Every night, the craziness continues. The general public is clueless about what goes on in the hospital when the sun goes down.

Agents of Chaos

The unforeseen consequences

Of unraveling spirals,

I am telling you, it's more than

Bacterial virals,

When your patient gets up

And whirls like a dervish,

It's crazy, whacked out

And makes me totally nervish.

Kate was with me that morning

And so was Ms. B,

When way over yonder

In room 893,

Mr. Whatzit got up

Spun in circles and cables,

Wound up like a top

In old Aesop's Fables.

He killed 6, with one blow

He fired mortars, o'er the wall,

And our biggest concern

Was that he would fall,

Because his left-arm was missing

And his right-brain was bonkers,

And I'd heard some big lawyer

Was driving up from New Yonkers.

The worst of our fears

Like whirling twisters,

Bosses from the big house

Were developing blisters,

From the tickets they'd written

Regarding the fouls of this case,

What a collective embarrassment

On dear, sisters' face.

Our careers were on the line

Our licenses in peril,

This whirling dervish

Had us over a barrel,

And collectively we three

Had over a hundred years knowing,

Cyclonic phenomenon

Like an ill wind, were blowing.

We gathered our thoughts

And pondered each option,

We knew if we failed

We'd be up for adoption,

Three orphans of nursing

Tossed out with the trash,

When suddenly, Kate

Had a powerful flash,

Of woman's intuition and

Her Feng Shui power,

She said, this agent of chaos

Needs a bath or a shower.

Ms. B gathered towels

While I warmed the water,

We all prayed to Gaea

And Chaos, her daughter,

To reveal to us the means

To find peace amidst fury,

Then we soaped up our washcloths

And bathed in a hurry.

The spirals unraveled

The twisters tore down,

The cyclones collapsed

Into fairy-tale town,

While the bystanders cheered

And authorities arrived,

Ms. B, Kate and I

Why we, just high-fived!

Heroes of Nursing

They called us, that day,

Be we all knew better

With a smirk, as if to say,

Our backs will be stabbed

Before the sun goes down,

Because heroes are orphans

In fairy-tale town.

Fibril_late;

5/26/08

HOH - Hard of Hearing. We've all been there with the individual who can't hear a pin drop, let alone an H-bomb drop. But, what if it was you?

Cousin Vinnie

I haven't heard a thing in 34 years
Everyone is giving me lip,
Yelling at me like I'm a crazy person
I tell them to just get a grip,
Because what is the point of the yelling
It's obvious I'm as deaf as an adder,
In a way, it's all kind of humorous
To watch them get madder and madder.

Of course, some of the time I get irritated
Some people are dumber than dirt,
It appears that they think that a deaf person
Has lost the capacity to hurt,
They don't think that I know what they're saying
With their wise-cracks, as they exit the room,
Little do they know, my cousin Vinnie
Will blow up their car, Ba-da-boom!

Fibril_late;
5/24/08

Sometimes talk is cheap and other times it's dangerous, because it may delay treatment. "Nuff" said.

Wizards of the Badlands

Can you tell what's real

Do you know what's not,

Can you determine from 50 yards

If it's sputum or snot?

Does an elevated CO2

Of one-twenty-five,

Give you any indication

About the odds, if he's alive?

Well, maybe for a while

But I wouldn't place any bets,

I think it's time to call your markers

And pay off any debts,

Because arguments at this time

Are pointless and invalidated,

Just get the flippin' ventilator

Before you're excommunicated.

Now don't take this personal

We're all hired hands,

It's just that some of us call the shots

While other's holler from the stands,

With an opinion here and there

About what ought-to-be,

And at this very moment

You should be listening to me,

Because this dude is going south

He needs an endotracheal tube,

Please don't stand there arguing

Like some existential rube,

Quoting laboratory data

And his history of CO2,

We're the wizards of the badlands

And we know much more than you.

We don't want to code this sucker

We don't want a Rapid Response,

We don't want to toast his remains

With a sterling-silver sconce,

No, all we want to do

Is the best right thing, right now,

And that my friend, is to intubate

Before I have a cow!

Fibril_late;

5/23/08

Perhaps you've seen the weekend news regarding the West Virginia woman who had a cardiac arrest, brain-dead EEG, rigor mortis setting in, and had been slated for donor status, when she abruptly came back to life, and has been found to have absolutely nothing wrong with her heart!

Here's the link:
http://www.newsnet5.com/health/16363548/detail.html

This prompted me, to once again write about the miraculous events, that some of us have been participants in or witnesses to:

The Miracle Flavor

Miracles happen

Oh, yes they do indeed,

It has nothing to do with religion

Or the basis of your creed,

It has to do with the unbelievable

Beyond any science we know,

But in the presence of our sophistication

The most scientific mind will grow;

Knowing miracles truly can happen

I'm not talking about blind faith or dreams -

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

When the dead come to life

Beyond the limits of survival,

And there is proof beyond truth

Without electrical revival,

Too many witnesses

To possibly discount,

Not one of them cares

About the Sermon on the Mount,

No one of them talking

About the power of prayer,

Not a single one thing

About the power up there,

Those pragmatic, no nonsense

Scientific minds,

Totally surprised

With the results of their finds,

Everyone of them halting

In wonder, amazed,

Whispering to each other

Quite totally dazed,

Holding precious, this moment

In their own way, to savor,

Finally knowing they've tasted

The miracle flavor.

Fibril_late;

5/23/08

Go figure! We admit a DNR and then she died in about 4 hours. Now, that was one heck of a waste of resources, I'm telling you. So I think we need to revisit the whole DNR thing.

Too Damn Late

DNR by definition
Means, Do Not Resuscitate,
You don't belong in the ICU
Because it's too damn late,
You shouldn't be admitted
In the notorious 11th hour,
We don't do resurrections -
We don't have the power.

DNR, should mean
Do not re-locate,
A sudden change of scenery
Has no effect on your fate,
And though the nurses look like models
From the pages of the New York Times,
DNR, is just abbreviated nonsense
That fits into this funeral rhyme.

Fibril_late;
5/23/08

I'd been looking for the Underside of Nursing, 1998 archive, and at last I realize I found it! Just a few entries that year, and quite a few are funny. This one must have been inspired by some news report of a Surgery gone awry. One of those instances, where the wrong body part is removed.

Speechless

Doctor, dear doctor
I thank you
That medicine sure did the trick,
The minor complaints I was suffering
Are gone, because now I am sick,
The pill that you gave for my tremors
A side effect from some other med,
Has been making my heart so irregular
Tomorrow, I just might be dead.

Doctor, dear doctor
I’m speechless
It shouldn’t have happened this way,
You cut out my tongue and my larynx
And replaced them with paper mache’,
I have a buzzer
Where I once had a voice-box
I pour dinner
Through a tube in my gut,
When all I needed
Was a simple excision,
To take out a mole on my butt.

Fibril_late;
1/98

Back when I worked at the "Big House" (name hidden to protect the innocent), it was a place that encompassed Medical doctor training. Working in the ICU's, a nurse had to stand by, when those trainees, were doing all sorts of line-placements. Some of those blokes, didn't remember landmarks of anatomy very well. For example, when searching for the femoral artery, one is supposed to remember the following mnemonic: Nerve, artery, vein.
This poem describes my frustration, watching an untrained operator, poking around in the groin area, of some unfortunate male subject.

Back to School

Nerve, artery, vein, uh-oh
Be careful where you poke,
Your next testiculectomy
Won't understand the joke.

Nerve, artery, vein, oh darn
You missed again, you fool,
One more try and if you fail
You're going back to school.

Nerve, artery, vein, oh well
You missed it by a mile,
You'll be a great success at Burger Boy
With your attitude and smile.

Fibril_late;
1/98

10 Years ago, I wrote this one about suicide. And I think it was in regards to the one who suffers first, relentless pain, and then this leads to a severe depression.

The End of All Dreams

The future has ended
Tomorrow is past,
The end of all dreams
Happens way too fast.

It's the uncommon denominator
Of depression and pain,
When the cleanup is over
There is hardly a stain.

What do they think?
The family, the friend,
When the one that they loved
Orchestrated the end,
With a bullet or poison
Or exhaust-pipe inhaled,
They'll spend the rest of their lives
Wondering how they had failed.

Have you ever been a bystander
Reviewing the remains,
After Jo-Jo, the party guy
Blew out his brains,
You think over and over
If only I knew,
But you can't buy enough
Of miracle glue.

Fibril_late;
1/98

Working night-shift, some nurses depend on caffeine to help them through the night. One night there were complaints, regarding the making of coffee, and the possible absence of caffeine.

Coffee Rapture

It was a coffee calamity

Of epic proportion,

Where I promised caffeine

But gave a decaf distortion.

Humor was absent

And tempers were hot,

I felt there was a chance

That I might get shot,

With a bolus of potassium

In my right cheek,

Don't mess with a woman

On her PMS peak.

It was a caffeine debacle

I made a mistake,

It was steamy and hot

But the coffee was fake,

'Twasn't Starbucks or Peets

Or even Java City,

The abuse I was rendered

I can tell you, wasn't pretty.

My rep, to that point

Was looking pretty good,

I'd saved a few lives

In my new neighborhood,

But in 7 minutes time

It all went down the drain,

Believe me when I tell you

That Nurses know pain.

Well, I got on my knees

In the eye of my mind,

I pondered deep and hard

For a solution to my bind,

To vanquish my transgression,

In the eyes of my peers,

After all, I had planned

To work a few years.

I'd bribe them with food

And bargain days off,

I'd take all the patients

That spit, puke and cough,

The multi-organ failures

On week thirty-three,

If only they would forget about -

That night..................caffeine-free.

Some committee is reviewing

My position at this joint,

Wiser heads, than those I work with

Have a task-force to anoint,

So they can banter back and forth

Like a political machine,

Recommendations to our boss

A referendum for caffeine.

Policies and Procedures

Are like the Constitution,

When the word becomes law

It's time to stop the retribution,

And just forget the whole story

Behind my reputation capture,

Knowing some night very soon

We'll experience caffeine rapture.

Fibril_late

5/18/08

This 3-word line popped into my head; so I ran with it.

Tall as Wide

It's a very bad thing
If you're tall as wide,
It's not one of those things
You can easily hide,
And you just might think
That you're on the ball,
But to everyone else
You're just rolling down the hall.

I can't say that I know
What to do about this condition,
But one thing's for certain
It's not a dietary omission,
Though it might possibly reflect
On some lifestyle choices,
Some of us drive Yugo's
And others Rolls-Royces.

What I possibly allude to
Is the dichotomy of this age,
When all things regarding good
Can be read upon a page,
And advertised on TV
The radio and wireless,
Perhaps the populace is inured
Because advertising is tireless.

Because it's hard to believe
That you can't control your weight,
Although certainly there are disorders
And diseases of the state,
Of the homeostasis of your
Body and your mind,
That are beyond lifestyle choices
And all the fun you can find.

When you are as tall as you are wide
Presents problems you must endure,
If preventable, we'd be happy
Because we all love a cure.

Fibril_late;

5/17/08

A family of trolls, they were. You had to be there, but I wouldn't advise it.

Still Doing Dope

72 years old
And still doing dope,
Maybe she needs more length
In her self-hanging rope,
But then I saw her kids
And saw what-is-to-be,
I'd like to give them all ropes
Guaranteed and free.

Now, I know that's not cozy
I'm a nurse, after all,
All lives are redeemable
There's a tide before the fall,
But I don't have time
In critical-care,
To sling hopeful platitudes
While they are gasping for air.

I met four offspring
And they were short in the tooth,
I guess they traded them in
At the methamphetamine booth,
And they swagger through life
Just like Momma-dearest,
In a family contest
They were the queerest!

Fibril_late;

5/14/08

(Part II)

All In the Family


The 8th decade of life
Could be one of reflection,
But in your case, you're still fighting
A ravaging infection,
Brought on by stupid choices
And tired excuses,
Ill-devised foolishness
And substance abuses.

Having met your progeny
Perhaps you're attempting to escape,
Collectively I was impressed
By their sorry-assed shape,
And you know that the apple
Doesn't fall far from the tree,
A whole family abusing drugs
Is the way it looks to me.

I was creeped-out for sure
When your number one daughter,
Made a beeline for me
With her eyes full of slaughter,
Demanding I call the Doctor
About methadone for Momma,
I figured she was a dead-ringer
For the wife of Osama.

I called Central Services
For pepper-spray and mace,
While she pulled out a Taser
And aimed it at my face;
I drew down on her with a scalpel
And dove under my chair,
Remembering "duck and cover"
While gasping for air.

She fired that Taser
And it hit Betty Lou,
There wasn't a damn thing
That anyone could do,
As Betty hit the floor
With a resounding thump,
That daughter was reloading
When I got the jump,
And I knocked her on the head
With the PDR,
While silently praying
I hadn't gone too far,
Such that I might get sued
By the family from hell,
But all she got was a bump
And man, did it swell.

Now she swung up that Taser
For shot number two,
While screaming, “Dear Momma
I do it for you”,
And in the midst of her soliloquy
I grabbed the defibrillator,
Zapped her at 360, saying
“Sayonara, see you later”.

It was a terrific free-for-all
That night in CCU,
Did you hear, that we're hiring
We're looking for you,
Fringe benefits are awesome
Martial Arts are a plus,
Just don't read the fine print
When you jump on our bus.

Fibril_late;
5/16/08

Here is a topic that never grows old; the incredibly sloppy handwriting of Doctors. Quite frankly, if you were to read my sloppy script, you might be of the same opinion. Maybe the greatest upcoming news, is that the health-care system is attempting to convert to computer charting, ordering, note-taking and so on: the Electronic Medical Record. So, it's probably my last chance to rail about it.

Your Writing

We've endured 25 years
Of your ineligible writing,
Frequent arguments
And frequent fighting,
Taxing your patience
Taxing mine,
Suits of malpractice
With threats of a fine.

You claim that your writing
Is easily understood,
But maybe you learned to write
In your old neighborhood,
Spray painting graffiti
On back alley walls,
Darkened parking structures
Behind shopping malls,
Gang rants and ravings
Bravado in paint,
Long before Med-school
And your status as saint.

Your beginnings are well hidden
Amidst your professional scrawl,
Hidden by your plaques and diplomas
On your office wall,
But for those of us who must decipher
Your scribbled orders and notes,
If this was a handwriting competition
You wouldn't get any votes.

Fibril_late;
5/12/08

Finally the end.........of the latest fugue* of writing.

Rhyming as Remedy

'Twas a high-output weekend
Of poetry and pain,
This rhyming as remedy
Is a panacea to my brain,
And the fictitious characters
Though realistic in their pose,
Are but whims of imagination
Unrelated to those,
In the narrow proximity
Of the proposed field of action,
All the truths I tell, are lies;
Should shield me from retraction.

Fibril_late;
5/11/08

*Fugue: A dream-like state of altered consciousness.

The truth, is sometimes, long in the tooth.

Surrounded By Girth

I lost my hand
In Billy-Bob's belly,
During an application
Of Nystatin jelly,
His pannus was huge
A multi-fold monstrosity,
I tried to escape
But it slowed my velocity,
When entropy ensued
And I was trapped in the fold,
My life passed ‘fore my eyes
Was I getting too old?
To partake in these shenanigans
Also known as, nursing care,
I’m fifty-five and puny
Compared to those who pay the fare.

My elbow disappeared
In Billy-Bob’s fold,
It was a scary situation
While I was hunting for mold,
And that’s one of those conditions
Of nightmarish ideation,
A multi-cellular symbiosis
Like the dawn of creation,
What would I be like
If I survived the ordeal,
Reduced to protoplasm
Or look like a wheal,
Of antagonized tissue
At the scene of the crime;
Mold is slippery stuff
It’s intelligent slime.

Buried to my shoulders
In Billy-Bob’s bowels,
The odor was horrific
And I was gasping for vowels,
To express my consternation
In my time of greatest need,
Looking back in retrospect
I prefer it when they bleed,
Because I can fix it with a bag
From a universal donor,
But now I’ve been reduced
To an air-gasping moaner,
With barely enough strength
To call out for a mate,
I’m left pondering my demise
Should I reincarnate?

We’re surrounded by girth
It’s a scary situation,
An elephantiasis epidemic?
Or obesity maturation,
You can’t tell from the surface
Though it’s a menace for sure,
But the ultimate question -
How will Nurses endure?

Fibril_late;
5/11/08

There is a "story teller" wherever one works, isn't that right?

Drama Queen

She's a drama queen
There is no doubt,
She'll use every opportunity
To shake and shout,
Like she's on a mission
Of pain and glory,
If you stick around
And bear witness to her story.

She's a drama queen
And if she spots a crowd,
She'll go from quiet thoughts
To being very loud,
Her lack of respect
Is boorish and operatic,
While her demand for attention
Is so friggin' dramatic!

She's a drama-queen

I tell you no lie,

New episodes will be written

Until the day she dies,

Every waking moment

She's like a target, waiting

A ready recipient

For drama-mating.

She's a drama queen
I'm telling you,
She has a distorted
Point of view,
As if the world revolves
Around her little old self,
Without attention
She'd rot on a shelf.

Fibril_late;
5/11/08

Here is quicky about personalities at work.

Personalities

Personalities at work
Are so diverse,
Sometimes it's a blessing
At other times a curse.

Fibril_late;
5/11/08

This is one of those universal statements, that describes a type of person who is always found in large, megalithic organizations. I'm sure you'll recognize the character.

Personality Deficit Syndrome

Personality Deficit Syndrome
Runs rampant in this joint,
Every time someone retires
There's a new one to anoint,
The candidates are racing forward
Aimed at the Administrators door,
Filling out forms in triplicate
Just praying, they'll be the one to score.

There must be a certain kind of engineering
Is it culture, genetics or what?
Some type of specialized grooming
To become, a pain in the butt,
Devoid of a qualifying personality
Lacking interpersonal skills,
If I'm around a person like this, too long
I come down with a case of the chills.

Personality Deficit Syndrome
Is dangerous, of that I am sure,
Despite decades and piles of research
There's no evidence of a successful cure,
And so, the candidates keep rolling in
Lacking any notable capabilities,
And the official stance of our management?
Who cares, you can't deny their servility!

Fibril_late;
5/11/08

There has been an excess of girth in our neck of the woods lately, with the end result being this pathetic stab at humor.

From Dearth to Girth

From breath to death
And from dearth to girth,
It's all strain and pain
From birth unto earth.

So;
Is there any correlation
Connection or mate,
To the auspicious signs
A birth-plan or fate?

Lo;
Life is a passage
A journey, a fjord,
Live a long arduous life
And fall on thy sword.

Fibril_late:
5/10/08

There are circumstances where (if I had the power) I would occasionally bestow honorary sainthood upon one of my coworkers, for deeds done, way beyond the call of duty.

Beatified

Beatified, dear Betty should be
After cleaning vomit, poop and pee,
And before the lights went down
And she'd raised the rails,
She washed the hair, and teeth and nails.

Her advice to me, and I'll heed it well
Patient's do better, when they have a good smell,
And pad the bed; why, that's her creed
Because patient's will vomit, poop and bleed.

Fibril_late;
5/10/08

Death.
I speak for myself, but perhaps others have similar impressions. Working in a critical care setting for 25 years now, I've witnessed hundreds of deaths / passings. These experiences are influenced by the persons / families associated with that patient who is dying. At the same time, our perceptions are influenced by who we are and what members of the staff, are also sharing in that death experience. It can become very disruptive and disconcerting, or it can be a time of peace and healing. It may be tragic or revelatory, horrific or ordinary. But as long as we remain human and compassionate, each death will be unique and worthy of respect.

See the Angels

"If only we could see the angels taking her away"
I heard those very words, when I was present the other day,
When that good woman died, at the end of her shortened life
She'd been a loving mother, she'd been a wonderful wife.

I can't say that I knew her
We had the briefest of introductions,
I can say that I cared for her
Because those were my instructions,
And during those few hours of care
Her spirit, I came to know,
Such that I can tell you truthfully
I felt her spirit go.

If only we could see the angels
Taking her away,
I didn't see them, but they were present
When she departed yesterday.

Fibril_late;
5/7/08

I posted this about 2 years ago, but thought I would display it one more time, because this is an important workplace topic that is being talked about in my local environ. Here is the whole piece:

For 15 years, I was a member of a bargaining unit, a union, and Nursing hammered out an agreement every few revolutions around the sun. We earned 1 sick day a month, had 3 weeks of vacation, holidays, education days, and who knows what else. But there was an undeclared and secret rule; "don't use your sick days too much". You would be shocked to see how many sick hospital personnel, go to work, because they are afraid of "calling in sick", because this might garner a reprimand, that would go into their personnel file. Talk about a freakin' walking, talking, fomite under power!

A Bitter Pill

A reprimand
If you are ill,
Is what I call
A bitter pill,
Though I know the system
Gets abused;
When reprimanded
I feel used.

I know my Nursing
Contract states,
That I'm allotted
Sickness dates,
To use at my
Mature discretion,
Without requiring
An employee confession.

So please don't try
To threaten me,
With some secret
Unit policy,
Nor threaten my yearly
Pay raise portion,
Or I will charge you
With extortion.

Fibril_late; 5/94

Here are two poems from my 2001 Archive.

Nurse

Your Excellence
Your Compassion
And your Soul,
Enhance the healing
That is imbued
Within your role,
To reach out
To offer comfort
To another,
Maybe an enemy
A neighbor
Or a brother.

Like a magnet
You have invisible power,
This path of healing
Is a beautiful flower;
With the water of compassion
And the sunlight of your care,
No words can describe
The divinity that you share.

Will you heal all the people that you treat?
It's not your role to accomplish such a feat,
Like an ocean with a shore upon each side
The continuum of life is deep and wide.

Fibril_late;
7/13/01

Ode to the Recoverers

They stand beyond the Surgeons gate
Dressed in sheens of life,
Waiting to receive the Sacred ones
Who touched the Surgeons' knife.

Masters of assessment
They're always poised for action,
Amidst chaos and disorder
They exhibit no distraction.

Every little vital sign
Is examined for perfection,
Should one deviate the slightest
They will seek the best correction,
To stabilize your system
To the nth of nth degree,
The Recoverers will protect you
It's their duty bound decree.

Suffice to say, a surgery
Like a minefield, has its dangers,
And when you rouse to wakefulness
You don't want to deal with strangers,
The Recoverers will care for you
Like a member of their clan,
They're agents of goodwill and hope
Because that's their master plan.

What purpose is their calling
What caused them to enroll,
What secrets do they harbor
In the depths of mind and soul,
The answer to these questions
Is never understood,
A thousand words can not define
The blessed and the good.

Fibril_late;
1/01

It's about neatness...................

Tangled-String Theory

We talked about this
Just last night,
How some people are neatniks
And are willing to fight,
About the necessity of order
And the fixed way of things,
While others like myself
Give disorder a fling.

It would be totally untrue
To call me a slob,
But a passion for neatness
Isn't a part of my job,
I just can't get fanatical
About the placement of the linen,
I place vital signs and viability
At the end and the beginnin'.

I admit to being totally frenzied
When the lines are all twisted and coiled,
In a moment, I nearly lose all control
As if my brain and my blood have been boiled,
And according to tangled-string theory
This phenomenon cannot be prevented,
Like a contortionist freebasing adrenaline
Within minutes, I am totally demented.

Suffice to say, in the above scenario
The neatness of my lines, holds no rival,
I say, screw all the linen and the plastic essentials
I know the secret to my survival,
And if I know where the essential cables and IV's
Are attached to the patient and pumps,
I can pretty much guarantee, that after 12 hours
My patient won't be in the dumps.

Every nurse has their particulars
And our priorities, don't necessarily match,
I've seen so many patients die, during a bath
The group qualifies as a classified batch,
And if you're rustling around, with your mind on the neatness
Of the furniture, room and possessions,
You might overlook some physiological disaster
While attending to your neatness obsessions.

Fibril_late;
5/4/08

Today, 12 hours post night shift, my brain-waves are flipping and flopping. The following poem is about duality.

Flip-Flop

There's a flip side to everything
And here's the flip,
No matter where your journey leads
It's still a crazy trip.

There's a flap side to everything
And here's the flap,
What flies through the air
Just might land in your lap,
When it gets in the air
It has a tendency to hover,
And should that stuff hit the fan
You better duck and cover.

There's a flop side to everything
And here's the flop,
You can sow some good seeds
And still get a bad crop,
You can cut out the deadwood
To eradicate the weevil,
But still, the best intentions
May turn out to be evil.

The best laid plans of
Big mice and little men,
Are often torn asunder
By the power of the pen,
And while the downside type of person
Will tell you, what they should have had,
Each experience will be tainted
When all they see is bad.

So the flip side to me
Might be the flop side to you,
It's just a matter of perspective
A singular point of view,
And there is a flip side to everything
But to me, it's all the same,
The experience is the reward
It's a unique kind of game.

Fibril_late; 5/1/08

Superstitions? Do they have a valid place in the work-setting? Perhaps not, but they are practiced all over the world, even here in the enlightened USA.

Superstitious

Superstitious practices
Of educated folks,
To the level-headed pragmatist
It seems to be a joke.

But the degree of education
Can't be factored in the mix,
When modern medicine itself
Looks like a bag of magic tricks.

Nurses of the ICU
Are superstitious creatures,
We're trained to look for omens
And other sickly features,
That might portend a menacing
Or evil lurking force,
Like that creature of Mr. Websters
The headless man and horse.

When we get a special feeling
That death is prowling near,
We don't cringe or shake and shudder
Nor show a bit of fear,
But we'll roll the mighty crash cart
To the threshold of their room,
An invisible shield of power
Dispelling any doom.

Another nurse prepares
An empty room this way,
She freshens up the linens
All equipment is OK,
With a flourish of her wand
She casts a spell both left and right,
Protecting her from admits
All throughout the night.

A thousand different nurses
Have a manifold of ways,
Some work best in the middle of night
And others during days,
Thus with superstitious practices
Of an educated crew,
Our workplace is safe and guarded
It's the prognostic thing to do.

Fibril_late;
4/30/08

A flight of ideas, clumped together, wandering around like atrial fibrillation.

Exhaustion and Fatigue

I pretend that I’ll write
After work, so inspired,
But more often than not
I am just, grossly tired,
Overly fatigued
From the labors of thinking,
Junk food snacking
And coffee drinking,
Weight-lifting patients
Who didn’t diet, last year,
Decubitus ulcers
Draining gallons of beer,
Or something quite similar
I kid you, not,
It smells like it’s fermented
And has the thickness of snot.

What clients like these
Are doing at our station,
We can’t figure out
It’s an abomination,
We’re a Cardiac Unit
It’s supposed to be clean,
But the hospital has become
An infection machine,
Where any Tom, Bill or Mary
With a debilitating disease,
Will squander our resources
Can you say, “Medicare, please?”

Now, the specialist doctors
And in-house boss leaders,
Looked hard at statistics
And the money-loss bleeders,
They initiated a recommended
Model of care,
An around-the-clock doctor
Is the latest fresh air,
To attack any problem
Or intervene in a crisis,
They will drown it with knowledge
And life-saving devices,
And the specialist doctors
Can be home with the wife,
Finally having a chance
To live a doctor-normal life.

Now, this 24-hour physician
Is the latest twist,
They have a catchy kind of name
Hospital-ist,
And they seem kind of young
Like they recently jumped ship,
They have their hand-held computers
And their language is hip,
They say, “no problem” and “what‘s up”
When they’re paged at oh-four-hundred,
Often reluctant to make decisions
And be accused that they blundered,
In the middle of the night
With a patient they didn’t know,
So, it’s business as usual
In this medical picture show.

Once again, I have rambled
“Like, what was the point?”
You are probably thinking
I was smoking a joint,
But it all had to do
With exhaustion and fatigue,
This ain’t the sandbox, boy
“Like, it’s totally, major league”.

Fibril_late;
4/28/08

Countless times I have seen the individual patient who had clearly stated and defined in their written record, that they held a "DNR" classification. Yes, that's right, Do Not Resuscitate. Oh, but then they need to have some kind of surgery and DNR apparently doesn't play on the sound system in the O.R.
So, for just a short time.........they will be temporarily classified as a "Full Code". If something bad happens, like a cardiac / respiratory arrest, then they will receive the Cadillac Escalade of emergency therapies. Somehow a few brain-stem neurons survive, their heart keeps beating, they do some guppy breathing and bingo!, they slowly dissolve over the next 7 weeks. What the heck?!? I could have sworn I read "DNR" on his Admission Record!

It is a horrid, unethical, immoral crime against humanity. Hard to say that in the same breath, when we claim we are advocates for human dignity. Give me a flippin' break, Jake!

Free Resuscitation

When I got too old
To drive my car,
My doctor made me
A DNR,
But when I went in
For my surgery,
They offered resuscitation
Completely free.

That's a heck of a deal
The surgeon said,
If you crump on the table
We'll bring you back from the dead,
Because we don't want people dying
In our operation room,
It's bad for my reputation
And it's a flippin', dollar doom.

But worry not, sir
There ain't no one better,
We operate by the book
Down to the last letter,
And the gist of all of this talk
Is about risks and regulations,
You'll come through with flying colors
And standing ovations.

So you did poorly, after surgery
Well, it's clearly not our fault,
We performed what we promised
And you didn't tell us to halt,
When you had the opportunity
Before morbidity and mortality,
Would get the upper hand
And you'd become a fatality.

You should have put your foot down
And stayed a DNR,
'Cause now you're riding in a hearse
Which you traded for your car.

Fibril_late;
4/28/08

I can't begin to explain this whole time-card thing, but I can take a stab at it with a rhyme [actually, it's becoming a series of poems -5]:

Time-Clock Wars

When I went back to work
The time-clock wars were raging,
What with Union regulations
And Administrative staging,
Petty minds and silly rules
Made professionals shake in their boots,
Sure to chase us into retirement
To make room for some ignorant recruits.

Dead Brain Waves

Part II; Time-Clock Wars

The old ones are dropping, like flies in the sun
They've worked here for years, and they're nearly all done
With the hemodynamics of pressure, dead brain waves and more,
While some obsessive-compulsive janitorial panel
Should be placed in strait-jackets constructed of flannel
Because this break-time snafu, is just one more, insane stupid chore.

(Chorus):
Snafu, is just another
Of my favorite acronyms,
Like, s-bar and fubar
And flams that are flims,
By combining these terms
We can describe where we are,
This time-clock snafu
Has become a fubar.


Two Fifteen's
Part III; Time-Clock Wars

Did you clock your 30 minutes
Did you take your two "fifteens",
Did you record it for posterity
Or just to earn your magic beans?

This time-clock we pay homage to
Is omnipotent, and called Ceridian,
It must be approached with deep devotion
At the 45th meridian,
Seven minutes before or after
On any quarterly divide,
Don't ask me to explain it
I'd much rather let it slide,
Because, here it comes around again
It's my golden opportunity,
If I don't swipe my badge correctly
I'll be punished without impunity.

Fibril_late; 4/9/08

Souffle' Surprise
Part IV; Time-Clock Wars

The soup has thickened
The griddle is hot,
This Ceridian concoction
Is thicker than snot,
New broth was added
For more flavor, less spice,
But the dishes on the table
All come with a price.

The chef is ticked off
The waitress is bloated,
They both missed their break
When the soufflé' exploded,
And when that egg hit the fan
Why, everyone ducked,
They collectively exclaimed -
We are totally mucked!

(Actually, my agent was there and heard something different... but that's another story!)
Fibril_late; 4/10/08

Us Dogs
Part V; Time-Clock Wars

Even when some dogs are sleeping
Others will remain awake,
We vigilant loyal watchdogs
Recognize what is at stake,
Our masters wish to control all our boundaries
Including leash laws and when we may rest,
How they revel in their control of our destiny
To us dogs, it's just another stupid test.

Fibril_late; 4/28/08

Exploited
Part VI; Time Clock Wars

Yes, I clocked my 30 minutes
Yes, I took my 2 "fifteens",
And someone marked it in a book
Though I don't know what it means,
It might be evaluated
By some expert panel folks,
In the meantime, I've exploited it
To rhyme these silly jokes.

Fibril_late;
5/4/08

Out of Reach

I use to enjoy
Calling you on the phone,
No matter the mood
You had a good tone,
With your sharp witted thoughts
And colorful speech,
But now, dear old friend
You seem far out of reach.

(to be continued)

Fibril_late;
4/25/08

I guess I could file this under the heading of, "Fibril_late's Believe It or Not". Clearly, it was a story begging to be told and thus...............out it tumbled!

Talk To the Ghost

What is the thing
That bothers me the most?
Unrelentless streams of visitors
Or the ever-present ghost,
Who rattles in the closet
And hides behind the curtain,
At times, I prefer the ghost
Over visitors, that's for certain.

I can talk to the ghost
He doesn't talk back,
He tries to throw ectoplasm
But his aim is out of whack,
Although he manages to frighten
The ones who see him not,
I guess I'm some kind of emissary
The only friend he's got.

Everywhere I've worked
There has always been a ghost,
I think he's a greeter for death
Like your friendly Walmart host,
Essentially, non-threatening
Offering his invisible, twisted smile,
A member of the welcome wagon
With his own peculiar style.

There have been she-ghosts
But they bear a different role,
As experts of duplicity
They come to recognize the soul,
Do an assessment of lifetime value
The good and bad and the duration,
Flip a coin and do the numbers
For the ultimate destination.

All in all, I count my blessings
For the role I chose to play,
There are wonderful people I work with
Each and every day,
And when relentless streams of visitors
Fray my nerves, like overcooked toast,
I can stick my head in the housekeeping closet
And talk to my friend, the ghost.

Fibril_late;
4/24/08

He was a mountain of a man, and now, he is a man beneath a mountain.

CPR Calypso

Billy-Bob Boiko
Was the father of the clan,
Well respected amongst his peers
He was mountain of a man,
Pound for pound, magnifico!
He was worth his weight in gold,
But each pound of flesh was killing him
He was prematurely old.

He denied his diabetes
He ignored the heart disease,
He smoked two packs a day, or more
You should have heard him wheeze,
But he claimed it was his allergies
He'd never been sick before!
While a shadow of death was hovering
Outside his bedroom door.

The family freaked when he had chest pain
And called a "9-1-1" emergency,
They screamed and moaned to the dispatcher
With overwhelming urgency,
The ambulance crew should have brought a hoist
Because Billy was immense,
They had to fabricate a gurney
From a neighbors redwood fence.

It was a terrific tale
Of sound and fury,
A rich, full life
Lived in a big, damn hurry,
Ignoring simple rules
Of pleasure and pain,
Fourteen dishes for dinner
And no alcohol refrain,
A boatload of dependents
As his life went down the drain,
When he flat-lined and keeled over
And left nothing but a stain.

He did the CPR Calypso
During the ambulance ride,
Clearly brain dead from anoxia
Oh how, his family cried,
They pointed fingers left and right
There was a thunderstorm of blame,
But underneath it all, I hope
They were floundering in self-blame.

They had unreal expectations
For the medical team that day,
They thought Billy-Bob would be revived
And he wouldn't have to pay,
Because that's the all-American dream
For any foreign son,
America, the land of the free
Should apply to everyone.

Billy-Bob Boiko
Is now a man beneath a mountain,
His pigeon-crap plastered statue
Sits in a dried up fountain,
His baby brother Besnik
Has stepped into his brother's shoes,
He tops the scales at four-fifty
Like there's nothing left to lose.

Fibril_late/ 4/17/08

I saw this bit of history in the chart of a 21 year old, who had been admitted for attempted suicide, that he had the diagnosis of "A.D.D.". By now, thanks to the psychological / pharmaceutical industry (and Dr. Phil), everybody knows this means Attention Deficit Disorder. However, what came to my mind, was how he had started out with ADD, and now, having tried to commit suicide, he had effectively tried to subtract himself from earth.
I knew immediately, that a poem was due to address this unique situation.

A.D.D. and Subtract

He started out life with A.D.D.
But he finished with subtract,
He claimed to be a well mannered fellow
But it was truly just an act.

He was a testament of early intervention
And a reservoir of latent potential,
A proud owner of classic presentation
While supplying the diagnosis differential.

He could prove to the average proud parent
That he was a child in need,
He qualified for therapies galore
And memorized the A.D.D. creed.

His mother learned the lingo and practiced for hours
She was a regular A.D.D. moxie,
Any seasoned professional of forensic practice
Could recognize Munchausen by Proxy*.

As his advocate for treatment and cheerleader for attention
This mother had a well rehearsed act,
But what started as textbook A.D.D.
Would metamorphose into classic subtract.

His old lady was clearly complicit
In the development of his mental condition,
Although psycho abuse indeed was the problem
He helped her by his own volition.

As a poster-child for A.D.D.
He learned about kiddee cocaine,
If you crushed the Ritalin and snorted it up
You could mainline it straight to your brain,
It was the rage among kids, in the friends that he kept
They laughed and called it Vitamin “R”,
It was cheaper than buying illicit drugs on the street
When you kept it at home in a jar.

The final chapter of this sordid, sad story
This miserable cretin lost hope,
After an alcohol binge, Vitamin R and cocaine
He finished life, at the end of his rope.

Fibril_late;
4/13/08

For an easy description of "Munchausen by Proxy", check the following link:
http://www.kidshealth.org/parent/general/sick/munchausen.html

(stay tuned)

Fibril_late;
4/13/08

OK, I admit it; once in a while, I get a vibe, that maybe, the poems that are written here at my site, might cause some fur to rise. But then I remember, hey, I'm anonymous. I'm "Princess Peanut" the cat. Meoww. Sure, I understand that I'm one of the few blessed cats on earth, that is the channel (we're talking spirits here) for a real human, aka, "Fibril_late". I can't reveal her/his name, because of course, they might get in trouble. Big, bad Meoww!
But the fact is, I can't help but obey the spirit.

Perhaps the following poem, might help out those fur-raisers:


Just Call me a Fool

I write about this
And I write about that,
But don't take it personal
Because that's not where it's at.

My attention is focused
On ideas and pain,
A loss of satisfaction
And ill gotten gains.

Crimes of humanity
And irritations of employment,
Shortening life spans
And a loss of enjoyment.

Policies and directives
From a corporate point of view,
Adversely affecting
All of me and all of you.

Freedom of speech
Just isn't my fortay,
Freedom of writing
Is where I earn my pay.

I won't use my words
To cause harm to another,
But I might use some terms
That are offensive to your mother.

And most of the time
I'll use humor as a tool,
And for all of the rest
Just call me a fool.

Fibril_late;
4/10/08

No words needed to describe this poem.

Double Casket

A foreigner to me
May be a relative to you,
It is clearly all about
Our particular point of view.

And when they're whacked out crazy
I'm about to blow a gasket,
If the both of us expire
We're going to need a double casket.

So my modus operandi
Is to be liberal with the drugs,
And my advice to family
"Could you give them lot's of hugs?"

Fibril_late;
4/9/08

This particular morning, I came home after "Round 2", of the wrestling match with a tag team of two sick foreigners. Something seemed to break; my knee, my back and my psyche. Luckily, I have 3 days off. Here is a telling of what didn't really happen.
Enjoy:

From Here to Dover

I am just another chap,
Who has lived through too much crap,
And I'm really getting sick and tired of it,
But the folks, where I hang out,
Love to fling it all about,
And most recently, I told that guy to shove it,
Now, I'm lucky no one heard,
That I flipped the guy, the bird
Or most likely, I'd have to pay some sort of fine,
But if you ask, was I surprised?
Have an inkling, or surmised,
I'd find myself, in ye olde Unemployment line?

Quite frankly, I was shocked
They were loaded, door was locked,
When I tried to come to work this very day,
They said, I'd really gone too far
This was a hospital, not a bar,
And consequently, you have no job, and get no pay,
At that moment, I was flippin'
I said, "Boss, you must be trippin'",
Why every Nurse, has horrid days like this and that,
But if you want to screw me over
I will sue you, from here to Dover,
And my attorney, will be the one who trims your fat.

Fibril_late;
4/6/08

Another hard-to-believe tale, that is filled with truth; really, just ask any Nurse!

Looking For Some Sturgeon

Now here's a strange phenomena
I've noticed o'er the years,
The gastroenterologist
Has stomach cancer fears,
And sure enough, before too long
He suffers bowel constriction,
Good golly gosh, I'm not surprised
He was a specialist of the affliction.

And then the neurosurgeon
Has a headache of grand proportion,
A nasty neuroblastoma
Has caused a brain distortion,
And the pain is so damned awful
Like a pterodactyl sting,
He takes a buzz-saw to his head
To eradicate that thing.

The saddest one most surely
Is the cardiology dude,
When the crushing pain and tombstone lines'
Begin to threaten his good mood,
He's inclined to pass the time away
Denying it's for real,
No Cardiologist worth his salt
Would accept such a lousy deal,
Alas, this can be fatal
Unless his family has some guts,
Accustomed to his attitude
They'll take no "ifs or buts",
And haul his sorry, dying ass
To the neighborhood cardiac surgeon,
He'll soon retire and buy a boat
And go looking for some sturgeon.

Fibril_late;
3/31/08

Many will tell you that it's hell getting old. It certainly is when ye olde hollow husk disintegrates slowly. Nary a nurse looks happily forward to that kind of existence.
Here are some quick thoughts about meeting the ancestors.

I'm Going to Meet My Ancestors

I am hoping to meet my ancestors
Perhaps they'll come and get me,
To join my ancient family
If only they would let me.

I'm old and feeble and misunderstood
And commonly feel alone,
But I have limited capacity
To make my wishes known.

I'm going to meet my ancestors
It's so painful being sick,
I've called my long dead family
To get me soon and quick,
They left so very long ago
But finally it's my chance,
I'm going to party with my relatives
And do the death-march dance.

Oh look, I see my ancestors
They are waiting at the door,
They've come to take me sailing
Yes, my boat is at the shore,
I don't need a life-preserver
Nor a compass for this trip,
I am ready for my maiden voyage
As the captain of my ship.

Fibril_late;
3/31/08

Deja Vu all over again. Yup, I'm reliving every flippin' nursing experience that I ever had, all over again, one-by-one. Last night it was the "Ketoacidosis, Bipolar, immature, positive drug history, non-compliant, adult-in-childs-clothing, whoops I didn't use my insulin for a week", individual.
I was a party to all of the emotions and behaviors associated with each disturbance. I really can't begin to tell you how much fun I had, (so I won't bother). However, let me share with you what it might feel like, if you were to be picked to be the nurse for that kind of patient, over and over again.

First, here is the cartoon: A wonderful quote from my favorite humorist, George Carlin:

In Rome, the emperor sat in a special part of the Coliseum known as the Cesarean section.
George Carlin, Brain Droppings (1997)

Thank you; and now for the main attraction:



One Nutcase, Too Many

Sometimes I feel like
There's a target on my butt,
It says, "Give him the patient
Who is whacked out of their nut",
Or maybe, I'm wearing
The hat with the logo,
It reads, "Welcome all zombies
From the Whisky a’ Go Go
Whatever the reason
The cause, or the blame,
What to me, is a conspiracy
To others, is a game.

There is probably a lottery
Going on behind my back,
To name the hours and minutes
Wagering when I will crack,
Where I go running and screaming
Yes, totally ballistic,
One nutcase, too many
And now I'm just a statistic.

Fibril_late;
3/28/09

Over the years I have written often about excrement. And here I am, less than two months into my reincarnated career and I find myself knee-deep in the slimy stuff again. Sheesh, nothing ever changes (at least in that territory). What has changed is the.....................

The Arc of Ejection

Bowel movements times four
And Urostomy leak,
Do I dare disturb the bedclothes
And venture a peek?
It's been a long night
Of cleaning up crap,
Patients lying on their sides
Try to launch it in my lap,
And I covered that topic
Must be 15 years past,
But nothing has changed
They have to crap, really fast.

Fifteen years later, and
What is the matter?
The crap is the same
But the clients are fatter,
The arc of ejection
Has increased in proportion,
The pattern of splatter
Is one of distortion,
And along with my age
And my weary old bones,
I don't leap, hop or scamper
Without a few groans,
As I seek to escape
The crap launched my way,
And I ponder again
About the terms of my pay,
But then I recall
My oath, Hippocratic,
You fool, you’re a nurse!
This crap is automatic.

Fibril_late;
3/24/08

It was as I thought; if I went back to work, I would be inundated with a review of topics that I probably wrote about in the past, but now I'm 10-15 years older, and I might possibly have a new perspective. Well, actually I have the same perspective, I just write a little different.

Suicidal

Nineteen years old
With suicidal ideation,
After seven years
Of self-induced degradation,
Popping pills and whatnot
In the name of “I hate me“,
Abusing all who care
I'll drag them down, just wait and see.

Nineteen years old
Whining, wailing, look at me,
Don't you know I was abused
And now my life is misery,
I'll keep trying to kill myself
Because, you know, I want to die,
As soon as I leave your care
I guarantee, another try.

Nineteen years old
What a waste, I say,
I'll care for you tonight
But tomorrow is another day,
Where you'll get the opportunity
To look your sorry self in the eye,
But tonight I'm going to tell you
You're just too weak to die.

Nineteen years old
And you've wasted seven years,
Nobody gives a crap
About your story of abuse and fears,
Your life is really easy
No working, school or tasks,
You just lay around and whistle
Through all of your phony masks.

Nineteen year old persons
I've seen paralyzed and more,
They didn't wallow in their misery
They were wheeling out the door,
With active minds and iron wills
They weren't whining, oh, poor me,
They weren't dreaming about their suicide
On Wednesday, at three-forty-three.

Nineteen years old
You need to begin the day and say,
Whatever happened to me before
Is ancient history and just the old way,
I have one choice, about moving forward
Each day is a fresh new start,
Those who care about me will do so
No matter if I depart,
But they are locking their doors
Watching to see where I will head,
Will I choose to be alive and live again
Or take the easy way out, and be dead.

Fibril_late;
3/16/08

I clearly missed out on a few "new" things in the past 7 years, away from the bedside. Maybe others did too.

Are you subject to the whole JCAHO "communication" directive regarding the SBAR acronym (Situation, Background, Assessment, Recommendation)? Everybody and their brother seems to have had to start reporting that way, or something similar, I guess. Well, it reminded me a heck of a lot of the old FUBAR acronym, which I'm sure many of you know to mean, Fu**ed Up Beyond All Repair. SBAR looks almost like that, right? Well, I sure thought so. And the following poem spells it out pretty clearly.

SBAR vs. FUBAR

I merely left the bedside
For seven short years,
But naturally I wondered
How I'd fit in with my peers,
I need worry not
They are stellar professionals,
But the workplace is different
Thanks to Jayco Congressionals.

Leave it to the Joint Commission
To give rules of communication,
They say it's all about patient safety
But it's more like approbation,
And another thing about it
Is the acronym, or name,
Just trying to pronounce SBAR
Those executives put us to shame.

Situation and Background
Assessment and Recommendation,
Up to five syllable words
Clearly testing my mentation,
Is this some kind of experiment
Are we rehearsing for the future?
If there is a threat of a lawsuit
Can we repair it with a suture?

But my greatest concern
Is with the choice of the acronym,
Having an Engineering background
It sounds like our marching hymn,
FUBAR was our mantra
It covered any possible disaster,
Fu**ed Up Beyond All Repair
Was our answer, to the master.

I know, that I possibly shocked you
But the world is a wretched place,
There are times at the hospital
When all Hell breaks loose
And the SBAR just flies in your face,
And I suspect that some members of Jayco
Were laughing while gasping for air,
Knowing the true meaning of SBAR;
Screwed Beyond All Repair.

Fibril_late;
3/10/08

Back in the gay old '90's, I wrote frequently about a local hospital system that was suffering through the throes of "redesign". They had adopted some sort of chest-thumping, corporate blah-blah, best-practice BS, that was going to save money, garner applause and launch them fiscally solid, into the 21st century. I think it went hand-in-hand with all the excitement of Managed Care. Fade to the future:

Now, they are heralding a "communication tool", with the acronym of AIDET - Acknowledge, Introduce, Duration, Explanation and Thank You.
I have since learned it is the brainchild of one, Quint Studer (www.studergroup.com), who at his own website claims, he is one of the "Top 100 Most Powerful People" identified by Modern Healthcare. Apparently, he's also famous for his "Five Pillar" approach to achieving operational excellence, goal setting and measuring progress under service, people, quality, finance, and growth.

It's all a smoking pile of feel-good, smiley-face, top-a-the-mornin'-to-ya, remember my good name on your patient satisfaction form, best hospital in town, front and back door advertising. For Nurses, who have already racked up 20+ years of loyal, back-breaking service to humanity, it all seems a little like heavy-duty glad-handing.

Therefore, I was assigned by my society to speak for all of us.

At the End of the Day

Until you've learned your AIDET
You haven't really made it,
Acknowledge their name
At the threshold door,
Introduce yourself
(Try not to bore),
Define the time
Of the things you'll do,
Explain, entertain
Educate them too,
At the end of the day
When you're on your way,
Say, thanks for the fun
Now, what about my pay?

Fibril-late;
3/10/08

I was thinking about how so many "professional caregivers", such as Nurses, Doctors and many others in the broad spectrum of those who attend to the health-care needs of humanity, commonly overwork themselves way beyond what might be expected of them.

My impression, both as one who has led the life, and also observed many of my colleagues, is that most of the time, we are doing it for others. Sure, once in a while, we're chasing the $ because we want the new car, or the Costa Rica vacation and so on, but really, it's almost always because we are the caregivers in our own personal sphere of influence.

We can earn some major cash, working overtime. If our spouse is just an average wage-earner, heck, we might be pulling down $1000 a day, for a little extra work. So naturally, all eyes look to us and open palms extend our way, and since it is our very nature to care, we just knock down a few more hours. Well, it's a slippery slope into oblivion, substance abuse, auto accidents, suicide and other similar miseries.

I call it:

Our Fountain of Giving

Regarding professional caregivers
Overworked, burned-out, and dedicated,
Performing with such depth of compassion
Commonly coping, self-medicated,
Amidst an over-capacity workload
They perform at the peak of their prime,
Look closely, it's not selfish fulfillment
It's for somebody else, every time.

Each one of us dedicated professionals
Came to our path, perhaps fated,
Like genetics, or family predisposition
A long history, to be traced, carbon-dated,
We often suffer, from a primitive condition
Where we overlook our own precious needs,
Eventually we crash, torn asunder and maimed
And suddenly everyone bleeds.

Because, attached to each one of these professional caregivers
There's a long line of benefited receivers,
They depend on our fountain of giving
We’re their God, and they’re the believers,
But even a God needs to rest
And that is the sober reality,
The ongoing demands of those persons
Deplete our very essence of vitality.

Premature retirement, disabled or dead
Is often the path that we follow,
Many caregivers are completely depleted
Their mortal remains are but hollow,
Left by the wayside of existence
Empty shells, that once held a precious light,
A dedicated professional, drifting off in the mist
Succumbs to the quiet of night.

Fibril_late;
3/5/08

For a friend undergoing a terrifying health dilemma; kind of a review of old times.

Back In The Day

Certainly,
There were times we had
Some were good and
Some were bad,
Plenty of laughter
Back in the day,
Hanging out with
Uncle Jay,
Taking trips
On a wing and a dollar,
Years of study
From High School to scholar,
Then somewhere, someday
Fragments coalesce,
The chaos of life
Is no longer a mess,
The answer seems startling
Why, it took so long to know,
That all the pieces were important
In this emotion picture show.

Fibril_late;
2/25/08

I started working again. In a hospital at that. In a busy ICU. Still on orientation (scraping the rust off, as my stellar preceptor says) and just a couple days into it, I have my first poem. It's an updated view on the thrills and chills of Kaexalate therapy. I don't know what stinks worse; the treatment, or my rhyming.

Kaexalate, Revisited

Kaexalate is rarely
Shared upon a date,
Kaexalate commonly
Will seal your fate.

Kaexalate, is best taken
Like a shot of nasty medicine,
Make reservations with a restroom
Your shit will soon jettison.

You can always tell your visitors
That your afternoon will be busy,
You can say you're writing a thesis
On the lyrics of Thin Lizzy,
They may look at you strangely
But probably won't query,
The very idea of that endeavor
To the novice, sounds scary.

Kaexalate is best taken
Shaken, or even stirred,
The smoother it goes down
The more slippery the turd,
It's better than Ex-lax
Or cod liver oil,
It eliminates work
And fertilizes soil.

The user will discover
The need for ventilation,
Because Kaexalate promotes
Rapid evacuation,
Of the immediate area
Of all personnel,
A Kaexalate dump
Carries a frightening smell.

And finally, heed my warning
It's best taken in the morning;
'Cause if you wait till lunch
Or afternoon,
You'll be on the toilet
With the rising moon.

Fibril_late;
2/20/08

Getting old; some people feel as though every year brings about the loss of another freedom. One of the most difficult to let go, is the freedom to drive a car.

Old Driver Blues

When I do my shopping
I drive into town,
The people in the streets
Look at me and frown,
The other drivers are terrible
They get in my way,
Why, the streets were much safer
Back in my day.

I've been driving
For something like 70 years,
Now it makes me so nervous
Unless I've had a few beers,
Because everyone else
Drives so gosh darn fast,
Like they're racing to the future
While I dwell in the past.

These new-fangled cars
Have so many dang buttons,
I think the kids of today
Are technological gluttons,
And by the time I have learned
What all of them are,
Ten years have gone by
And I need a new car.

I know some day I'll have to
Get someone else to drive,
But I swear to you now
Not while I'm alive,
I'm an independent man
And I'll have no drivin' slave,
I'll be behind the wheel
Till they drop me in my grave.

Fibril_late;
1997

Now that Obesity has been declared an epidemic, I guess I can cast all caution to the wind, and spell it like I see it.

Fat and Shortening

Something needs to be written
But dare I be the one to do it,
There's a backlash in society
For those who like to chew it,
There are over-eaters clubs
And natural shape coaches,
Big and husky clothing shops
And a hundred other approaches,
To address the significant fact
That many of us are overweight,
But if you don't do something about it
You're making a heart attack date.

There are a hundred easy reasons
Why we add the extra fat,
To insulate insecurity
Ninety-nine more than that,
But whatever your excuse
You better look it in the eye,
Twenty percent over your ideal body weight
And you're shortening your time to die.

In these days of over-sensitivity
Politically correcting any sort of verbal affront,
You can barely talk about the human condition
Without becoming the victim of a witch hunt,
Just look at the language we have formulated
To talk about what we are thinking,
Weight challenged with adolescent appetites
While the ground under us is sinking.

Now I know, I'll be attacked for my stance
An inflammatory response is just around the bend,
My teeth are crooked and my hair is falling out
But I don't think it will kill me in the end,
I'm thinking I ought to throw this away
But obesity is fat and we know it,
It's one of those challenges that stands right out
If you're as big as a house, you will show it.

I agree that all of the media hype
About biceps, abs and buns,
May cause the hopeless fatty's to commit suicide
Or seek murder, mayhem and guns,
But it isn't OK to condone it
In the context of feelings and disposition,
There are far reaching medical consequences
For the rampant, obesity condition.

Geneticists spearhead a campaign
To discover the causative gene,
That triggers the body to fill fat cells
It will be a lucrative, capitalist scheme,
The pharmaceuticals will jump into the foray
Bulging bank account sharks that they are,
To charge you an arm and a leg, sir
So you can fit into your car,
But if it's a magical pill that you want
The future can't guarantee that,
It comes back to good health habits and will power
The secrets, to not getting fat.

Fibril_late;
1997

All those damned credential abbreviations again, and I have to go off and invent a new one. Sheesh. But hey, it applies to me. I'm the aged nurse, heading back into the ICU, following a few years of retirement. So, for all of you like me, RN = Reincarnated Nurse!

Reincarnated Nurse

I'm just an aged RN returning
To the original scene of the crime,
The question that everyone's asking
How many years has it been, since his prime,
While the average age of a nurse
In California, is just forty-seven,
30% of us, clock over 50
You might say, we’re just closer to heaven.

But I suppose, we can’t take all for granted
When you pluck an old nurse from the crypt,
You’ll want to check the degree of senility
And how many discs have been slipped,
Are any critical devices required
For the operation of their bodily functions,
What are the odds, in the midst of their job
You’ll be required to perform extreme unction?

He has twenty long years, in critical-care
How much he retained is unknown,
You can’t train an old dog; can you train an old nurse?
Perhaps his brain has been turned into stone,
But this vacant position, has been unfilled forever
Our list of applicants amounted to two,
No young-nurses applied, perhaps they all died
When they learned how much work they would do.

Perhaps an old nurse, is better than none
All the tricks of the trade have been learned,
He may have lost a little speed, after 4000 shifts
His aches and his pains duly earned,
His competitive spirit, still fires his efforts
His good deeds have no need to be overstated,
A legend in his own time, if you ask those who know
An experienced nurse, reincarnated.

Fibril_late;
1/19/08

First post of the New Year is about becoming sensitive enough to be aware of death at a distance. With Nurses, that is an important tool to have on hand. Critical thinking is good, but Visual Mortality Acuity ranks higher.

Visual Mortality Acuity

Just how far away
Can you determine death,
Can you sense the subtle vibes
Of a beating heart or breath,
Can you see a vapor trail
At 27 meters,
Do you hear the failing heart
By the backfire of its beaters?

Can you hear the deathman's rattle
As you stand outside the door,
Or the whisper of the raven
Softly chanting, "Nevermore",
I like to think, it's just the tailwind
Of a guy who's heaven-bound,
Doing solo flying
With the wings that he just found.

Can you measure rigor mortis
With a telephoto scope,
Can you guarantee a suicide
By the tension on the rope,
Can you call a drive-by shooting
And the bullet riddled brains,
By the ashen colored skin
As the blood pours down the drains?

When you're driving in your car
And there's a guy down in the gutter,
Can you tell from half a block
If his heart beat has a flutter,
Is he a catatonic schizoid
With a blank and staring look;
If you've had the proper training
You could read him like a book.

When you've learned to spot a dead man
At any distance you inspect,
You must study proper timing
To be sure you are correct,
Because uniqueness is the key
When determining a stiff,
This application of your senses
May require just a whiff,
Because death is an olfactory
Experience indeed,
A body laying undisturbed
Begins to go to seed,
And the germination process
Is a documented science,
The timing quite predictable
Like a clockwork geared appliance.

What this boils down to, folks
Is a measurable skill,
It is used by law enforcement
At the scene of any kill,
It can guide the health-care workers
In the plan of their attack,
The odds are, death has not set in
If the body is warm and slack;
So if you'd like to earn your license
With a handsome annual annuity,
Train for certification
In visual mortality acuity.

Fibril_late;
1995

1997. We were using live-leeches for certain wounds, to protect the microvasculature. Leech saliva contains Hirudin, which is an anticoagulant. It got me thinking and that led to this:

Leech Spit

Leech spit for you
Hirudin for me,
With a torque wrench or hammer
Get your leech spit for free,
Fat bloody suckers
Latch onto your skin,
They suck up the pus
And keep your blood thin.

When those fat little suckers
Have appeased their appetite,
Apply the leech tweezers
To loosen their bite,
You can toss them in a salad
With garlic and oil,
Or throw them in the garden
To enrich the soil.

Leech spit is tasty
Just take it from me,
It's better than jelly
Or a fancy French Brie,
Spread on your cracker
While at brunch with the Queen,
And you don't have to floss
Because it keeps your teeth clean.

Fibril_late; 1997

As it turns out, you should read the previous entry ("So Very Clear"), before reading this one, (but that is not human nature), so I digress.
Together, these two poems, chronicle events that were happening in the same time frame. Thus, if you were to read the previous one, maybe it would all make some total sense.

Digging My Hole

I'm bound to get in more trouble
Digging my hole deep and wide,
But after our "attitude" meeting
Our morale, just rolled over and died.

Theoretically, as professional persons
We can communicate by "Doyles book of Rules",
But we're all emotional cretins
And few of us have all the tools.

I've commented before in my ramblings
About the ways in which real people talk,
The mirroring/rephrasing proponents
Make me cover my ears and squawk,
To me, it's too stilted and phony
Lacking empathy and a sense of connection,
I believe that it alienates people
And personally, I want some protection.

I'm bound to get in more trouble
For spreading my thoughts in the press,
But I'm merely recording my insights
As a participant in this morale building mess.

Fibril_late; 1995

It was 13 years ago. There were some heavy emotions and discord, curdling among our night shift crew. The Unit Manager had us all sit down together, in an attempt to attain an accord of understanding, and presumption of harmonious relations. It wasn't easy, it didn't flow smoothly, but in the end, compromise was reached and our journey together resumed on a fresh course.

So Very Clear

It's all, so very clear
But I question our success,
Ten people trying to communicate
To clarify a mess.

With our new found understanding
Will we share a common oath?
Or did we polarize our differences
And shatter hopes of growth.

Surely, we won't walk away
As though we are starting anew,
The memories of our discord
Are ingredients in the brew,
It just depends on how we stir it
And the elements we add to the pot,
Will it be a culinary masterpiece
Or just a soup, that's too damn hot?

Fibril_late; 1995

A.I.C.D. to those of us who know,.....refers to an Implantable Cardiac Defibrillator. I wrote this at least ten years ago, and revised it today. Not just to bring it up to date, but I know I'm a little better at writing too. Don't expect miracles, OK?

A.I.C.D.

The automatic implantable
Defibrillator,
Draws comparison
To something like
An angry alligator.

It's a guardian of the heart
And it has some discrimination,
But once the threshold is crossed
There's no possibility of evasion.

Imagine, deep inside of you
A reptile in repose,
Just waiting for your ventricle
To forget the things it knows,
The reptilian response
Is intriguing to explore,
That cold blooded, sleeping 'gator
Is just a hungry carnivore.

The device is touted broadly
As the answer to your needs,
Although placement has gotten easier
Everybody bleeds,
And the shock of the employment
When the device might save your life,
Might be that night of nooky
With your happy, smiling wife.

To utilize this gadget
You must understand its' name,
It requires a prescription
In the medical-lingo game,
Thus, discussing ye olde acronym
A. I. C. D. and all,
The medical establishment
Will rally at the call.

The "A" is for automatic
How it determines, when to fire,
It considers heart rate and morphology
And the odds if you will expire,
Taking into consideration
Last will, Trust and all bequeathments,
Calculating death expenses
And subsequent bereavements.

It is commonly felt that "Implantable"
Is the word, best attached to the "I",
But contrary to that opinion
It's a concept I boldly deny,
I contend that it's a part of the
Medical-miracle always a cure over-rate-able,
In an endless array
If you got bucks to pay
For the price that is always inflatable.

The "C" could stand in for anything
But here, it corresponds to your heart,
If your Doctor believes that you need it
You'd better be playing your part,
Doing research on all of the avenues
Acquiring a second opinion, too,
Be your own consumer advocate
Before committing to saying, "I do".

The "D", is up for discussion
Though it's translated, to imply defibrillator,
If you ask me, a better description
Would define it as, de-liberator,
When you think of the dead guys we are saving
Who otherwise would have departed,
When their heart started flippin' and floppin'
And their A.I.C.D. got it started.

If they had reserved a heavenly timeshare
Some years in the far distant past,
There might be a statute of limitation
Because that heavenly place fills up fast,
Thus, you might lose your priority status
And survive, to commit mortal sin,
Losing your passport to Heaven
When St. Peter, won't let you come in.

I'm hoping you take into consideration
The facts I have carefully spelled out,
Debarking on the path of the A.I.C.D.
You must choose, when you have no more doubt,
Remember to visualize the image
An alligator awaits your instruction,
His bite might surprise you during dinner
While his goal is to prevent your destruction.

Fibril_late;
1996 / 2007

Just a simple birthday wish.

Mika

If Mika is just like her mother
The world is a better place,
If Mika looks like her mother
Then surely, she has a beautiful face;
And if Mika learns from her mother
Perhaps she'll live in a state of grace.

Fibril_late;
11/30/07

oops, I went into a fugue of emptiness, or something. Here is my latest, current poem. I need to dig into some boxes to get to the Nursing stuff, which I will return with in a few days.

What Matters

You may start with something
And it never finishes
But you started, and that is what matters;
Think of things you started and lost
And everything
Ended in tatters,
The journey is life
And life is the journey
It's all about learning and attention,
Insignificant now
Or so it may seem
At the end, may be an honorable mention.

What I have learned
In the course of my years
Has left me open, to the all of potential,
All that may seem
Unconnected and divided
Is but the seed, of the utmost sequential,
Every step of the way
Every motion of breath
Has a purpose to the end of all action,
But we know from our physics
Motion never finds rest
There is always some kind of distraction.

Fibril_late;
11/24/07

It's really quite simple how the pseudo-life we attempt to recreate in the average hospital admission, reflects life in the real world. All you have to do is imagine.................

Everybody Feeds

Good taste and good value
A basic human desire,
From the day that you are born
Until the moment you expire.

So with that in mind
We tailor health-care to your needs,
Two sheets and a pillowcase
And everybody feeds.

Fibril_late; 1995