observe a broad milieu of patients

Multiple disease states and a few disimpactions,

So I think that beginning ones career

In a very specialized disease setting,

Is like sleepwalking on the interstate

For the naive' innocent, who enjoys betting.

I was a "top o'the class" Respiratory Therapist

With five years experience; but a new Nurse,

I was inspired by my ICU counterparts

But I knew I didn't know enough, to pick up that purse,

Thus, I chose Cardiac Step-down

Where I learned about every adult disease,

Honed my assessments and critical thinking

After four years, I could go where I please.

I moonlighted a lot

A mercenary nurse, for lack of a better name,

A hired gunslinger

At the top of his game,

I could handle anything

For one night at a time,

And early on I discovered

I could unwind with a rhyme.

It's a brave new world

For any fresh minted nurse,

You need to recognize your lack of knowledge

If you have a big EGO, it's a curse,

Don't say yes, all the time

Do exactly what your Preceptor says,

And if you lie to me, young novice

You'll stand there holding a busted Pez.

Fibril_late;

11/20/13

What We Are

I was having a conversation with someone, regarding what we do or don’t talk about with our loved ones. If we are hooked up with someone who also has a healthcare background, then our conversations might be on some common ground. When that is not the case, usually we seek out someone else in our own field of expertise, to be a sounding board for those experiences we’ve had, so we can de-stress and unload.

What We Are

My best friends

Are few and far between,

The most of them

Have experienced what I've seen,

We are Nurses and Paramedics

Soldiers and Doctors,

We learned many things in training

Then, experiences were our Proctors.

What we are

Is something tactile and moist,

Bodily fluids leaking

Jaws of life, or a body-hoist,

Being there in the midst of it

There’s no way, to just fake it,

With stress disorders on the rise

Grab something and break it!

Ah, the thrill of that gesture.....

What a power inside,

Many people can't see it

Because their spirits have died,

And the spoils of war

Go to those who remain,

We are the front-line insurgents

With experience lodged in our brain.

Fibril_late;

11/19/13

Guernsy's

In the hospital, we are told to keep our gurney’s out of the hallway, as it violates fire code, but then there is no alternate solution offered, regarding just where to place them.

It works like this: Our unit starts out full of gurneys; a patient is taken away on one, we replace the gurney, and add a new patient. The Cath Lab returns the prior gurney, and we must place it in the hall. The Dept Head comes by and states, “No gurneys in the hallway”. We then, pull it in, and hide it in the back alley. This shell game goes on all day long. Finally, after 5pm, when de bosses go home, we end up with about 4 gurneys in the hallway (and nobody reprimands us), until closing time, when we bring everything in at 11pm.

Silly, isn’t it?

Guernsey's

No Guernsey's in the hallway

That's what I thought she said,

But with that ringing in my ears

She might have said, no bed.

No Holstein's in the closet

They make a bloody mess,

Manure on the linens

It's overwhelming, I confess.

No Angus, in the break rooms

They're always passing gas,

And the cow pies are enormous

All that mushy, smelly grass.

No Guernsey's in the hallway?

Especially during days,

When Inspectors roam around

Working power plays.

Where can those bovines rest

To chew upon their cud?

They're just searching for some grass

And maybe smoke a little bud.

Fibril_late;

11/7/13

Dig-Nutty

Carrion Flies

Where there's Dignity

There's gotta be humor,

We're not all dying

With a tumor,

And even if I am

Laughing makes it easier,

Especially when the Chemo

Makes me queasier.

Where there's Dignity

You need a sense of funny,

What else can you do

When they're hiding all the money?

Blaming everything on our excess

Short-sheeting linen and supplies,

Human kindness and other platitudes

Are fodder for the carrion flies.

Fibril_late;

11/7/13

G, B & U

G, B & U

Anyone who has read my Nursing writing, is aware that I focus on the foibles of human nature, including all of us in the healthcare professions, and the user-public. The miraculous things I have seen, the precious wonders I have experienced, are those things I rarely talk about. The mere discussion of them, reduces their value in some way, as the listener wasn’t there. Also, how many persons really have experienced the absolutely unexplainable. Those things that defy understanding; where one must truly have an open mind to all things. Mysterious things of the Universe, that truly no one can explain. Whacky religionists might say it was the Devil, Science would try to debunk it, and you might label me as a nut.

Hence, I tend to write about people being stupid, persons making idiotic, moronic choices, and the end result of their endeavors. Some think I’m just a burned out, disgruntled Nurse, but I’m not at all. I work under stressful conditions, tending to the needs of persons with life-threatening heart disease and, I take it very seriously.

I enjoy what I’m doing, and if you or a loved one is in the hospital with a heart problem, you’d be damned lucky to have me as your nurse.

But I am driven to write about it; the good, the bad, and the ugly. But mostly, the last two.

Fibril_late;
11/6/13

Sublime Frustration

I came here, to take care of my bizness

But instead, I’m just venting my blues,

Thank gawd, I only work 3 days now

Any more, would truly loosen my screws,

Our leaders are cutting out blankets

Apparently, we’re using too many,

One for each patient and none for the staff

If you’re cold, bring a parka, Nurse Penny.

They outsourced the Lab

Medical Records and Staffing,

Environmental Services

Holy crap!, no one’s laughing;

Reportedly, we have 343 beds

According to Wikipedia,

And a lot of silly shenanigans

That never reach the media,

There was the gushing water-pipe incident

Earlier this year,

It closed down half of a Nursing floor

For a week, but did you hear?

I searched the Internet

And all of the local papers,

But no reporting was done

About this or other capers.

Just last Friday evening

An Angiogram, to discharge later,

Her vital-signs were suspicious

BP lower, heart-rate greater,

I drew a CBC

And the White count had doubled,

I informed the Doctor

And both of us were troubled

Keep her overnight

Draw blood cultures, give Cefepine,

I placed the orders, called the Lab

After forty-five minutes, no Tech was seen,

Until my third call for the “Stat”

Getting a little more adamant

Each successive time,

What was the hold up?

Only one Phlebotomist

For the whole hospital

Oh, how sublime.

If I was in the ICU

I would have drawn the blood myself,

But in our cramped little closet

We barely have

Bobby-pins on the shelf;

So, you can see why I’m frustrated

In the midst of performing top quality care,

It’s like trying to drive a car

When the tires aren’t there.

Fibril_late;

11/6/13