It seems like every big city has a Trauma Center, smack dab in the center of all the action. It's so convenient for the gangs and what not. When you get shot or stabbed, your friendly neighborhood Emergency department is just down the street looking for new business. Hey, we groove on it too; after all, there is nothing more boring than twiddling your thumbs all night in the E.R.

The Stockton Boulevard Shuffle

At night we go out cruisin'
For something fun to do,
We pack the glove compartment
With rock cocaine and glue,
We inventory weapons
And check our ammunition,
Then analyze the dress code
To prepare for demolition,
We'll boogie on the boulevard
Until the moon has set,
We're hunting for our rivals
It's a turf related debt.

We're doin' the Stockton Shuffle
It's our favorite expedition,
We'll keep our zip guns loaded
And ready for attrition.

The happy hombre' hideaway
Is actively recruiting,
Respect is guaranteed
If you've done a drive by shooting,
Because our leader, Jesus Wannabee
Got blown away last week,
He took a double shotgun blast
Directly on his beak,
Thus splattering his sacred essence
Upon the dashboard fur,
Now, when we take a low ride cruise
The windshield is a blur.

It's a party, it's a shuffle, on the promenade
We're kickin' up our heels out in the street,
We're paying our respects to Jesus Wannabee
While jamming to our favorite gangland beat.

Fibril_late; 1993

Who wants to get old and remain happy and productive? Most everyone would agree to that plan. But how about getting old and suffer dementia? Not a very desirable scenario, right? Well, here is one possible avenue of escape.

Demented Blues

Getting old
Don't look too fun,
I'm gonna get
A suicide gun,
Fill it full of bullets
Then hide it in my bed,
When I get demented
I'll ventilate my head.

I want a one way ticket
On the euthanasia bus,
Just let me die in peace
If I get delirious.

Fibril_late; 1993

Oh, my gosh; back to the topic of sputum once again. Since you're just reading the latest poem, you must become aware that I was once a Respiratory Therapist. Yes, many long years ago, prior to my exalted career as a Nurse. So yes, I know the ins and outs of sputum. After a while, one gets an attitude about it all...............

Cauterized

If you spit your sputum
On the floor,
Don't expect me
At your door,
Because the house-rule states
And, I'll be brief,
You have to use
Your handkerchief.

So heed my word
Don't be a fool,
It's easy enough
To follow my rule,
But if you continue
Don't be surprised,
When you find your lips
Are cauterized.

Fibril_late; 1994

In the presence of people with advanced stages of disease, you (Nurse) become sensitive to certain expressions of speech, or how they describe how they are feeling at the moment. Some of those expressions, portend impending doom and disaster.
For example, when the patient who has had a major Myocardial Infarction, suddenly states, "I don't feel so good" , yet all the while, everything has been looking peachy-keen. Don't ask questions, just call out the door, and say something like, "Would someone please bring the crash-cart to room-17, ASAP!!!". Yes, that is a clear example of your critical-thinking skills kicking in (aka, "intuition"). If you overlook it...................

Cruisin' Heaven

A mysterious event
Happened just today,
The man said, "I don't feel so good"
Then his heart-beat went away.

I told him not to do that
But he didn't seem to care,
His heart rate slowed dramatically
Until it wasn't there.

With bells and buzzers ringing
We wailed upon that man,
His color went from purple
To a lovely desert tan.

He received a hit of atropine
Some calcium and epi,
He replied with tachy-rhythms
But his pump just wasn't peppy.

With the force of seven doctors
And the strength of twenty nurses,
Collectively their aura
Dispelled the evil curses,
That had bound him to his destiny
In a room without a view,
Now he's cruisin' heavens highways
With an angel friend or two.

Fibril_late; 1997

A short story about a dying heart..............as told to me by (name withheld by request).

Ectopated

He had some pain
But then, he waited,
Because he didn't know
What it implicated,
Then he got real sick
Or so he stated,
When he became dizzy
And nauseated,
Because it's uglier than pain
When you vomit unabated,
Its the worst, God-awful feeling
That you ever have hated.

So he came into the hospital
To be evaluated,
He was worried that his body
Would soon become outdated,
He had never been a patient
And thought health was overrated,
He had never had a cause
Until death seemed almost fated.

His breathing was tachypneic
His neck veins were inflated,
His rhythm Sinus tach
And very ectopated,
His ischemic myocardium
Gave up and fibrillated,
We zapped him with the stunners
Till his heart electroplated.

Unconsciousness ensued
When his brain waves were ablated,
His astral body floated
To the ceiling elevated,
Then the angel guys arrived
And he participated,
There was no turning back
Because his life force dissipated.

Fibril_lated; 1995

Regarding the study of EKG, it is the topic of Heart Block that appears to confuse most persons. Let's take a look at it:

Demystifying the EKG

At work I ponder images
The waveforms of an EKG,
In the language of the beating heart
It usually is clear to me,
But sometimes I am mystified
About the A.V. block,
It manifests so many ways
My brain goes into shock.

First degree or second degree
Third degree and more,
P-waves are advancing
And can't get through the door,
I must utilize some rules
As my analyzing key,
To unlock the great unknown
Of this crazy EKG.

Fibril_late; 1997

This is another old, Joint Commission rant, regarding how all departments of the hospital must tidy up all their charts and documents.
It is also a poem where, with each succeeding line, the first letter subsequently spells out a phrase as you read downward through the lines. It's kind of a fun exercise in writing.

The Joint Commission

Justify each document
Condense a neat reply,
Harp on education
And answer what and why,
Organize your data

Within a structured format,
Anachronistic rules
Need you for a doormat,
There is really little
Sense to this, And I will tell you why

Piles of needless documents
Are mounting to the sky,
Plugging up the landfills
Eliminating trees,
Reasoning is absent, I think everyone agrees.

Fibril_late; 1996

Ok, (not OJ, ok?).
3 days a month, I am an Instructor in a class of students learning the fine art of Basic Cardiac Monitoring. I tutor as well. Over the years I have written quite a few arrhythmia poems and this one too, about AV conduction.

Just An Impulse

I'm on a Roman holiday
To find the Mother Lode,
The treasure map I'm following
Describes the A.V. node.

Yes, I am just an impulse
A vector plus or minus,
Traveling on a pathway
That started at the Sinus.

I'm scheduled for a rendezvous
A well earned coffee break,
A hang out at the Junction
To discuss which road to take.

At the crossroads there's a signal
That will guide my future travels,
If I violate the timing
Synchronicity unravels,
Then the trip that I had planned
Will require transformation,
As an impulse, I may follow
A course of aberration.

In the future I will hire
A tour guide for instruction,
As a stimulus, I must know
The pathways of conduction.

Fibril_late; 1998

Allegory is a form of extended metaphor, in which objects, persons, and actions in a narrative, are equated with the meanings that lie outside the narrative itself. The underlying meaning has moral, social, religious, or political significance, and characters are often personifications of abstract ideas as charity, greed, or envy.
Thus an allegory is a story with two meanings, a literal meaning and a symbolic meaning.

Well, this is something akin to an allegory. It's about a man who is dying, and in the course of his death, he loses the compass of his mind.

No One at the Helm

Stormy winter landscape, where
White capped waves
Wash a stony beach,
All within the minds eye,
This man is out of reach.

Cellular degeneration
In the microscopic realm,
The captain is in the forecastle
And there's no one at the helm.

The three-masted schooner
Of his body, mind and spirit,
Are hopelessly adrift, yet
He doesn't sense, to fear it.

Self induced or inorganic
The end result the same,
He won't remember where he lives
And might forget his name,
Once, the captain of the ship
That ruled the awesome seas,
Reduced to live out life
In diminishing degrees.

Fibril_late; 1997

Usually with each posting, the poem that I wrote 10 years ago or so, I actually remember that event associated with it; thus, this was a journaling of my reality at the time. But other times, I don't have a clue to what I was referring too. This poem is about near-death, something about EKG arrhythmia's, possibly about PVC's, but your guess is as good as mine.

The Death Bumps

Take heed, the rolling eyeballs
Beware, the gasping breath,
Take note, the tachycardia
Watch out for bumps of death,
They hide behind the rhythm
And rarely show their face,
But increase the vagal tone
And you'll see the death bump pace,
Attempt to stay the inevitable
The course, that all life takes,
Remain alert and ready for
The trail the death bump makes.

Fibril_late; 1995

There is an entire science built around the results of automobiles ramming into each other at high rates of speed. I think forensics fits in there somewhere, and no doubt, a whole lot of other stuff, like what I am about to describe.

The Multi-Auto Pileup

The Multi-Auto Pileup
Loose body part trajectory,
Has prompted in-depth studies
At the cannonball refrectory,
Those bug-eyed, quasi-scientists
Will poke their noses deep,
At the site of any accidents
Where body parts might heap.

Several questions come to mind
About these missing limbs,
Do you have a separate funeral
And sing fragmented hymns,
And then, there is the theory
About the phantom pain,
Is there a phantom body
If you find an intact brain,
You may find this topic gruesome
And too disgusting for your mind,
But someday in the future
We may cure the phantom blind.

Fibril_late; 1997

Thanks to TV and movies (I suspect), the most common sights that are recalled about the medical/nursing professions, have to do with the excitement in the Emergency Department or in the ICU. And to those of us who've spent a lot of time there, it often seems like:

The Outskirts of Hell

Some nights like this
Are too darn boring,
It takes a maximum effort
To keep from snoring,
But I must be ready
For catastrophe and clamor,
The component of nursing
That provides all the glamor.

Saving the lives of
The sick and the broken,
High fat consumption
And cigarette smokin',
Uppers and downers
Liquor, cocaine,
Greasing the pipes
As they slip down the drain.

Being an angel
Of mercy and death,
Holding the keys
To their heartbeat and breath,
Then going home hungry
And burnt out, as well,
It's a glamorous life
On the outskirts of Hell.

Fibril_late; 1998

When patients bleed unexpectedly, it is always worrisome. When it's enough blood to leak from the bed to the floor, it's a serious situation. Let me tell you about it:

Bloody Shoes

Petrified, I am indeed
I'm nervous, when
They start to bleed,
When blood leaks out
And stains the bed,
I get kind of dizzy
In my head,
If I find a pool
Upon the floor,
Spreading towards
The open door,
I want to run
The other way,
Because bloody shoes
Just ruin my day.

Fibril_late; 1999

I admit it; I'm over 50, and the AARP is sending me subscription queries on a quarterly basis. What's up with that? I'm not old, and certainly I'm not anywhere near retirement (but unfortunately, I fall back on that excuse to substantiate why I haven't worked much in the past 4 years).

Anyways, I do still suffer from some degree of chemical sensitivity, which I believe I acquired from the many years of hanging around in hospitals (25 years+). Here it is, 4 years since I officially left the "big-house" and most perfumes that are included in any type of household product, cause my eyes to burn and I become irritable ("what in the heck is that smell, and get it out of the house, NOW").
Considering all the chemicals Nurses are exposed to from the medications we have to handle, formulate and deliver and the myriads of "sanitation-cleaning" materials we come in contact with, there is no question that Nurses have to be counted amongst those with excessive chemical exposure issues. And the proof is in the following poem I wrote, back in the day............

The Saga of the Shiny Floor

Who would think
That critical-care,
Would need a floor
With a shiny glare,
Perhaps, it's for
The public eyes,
Who might be concerned
If Junior dies,
Inside a joint
With a dirty floor,
Patient care
May be less; not more.

To me it seems
A poor decision,
The chemicals
Irritate my vision,
As such, I may not
Spot the clue,
That Junior's demise
Is imminently due.

It's plainly clear
That someone wise,
Must find a suitable
Compromise,
To save the Nurses
And the sick,
Who are dropping like flies
Pretty damn quick.

Fibril_late; 1998

Why, do all my poems seem historical (or hysterical)? Because they are. I experienced a spinal-lumbar injury (at work) in September of 2000, that essentially ended my career (as it was previously understood).
I hung around my place of work for about 3 years, and then got acquainted with disability/retirement. What have I done since then?

I studied, tested and practiced a bit of Legal Nurse Consulting.
I studied at UC Davis and got a Certificate in Financial Planning. (sheesh, that was difficult!)
I studied Massage Therapy, and I graduate TOMORROW!!!!!!!!! This is where I belong. Along with the Registered Nurse, that I will always be.

My Massage Instructor, was getting ready to move on, but he hung around for just one more class.
Following, is my tribute to a fantastic teacher:

The Teacher

I've graduated
At last hurray,
The year went by
From then to day,
And it's more exciting
Than my previous time in college,
Where I got a grasp
On financial knowledge.

Way back then
3 years ago,
I was a stranded victim
Learning that I didn't know,
Enough to practice
On my HP-12C,
Financial knowledge
Was like Greek to me.

Along about, last summer
Craigs'list caught my eye,
I could study Massage Therapy
For a year, on the fly,
And right then I remembered
Where I was 3 decades ago,
Studying the rudiments of Touch therapy
Acupressure and Jin Shin Do.

I leaped at the chance
And chanced at the leap,
It didn't cost much and I wondered
Would the instructor be cheap,
But life is funny sometimes
It delivers unexpected,
The custom-ordered teacher
Arrives, as if directed.

I suspect the other students
Recognized him, as the best of teachers,
But if you've followed a similar path
There is another set of features,
Hidden beneath the surface
Known to those who traverse the same,
I know this teacher was directed
Am I worthy, to play in his game?

When the Guru or the guide
Intercepts the path you travel,
It's time to get your act together
Or for sure, it will unravel,
Because, so often they arrive
At our crossroads, of hesitation,
Where it's time to grasp the horns;
Accelerate and levitation.

The gratitude and thanks
Are sometimes difficult to convey,
Words seem shallow and so temporary
They come and go each day,
But the feelings of the heart
That are powered with the Shen,
I trust the Teacher can interpret this
These simple scribblings from my pen.

Fibril_late; 8/22/07
(aka: mojomassage)

I see myself as a chronicler of the secret thoughts of Nurses. Surely I am not alone with my devious interpretations about the berserkers in the hospital (aka, out of control and possible alien/outer space patients); right??? Actually, after reading this over 7 times, I might have been writing about a colleague. Who knows?

The Whiney Scale

On a Whiney scale, of one-to-eighty
Your score is really up there, matey,
You're irritating me, for sure
I'm wondering if, there is a cure.

In secret, I will be strategic
Then render you, a paraplegic,
I'll perform a tracheotomy
Combined with a lobotomy,
To complete this attack
Against irritation,
I'll administer
The best sedation.

I'm hoping this approach will endure
And I can claim a lasting cure.

Fibril_late; 1997

Another musical poem, set to the tune by the Beatles, "I'm A Loser".

I'm an Oozer

I'm an Oozer
I'm not what I appear to be,
I'm an Oozer
I'm bleeding out, oh, can't you see?

I had a cath
Then I bled
And almost died,
The doctor promised
Me the best
But he lied.

I'm an Oozer
My blood is dripping on the floor,
I'm an Oozer
My doctor's sneaking out the door.

If I should die
I will haunt
That S.O.B.
And I'll make sure
He won't forget
Poor, little me.

I'm an Oozer
I'm not what I appear to be,
I'm an Oozer
I'm bleeding out, oh, can't you see?

Fibril_late; 1998

There are times when a catastrophic event occurs (perhaps the latest rendition of "Code Blue" cardiac arrest) and the victim has about 13 intravenous lines, 7 medication drips, 4 invasive monitors, and there are 11 people in the room, including 5 who have no need to be there. That is when it is life-and-death crucial that you know exactly which IV-line is your "medication" line (and it's not dripping on the floor). Also, it helps if the vital-sign monitors are accurate too. Otherwise.............

Someone Dies

When you're reaching for the Lidocaine
The epi or the atropine,
The propane or the methane
Or maybe even gasoline,
The Wheaties or the Captain Crunch
The chocolate cupcakes for your lunch.

Be sure you check the vital signs
And ensure the patency of lines,
'Cause in the midst of great surprise
If you're not careful, someone dies.

Fibril_late; 1994

Central Line Changes

Central line changes
Are a mystical event,
A cosmic-three encounter
Undertaking to prevent,
The pitfalls of infection
That are monstrous in their scope,
Should you become a victim
There is little room for hope.

The success of this endeavor
Is an issue of sterility,
It takes a licensed person
And validation of virility,
To honor lofty spirit guides
Who safeguard this affair,
You must purify your conscience
And sanitize your hair.

Approach the hapless victim
Assure him with your poise,
Some folks respond to silence
While others love some noise,
Then don your gay apparel
And the dirty gloves of science,
Advance into the dressing zone
And attack with bold defiance.

The skin is red and puffy
The smell is overpowering,
A colony of yeast cells
Before my eyes are flowering,
Do I panic? No, I don't
I have faith in this technique,
This method is so powerful
When I'm done, the skin will squeak.

Silently I pray
To appease the Gods of Prep,
I've memorized the ritual
But review it step by step,
And secretly I offer
A gift to their account,
In turn they will agree
To reduce the colony count.

Right attitude and ritual
The strength that guides my moves,
Along the sacred path of prepping
In three concentric grooves,
Focused at the center
At the site of penetration,
The circles then get larger
As I prep with concentration.

I apply a sterile dressing
Then tape it with a passion,
While going to great lengths
To adhere to current fashion,
Because sloppy looking dressings
May reflect on my career,
The prep Gods might abandon me
If my Supervisor is near.

So, the changing of a dressing
Is like the changing of the guard,
If you follow the procedure
It isn't very hard,
And remember to placate
The Gods of sterile dressings,
They'll save the site and your career
And shower you with blessings.

Fibril_late: 1995

Never Say Dye

I went into the hospital
To have my vessels scraped,
I reacted to the dye, and now
My kidneys have been raped,
I admit the Doctor warned me
About some complication,
But he minimized the maximum
And now I've lost my urination.

The renal kidneyologists
Are studying my case,
I haven't peed for seven days
And I'm turning yellow in the face,
There's talk about a catheter
They could place into a vein,
To suck out all the poisons
And sudsidize my brain,
But frankly, I'll be honest
I don't trust this deadly trick,
So, I'm checking out tomorrow
Because I'm safer being sick.

Fibril-late; 1995

Breathless

It happened to her once before
The day she lost her breath,
We have a fancy term for that
We call it sudden death,
And her family searched around the house
But never found her air,
They had to call the factory
So she could have a spare.

Expectantly, she waited
With a grim look on her face,
Already made her mind up
That she'd leave the human race,
And, the factory delivered
Just a little bit too late,
Yes, that poor old breathless woman
Surrendered to her fate.

Fibril_late; 1994

Another Poem drifting in the breeze.

To Win The Game

I met a corpse
That wouldn't die,
So I asked the man
Please tell me why,
He couldn't quit
His busted frame,
And he replied
"It's just a game".

When I was young
I went to school,
I memorized
The Golden Rule,
My teachers said
"Son, what's your aim"?
And I replied
"It's just a game".

When I grew up
I looked around,
And tried to figure
What I had found,
I had success and
Love and fame,
But something whispered
"It's just a game".

In later years
When I wore out,
Some people heard me
Scream and shout,
I said to them
"I bear no shame",
'Cause life is just
A little game".

Now, I'm lying here
And my time is up,
I think I've finally
Drained my cup,
I've told the story
Of why I came,
So you might learn
It's just a game.

Fibril_late; 1990's

Another classic dredged up from the Archives of The Underside:

Tumbling Dominoes

She has been here several weeks
And had every kind of tube,
Can you believe, she was admitted
For just a jiffy-lube?
Her heart was sorta sluggish
And her blood was quite anemic,
And just like tumbling dominoes
Her brain became ischemic.

Combative and demonic
Obesity berserk,
She started bustin' up the place
And nearly killed a clerk,
We loaded her with Versed
Morphine and some Ativan,
Enough to kill an elephant
It knocked her on her can.

But side effects are side effects
And some can lead to death,
We finally had silenced her
But we took away her breath,
So she earned the respirator
It was the prize behind door three,
It includes a year of tubing
And a therapist for free.

Now her respiratory failure
Brought on shock and RDS,
Why, in just a couple hours
She became a total mess,
Reversible?, it's possible
But it's not the likely course,
We can treat her up the yin yang
But can't replace the lost life-force.

Because the woman was a time-bomb
Just waiting to explode,
She had multi-system failure
From a life on lipid road,
Her triglycerides set records
That will stand for many moons,
She had a steady diet
Of booze and macaroons.

Her husband was no better
He paid the grocery bill,
You couldn't make them understand
Their type of life would kill,
Now lying here before us
Is a body, life supported,
And we're rushing around like maniacs
Because her heart beat just aborted,
And it seems a little pointless
To apply our super science,
To a person who spent years
In stubborn, health defiance.

Fibril_late; 1994

Todays headline, and comments.

The Biggest Asshole

"Doctors find no cancer in Bush's polyps"
Proof that cancer prevention is their role,
However, doctors did state they had found
Quite clearly the worlds biggest asshole.

Fibril_late; 7/23/07

Quite frankly, I have no idea when I wrote this one, but it's about a "LOL" Little Old Lady, getting ready to check out, and the outcome of being the recipient of a "911" call.

Dial 9-1-1 (and have some fun)

I'm alive, I can't believe it
I had given up to die,
I'd arranged to kick the frame today
No one cared to ask me why,
I have lived a long eventful life
But foresaw a painful death,
Then I was boldly interrupted
When I took my final breath.

A local family member
Discovered I was prone,
He heard me fall upon the floor
And thought he heard me moan,
In truth, I was rejoicing
It was time for me to run,
Well, then that sucker saved me
He dialed, 9-1-1.

A gorgeous hunk of Fireman
Drove right up to my door,
Assessed the situation
And figured he could score,
Attached me to a monitor
Announcing an arrest,
Resuscitated me, oh, Lord
With massage upon my breast.

Aroused I was, and more alive
Than I had been for years,
I clutched that fellow to my chest
And nibbled on his ears,
He had a fancy uniform
That I quickly slashed and ripped,
It was barely 30 seconds
Till that Fireman was stripped.

My cardiac arrest
Was instantly converted,
When that fellow aimed his hose at me
Cut loose and really squirted,
I bounded to my feet
Feeling totally renewed,
I'm going to tell my aging lady friends
That they should all get screwed.

Well, I've changed my way of thinking
I'm no longer so depressed,
When I need a little excitement
At first I get undressed,
Then, with a helpless cry
I dial 9-1-1,
My Fireman comes quickly
And boy, we have some fun!

Fibril_late; 1997

On the suicide topic, there was a friend, who was a good husband, father, provider, scholar and accomplished dentist. He took his own life and checked out. I'm not sure why he did this, but he did tell me later not to worry about him, that everything was all right. When the dearly departed speak, what can you do but agree?

The Desperation

I can understand the desperation
that caused you to end your life.
Like turning off a light,
that had already dimmed
and only glowed with a dullness inside.

Crawl into the darkness
knowing without a doubt
there is no tomorrow.

High hopes
dashed upon the rocks of reality,
after a valiant struggle
in the undertow of life
giving up the fight;
alone in the surf.

Fibril_late; 1995

I'm not the suicide type, but I have on numerous occasions, been the Nurse of the suicide-attempter. What goes through their heads at the special moment? One of the more memorable ones, was an elderly fellow, who shot himself in the chest 5 times and missed all major vessels and heart. All he got out of it, was a new outlook on life and a chest-tube. However, I have written a few poems that examine the process.

Once a Rainbow Garden

Suicide is simple
I'll just drive right off the road,
The world is a heavy place
So I'll lighten up the load,
My life, it feels like madness
I wonder, what's the point of living,
Everyone is taking
I'm worn out, from all the giving.

Fatigue, an evil spirit
Has possessed my inner soul,
What was once a rainbow garden
Is now a dark and musty hole,
Resurrection?; it's unlikely
If circumstances have their way,
Yes, suicide is simple
Because it's just another day.

Fibril_late; 1995

4th of July; now the 5th of July, and what am I thinking about - - - - - sadly, this debacle in that Middle-Eastern land that our Leaders have dragged us through. Why should I care? Well number one, I have a close family member, who has this contract with the US Army and they want to take another "vacation" over there in August. Hmmmph! So I started to write this thing which I think is unfinished........care to contribute? I call it:

Slash, Burn and Kill

Call it a political mood
If you will,
The freedom with which our government
Will slash, burn and kill,
(July 4)

And I'm telling you now
That I'm totally pissed,
Our dead brothers and sisters
Will always be missed,
Their lives were given up
So the vultures could feed,
Those mouthfuls of men
With their menu of greed.
(July 6)

Under the guise of terrorism
Beneath the pseudonym of dollars,
The high-priests of capitalism
March in robes and stiff collars,
Spouting worn out sports metaphors
Where a solution always means a new war,
And our newly elected government reps
Are stranded on the shore.
(July 12)

And there are those that weep and moan
And those that wring their hands,
Some others pull their hair out
And plot disaster plans,
But what's the point of doing this
With our current administration,
They are fomenting terrorists as we speak
Planting seeds of devastation.
(July 19)

And still, the media moguls
Spout and print their propaganda,
There is Al Quaeda in our neighborhood
And a terrorist disguised as a Panda,
So the local zoo is cordoned off
The animals polygraphed,
Apparently, there were reports
Bin Laden was "giraffed".
(July 25)

I suspect, it seemed like nonsense
The stanza previously penned,
But the mouthpiece of our gov'ment
Tells us where to begin and end,
Just believe the media voices
As though the christian god hath spoken;
Now just suck-up the latest propaganda
And we thank you for your token.
(7/29/07)

Meeting old-time friends can produce the BEST of times. Recently I did this, and it was the best of the best.

A True Friendship

I finally got together
(after 30 years),
With an old-time friend
And we shed some tears,
Of happiness and joy
To see each other again,
Old-time friend I thank you
For holding up your end.

We hadn't changed much
In each other's eyes,
We'd done our share of living
No need for secret pries,
Into the unspoken deeds
That we might have performed,
When I left our brief reacquaintance
My heart was truly warmed.

I hope to see you again
Sooner than three decades,
It's likely that amount of time
Creates more significant fades,
Of memory and tissue
But still we could age with finesse,
Sixty years of lifetime rendered
A true friendship, none the less.

Fibril_late; 6/21/07

We nurses are well known for multi-tasking. If not, we'd never get through our day, and manage all the caregiver issues successfully. I have to admit, I'm far better organized, more timely, punctual, reliable, etc. in the work-setting, than I am at home (Type-A, at work; Type-Z, at home). In my abode and peripheral life, I take a more laissez-faire attitude about things; comme ci, comme ca, c'est la vie. A lot of French to describe, laid-back. What it means in real life, is that I miss a lot of birthdays, anniversaries and what-not in a timely fashion. So, I wrote the following poem yesterday, to cover my hmm, for missing a bunch of those things that were due to my son.

Here it is:

Pretty Lax

I suspect it seems
I'm pretty lax,
About anniversary days
And those family pacts,
That tie the knots
Between generations--
It all is true;
My explanation.

So to settle it out
To narrow the rift,
Please accept
This 20th Century gift.

Fibril_late; 6/20/07

Down In Your Colon

Have you ever wondered
What goes on, down in your colon,
When it feels like those microbes
Have decided to go bowlin',
Why not go see your friendly Doctor
He has an awesome scope and light,
For just a few minutes of your precious time
He'll demonstrate his hindsight.

Fibril_late;
4/82

If you would hang around long enough with the dead, the dying, the sick and maimed, the children and babies, the psychic, religious, atheist and what not, in their time of dire need , occasionally you will witness some qualified “miracles”. My understanding of a miracle, is an event, that goes beyond a scientific explanation, or beyond the means by which we “see” the causative agent of the extraordinary event. I know there are many energies of the spectrum of physics, whereby we do not yet have instruments sensitive or sophisticated enough, to measure either their wavelength, or their power, effect or influence. Heck, that’s why we have scientists to work on that stuff. In the meantime, I’ve seen enough to keep any skeptic, busy refuting my experiences!

The Skeptical Man

The skeptical man
A doubter is he,
Show him a flower
He says, "Prove it to me",
Tell him you've experienced
Lo, none but a miracle,
Still he won't believe it
Unless it's empirical.

Fibril_late;
5/82

Here I butcher the English language with lame rhymes.

Ream, Ream, Ream

The heart attacks
The myocardium,
Says, look out son
I beg your pardium,
But you’re in my way
This ain’t no dreamya,
Havin’ tonight
It’s really ischemia.

Call the Surgeons
Page the team,
Let’s take out your arteries
And ream, ream, ream.

Fibril_late;
5/82

Sneezing; some people have a quiet little mousy sneeze. Me - it’s like Mt. Vesuvius blowing it’s top. Now, imagine doing that with a strep-throat; yes, pure agony!

The Sneeze

There are moments like these
That I’m glad I don’t sneeze,
It’s so peaceful and quiet
And a sneeze would deny it,
Not to mention my throat
That is now, sore and tender,
I can imagine the pain
That a sneeze would surrender.

Fibril_late;
1978

There are those days where I'd much rather be somewhere else, enjoying nature, rather than dodging bacteria. In the end, you have to make the best of any situation I guess.

You know
Moments like these,
I'd rather be
Amidst the flowers and trees,
Wandering aimlessly about
In some predetermined direction,
Instead, I'm back in town
Surrounded by disease and infection.

I may as well
Make the most of it all,
Relieve some suffering
Answer that call,
Send someone home
And heal one or two,
And as for the rest
I'll leave them for you.

Fibril_late;
7/81

Memory; what it you lost it?

I Don't Remember

I know I must be someone
But I don't remember who,
I have a job somewhere
But I don't know what I do,
I have some friends and family
But I don't know who they are,
I would find them if I could, you know
But I cannot find my car.

Fibril_late;
12/82

A nearly ancient poem, just unearthed from 1982, regarding the dilemma of mental illness.

Derailed Thoughts

You know, when you're driving home
And it seems like the same old way
But suddenly, you're lost, and you find
You're across the border;
Well, that must be something like
The fellow with a mental disorder.

Derailed thoughts
Like a telegraph line
With its wires crossed.
It doesn't matter if you remember
Where your home is;
You're still getting lost.
So, what can you do?
Find an alternate route
Or maybe get a new map
Or get a mobile home -
Then you'll always be there.

Fibril_late;
10/82

Deep, so deep; bedrock deep!

The Wisdom in the Stones

I sat upon the bluff last night
And looked across the canyon,
I deliberated destiny
As I was my own companion,
The sunset spread across the sky
In a thousand colored tones,
Ancient voices echoed from the walls
The wisdom in the stones.

The evidence of centuries erosion
I have touched,
The absolute infinity of loving
I have clutched,
The tenderness of kindness
Presented by a friend,
These are things that have beginnings
But never have an end.

Fibril_late; 1994

A look at religious conservatism and something else about reading the words that others write and how we interpret those words.

Original Sin

Original man
Original sin,
Original scriptures
That won't let you in.

Original hate
Original fear,
Original prejudice
That won't let you near.

These are the beliefs
To which many subscribe,
Content in their place
As the original tribe.

Fibril_late; 1994

Ideas and Themes

Letters written
Letters sent,
You wonder what
The writer meant,
Interpretation
Requires constraint,
If you don't understand
The painters' paint.

Flexibility
Is the answer,
Like my imaginary
Dancer,
Leaping about
Ideas and themes,
Interpret them
Just like my dreams.

What it means
Can change with time,
Today a blessing
Tomorrow a crime,
Read with care
And intuition,
Allow flexibility
In your rendition.

Fibril_late; 1994

Here is a timeless rant about plundering governments.

Tragedy

Tragedy struck
On the street today,
A government collapsed
Many lives at play,
Innocent people
Slaughtered and maimed,
The propaganda machine
Says who should be blamed.

Tragedy struck
And families are broken,
Long promised freedoms
Are now but a token,
While deals made by men
Who wager with death,
Leave innocents gasping
For a last, dying breath.

Tragedy is felt
Far away from that place,
For the hundreds that died
I see but one face,
The tragedy occurs
When power fuels greed,
And the desires of a few
Overshadow what they need.

Fibril_late; 1994

Last post, April 15th? That's kind of hard to believe; after all, I started out with the lofty dream of blogging QD. Daily living, got in the way. I tell people I am a semi-retired nurse. Funny, even the nurses who have gone on to other careers, can never let go of this nursing thing, if they pursued it for 2 decades, like myself. I think it's an inborn genetic trait; it underlies all things.

Anyway, a few weeks have passed, too many daily distractions, so I delve into the "daily poems" that occurred alongside my health-care writings back in the day. There is so much to cover.

"Beyond Common Tradition" was about someone, who I can no longer recall; nonetheless, memorable in the retelling.

Beyond Common Tradition

Hers was a life
Of which legends are made,
She was born in the sun
And retired in the shade,
But somewhere in between
There was a fabulous rendition,
An exemplary existence
Beyond common tradition.

Her family was conservative
She always did her best,
Just follow Mom and Daddy's course
It's safe within the nest,
But it didn't fill her up inside
It left her, feeling hollow,
And though they knew she loved them
She had a different star to follow.

Though I use the word conservative
Her parents had great knowledge,
They encouraged all their children
To attend some kind of college,
Knowing that the value comes
In exploring brand new themes,
Then taking the experience
To carry out their dreams.

Her dreams were like a ball of yarn
Just waiting to unravel,
With just a little push, she rolled
Into the world of travel,
Returning now and then
Bearing gifts of life and laughter,
And then a dream would sprout again
Which she'd be chasing after.

A legend in her own time
Within the family tree,
When pressed for explanations
She'd say, "Because it's me".

Fibril_late; 1984

Back in the early '90's, I made the acquaintance of a fine nurse and nationally recognized educator, named Deborah Tuggle, RN. I attended many of her classes, worked with her a few times at one of the local ICU's and was a contributor of some poems for one of her CCRN classes. I just stumbled over my drafts for those poems and thought I'd do a little
21st-century revising and revisiting. I will load up the whole pie in this entry, as it has been more than a couple weeks since I posted last.

SVT versus TFS

Is it aberration or ectopy
S.V.T. or T.F.S.?
Sometimes I get, so darned confused
I quit, with just a guess,
I get so doggone overwhelmed
I can't recall my name,
Does it really matter in the end
Or would the outcome be the same?
I swear I think my "idiot-factor"
Has increased, by more than double,
Ever since I took that class
From the famous Mrs. Tuggle.

Let's examine a scenario
To illustrate my point,
My shift is all but over
I'm about to leave the joint,
When abruptly, I'm assaulted
By alarms and lights galore,
My patients' heart has gone whacko
(Now I'll have to chart some more),
His rhythm is wide and ugly
So I race down to his room,
My tunnel vision activates
The flashing lights spell doom.

Is he conscious?
Is he dead?
(Is he even in the bed)?
Should I stop a sec and clock him
Or just go ahead and shock him?
No, no….hey, I'm a pro
I've taken Tuggle's course,
He's fine for now….I'll stop and think
My memory, I will force.

I'll check a few key leads
Before I treat this guy tonight,
Is it S.V.T. or T.F.S.
Or Wolff, Parkinson and White?
Does a delta wave announce itself
Or remain concealed and silent?
Is it simply an aberrancy
Or something else more violent?
Is the phenomena reentry
Are the P-waves retrograde?
Does the AV node dissociate
Or do P-waves simply fade?
Is the axis indeterminate
Is it normal, left or right?
Is V1 looking up or down
Is the R-wave broad or tight?
What else was I supposed to check
What else did teacher say?
My God, that woman drives me nuts
I don't care anyway!

There's just, too much to think about
It's too much to recall,
These silly EKG rules
Are just no fun at all!
You know, he looks a whole lot worse
Let's just forget the clues,
I think that I should shock him now
And end these rhythm blues!
So I hit him with some macrovolts
To turn his rate around,
His body jerked right off the bed
He moaned a frightful sound.

Despite his pain and suffering
His rhythm was reversed,
He was mad as hell I zapped him
And announced that I'd been cursed,
In the end, what only mattered
Did I fixed him or did I not?
I halted decompensation
Plus all my nerves are shot!
But was it V-Tach or SVT
Or was it really T.F.S.?
That Tuggle Frustration Syndrome
Is the cause of my distress!

p. hupp; 1991
rev. 2007

Advanced Certification Blues

It's a lot of stress and worry
A major pain in the neck.
Some nurses want to do it
To enhance their weekly check,
Then others seek a challenge
To prove their skills exist,
Or to correct a prior-exam upset
To right the wrongs they missed.

Anxiety commences
Before beginning class,
We're talking, major chunks of money
To ensure you're going to pass,
And what if you should flop
Despite this education,
Your self-esteem will under go
Its' final degradation.

You can see the task is mighty
For the dedicated teacher,
They must ignite your feeble spirit
Like a fire and brimstone preacher,
And cast aside the devils
Of ignorance and fears,
Hoping you'll be back to take
Their class in three more years.

p. hupp 1991
rev: 2007

Balloon Pump

When your heart doesn't want to thump
It's time for an aortic-balloon pump,
It squirts the blood back, retrograde
To reduce the myocardial fade,
It unloads the diastolic side
And improves the coronary glide,
It has many complications, though
You could lose a foot, a leg or toe,
Or if a clot, by chance should travel
Some precious organ might unravel,
It could migrate up into your head
And though we saved your heart,
You'd still be dead.

p.hupp; 1991
rev. 2007

Neuro Learning

You used to think that Parkinsons
Was a place to buy your clothes,
And Babinski was a guy
That manicured your toes,
You thought a Grand-mal seizure
Was a grocery store arrest,
And a thing called quantal squander
Was a competency test.

And by now your cerebellum
Has tremors from the strain,
From cramming unrelated
Facts into your brain,
And you suspect your C.P.P.*
Is dangerously low,
From an obscure malformation
Redirecting neural flow.

But how fortunate for you
Your condition is benign,
All you have to do is study
And memorize each line,
Then the words will fall into place
Into memories, defined,
And despite your greatest worries
You've intellectualized your mind.

p. hupp, 1991
rev. 2007

Addison's Prices

No matter where you're going
No matter where you've been,
Make sure you don't ignore
The system Endocrine.

Back in the days
Of James Madison,
Came the naming of diseases
Like Addison;
One day he was shopping
For some coffee and tea,
He had a jones for some brew
(Though it always made him pee),
But he went into shock
When he saw the prices,
And thus begat
Addisonian crisis!
Hypotension
And hyperkalemia,
Pigmentation
And hyponatremia,
Dextrose and saline
For fluid revival,
Corticosteroids
For long term survival.

Don't sit around
Debating the cause,
This Addison's beast
Has some serious claws,
So if you treat it rapidly
With the latest regime,
Impending death
Will be yesterdays dream,

Don't be a doubter
A skeptic or a cynic,
Make follow-up appointments
And we'll see you in the clinic.

p. hupp; 1991
rev. 2007

G.I.

G.I. troubles
What a mess,
Gastric bleeders
I confess,
Turn my stomach
There's no doubt,
When their blood
Comes gushing out.

An acute abdomen
Or ugly bowels,
Causes people
To scream in vowels,
Call the doctor
And sharpen the knife,
It's their only
Chance for life.

Hepato this
And chole that,
Secretory
Neighbors chat,
Liver function
Out of kilter,
Won't detoxify
Or filter.

Massive ascites
Ain't no fun,
You look like a pumpkin
In the sun,
Tap the belly
Before it blows,
Ascites fluid
All over your clothes,
Kaexalate
All day on the crapper,
This is the song
Of the liver-failure rapper.

p. hupp; 1991
ref. 2007

Ketoacidosis

The acidosis diabeatus
Is not a crisis of the fetus,
It's most often those
Who are type one,
Deficient
In their insulin.

The fatty acids accumulate
Producing a keto-acid state,
A greater than fifteen
Anion gap,
Encourages their
Lungs to flap,
To dissociate carbonic acid
Meanwhile this dude, is totally flaccid.

When the patient
Is dehydrated,
Electrolytes
Become concentrated,
Aggressive treatment
Is required,
Before the victims'
Heart gets tired.

Insulin and fluids free
I.V. route most rapidly,
Check the glucose every hour
So the treatment won't go sour.
Discharge plan?
To educate;
To prevent a similar
Repeat date.

p. hupp; 1991
rev. 2007

The Big Test

The night before the test next day
There's a trepidation creeping,
A few will burn the midnight oil
To study, instead of sleeping,
Some others actually go to bed
Yet their sleep will be forsaken,
They'll toss and turn the whole night through
Afraid they won't awaken,
To the din of 17 alarm clocks
Placed strategically around the room,
So they get up in the morning
With a foreboding sense of doom.

What kind of clothes
Do you wear to this test?
Should you go as a slob
Or dress in your best,
If you give it little thought
And leave it up to chance,
Before you leave the house
Make sure you have your pants.

The test is always on Saturday
So you are the only commuter,
You spend the whole drive dreaming
That you owned a mini-computer,
Hidden in the glove-box
With a modem in your ear,
Then you'd be the only scholar
With a perfect score this year.

Outside the somber testing place
Small groups of nurses collect,
Presenting each other with questions
With the hope they will choose what's correct,
When faced with a similar topic
On the test, they will soon undergo,
The moment of truth can be merciless
When you realize how little you know.
___________

The exam is really over?
You can't believe it's finished,
The results will come in about two months
But your worries haven't diminished,
Because now you dwell on the questions
Where you clearly had no clue,
And since the test is behind you
There's not a damn thing you can do.

You might pray to your Gods and your Goddesses
To grant you just one small request,
Sacrifice a lamb and rub that rabbits foot
To guarantee that you passed the darn test.

p. hupp; 1991
rev. 2007

Necrotizing Needlepoint

Perhaps you thought that breathing
Was a commonplace event,
And the term, "A dime sized lesion"
Was just money that you spent,
Did you think that hypoxemia
Was a viral titer test,
Or that tracheal malacia
Was a common household pest?

Did you know that bronchiectasis
Hung out with atelectasis?
Or grasp that wheezing airways
Were often found on stairways?

Don't ignore that pneumothorax
Muffled breath sounds are a clue,
A deviated trachea
Accompanies it too,
Hypoxemia develops
Mental confusion in the head,
You better place that chest-tube quick
Or this fellow will soon be dead.

Hospital-acquired pneumonia
Is the going thing today,
If you never wash your hands
You'll put a lot of them in play,
And the antibiotic resistant bugs
Will thank you for the chance,
To do their necrotizing needlepoint
At the pseudomonas dance.
Joe Camel has retired
But advertisers never quit,
Pre-teen little Bobby smokes
His cool factor is up a bit,
In health class he just snickers
Tarry lungs, no that ain't me,
In forty years he'll curse the beast
We know as C.O.P.D.

p. hupp; 1991
rev. 2007

Blood Cell Party

The white cells attack foreign proteins
The red cells just go with the flow,
The platelets are seen stuck together
On their way to a matinee show,
It's a film about tubules and solutes
Of osmo's and creatinine clearance,
It adds up to only one thing
A very confusing appearance.

The syndrome of I.A.D.H.
The SED rate and left-to-right shift,
Require the proper translation
Before you catch on to their drift,
But sooner or later the meaning
Will find itself well understood,
When these systems are all out of kilter
The outcome won't look very good.

p. hupp; 1991
rev. 2007

Another reawakening, an eye-opener of realization. I wrote about it back in 1995, and now a recent issue of a local Nursing magazine, has substantiated what I feared back then; Nursing is burying itself in "after-the-name-titles identified with mysterious letter combinations", where everyone and anyone, has to make their little stamp of recognition. It seems so childish to me. Who gives a rats-ass? Why not just show the RN, and then carry around a little card with all your extra-special, super-duper, ain't they awesome, look what I did, credentials identified by their "letters" and what the heck it all means. Stop giving me a headache, every time I pick up some nursing literature, Ok?

And this is just the beginning! Stay tuned for the latest interpretations.

Toxic Credential Syndrome

I was present at a seminar
Just the other day,
Presented by some experts
They captured me all day,
Enthralled I was, I must admit
Astounded, I confess,
I learned some facts I never knew
But I pause, and now digress.

What captured my attention
Were the credentials after each name,
Without a glossary to help me
I was almost put to shame,
When I realized no one else
Would know the meanings, either,
I silently relaxed
And took a little breather.

Little do these experts know
They have a sickness; it's incurable,
Toxic Credential Syndrome
Rarely, is insurable,
It's a chronic, life disorder
Of self-substantiation,
Seeking after-name initials
That defy interpretation.

After days of in-depth study
And cryptogram decoding,
I almost had the cypher, but
I felt my mind eroding,
The breakthrough came, when I was sitting
Upon the holy throne,
While bearing down, I visualized
A new Rosetta stone.

My interpretations
Are that and nothing more,
Other scholars may follow me
But I warn them, it's a chore,
Fellow collaborators
Have chosen to stay unnamed,
I understand their reluctance
The risk of being blamed.

I may become notorious
Denounced, more likely banned,
But I have my convictions
And have to take a stand,
The TCS condition
Is a threat to any nurse,
Should this research halt their suffering
I will gladly bear the curse.

Fibril_late; 12/95

Remember when we all laughed about that silly "Valley Girl" song, by Frank Zappa. It was filled with all those juvenile forms of speech such as:
Like, He's like, I'm like,……
As if
Ya know
Bitchin'
Totally Rad
Oh my God……

Now our whole flippin' society talks in this manner. The problem I see, is that when professionals speak this way, it makes them at best, appear poorly educated and at worst, just blathering idiots. So, there I was at some ACLS course and the physician instructor kept saying, "If you will" with a smattering of "ya know's" thrown in (like, every sentence, and it was not even, totally, like rad). Word.


Listen Carefully To Speech

"If you will", please let me clarify
A point of worthy status,
"If you will", I'm very tired
Of catchy phrase-like flatus,
"If you will", is touted daily
From the mouths of modern man,
"If you will", is like, I mean, ya know
Over and over again.

If this is too confusing
Listen carefully to speech,
Repetitive terms, like um, it's all
Are enough to make you screech,
The continual daily bombardment
Of sloppy vocal expression,
May undermine the professional
Leaving a less than desirable impression.

Fibril_late; 12/95

More about cost-cutting and budget cuts.

A Dangerous Method of Efficiency

Casting caution to the wind
Making budget cuts galore,
It's a dangerous method of efficiency
Kicking your people out the door.

Our industry needs to be streamlined
With careful consideration and pride,
Unlike the methods you see today
Which is technically suicide.

Fibril_late; 12/95

Some thoughts about the final destination: Death.

What it Means To Die

I sought a definition
Of what it means to die,
I asked for a description
And then I pleaded, why,
A man might suffer needlessly
While his life-force slowly drains,
A victim of this system
And our God-almighty brains,
How we can define atomic physics
Or support the gasping breath,
Yet we shudder when we're faced
With the choice of life or death.

Afterlife, what's after death
What goes on beyond the after breath,
It is a question, understood by few
While even less, know what to do,
In a world of increasing technicality
We grapple with our ultimate finality,
Exactly where this road may lead us next
Can not be found in any medical text.

We seek a lot of answers
To define our own morality,
When at the bottom of it all
We fear our own mortality.

Fibril_late; 12/95

Who would think 12 years ago, that we'd now be viewing a television reality-show, covering the life and slices of a young, rich, Beverly Hills Plastic surgeon (and all the customized men and women plopping down the big bux for a new shape or look)?!?

My Belly Button

I am currently recovering;
I had my belly-button moved,
I never liked the way
It puckered and it grooved,
I began to think about
The way my ears are tweaked,
And how I hate my natural nose
Because it's sort of beaked.

I called the Plastic Surgeon
And he offered me a deal,
So the next time that you see me
I'll have some sex appeal;
Isn't it great, we have the chance
To change the way we appear,
Because life would be so boring
If we looked the same each year.

Fibril_late; 12/95

Probably once a year, there would be a family so dysfunctional, screwed up, and angry, they would literally be fighting over the estate of the poor fellow who was at the precipice of his journey into the afterlife. It was so disheartening to see such consummate selfishness at play. Thus begat,

The Family

A dying patient's family, can
Do more harm than good, I assure you man,
While contesting the contents of his will
They're hovering closer for the kill,
They may be harboring hidden guilt
About the time the milk was spilt,
Then clutch at every thread of life
And claim it's for his loving wife,
When life support, becomes death denial
He feel like he's been put on trial,
He wonders what his crime must be -
The poor fool had a family!

Fibril_late; 12/95

Another trip to the Dentist. Everybody got excited when they thought I was having angina; me, I was awakened out of a reverie, dreaming about the dental assistant.

Mondo Pick

I gazed upon, your lithe and limber
While the novacaine was spreading,
Under your hypnotic gaze
I almost started shedding.

Your ever smiling sidekick
With her subtle perfumed pose,
Calibrated instruments
While I began to doze.

Is a I dreamed a tale of triplicate
My arm began to ache,
I wondered, "Is it Memorex"
Or is this feeling fake,
The dental crew began to play
A game of different rules,
They checked my mouth for hardware
Or any missing tools,
Perhaps a stainless Mondo pick
Was lodged behind a filling,
The office girls placed wagers
While I tossed in a shilling.

It all worked out, without a glitch
My Dentist has it down,
She liberated my decay
And left me with a crown.

Fibril_late;
12/95

Whoa; I lost a whole week in illness. Felt like I picked up one of those virulent strains and deposited it into my lungs, to see how tough I was. Not tough enough!

So, back to the chronicles of the underside. Here is a tale about a coworker making the transition, following a promotion to a position of higher authority. Kings are not made in a day.

A New Title

You once were a friend
A comrade at work,
You earned a promotion
And now you're a jerk,
Afraid to lost control
Of your acquired dominion,
A perfectionist at heart
You don't want an opinion.

We continue to be equals
No, you're not our God,
Your power of office
Is just a façade,
A couple more initials
Written after your name,
You have to read the rules
If you want to play the game.

Rule number one, is
"Little has changed",
You get a new title
Yes, that was arranged,
You henceforth are known as
An Assistant Head Nurse,
It's up to you to make it
A blessing or a curse.

Rule number two, is
"Remember your roots",
Your fellow staff-nurses
Are not the dust off your boots,
We're equals, remember
On whom you depend,
Treat us like dirt
And that will soon end.

Rule number three, is
"Be a student of history",
To become a great leader
Is no longer a mystery,
Practice fairness and respect
You will earn it in return,
Or be a control freak
And watch it all burn.

Fibril_late; 10/95

"Active Listening", I'm sure you've heard about that much-hyped tool of communication. It goes something like this. Bob: I hate my dog. Mary: I hear you say, you hate your dog. At this point Bob wonders, what is the matter with this woman; does she need her head examined?
Well anyway, I probably simplified this complex mechanism of truth seeking, but it's right up there on my list of the Top 10 worst ways to carry on a real conversation. As soon as I hear a person speaking like that, I automatically tune them out.

As a matter of note, I also clump this into the list of useless Nursing tricks, along with Care Plans with their "special" nursing language. Doctor Dude writes, SOB, or short of breath. Nurse Clump has to write, "Impaired Gas Exchange". Take it from me, if you stand downwind of Nurse Clump, you will clearly discover there is no impairment in her gas exchange, and quite frankly you will be S.O.B. too. I suspect most of these Useless Nursing Tricks are devised by underpaid Nurse Researchers. More on this another day, ok?

Back to the main topic of Active Listening:

The Wilderness of Speech

Active listening, is one of those things
That is destroying this life, as we know it,
Repeating the works that the other one said
Prompts me to tell them to "stow it",
It doesn't feel right to me, I will admit
It isn't a part of my vernacular,
And I have a suspicion that the active adepts
Undoubtedly feel quite oracular.

It's touted quite often, by communication experts
As a fabulous, simplified tool,
But who has the guts, to agree with me here
Just who are they trying to fool?
It sounds too damned phony, I'm not put at ease
By the smooth talking, active practitioner,
I'm a small voice of protest
In the wilderness of speech,
Wondering who is the language commissioner?

Fibril_late; 10/95

Here is an oddball rhyme that I didn't write. A colleague comments about their aged, female poodle and her stinky habits. Actually, if you will read a couple of days back, this certainly falls into line with the topic of Nursing Research.

"Case Study: Canine Sexual Deprivation Resulting in a Perverse Desire to Consume Bananas and the Effects on Owners of Said Dog":

You know the virgin sturgeon
The Virgin Mary too,
Now may I introduce to you
The virgin Suki-poo?

Some have expensive toys
Or discount fantasy,
But Suki states (naively)
"Bananas are for me".

Bananas have a friendly
Compliant sort of way,
They're always firm and ready
For Suk's indulgent day.

With teeth now old, but eager
She masticates the pulp,
It forms a little bolus
She swallows in a gulp.

But gone is not forgotten
The fruit did not depart,
At six o'clock that evening
It comes back as a fart.

This precious Virgin doggie
Groomed, trimmed, and spayed, so fair,
Enjoys her sweet revenge
As she permeates the air.

And so, ye doggie owners
Take warning from this tale,
Leave those ovaries intact
And get yourself a male.

K.B., RN
10/95

It's totally gross! Don't read it if you just had a meal. Wait, hold on; if you're a nurse, of course you can stomach it, because you've seen something just like it - maybe only 5 minutes ago. No doubt you were momentarily taken by surprise, until you realized it was only..................

Activated Goo Blobs

Genital yeast farm
As a gross-out, it’s top notch,
Crawling in the linen
Growing in the crotch.

Activated goo blobs
Multiplying every hour,
When your shift is over
Be sure to take a shower.

Proceed at your own risk
When you travel in the area,
Wear protective clothing
It’s a lot worse than malaria.

Dark forces are at work
And the humidity is prime,
In our antibiotic wasteland
You can grow some killer slime.

Resistant cream cheese exudate
Its quality can’t be beat,
With genetic engineering
It might be good enough to eat.

Fibril_late; 9/95

Another episode of the cost-cutting days of the gay-nineties.
However, it's still pertinent today. Just keep your eye on the topics of research and no matter what, you will see a plethora of dubious ideas, wasting countless hours and dollars. One of my favorites was the study regarding the variation in counting a radial pulse rate. Did you begin at "0" or "1" with your counting? Let's see now, did you end up with 100 or 105 and what did the next nurse do 8 hours from now? Now me for example, I always started at "1"; who knows, maybe countless lives were lost because of my carelessness?!?

Nursing Intensity

The intensity of some nurses
To be a part of research history,
For complexity, severity
And the psycho-social mystery,
Emblazoned with multiple credentials
Exalted with power, with purity,
Producing results, without question
That threatens their own job security.

The unacceptable growth-rate of health-care
Has little to do folks, with nursing,
It's more about top end mismanagement
And the deep pocket ways of reimbursing,
The financial investments of technology
Far outspend the paltry cost of our salaries,
But as the single greatest body of workers
We're the targets for their shooting galleries.

Yes, I am a skeptical nurse
And I question the work of our scholars,
Is it money well spent in the long run
A well invested use of our dollars?
How many nurses will be out of a job
At the mercy of staffing acuity,
While top management back slapping big boys
Will applaud their cost cutting ingenuity.

Fibril_late; 9/95

Here's a jolly reminder why smoking is such an appealing habit.

Things To Look Forward To

Things to look forward to
After years of smoking,
Sputum in the morning
And midnight choking,
Nicotine stains
On your teeth and fingers,
Wherever you've been
A scent of smoke lingers,
Ashes in the toilet bowl
Burn marks on the tables,
Are guaranteed signs
Of the nicotine fables.

Premature aging
Self-inflicted disease,
You can't climb the stairs
Because you rattle and wheeze,
Bronchitis and asthma
And C.O.P.D.,
Retire on oxygen
At age sixty-three.

Set fire to your lungs
Day in and day out,
Make plans for pneumonia
Every year a new bout,
Smoke when you're pregnant
Have a low birth weight kid,
When he's slower than the others
Deny that you did.

You'll taste like an ashtray
Each time that you pucker,
So you'll marry a guy
Who is a nicotine sucker,
Your non-smoking friends
Will leave subtle hints,
To bring along perfume
And a mouth washing rinse.

Pay higher insurance
More sick days each year,
Cancer and heart disease
Surprise!, they appear,
Like silent assassins
They attack without warning,
Remember it started
With a cough in the morning.

Things to look forward to
On the nicotine cruise,
You have nothing to gain
And too much to lose.

Fibril_late; 9/95

Whew, time for just a couple more ode's (or is that odors) to the tales of the toilet seat.

This Chamberpot

There is something about this chamberpot
The seat is neither cold nor hot,
It's comfortable and built for speed
With accessories for personal need.

I'm kind of jealous, I admit
This is a really fancy place to shit,
I'll leave a tip for my gratuity
And praise American ingenuity.

State of the Art

This toilet top is state of the art
It can accommodate the largest fart,
With its custom, elevated seat
And a bowl designed to take the heat,
The paper dispenser on my right
Is clearly art-deco and out of sight,
Across the room, that fancy urinal
Was written up in the Wall Street Journal,
I'm proud to work for such an employer
Who is obviously a bathroom enjoyer!

Fibril_late; 7/95

You've probably seen those toilet seats that actually have two seats, right? Who came up with that idea? It always seemed kind of silly to me. Kind of like those booster seats at IHOP for the toddlers. I don't think you'll find those two-story lifters anywhere else, but in good old USA. So, two seats deserve two poems.

The Two Seated Concept

I've done my research
About this chair,
While sitting upon it
I noticed the air,
Was quite a bit fresher
At that elevation,
The two seated concept
Is some revelation.

I don't get the chance
To visit here much,
But I'll never forget
This toilet seat touch.

The Jacked Up Seat

I’ve wondered long
And pondered deep,
I’ve lost a lot
Of gash darned sleep,
Trying to solve
The mystery,
Of the jacked up seat
Where I must pee.

I’ve measured it
And found its weight,
The manufacturer
Place and date,
But it isn’t clearly
Understood,
Why a raised up toilet seat
Is good.

Fibril_late; 7/95

I'm pointing the finger of blame in many directions, against any of us, who choose the work setting as the place to make our cultural stand. What do I mean by this?

Here in the United States, English is the language of communication in the health-care arena. If you and your cohorts, think the office/clinic/hospital is the perfect setting for your special cultural clique, excluding those around you by speaking in your home language, I've got a hint for you; save it for the weekend parties at Uncle Festers house, ok?

Sure, cultural diversity helped you get the job; but the intent of the writ, is that people of many cultures can work together, and to do so, it helps that they speak in the common language, while they are together in their place of work.

Enough of explanations; I've got the NYC Blues!

NYC Blues

I know what you're thinking
Or I suspect that I might,
When you look at that title
You want to put up a fight,
And defend your dear village
But I beg you to wait,
It's about New York city
But the title is bait.

Someone told me a story
Based on rumor and hearsay,
Supplied hints of nepotism
Power struggles, unfair play,
Out in the corn patch
Of the furrowed nursing field,
It would be easy to discount
Until my conscience appealed.

Because I am a nurse
And I've been there too,
Amidst the culture of our kind
There are small minds in view,
Hanging out with their brethren
Speaking a language of their own,
An isolation foundation
Built stone by stone.

In position's of power
They will gather their forces,
While speaking in tongues
And crapping like horses,
Then you better know your brother
Or you'll step in their shit,
And the NYC gestapo
Will force you to quit.

Before I go further
I'll quit while I'm ahead,
Secret NYC agents
Just might want me dead,
And in the past 20 years
I've paid many dues,
But there's nothing quite like
The Not Your Culture Blues.

Fibril_late; 1/07

Toilet seats. What's up with the double seat, one on top of the other, concept? Why not just make one seat that is double thick? In 1995, I looked at this topic right up close, (what was I thinking, you ask); and I came up with some theories. Here's one of them now:

A Tale of Two Seats

Mystified, I am indeed
About this toilet seat,
While one is really common sense
Why two? - It's got me beat.

If it's just a simple case
Of elevated view,
How come bathrooms have no windows
Instead of one or two.

Well, maybe for the shy folks
It's O.K. to have one seat,
And the toilets with two lids
Are designed for friends to meet.

All in all, I'm still not sure
About this complex issue,
And I still can't figure where to put
The sanitary tissue.

Fibri_late; 8/95

Tensions can run high in the care-giving environment. Angry words spoken in the midst of a crisis, can lead to the destruction of friendships. All that is left is the aftermath.

In the Days of Aftermath

Just another casualty
In the days of aftermath,
Trumped up charges, petty crimes
Fear and loathing on the path.

Accusations, hurled in anger
Pressure cooker, tempers flashed,
In the name of jurisdiction
Camaraderie and friendships trashed.

We’re the actors, we’re the victims
Floating face-down in the bath,
Much too late for intervention
In the days of aftermath.

Fibril_late; 6/95

Nurses are hands-down, the masters of the universe, when it comes to dealing with feces. But, that's nothing to brag about, I think!

The Mystery of Life

Welcome to our special
Old fashioned kind of action,
Push up your shirtsleeves
It’s time for dis-impaction,
Bedrest is the burden
The damnation of immobility,
The loss of muscle tone
And G.I. motility.

Nurses far and wide
Despise this ugly task,
You have to get real close
And you need a scented mask,
After milk-o-magic citrate
And a dulcolax bullet,
You need to grope around inside
Find a knobby chunk and pull it.

The colon is lengthy
Sinuous and twisted,
How deep can you reach
When your gloved hand is fisted,
It may require some force
To open the tunnel,
So you may need a grease gun
And a fifty -french funnel.

I focus on the misery
Visited on our species,
The mystery of life
Once again is feces.

Fibril_late; 6/95

What happens when a business leaves a community, after 17 productive years. It's a problem situation with outcomes that stretch into the community as a whole.

Seventeen Years

Seventeen years of loyal service
Out the door with the morning trash,
Save some dollars, remove dissension
The local media, ignores the crash.

Seventeen years of community involvement
Pull up roots and move away,
Spread sheet columns of gains and losses
It’s just another corporate day.

Seventeen years, too much of a lifetime
To be thrown away like yesterday’s news,
Sowing the seeds of revolution
Corporate cutthroats will pay their dues.

Angry bombers and innocent victims
Society bears a burden of shame,
A friend of seventeen years is gone now
The community states, “We’re not to blame”.

Fibril_late; 6/95

More ranting about the days of "reorganization" and all that. The title is a nod to Neil Young ("Keep on Rockin' in the Free World).

Downsizing in the (not so) Free World

Everybody's worried about their job
Will I be working next week,
If I don't pay my child support
My ex-wife will moan and shriek,
She'll threaten me with a lawsuit
And garnish my wages with glee,
But if I don't have a job
She can moan for eternity.

My friends are worried about security
Their seniority is shorter than mine,
Going home with a clear conscience
Is really the bottom line,
If they are laid off and I am not
We'll share some mutual pain,
Downsizing shrapnel everywhere
Leaving its bloody stain.

Reorganization is an industry fantasy
Destroying its structural strength,
Cutting the competitive edge of discovery
When the budgets are pared at great length,
The money that was in our wallets yesterday
Still circulates inside the machine,
Lining the HMO's pockets
They get fat, while we become lean.

The pendulum slows in its arc
Preparing to reverse its direction,
After cutting a swath of destruction
It's time for a little inspection,
The unusual pattern of injury
Tells a tale of dishonesty and greed,
As the downsizing moguls of mayhem
Return again and again to feed.

A workforce is like a foundation
Supporting the structural frame,
You can take it apart a block at a time
But it's a Russian Roulette kind of game,
Understanding the risk of mortality
While betting the odds of survival,
Nonetheless shocked when the bullet
Makes its untimely arrival.

Everyone’s worried about living
In the cost cutting days of Our Lord,
Insurance companies becoming much richer
While there is little, that we can afford,
What recourse is there, for the little guy
Struggling at the end of the hook,
Maybe it’s time for a revolution
Rewrite the current chapter of this book.

Fibril_late; 6/95

I got to thinking that the hospital could be characterized as a specialty restaurant, where you could order just about anything you wanted. Thus was born, "Flo's Diner".

Flo’s Diner

Bring your family and friends
To sample our food,
An eclectic selection
Cooked by Chef Dude,
An expert on fish
His favorite is sturgeon,
He moonlights for money
As a Cardiac Surgeon,
He interviews customers
In his favorite recliner,
And gives them free drinks
Down at Flo’s Diner.

High fat or low fat
Whatever you wish,
Cholesterol entrees
With your favorite dish,
TPN slurpees
And Pulmocare punch,
Fantastic nutrition
For an affordable lunch,
You want it, we’ve got it
Just don’t be a whiner,
That’s the only restriction
Down at Flo’s Diner.

Stop at the jukebox
And drop in some change,
Our music selection
Covers a range,
From the Screaming Tourettes
To the Stokes-Adams Blasters,
The Korsakoff Kids
And the Menopause Masters,
No musical menu
Could ever be finer,
Than the soothing tones found
Down at Flo’s Diner.

Chef Dude is an artist
When it comes to dessert,
He knows human nature
And what makes us hurt,
For the sweetest delights
The man is an ace,
He has studied the ways
For stuffing your face,
A vociferous vocalist
He knows every one-liner,
You’ll have nothing but fun
Down here at Flo’s Diner.

Fibril_late; 5/95

About trying to kick the coffee habit, and the possible alternatives.

The Coffee Grip

I tried to kick
The coffee grip,
Because my heart
Began to skip,
Occasionally
I felt a pause,
Which made me wonder
About the cause.

Am I anxious
Should I worry,
Is my life, just
Too much hurry,
Is it age
Or lack of bravery,
After years of
Repressed slavery.

I talked it over
With my Doc,
I left his office
In a shock,
Because he offered
Fix-it schemes,
That echoed Doctor’s
Greatest dreams.

And then I couldn’t
Stay awake,
Each night at work
With lives at stake,
So, I embraced
The coffee bean,
Because all-in-all
It’s a healthier scheme.

Fibril_late; 5/95

It was the early mid-1990's here in our capitol city; almost every hospital in town was reorganizing into some kind of "it's the best way to save money", business model. Well, we all know what a total flop that was and the entire health-care industry is still reeling from the long-term complications of that debacle. Can you say "nursing shortage"? They left in droves, never to return; thanks to the Cost Cutting Days of Our Lord.


The Cost Cutting Days of Our Lord

Health-care downsizing?; you have to be kidding
That’s the typical political flash,
It’s a high stakes game of money, my friend
With the HMO’s grabbing the cash.

My unit was closed last week
I was angry because I wasn’t told,
I’d been a productive slave
Now suddenly I’ve been sold.

There is little threat of losing my job
I’ve been here forever and more,
They’ll redefine my job description
Then send me to some other floor.

With my accumulated years of seniority
I’ll displace someone else on the heap,
When that guy loses his job
I won’t be able to sleep.

The wages are frozen, positions unfilled
In contrast, the workload has soared,
Top CEO’s, whose salaries are doubling
In the cost cutting days of our Lord.

Fibril_late; 5/95

A true story that I wish could be played back. We could try different interventions, like maybe an Intra-aortic balloon pump. That was probably the only thing that would have helped. It's always wrenching to second-guess in the aftermath of disaster.

This Moment in Our Fame

Another San Onofre’ meltdown
Was headed for our floor,
A mystery diagnosis
Seven drips and so much more,
A scant report was taken
On the phone an hour past,
I was ready for disaster
But the time went by too fast.

A commotion could be heard
In the hallway by the door,
As I walked to meet the entourage
I tallied up the score,
The patient was attended
By a crew of EMT’s,
With a Doctor and a Lawyer
Haggling over fees.

A hundred different IV lines
Were tangled on the gurney,
I had to push aside the Doctor
And wrestle the Attorney,
To acquire my position
Of authority and leverage,
I tossed them both a dollar
To get some candy and a beverage.

With the patient safely settled
And his life support attached,
I did a brief accounting
To see if facts and figures matched,
Then I sent some bloody lab tests
To bring us up to date,
When we had gathered all the data
We could figure out his fate.

In the meantime I was struggling
With a metabolic mystery,
Profound acidosis
And a complicated history,
Respiratory failure
In cardiogenic shock,
There weren’t a lot of hours
Left upon his clock.

What a night, it seemed like days
But the morning finally came,
Was he better?; not at all
Though we’d fought a vigorous game,
We had stabilized his pressure
But his oxygen was worse,
In this metabolic setting
Could his heart rate be the curse?

In the future we’d look back
At this moment in our fame,
We’d search for untold answers
And try to shake the blame,
That the choice of intervention
In this case, to beta-block,
Was the icing on the cake
In fact, it stopped the clock.

His heart rate slowed, that was the plan
But the progression wouldn’t stop,
His pressure held on for a bit
But soon began to drop,
The Code-blue team performed on cue
But the fiber of life unraveled,
Before the survivors left the scene
His soul had long since traveled.

Another San Onofre’ meltdown
History written in a book,
We could read the notes in retrospect
To contemplate, to look,
Prepare to meet the future
A little wiser, that’s for sure,
In certain situations
Beta-blockers aren’t the cure.

Fibril_late; 5/94

Some nonsense about bleeding where I butcher all poetic syntax; and then a poignant tale of a little old lady with dementia, who should not have had open heart surgery.

Where It Spurts

Hemorrhagic shock, oh my
Too much leaks and then you die,
You have to find out where it spurts
And the mechanism of the hurts.

Compensatory means
Of life survival,
Forego thera-
peautic arrival,
Recognition
Is the key,
And that comes down
To you and me.

Mama, Mama, Mister

Mama, mama, mama
She chanted all night long,
It was just a long refrain
To the, “Mister, help me” song.

So confused, she had no clue
That her chest was sawed in half,
She said, “Mama, mama, mister, lord”
So much we had to laugh.

Her nights stretched into days
The days became a week,
Her mantra echoed in the halls
Our situation bleak,
Because we couldn’t send her home
In her current state of fitness,
The program might be threatened
If she was called to be a witness.

Now she’s parked out in the pasture
Because we didn’t have a choice,
If you’ll take the time to listen
You can hear her plaintive voice,
Chanting, “Mama, mama, mister, lord”
Come help me won’t you please,
Or it might be just a trick
Of the early morning breeze.

Fibril_late; 3/95