Just Stay Home

On the recent Saturday, I attended a Cardiology conference. There must have been at least 200 attendees, mostly physicians and a handful of nurses. Sitting behind us, and to the Right about 5 chairs, was a gentleman with a bothersome cough and clearing of the throat. This occured continuously, minute by minute, the entire day long. We professionals are polite endurers of bothersome personal habits and discomforts, so I suspect the majority of us where silently praying the dude would either buy a cough-drop at the commissary, suck on ice cubes, get a beverage at the hotel bar, or just go home. Evidence suggests he did none of these things, much to the displeasure of many.

Sir Coughalot

Sir Coughalot
Should have stayed away,
Coughing continuously
All night and all day,
With little consideration
For others nearby,
Is that cough contagious?
If so, we'll ask why,
Did he bother to attend
And potentially expose,
200 colleagues
With debris from his nose,
Plus, flying projectiles
With each coughing hack,
I think his choice to attend
Looks like a terrorist attack.

Sir Coughalot
Didn't listen to his marm,
She admonished him often
"Remember, do no harm"
But he's here today
Sharing his coughing disease,
Sir Coughalot
"Why don't you go home, please?"

Fibril_late;
9/27/14

Exposed Iceberg

I know about harrassment
And all about assault,
I've delved into my psyche
And considered Gestalt,
But here is a topic
Upon which, I have never written,
And if I dare say the word
I will surely be bitten.

As a writer of medical mayhem
I thought,
That no topic was sacred
Where anything could be bought,
But a situation is present
With Danger supreme,
The iceberg is exposed
Oh, it makes me want to scream.

I'm skirting the swamp
As I don't wish to be beaten,
There is a threat of a lawsuit
And I don't want to be eaten,
The core of the issue
Power and culture,
The best and worst of that
Thrown into a mulcher.

Now, Sister Euphemia
Is at her wits-end,
She's got a bagfull of troubles
That she wishes she could send,
To a secret incinerator
The proverbial compost-bin,
But all she knows is crucifixion
For Original sin.

This is a Tequila Sunrise
Running for too many hours,
While the Pina Colada's
Have become Whiskey Sours,
Whoever mixed those ingredients
Well, that Bartender is long gone,
I ran into her 2 months ago
And she's singing a new song.

"I am totally happy with
Something new, really fun,
Bartending was Ok
But I needed a gun,
To keep the help-staff and patrons
Under control and out of trouble,
When I had the chance to jump ship
I got out of there on the double."

Then she went across town
Another, bartending gig,
It was like going to the Hilton
On a ship just as big,
Run by regimented officers
Steeped in duty and decorum,
Every decision she had to make
Needed to be reviewed by a forum.

Two years were enough
On that formulaic farm,
Where policy's and procedures
Come first, before harm,
Where one must toe the line
Or be keel-hauled by the boat,
A grand salary isn't enough
When crap is shoved down your throat.

And at the Heavenly Hilton
The Pina Colada's suck,
They are subsidized heavily
And only cost a buck,
Mixed with probiotics
This contaminated culture,
Isn't fit for consumption
Not even by a vulture.

So, one must tread carefully
Speak in code, and watch your back,
At any given moment
We might come under attack,
There's a culture war in town
This is a dangerous place,
A Pinot Noir of mystery
That I'd rather not embrace.

Fibril_late;
9/15/14

My Latest Rant

Recently I noticed a "new" paper form in my workplace, named the "Just Culture Event Investigation".......(something like that). Apparently it is used when some type of Audit has been done, and an error was identified. What bothers me, is that since it is a new idea, why was I not made aware of this tool?

Frankly, I think the naming of the process is stupid. "Just Culture Event"? 

1.) At first, I thought it was some kind of notice for a concert, or something like that; a Cultural Event. Perhaps a time to celebrate that dubious thing called, "Adversity". Well, adversity might be truthful, because if my Boss person, lays this form on me, I feel like I am in a situation of adversity, as in, bad luck, trouble, suffering, and misery.  

2.) Second bothersome thing to me:

I don't know who the Auditor was. So, as I showed proof that my audited error, was incorrectly identified, why don't I have the opportunity to educate that person (the Auditor) and show them the error of their auditing method. In other words, that Auditor person should be served with their own "Just Culture Event Investigation" form.

What my Boss person said, when I pointed out the true error of the Audit: "Oh, then I'll just tear this one up". But I think that it is very likely, that there is an accounting somewhere, that shows I made an "error of omission" in my charting. That won't be corrected, because the Auditor won't be aware of their own error. 

Because of all of this, I decided it was prudent and necessary that I perform some research on "The Just Culture". I am not surprised that big business has jumped on this and turned it into a money making scheme, with similarities to, "The Seven Pillars", "Project Redesign" and other nonsense. 

It dates back to around the year 2001.  

Patient Safety and the "Just Culture": A Primer for Health Care Executives.

Marx D. New York, NY: Columbia University; 2001.

Review Excerpt:

Written prior to the acceptance of open disclosure or general policy support of it, the primer thoughtfully outlines the complex nature of deciding how best to hold individuals accountable for mistakes. Four key behavior concepts serve as the structure for the paper: human error, negligence, reckless conduct, and knowing violations. How they are applied to various situations in health care and how the individuals involved should be disciplined provide thoughtful reading.

And finally it slithers down to my workplace, thirteen years later. 

https://www.justculture.org/the-role-of-event-investigation/

http://www.health.ny.gov/professionals/patients/patient_safety/conference/2007/docs/patient_safety_and_the_just_culture.pdf

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

Same old sh*t slathered on white bread

Fibril_late;

9/15/14

Dental Dana 31

Dental Dana
Oh, what else can I say?
That I'm too frisky
But she never wants to play,
How she's so professional
With her knowledgeable smile,
How she twitches an eyebrow
It's her own particular style.

Other Hygeinists
They're good, so don't get me wrong,
But they aren't humming
The Dental Dana song,
Her mysterious aura
Well, it just vibrates in the room,
And when she supines me in the chair
My heart skips a beat, badda boom.

Dental Dana
What a chick, what a queen,
She's infused with something special
If you know what I mean.

Fibril_late;
9/15/14

Demise

Always here

Our ultimate demise,

Although medical science

Seeks more tries,

To prolong our natural life

And I can’t argue with that,

I’m just beyond sixty

And I want 30 more, in nothing flat.

I feel pretty good for my age

My weight is Ok, just a little more than I intend,

More exercise is needed

It’s not something I can pretend,

To make it dematerialize instantly

After all, work is required and such,

My pretty baby is in favor of it

But she’s not willing to hand me a crutch.

Demise, my bad habits

Although, I’m not so sure what they are,

I have a pretty good diet

Forty years, an anti-meat Czar,

That’s gotta have some value

In the , “It’s good for ya”, category,

I like raw vegetables

Not so much cooked, that’s the story.

I don’t smoke anything

Nor snort, mainline or whoof,

I don’t eat fish or fowl

Or anything on hoof,

Fermented grapes and hops

Oh, surely I do,

Probably just about as much

As the rest of all of you.

So, if Scientists find ways to prolong

The quality of life, in its length,

I’d like to sign up for that

While I work on my strength.

Fibril_late;

9/15/14

Medical Assistants

Responding to a recent "letter to the Editor".........sort of..........here is my take on the necessity of Medical Assistants.

Medical Assistants

Medical Assistants

Without them, the system would come to a stop!

A necessary cog in the gears of countless Clinics

They are the lubricant

That runs a slick shop,

Vital signs and medical records

Everything operating smoothly or not,

Honor, your Medical Assistants

Or brother, your Clinical Practice is shot. 

Fibril_late;

9/14//14
 Stagnation

East Coast steve

Is really right,

My creative words

Are missing their bite,

Stagnation

That's the word for me,

No excuses count

Stagnated, I be.

Ashlee, blog-comment

Helped show me second sight,

Of course, I had to respond

She put me in a favorable light,

So, Quid Pro Quo

And do unto others,

A Medical Assistant Hi-ho

As if written by their Mothers.

Fibril_late;

9/14/14