Gordy, Lordy! WTF?!?

We, (all nurses, in this singularly broad arena of a particular organization) must assimilate, into our already, highly-demanding and the-plate-seems-too-full-and-I'm-stuffed-with-27-things-that-should-never-happen-in-the-hospital events, faced with but another way, that we the bedside nurses, are supposed to increase the odds, that Mr./Mrs./Ms. patient, will be happier than a pig in shit, to recommend our hospital to others, and bother to come back here again.

Look folks, our town is at the "ground-zero" of Managed Care and Capitation. Our clients/patients don't really get a choice regarding where they get care. Who are the powers-to-be, trying to fool. In this community, we have about 5 predominant Health-care insurance providers in place, and if you belong to them, you essentially have been assigned to Hospital A, B, C, or D, whereupon, you will be delivered, to get your infected Gall Bladder removed. This is not about satisfaction and choice.

But perhaps it is all about reportable statistics? Hmmmm, that has a nice sound to it, n'est pas? Oui!

But, because of the way the "business" model works best, there is a filtering down of ideas, to the basic level of care. Thus, the collective we, are faced with, "The Nursing Bungle". Sure, I know that seems a bit odd for a name, but.......well, in fact, that is truly my derivation of what is being passed off as the greatest thing since french-bread with snails, "The Nursing Bundle".

I know this was along harangue, but I'm just letting you know, there will be a bunch of poems to follow, that will address this topic.

Stay Tuned

I’ve got a slew of poems
About the Nursing Bungle,
Stay tuned for the latest
Coming out of the jungle,
The morass of misfired management
It goes all the way to the top,
The hot topic this year?
Patient satisfaction slop.

Fibril_late;
9/22/09

The Nursing Bungle

The Nursing Bungle....
We heard it first,
From the very mouths of babes
Man, it made me really thirst,
The refreshments were okay.
Crackers, cookies, and cheese,
I kept going back to the chef
And begging, “Mister, please”,
Do invite me again
To the next festive event,
I swear, in the meantime
I'll do my best to repent,
For my overt body language
Silently screaming, without a sound,
As I sat pondering all that information
Joe Studer discovered and found.

Look, it's the same old data
Repackaged and pretty,
Shiny mylar balloons
And a parade in the city,
With new benchmarks and measures
Lengthy checklists and more,
Observations by the charge-nurse
Who will stand by the door,
Observing our behaviors
And making check-marks on a paper,
Yes, these are the hallmarks
Of another questionable caper.

The Nursing Bungle it is
The name is so apropos,
Educate ye olde bedside nurse
As if they don't know,
About care and collaboration
Critical illness and more,
Now, it's all about “satisfaction”
When Mr. Patient leaves our floor.

Let's recognize the fact
It's just old stuff renewed,
And management has emphasized
Follow orders, or you're screwed,
Because we have to be compliant
And take on new behaviors,
Avoid 27 new bad things
Then all is well, proclaim our saviors.

It's old and it's new
And we get tired of this,
Every five years, or so
We're told something's amiss,
But the problem really isn't
On the street of our action,
It's just a management perspective
And I call it, distraction.

Someone way at the top
Looks around at the horizon,
Some study results tell him
You're losing money, it's not surprizin',
The economy is down
But you must blame it on people,
Find the guy at the bottom
And impale him on a steeple.

The dollars float up
To the top of the pond,
Mr. ground-cover boss
Wants to wave his magic wand,
And ensure that the fiscal
Prosperity of his being,
Remains all omnipresent
Instead of his salary fleeing.

So the shit slides down hill
To finally find the plateau,
We're inserviced, “The Nursing Bungle”
It's the same old stuff, don't you know?

Fibril_late;
9/23/09

Doubtful Old Man

Call me a conspiracy theorist
Call me a fool with a pen,
Whenever there is a new fangled program
I want to know why, where and when.

Call me disruptive and cynical
Call me a doubtful old man,
Laugh when I'm doing the research
Following the trail of the plan.

I want to know the cause for new action
When management demands our compliance,
When rules and directives are jammed down our throats
Under the guise of some evidence based science.

Fibril_late;
9/23/09

Scathing Words

Oops, I stumbled on some toes, and underwent some body blows.............

Scathing Words

What an experience that was
The power that sits, sat down with me because,
I had ruffled some feathers
Last evening by phone,
I called, old Doctor what's-his-name
And struck a funny bone,
He rattled his saber
About missed communication,
So this morning, I got an earful
In the middle of the nursing station.

I apologized to yonder doctor
And I acknowledged my error,
There was no intimidation
Not a shred or whiff of terror,
Just an agreement of sorts
That our computer documentation,
Leaves a lot of buried orders
An unintended complication.

Last night he was so busy
Over-stressed by demands,
I sought simple clarification
And bought a reprimand,
Uninvited scathing words
Where a simple sentence would suffice,
On-call, is a professional obligation
A pleasant deportment, is my advice.

A couple of salient points
Were hammered home to me,
Be careful whom I call at night
And keep the blaster, on setting #3.

Fibril_late;
9/19/09

Another stab at our digital medical record. Why? Because there are some screwy new terms, that seem like they originated in some foreign country. "Bedfast / Chairfast"...what in the heck does that mean??

Flatus Findings

I've already told the story
Of our new charting ways,
A preponderance of data
Absorbing our days,
Removing us from the bedside
Although our patient's need us more,
The boss of the bosses
Demands adherence to the chore.

There are new terms to contend with
That I don't understand,
Bedfast and chairfast
Initiated and planned,
And other strange items
That demand some rewinding,
Just what is the meaning
Of a Genital Finding.

Am I supposed to chart, "Yes"
I found the appropriate organ,
Or maybe, Miss Betty
Is endowed more like Morgan,
I can't seem to find the answer
And I'm embarassed to ask,
I didn't think that my charting
Would be a sexual task.

Perhaps I'm too old
For this digital charting,
Because, I also noticed
There's a query on farting,
A delicate subject
Regarding flatus of the gut,
In summary, I tell you
It's a pain in the butt.

Fibril_late;
9/17/09

Someone was telling me about the latest diet, and then we had a laugh about the "obesity chain letter" that you would have to send to 3 other people so the secret magic worked. I enjoy silly ideas like that; they stimulate my writing.

The Diobesity Chain Letter

When the letter first came to me
It almost made me cry,
It said, "You better lose weight
Or you will surely die",
Your cholesterol (Oh, lordy)
Is so high it can't be counted,
Your HDL is puny
And your LDL has mounted,
To a level never seen before
In the annals of Cardiac medicine,
"Beyond a chance of survival"
Said (the famous), Dr. Edison.

I was on the verge of tears
Because I didn't know what to do,
So I grabbed a tasty side of beef
For a 14 hour chew,
While my triglyceride's kept leaking
From every available pore,
(They help me slide out sideways
Out my Winnebago door.)

After reading all of that letter
Every chapter, page and verse,
I felt that I was doomed
By my genetic family curse,
Those generations on the prairie
Raising cattle, sheep and swine,
With deep subliminal messages
That said, "Baby, you must dine".

Genetic memory eaters
Can't be blamed for their bad habits,
When we consume a couple calories
They multiply like rabbits,
Pretty soon we've grown some haunches
That have no rivals anywhere,
One day we balance upon a stool
And tomorrow we bust the chair.

After several rounds of reading
I knew the message was a beast,
My health was heading south
While I continued driving east,
To get as far away as possible
From the evidence in that note
I was convinced that "fat and happy"
Was baby, "All she wrote".

I crumpled up that paper
And headed for the shredder,
But I slipped upon my lard
And nearly took a header,
Finally noticing a post-script
That offered me some hope,
Would it be enough to save me
Here, at the end of my rope?

The instructions were so simple
"At least that's the way it sounds",
What have I got to lose
Other than 150 pounds,
And one more thing, it mentioned
I must forward the letter to others,
Similar folks, of similar means
Diobesity sisters and brothers.

I'd be cutting back on eating
All my favorite types of food,
The thought of that, was so heavy
I had a 17 hour brood,
But the alternative, yea the options
Stared me boldly in the eye,
Remember what I told you, chick
"You could surely die".

My family had already been down this road
Sisters, brothers, and cousins too,
An inch would come off, then add an extra pound
Just stand in the mirror, and there's more of you,
It's a vicious cycle and around the bend
Diseases are waiting to pounce,
In for a penny and out for a pound
Over the years gaining ounce by ounce.

That Diobesity chain letter?
I sent it to three people, in a hurry,
I guess it really comes down to me
Cut back on the calories and curry,
But what have I got to lose
Other than one hundred fifty pounds,
Get buried before death is due to me?
Or lose all my heaps and mounds.

Fibril_late;
9/15/09

Go Home Now

I'll be hitting 60 in quattro years. Thanks to the almighty Pixie, I'm way healthier than all of the clients who roll through the doors. Take the 39 year old guy who was in for Acute MI #3. The deal was, that 10 days ago, he had an elective Cardiac Cath with Stent placement to his Right Coronary Artery. After his free-7 day supply of Plavix ran out, he didn't order anymore. Somehow that pack-per-day cigarette habit, seemed more important. This time he returned with full blown acute Stent closure MI with cardiac arrest, Intra-aortic balloon pump, Hypothermia protocol, etc.
When he finally got extubated 4 days later, he seemed to have lost a few brain cells in the flux, but did finally discharge home, with the S/O he now wants to marry. She's the one that deserves a medal for sticking by his lame and lazy side. Anyway, I'm healthier than he is.

Still, even old warriors get punked out a little. To go to work, feeling like maybe I've got a touch of the piggy flu or maybe I'm suffering from California wild-fire smoke pollution, I wore out fast during the two nights I spent at work. We have a running joke in the ICU where I hang my proverbial hat. If there are any whacked out, crazy, on the call-bell every 15 minutes, or totally psycho nutcase patients, you can bet that either Jerry or I, will automatically have that assignment, if one of us is working. That's how it was last night.

Hello Shanna, I'm your Nurse for the night. Shanna responds, "Why do you want to kill me?". She says this over and over, for the next 15 minutes. It only got better when she started yelling obscenities. And that was just the first hour. The Morphine and Ativan sort of helped, but then again, maybe not. Ms. L. was as usual, somehow helpful with her calming presence. Thanks, K.

The night ended with my following thoughts around the theme of Going Home:

Go Home Now

I have to go home
When I'm tired of the bull,
All the idiotic innuendo
I eventually get full,
All the Care-plan duplications
And the unrelenting charting,
I have to go home now
Goodbye, I'm departing.

I have to go home
When my inertia is lost,
It was stolen by someone
Or maybe it was tossed,
Into the trash by mistake
By the legally blind,
I have to go home now
I hope you don't mind.

I can't stay any longer
Unless you're willing to pay,
Double-time for my troubles
There's just no other way,
That I can put up with this garbage
That I shoveled all night,
Don't threaten to keep me
I'll put up a fight.

I'm home now, and happy
Just typing this note,
A glass of wine in my hand
While my thoughts drift and float,
On the stream of contentment
Amidst bubbles and foam,
I'm so glad I left work
Because now I am home.

Fibril_late;
09/09/09

Some doctors seem older than dirt, still keep practicing, and have great results, regardless of how archaic they may seem.

He Cuts and Slices

The olde-time surgeon
He's the one,
He cuts and slices
Until he's done,
He might even dabble
In ways of the occult,
Whatever it takes
To get the best result.

He'll follow-up every morning
To see the result of his work,
He had a personalityectomy
So he's kind of a jerk,
But you just can't argue
With the results he gets,
If you need something cut out
He wins all bets.

Fibril_late;
9/6/09

Maybe you know someone who gets a "bee in their bonnet" regarding some affront to them, whereupon the offended one has to "share" their misery, with anyone within earshot.
I say, get over it dude, or prepare to meet Mr. Hammer.

Mr. Hammer

When she gets a bee in her bonnet
She won’t take off her hat,
I just stand back and watch,
And wonder, what’s up with that?
She starts to holler and screech
With moaning, all about,
"Just remove the damn hat"
I am tempted to shout!

It’s some ownership thing
This pain that she earned,
I can’t take it away
Or I will get burned,
By the heat of her anger
Regarding the bee in her bonnet,
But I have a solution
I’ll slam my hammer upon it.

Fibril_late;
8/28/09

People are admitted to the ICU for many reasons. Usually their first questions will not be regarding their length of stay or treatment, but rather, they want food and and they want to to know how to turn on the TV. Let's take a look at that:

On Admission

The most important thing
That we explain,
It's not the heart
It's not the brain,
It's not the
End of life decision,
It's the wired remote
To the television.

What's more important
Than our Nursing role?
The channel-choosing
Volume control,
But heed my warning
You better listen, right now,
That Nurse-call button?
Don't teach them how!

Fibril_late;
8/27/09

One Night Only

Over and over again, I repeat, I WANT A DIFFERENT ASSIGNMENT, every night that I work.

Apparently, nobody gives a rats ass about what my theory is regarding the "care-experience". Heck, it's probably because they don't follow the writings of "The Underside of Nursing".

One Night

We're not family
And we're not friends,
Particularly if
I have to clean your bottom end,
More than 5 times
In the course of 12 hours,
Super-nurse that I may be
I lack certain powers.

I don't want to know you
Longer than one night,
Some relationships are short
And ours just ain't right,
There's no need to prolong
An association such as this,
When I return tomorrow night
You're not the one that I will miss.

I'm a natural born mercenary
I want to choose my own battle,
Continuity, is a concept
That works well with cattle,
But these patients have personalities
With excretions, you can't envision,
Every day a new assignment
Is my career decision.

It's so easy to become enemies
When you're fighting hand to hand,
With a sick and twisted adversary
In the jungles of hospital land,
So, if I had my druthers
I'd fight a different one each night,
They're not my family, friend or neighbor
If I want to treat them right.

Fibril_late;
8/19/09
__________________________________

And then it came to this:

Transfer To The Floor

Last night my patient
Took her life in her hands,
Wrote notes by the thousands
And made her demands,
Let me walk to the toilet
Let me walk in the hall,
No, I replied
I believe you will fall

Her Doctor had written
That she could transfer to the floor,
Though the time had not arrived
For her exit out the door,
He postponed her departure
Because she acted a bit strange,
He felt she wasn't quite ready
To roam on the range.

She had a previous history
Of alcohol and drugs,
And in my esteemed opinion
Her brain was full of bugs,
Clearly she was infected
With a disordered personality,
I thought, if she gets out of bed
She'll be the next fatality.

Be as that may, she decided
To ante up her score,
In the middle of the night
She transferred to the floor,
Climbing out of bed
Without notifying her nurse,
Was she going to the bathroom
Or looking for her purse,
I'm sure I'll never know
And it doesn't really matter,
On the floor or in the bed
She was as mad as a hatter.

No injuries were apparent
When we hauled her back to bed,
Her escape had been aborted
And she wasn't even dead,
Perhaps a Posey-Vest would hold her
Until my shift was over,
After that I will not care
If she falls from the Cliffs of Dover.

Fibril_late;
8/19/09

It's my biannual rant regarding restraints. The regulations regarding what to chart, how often, and what must be addressed are ridiculous for those of us who work in Critical Care areas. So let's roll............and then one follow-up, Coup de Grace.

Extremity Management

By now it's the 21st century
And clearly time to revise an old term,
Regarding a particular topic
That causes some people to squirm
If you're a nurse in the hospital arena
You will know what I'm talking about,
Regarding, the rambunctious patient
Whose mental acuity is in doubt.

For the safety of the patient in question
There are times we must secure foot or hand,
Perhaps they are climbing out of bed
Without a lick of a chance that they can stand,
They may not remember the surgery
The amputation, of five necrotic toes,
They'll leap out of bed like a revived Fred Astaire
And go crashing to the floor; so it goes.

Such an outlandish occurrence as identified
Demands mountains of details in writing,
Old Gimpy, on the floor, has just busted his hip
And his family and I, are now fighting,
They were the ones, in the first place
Who were outraged, when we tied Poppa down,
When we complied with their wishes, and released him
He just figured he’d go dancing downtown.

We’re sued when we do, and screwed when we don’t
Any injuries will be blamed on the Nurse,
Thus I believe, it’s time to toss out the word
The terminology, “restraint” is a curse,
I’ve researched for hours and interviewed for more
And I think I have found the solution,
We need to obscure, the description of our actions
And resolve it with a binding resolution.

I recognize the value of convoluted terms
That were popularized in the business domain,
With an acumen for language, I believe I found the answer
“Extremity Management”, will be the name of the game,
An umbrella of sorts, for a variety of methods
To achieve the best outcome, over time,
Securing, old rambunctious Roberto in bed
And never to be sued for a dime.

We won’t be required to document
The same, silly details each hour,
I’m telling you, that’s such a waste of our time
A guaranteed drain of Nursing power,
We’ll Implement “Extremity Management”
The latest, hot care-plan in town,
With a protocol like that, I can chart in nothing flat
Forcing the Joint Commission to back down.

Fibril_late;
8/11/09
_ _ _ _ _ _ _ _ _ _ _ _ _

Coup de Grace

Extremity Management is my coup de grace
In the face of excessive regulation,
The protocols in practice, regarding Restraints
Are a conglomerate of nonsensical information ,
Foisted upon us by unreasonable voices
Claiming human, and animal rights,
They don’t have a clue to what happens
When Billy-Bob goes bonkers each night;

His Nurse won’t be found at his bedside
With continuous attention for hours,
She has to attend to her other 9 patients
For their meals, dressing changes and showers,
Upper management won’t find us a “Sitter”
A lowly-paid person to watch Billy,
After all, they would have to pay benefits
And for minimum wage, that is silly.

Now sealing our fate, like a 500 pound weight
Are the regulations regarding restraint,
And the all-seeing eyes, of the management guys
Want a guarantee, there's no legal complaint,
While the Nurse on the street
Spends 12 hours on her feet
Walking miles to appease every master,
When old Billy gets loose
He is one wild goose,
And his condition deteriorates that much faster.

I chart every two-hours
So much that it sours
I mark the same boxes each time,
On my 12 hour night
Billy remains snug and tight
In the morning, he's still alive
Is that a crime?

Some officials might claim
I have doctored the game
To tie down the patient, for convenience,
If Billy falls out of bed
Busting a hip and his head
I am sure a court of law, will show no lenience.

So, I tie when I can
If escape is his plan
Don't look to me
For psycho-social recommending,
Patient safety is my mission
And I'll hook him like I'm fishin'
I've got 12-hours to keep him alive
And that's my ending.

Fibril_late;
8/16/09

Floating (working in an unintended area) can be a nightmare. Not always, but it's a good set-up for a bad shift. Anyway, it was my turn, and off I went to Trauma ICU.

Cut Out

I'm not cut out for Trauma
It just isn't my gift,
Too many busted young guns
Too heavy to lift,
Now, don't get me wrong
This ain't about knowledge,
Why everyone knows
I spent a few years in college.

I'm not cut in the mold
Of the great Trauma nurse,
Masters of bone breaking
And they know how to curse,
Now me, I'm content with
The cardiac arrest,
Stent an artery or seven
Why, it brings out my best,
And let me play Sherlock Holmes
For that complicated EKG,
Just please keep your busted femur
Far away from me.

A visit to Trauma
Once a year, is enough,
C-collar practice and log rolling
Just to prove I am tough,
And then a visit to ICU
To catch the latest in slicing,
Oh, the secret is out
Floating: is so enticing.

Take it from me
I'd rather see Trauma,
Than Neuro ICU
Stuck with Godzilla's Momma,
Fresh off a stroke
In her right hemisphere,
Now that is a nightmare
Where I'd rather keep clear.

All in all, I am jealous
The news-clipping is in my purse,
Down at the big house
There's no floating a nurse,
Or so, the smiley one claimed
But why shouldn't I believe,
UC gets hot benefits
While the rest of us grieve.

I'm not cut out for Trauma
I had a Cardiac birth,
This is no war of worlds
To determine our worth,
We all have our talents
Our specialties and more,
And the patients don't care
When they roll through the door.

Fibril_late;
8/5/09
___ ________ ___

Slice of Life

A Trauma nurse
No, I am not,
But I love to learn
Why Bob got shot,
And how about Mary?
She paid the price,
When her boyfriend Billy
Gave her neck a slice.

The morbid details
Are fascinating,
The monsters mayhem
Is not abating,
Such an endless scope
Of injuries,
I want to know
So tell me, please.

Hour by hour
In the dead of night,
Visions of trauma
Are always in sight,
And even though
I'm not that kind of nurse,
I keep a police scanner
In my purse.

Fibril_late;
8/5/09
__ __ __ __ __ __ __

12 Hours

A Trauma nurse?
Oh that, I'm not,
I'd rather have my
Left foot shot,
From a careless moment
Cleaning the gun,
A buckshot foot
Is surely more fun.

Bariatrics
Isn't my gig,
The patient's are
Just too damn big,
But like it or not
It's part of the job,
When you buy the corn
You get the cob.

Obstetrics would never
Be my career option,
I just wouldn't fit in
Like a bad adoption,
With lochea's and placenta's
Flinging right and left and center,
Now that is one arena
I have no right to enter.

I considered Neonatal
I heard the babes were really small,
That piqued my curiosity
Call me kinky, that is all,
One kilo is so tiny
I can hold her in my hand,
But to wait for 20 years of growth?
Is more than I can stand.

To be a Nurse Anesthetist
Looked pretty slick indeed,
Passing gas for hours
While I watch somebody bleed,
But I'm a little claustrophobic
Stuck in the operating suite,
I'd rather be more mobile
On my bloody buckshot feet.

I'm settled in with Cardiac
In the middle of medical mysteries,
Instead of just dealing with body parts
I get to know the whole sordid histories,
Dwelling on complex disorders
Fills me with ideas and drama,
And having stuck with this job, for all of these years,
I play the role of the old and wise Lama.

I'm not a trauma-pedi-bari-neo
O-b kind of guy,
But when forced to float, I'll do my best
To make 12 hours fly.

Fibril_late;
8/6/09

I suppose that some of you must have heard about the latest and greatest can-opener,that is circulating the country. It's called, "The Nursing Bundle". I'm sure all of you have experienced something like this before, where your hospital organization believed the need for greater efficiency, and dollars saved, carried a higher importance than what was happening directly at the bedside.

Sure, I know, the "new" ideas are always couched in cool new slogans, and psycho-babble business speak. Another way of recognizing these insidious trends, are all the catchy Acronyms that the trainers sling around, like cheap 19-cent hamburgers, and would you like some fries with that, Honey?

I'll tell you what........Sister Euphemia has always been a sucker for this stuff, and there's no pulling the blinders away from her eyes; but why worry when we all know, the pockets of her habit are deep and lined with green.

Let's get to the story, the way that only I can tell it, ok?

The Nursing Bundle

The Nursing Bundle
I'm glad I missed it,
But from what I've heard
I could have kissed it,
Though all in all
It makes me wonder,
Should I have gone?
Did I commit a blunder?

I too, could have tasted
The Acronym soup,
With it's endless supply of
Loopedy loop,
Those inspirational moments
When ideas start firing,
And I give up the idea
Of maybe retiring,
Because, where else could I go
To get ideas like this,
The Nursing Bundle Workshop
Was not one to miss.

I can merely report
Third person, quite respected,
Why heck, I'm so jealous
That I wasn't selected,
But they told me the following
Version of truth,
Quite probably embellished
With 3 glasses of Vermouth.

We came with our questions
They were answered and more,
We received a lovely binder
And a "high-five" at the door,
They said, "Thank you, for coming"
There's so much you can learn,
Quite frankly I wondered
Just how much did they earn,
For a gig such as this
It has to be sweet,
Driving all around the country
With an expense account to beat.

I guess that's what you do
After your bedside tour,
Go from hospital to hospital
Selling the marketing cure,
The ploy to bring dollars
And a shine to our reputation,
The bread and butter, of repeat customers
Earns a standing ovation.

Ask Nielsen and Johnson
Because they measure the stats,
If we score near one hundred
There will be bonuses for those cats,
Sitting high in their offices
Running the numbers for this quarter,
And, "By the way" they admonished
"Keep the overtime shorter".

Now those Bosses, who are nurses
Tap their feet and giggle,
Knowing that years behind the desk
Have only added to their wiggle,
While visions of floor nurses
Dance in their heads,
Imagining how their staff
Will chant slogans, while making beds,
For their clients every morning
To boost morale and good feeling,
Yes, that's what is most important
Second fiddle, comes the healing.

Nursing Bundle is our friend
That's the take-home message, I guess,
Sister Euphemia, likes the idea
If it will clean up this mess.

Fibril_late;
7/28/09

This is no particular complaint about a specific person, but rather, just inspiration from something Ms. B said today. It does seem at times, that the shift was 15 minutes long, after a grueling 12-hour report!

15 Minute Shift

It was a 15-minute shift
After that horrendous 12-hour report,
43,200 seconds
While I listened to him suck and snort,
About the complicated events
Between the beginning and the end,
It seems like the dude was on offense
And I was the one to defend.

It seemed like a long 15 minutes
While you gave your 12 hour rendition,
How those bastards in Pharmacy processing
Could care less about someone’s condition,
You ranted, and railed and you moaned
And you simply just ran out of time,
There’s no one who works, quite as hard as you do
You’re a savior amidst all of this crime.

It was a long 15 minute triathlon of pain
After the 12-hour report from south Hell,
We’re lucky that anyone is left standing
Your oration could crack a coconut shell,
I survived because I always wear earplugs
When I know that you’re headed my way,
But who did I piss off, I'd just like to know
To earn this kind of punishment today?

Fibril_late;
7/27/04

Criminal Edema

There are times when a simple 12-hour shift can seem to last 24 hours in duration. Last night was one such night. I had to transport the blob (1950's Horror movie), to Nuclear medicine for a WBC scan. The blob had an anxiety attack during the procedure, and if you've ever seen the movie, you already know it is difficult to communicate with water. It just isn't like those Timothy Leary moments from the sixties, where I floated on a lotus flower, talked to the colored orbs in the sky, and chanted "Om" in reverse, which came out as "Moo". Oops, maybe you missed the 60's!?!

Anyways, luckily the reader never knows if I'm actually relating something from real life, or if I'm still on some kind of acid trip.

Regardless, if you've worked with many horrid conditions, you certainly have met up with Ms. Anna Sarca. She hangs around and makes your life miserable.

Criminal Edema

He has criminal edema
It's coming out his ears,
Even Anna Sarca
Almost came to tears,

It's a crime against his passion
Perpetrated on his life,
A transgression of such proportion
That he wished he had a knife,

An insidious attack
That caused him such rancor,
It weighed upon his body
Like a 300 pound anchor,

He's a blob in the bed
A jellyfish on the shore,
Like a gasping guppy monster
That I dream of when I snore.

Because he suffers, oh he does
From edema on the run,
Escaped from Alcatraz
He'll tell you it's no fun,
To have your skin weep wonky water
You can't drink it, that's for sure,
And although it's the 21st century
Ask a doctor, there's no cure.

He has criminal edema
America's Most Wanted?
It's not him,
Though he has a proper future
Filling swimming pools;
To swim.

Fibril_late;
7/24/09

Someday, in the far reaches of your career, you will look back and recognize that one special person, was your nursing soul-mate. I know who mine is, although we no longer work together. However, I know that if we were to be reunited in the work setting, incredible things could, and no doubt, would happpen. Our assessment and technical skills were complimentary, we were always looking out for each other and most importantly, mutually focused on the most advantageous outcome for the patient.
Sometimes I go to work, look around, and long for just one more shared work day, with my old friend.

Soul-Mate

Sixteen years now
And I've figured it out,
You were my Nursing soul-mate
Without a doubt,

No one since
Has had your tools,
You were my balance
When we were surrounded by fools.
My sounding board
Whether wrong or right,
We could face any disaster
In the darkest of night.

'Tis a rare opportunity
To work with someone like you,
Nothing could stop us
When there was a job to do,
Under the circumstances given
The best outcome was guaranteed,
What might have been a hemorrage
Became a small bleed.

Now all these years later
When I scan the scene before me,
Searching for a comrade
Whom I can always trust,
I wish that you were there
To share the vision that I see,
With your fine tuned assessment skills
We can both decide, success or bust.

If ever we are reunited
I'm sure the years will melt away,
I know you're still working the circuit
As I do, to this day,
We'll talk about the old times
And share our aches and pain,
I'll check you out, for the kinds of injuries
That leave a permanent stain.

And when we part, I'll feel whole again
Like those years so long ago,
Reminded that your spirit is with me
In every episode of this show.


Fibril_late,
7/21/09

We have this new computer charting and it comes with about 50 tiny, (font 8) icons, that look like little bugs crawling across the screen. Thus, I had to write the iconic poem.

Icon

Icon not understand
Nor fathom what they mean,
All those silly little symbols
Running circles on my screen,
The experts call it my PAL
But it ain’t no friend of mine,
A pal is strong and helpful
And this one has no spine.

Icon not discern the meaning
Icon not discover a solution,
Too many icons running around
That deserve an execution,
Icon hardly wait the day
When we finish up this caper,
There will be a mass revolt
And we will welcome back the paper.

fibril_late
7/9/09
_ _ _ _ _ _ _ _ _ _ _ _

I wrote "Icon"; then I slept. I woke up and wrote "Yukon"..........................must have been the Boss invading my sleep.

Yukon

"Yukon", she repeated
"Yukon, do what I say",
Treat these icons with respect
All night and all day,
Because that's our new language
Our lexicon, our lingo,
Get on the boat and behave
You, pestilent gringo.

Whether she said that exactly
I can not be sure,
But if I want to get paid
I better find me a cure,
To my symbolic sepsis
This agonizing irritation,
Or yukon bet my next boat trip
Might be a smoldering cremation.

Fibril_late;
7/9/09

This shouldn't be an issue, in our line of work, but believe me, it is. Trust. Who can I trust, when the rubber hits the road. When the Sht hits the fan, or when I am away from the bedside. It isn't always about being untrustworthy, but rather, someone who may lack common sense, or has yet to develop their critical-thinking skills. The danger in this case, lies in the fact, that the person in question, doesn't realize they "have a problem". After all, when you don't know what you don't know, by golly, you don't know Jack!

And Jack is dangerous!!!

Thick and Thin

Who can you trust
When your IV bag runs dry,
Let's just say you're out to lunch
And your patient could possibly die,
You surely expect to hope
That fellow nurses on your crew,
Will walk into that room
And know exactly what to do.

Who can you trust
When the ventilator tubing comes apart,
You're on a trip to the pharmacy
And your patient isn't smart,
He dislodged the vital tubing
And now his lungs no longer inflate,
Can you trust the members of your crew
Before it is too late?

Who do you trust
When you need a vital favor,
You're so busy with one patient
And cherry is the flavor,
Do you query anybody
Or single out, one or two,
The ones you know, through thick and thin
Would do the same as you.

Who do you trust at work
It should be any person,
In this critical-care arena
If we don't cooperate, patient's worsen,
But after all is said
And most of all, is done,
Who I trust, is selective
It isn't everyone.

Fibril_late;
7/8/09

"Bless you": this line is uttered so often, you'd think there were a bunch of Gods running around. Or agents of a God, dressed in the clothing of the day. Hmph. It sure makes me wonder.

Gesundheit

I wonder sometimes
What stories I'll tell,
When I have left Heaven
And I'm not in Hell,
Some might think I'm crazy
The things that I'm saying,
But if you are religious
I know that you're praying.

At work the other night
I performed some good feat,
The nurse that I helped said
God bless you, Pete,
And it caused me to wonder
If she somehow had the power,
Bestowed on her, by God
To bless me for an hour.

I didn't notice any difference
That a blessing could have made,
Perhaps the blessing is in storage
To be sometime, later played,
To my better advantage
In a time of greater need,
Like when I stick myself with a needle
Causing me to bleed.

What makes people think
They can randomly send a blessing,
As personal agents of God
It's almost depressing,
Because that's what the whacko's say
Before they poison their flock,
It fills me with trepidation
As I prepare for the blessing shock.

Who knows what it means
When you're blessed for a sneeze,
Though I've always preferred
"Gesundheit", if you please,
That kind, German wish
To offer me good health,
But I'd really prefer ten dollars
And wish me good wealth.

Fibril_late;
7/8/09

I woke up from my "first day off sleep" and immediately wrote this poem. All I had was the line, "At risk for skin integrity", which had earlier struck me as an odd way to describe skin that had the potential of being damaged.

Where did I get that line, you ask? From a memo, of course. Furthermore, a "bathroom memo", with its accompanying flowchart format. I'm telling you, that this organization I work for is a veritable writers dreamland; a germinating pit of poem seeds, if you will. I suppose that might be going overboard, but to me, it is constantly entertaining.

Skin

At risk for skin integrity,
It could happen to you
It might happen to me.

Your skin was ragged
And worn, at each seam,
We tried to repair it
'Twas a heck of a scheme;
But you wouldn't have it
You scratched and you picked,
The carefully placed Duoderm
With your fingers, you flicked,
It littered your bed
And fell to the floor,
The housekeeper bitched
At one more, extra chore.

They came with their science
Those Hyperbaric nurses,
You flailed and you spit
And heaped them with curses,
And thus, you were blessed
By the most basic of karmic laws,
You reap what you sow
The effect is your cause.

Your skin wouldn't heal
You moaned as it wept,
Perpetually, you were awake
While everyone else slept,
With your circadian rhythm
Totally, fu-barred,
Even if you survived
You'd be horribly scarred.

Yes; skin integrity
Oh, my,
We fixed your skin
But still, you died.,
You fought all of our efforts
So valiant; with vigor!
But it matters not
With your mortis and rigor.


Fibril_late
7/6/09

Picture this scenario: The patient, a young mother dying with cancer, a family in crisis, a husband going ballistic, a teenage son overwhelmed with the burden he is shouldered with, a grandmother newly arrived from the old country, without a lick of spoken English. Then, the patient has a respiratory arrest: the outcome.........chaos!

Letter To Sergei

In my letter to Sergei:
There's so much I want to say,
I recognize your anger
But don't aim it our way,
We care for your wife
Much like you do,
Just a different perspective
Than the loving husband view.

We want the best for her
And we're doing what we can,
Please hold back your anger -
Be strong; be her man,
Her protective custodian
Her pillar of stone,
If we can all share this space
She won't be alone.

We suffer your loss
We're included in your pain,
Love is a journey
It is never in vain;
I see the strength of your love
And recognize your power,
Please set aside your anger
And love her, one more hour.

Fibril_late;
6/30/08

I've been an EKG fanatic for years. It's the topic I study the most. When I see some arrhythmia scoot by on the monitor, I want to capture it, and analyze it as if I'm Sherlock Holmes. I've never been successful in learning other spoken languages, (as my mate will attest to), but the EKG, that's a different story.

SVT vs. TVS

Is it SVT
Or TVS,
Sometimes I get
Confused, and guess,
My idiot factor
Increases by doubles,
With an exponential
Rise in my troubles.

Let's examine a scenario
You've got the night-shift blues,
It's your fourth night in a row
And this one's an easy cruise,
When abruptly, you're assaulted
By alarms and lights galore,
Awakened from your reverie
You fall upon the floor.

The rhythm is wide and ugly
And it's totally bizarre,
The short trip to your patient's room
Suddenly seems quite far,
You fumble for the Lidocaine
Then stagger in the room,
Your tunnel vision activates
The flashing light, spells doom.

Is he conscious, is he dead
Is he even in the bed?
Is he watching television
Can you make a quick decision?
Should you stop a moment, and clock him
Or just go ahead and shock him?

Well, there isn't always time
To plan a course of action,
You will always get opinions
From many other factions.

Now you zap him with the macrovolts
And raise a head of steam,
He jerks up off the bed
And summons a frightful scream,
“Holy Mother of my ancestors
Deliver me from Hell,
If this is getting better
I'd rather not be well,
Because I have no recollection
No, I never have agreed,
To allow electrocution
It's just not a thing I need”.

Despite his pain and suffering
His rhythm has reversed,
He is mad as hell that you saved him
And announces, you've been cursed,
By the mother of his ancestors
The mark is on your head,
(Lord, another thing to think about
When it's time to go to bed).

Did you get a few good strips
Before you shocked that creep tonight?,
Was it SVT or TVS
Or Parkinson, Wolfe and White,
Does a delta-wave announce itself
Or remain concealed and silent,
Was it SVT aberrancy
Or something else more violent?

Is the phenomena reentry
Are the P-waves retrograde,
Does the AV-node dissociate
Or the P-waves simply fade,
Is the antegrade conduction
A sign of CMT,
Is it Atrial Fibrillation
With ventricular ectopy?

Is the axis indeterminate
Is it normal, left or right?
Is the complex wide or narrow
Or the R-wave broad or tight?
Does the QRS morphology
Have a well defined polarity?
Is it positive or negative
Are the fusion beats a rarity?
Do you notice a concordancy
In the horizontal plane?
Is there evidence of R-wave loss
Or just too-little gain?

Beware of helpful hints
That are often unreliable,
Choice of drugs is crucial
For the patient to be viable,
Like compensatory pauses
Gross appearance and the rate,
Commonly unsubstantiated
Clues of someone's fate.

The outcome, is all that matters
Did you fix it, did you not?
Could you halt decompensation
Or do you feel, your nerves are shot?
Did you conquer SVT
Or succumb to TVS,
Terrifying Ventricular Syndrome
And its' consummate distress.


Fibril_late;

1995

My co-contributor in Virginia has sent another riveting story of his Nursing life; enjoy!

Life on Neuro Unit

The patients were all quiet,
The night was quite slow.
'Til this guy with a stroke
Complained of gout in his toe.

He asked for some morphine,
So like a good nurse.
I drew up the max,
And said “thanks”, when he’d curse.

I pushed it in quickly
So it would act really fast.
I’d just give him another
When that didn’t last.

But, things don’t always work
The way they are planned.
He saw bugs on the wall
In dinosaur land.

He stood in his bed
And in some Shakespearian verse,
Screamed “I’m Dorothy, you wicked witch of the East”
And then pee’d on his nurse.

And with all the excitement,
Sir Dorothy’s pressure did soar.
And with one pirouette
He was flat on the floor.

Well, he wasn’t really hurt
When he fell from that bed.
Except maybe that subdural
He got in his head.

And the coumadin didn’t help none
As he took all those knocks.
Nor did the Aspirin,
Least of all, Lovenox.

Now I’m writing the report
Doing all the explaining.
While “Dorothy” pushes up daisies
And does no complaining.

S. H.
4/17/09

People experience grief in different ways.

Shades of Grief

Different ways to
Experience grief,
Some strike out in anger
Others cry for relief,
Some choose innebriation
By smoke, booze or pill,
One man's poisonous elixir
Is another man's swill.

Fibril_late;
6/25/09

Back on May 28th, I wrote about the "boxes and arrows", referring to a "what's new" document on the bathroom wall, with some kind of nifty flowchart, in this case, regarding pressure ulcers.

Now,(in my opinion) it's time to take it down, and show us something new, because of course, we are monsters for continuous learning!

Show Us The Way

What with boxes and arrows
And asterisked notes,
I'm sure we'll be influenced
To offer our votes
With a highdy-hy-ho
We'll all dance to the tune,
While the Stage 3's and 4's
Will heal up real soon.

We'll be featured in "People"
"Cosmo" and "Us",
Oprah will invite
And we'll get on her bus,
Dr. Phil will offer
A warm and groovy kudo,
But frankly, I'm thinking
He is full of menudo.

Now, those boxes and arrows
Will soon be replaced,
This idea is old
And can now be erased,
But don't you be worried
Something new will be in play,
Another flow-charted document
To show us the way.

Fibril_late;
6/21/09

Nursing, is a weird industry, in terms of how we relate to each other. In what other career/job, do workers "write up" each other? This means, that when a co-worker makes some kind of mistake (according to me), or perhaps, throws off some kind of attitude that I don't like, I can write them up. As a nurse of 26 years (yowza), I have never performed this writing-up thing. Probably somebody has done it to me, although I don't remember, but I'd like it to be known right now, that it isn't a good idea, because I'm sneaky, devious and smarter, and you will get no advance warning, when I decide to put a rat-trap in your locker.

Write Me Up

If you write me up
I will write you down,
I'll have your car followed
All over town.

If you call me to the front
I'll meet you in the back,
You better be ready
I just might attack.

If you have a complaint
Don't take it to the boss,
Keep it to yourself
And you'll suffer no loss.

If you write me up
And I retaliate,
Remember, I warned you
'Twas you, that sealed your fate.

Fibril_late;
6/14/09
__ __ __ __ __ __ __ _

And along similar lines, there is this option:

We'll Blame It On You


We'll blame it on you
When you're not here,
It's the easiest way
To get back at you, dear.

We'll blame it on you
That's the best way to do it,
You're not here, so we can
Say that you blew it.

Now, you may wonder why
We blame it all on you,
It's really quite simple
It's the petty thing to do.

Fibril_late;
6/17/09

I was reminded (by me) regarding why I like to have a new assignment every day I work. Familiarity. I find that more mistakes are possible if I think I know everything that has been going on with Patient "X", if I took care of them 2 or more days. Sure, I know it makes the Nurse-to-Nurse report easier, and supposedly the patient and their family like to get to know "their nurse", however, I can assure you, families will let you know right away, if they NEVER want you as a Nurse, ever again. So, I guess that's familiarity in reverse.
Anyway,
the poem writing also brought out how we all know people (perhaps I'm one....) who talk too much about stuff that is private, or best kept at home, and certainly not aired in the workplace. So that's why I call this the:

The Privacy Store

Familiarity may breed contempt
I suspect you've heard this before,
Knowing another, more than is necessary
Can lead directly to the privacy store.

The place where precious secrets
Are hidden from prying eyes,
A place where hurts and insults
Can be found with accompanying cries.

Stuffed away incidents of injury
Long forgotten, and best filed away,
Might pop up in moments of vulnerability
If familiarity influences the play.

Some people keep their store open
Friendly and inviting, they'll share,
Every damn thing you can think of
Cluttering and polluting the air,
Innuendo, and other meaningless blather
Couched around an occasional thought,
As if we need to know all the details
Of the latest hot gadget they bought.

Oh familiarity, it presents kind of friendly
But as the details stack up it's a bore,
My advice to the public at large
Come on, won't you please lock your door.

Fibril_late;
6/7/09

Every time there is a new paper on the restroom bulletin board, and it outlines a "flowchart", well good golly, it must be another "latest hot thing to do". Yup, that's a surefire countryfied guarantee!

Boxes and Arrows


Note the boxes and arrows
Some wide and some narrow
The emphasis, where asterisks lie,
Another awesome directive
For Nurses collective
The Pressure-Sore Flowchart, oh my!

It has every ingredient
To demand we're expedient
It describes what to do, when and how,
Make sure you do it right
If a pressure-sore is in sight,
Or surely, (you-know-who), will have a cow.

It's a Medicare didactic
To use threat as a tactic
To shift the cost of the problem to us,
And thus the panic doth fly
From those leaders up high,
And the workers bear the burden and fuss.

- - - - - - -

While those boxes and arrows
Were so orderly and neat,
The conditions and diseases
Causing sores, can't all be beat;

Thus, we pay through the nose
For the wounds that won't close,
[Medicare bean-counters are happy
They're not paying for those],
Some hospitals will go bankrupt
Then doors will close............

At last the boxes and arrows
And the occasional asterisk,
Will go the way of the dodo bird
And the old floppy disk,
Succumb to the vagaries
Of regulation and defrayal,
Another typical case
Of healthcare betrayal.

Fibril_late
6/4/09

JCAH In the News again.

Where To Go

We have boxes and arrows
And flowcharts galore,
Which is a sure guarantee
It will mean a new chore,
And when two chores a month
Are introduced with regularity,
It becomes quite a challenge
To a Nurses dexterity.

I’m not pointing fingers
Nor assigning any blame,
Although I suspect there’s a connection
With that famous Jayco Game,
It’s a bit like Monopoly
Hooks-and-Ladders, and Chance,
Dress up in your Disco boots
Start the music, let’s dance.

With our arrows and boxes
Pointing sideways and down,
We can tell them where to go
When Joint Commission comes to town.

Fibril_late;
5/28/09

HNNK/DKA - Thats a mouthful, isn't it? For some reason, what used to be HHNK (Hyperglycemic Hyperosmolar Non-Ketotic : Diabetic Ketoacidosis, has been renamed HNNK) ....sounds like Mary Poppins is at work here, huh?

Anyway, at our facility, some BODY has chosen to vote in the HNNK, abbreviation, and it still means the same thing, but the initials don't really work out. Whatever!

To those of us who are shackled with doing fingerstick blood glucose tests every 30 to 60 minutes, I assure you, we recognize it as SOS.

Yes, that means:

Same Old Ship

HNNK
Used to be HHNK,
Don't ask me why
They didn't say,
It still is packaged
With DKA wrapping,
And you read about it first
Where everyone is crapping.

I can hardly wait
For the next revision,
As usual, it won't be
Our decision,
We're just the folks
Who play by the rule,
That's what they taught us
Back in school.

HNNK
It sounds like a ship,
Ready to sail
On its maiden trip,
But ask any sailor
It's the same old boat,
As ready to sink
As it is to float

HNNK
Three pages of orders,
So entirely typical
With these types of disorders,
No doubt derived
By an oversized committee,
And as slaves of the document
We beg you, have pity!

Fibril_late;
5/24/09

This topic has caused another poem!

HNNK Revisited

This HNNK thing
Is a document to admire,
Dr. M, is promoting it
So we'll save it from the fire.

As stubborn as we are
I guess we'll take it for a spin,
That previous HHNK thing?
We'd had it up to the chin!

Mutiny had previously been scheduled
To arrive, June 4th, oh-nine,
HHNK orders, were getting keel-hauled
And afterwards, pickled in brine.

Perhaps our bitching and moaning
Finally passed the deaf ears,
It overstepped many a brain
Misfiring on 10 gears;
Because................
Reversing acidosis
And tweaking the glucose,
Is not a refined science
No, that doesn't even come close,
To describing the ways
The problem has been addressed,
As if every 5 years
It's another new test,
Of our capacity to follow
Convoluted orders and a hot new plan,
When we know good a well
We're back where we began.

This HNNK treatment thing
Is a sight to behold,
By the time we understand it
Most of us will be too old,
To prepare for the next version
Due in seven years,
Retired by then, anyways
We'll reminisce over a few beers.

Fibril_late;
5/27/09

This poem dates back to about 1980, and it's a real classic.

Ode To Gomer

What do you see, Nurses
What do you see?
What are you thinking
When I take a pee?

Did you notice my bladder
Distended and firm?
And that thing in my stool
It looked just like a worm.

Did you observe that my sputum
Was crawling and green,
Can't you see I need treatments
On my breathing machine?

I'm nauseous and nasty
Whoops, up comes my brunch,
Please save it for me
I'll have it for lunch.

That IV solution
Is really poison, you know
And you're trying to kill me
But I won't let go.

I'm calling my lawyer
To represent me,
I'll have you all jailed
And I'll be set free.

Oh my God, my heart's pounding
Like it's hitting my rib,
And I hear a loud voice announce
"Look, it's V-fib"!

Someone's thumping my chest
As ribs crack, one by one,
Why is everyone smiling
Like this is all fun.

Now I'm just an old body
Lying limp on this bed,
The crowd sighs with relief
'Cause this old gomer is dead.

Fibril_late;
1980?

Now, from the not so good ideas department. In this day and age of "names that catch the attention", why would Sister Euphemia allow her Pharmacy to name a new directive, "Pharmacy Profiling"? I immediately thought of "racial profiling". Duh!
So, what in the heck is Pharmacy up to, with their brand of profiling?!? I sure don't know, but I have at least one idea.

Pharmacy Profiling

Pharmacy profiling
Is the latest aberration,
Delivered by a department
Famous for obfuscation,
After numerous MERP alerts
And countless Pharm-a-grams,
They are pulling out the stops
And kicking out the jams.

Pharmacy profiling
Am I on their list?
Are they hunting down perps
Regarding meds that were missed,
Planning pointless punishments
For punks such as me,
Pharmacy profiling
Will be a catastrophe, you'll see.

Pharmacy profiling
I'm worried a bit,
Big Brother is watching
They're profiling my shit,
Luckily, I'm devious
Sneaky and sly,
Profiles be damned
Will be our battle cry!

Fibril_late;
5/15/09

A Poem Inside

When there's a poem inside
And it's sneaking out,
It might make a little squeak
Or exclaim with a shout,
Sometimes with a holler
At other times a whisper,
At times with a crunch
Like lettuce in a crisper.

It's very spontaneous
With a little assistance,
Words chosen at first
Take the path of least resistance,
With quite a few readings
The words sort themselves out,
I'm happy with the result
Or knock it over with a clout.

It might land in a trash-heap
With potato peels and rice,
Or find the desk of a publisher
Who turns out to be nice,
And in most cases the writing
Will find a way to be fun,
Just one page or two
And then it's all done

Fibril_late;
5/12/09

Loose stools.........certainly a problem!

Loose Stools vs. Loose Schools
Part 1

I think I’ve discovered
The answer for the ages,
After studying diligently
Well over 5000 pages,
A query frequently posed
Regarding loose stools,
It originated I’ve discovered
From those days of loose schools.

All sorts of problems
Can be traced to those times,
And I assure you, it's difficult
Making all of these rhymes,
Regarding a topic like this
But I shall prevail,
Loose stools need a solution
There is no room to fail.

Fibril_late;
5/12/09

Dementia: out in left field, scrambled, discontinued, broken neuronal connections in the brain, and currently irreversible.

Into This Moment

Happily demented
You don’t know what you’ve missed,
Live the moment right now
Forget who you kissed,
You don’t know your daughter
Your husband or son,
You live the moment right now
And it all seems like fun.

Happily demented
You won’t realize that you’re lost,
You could shop every day
And never know what it cost,
So just sit on the porch
Reminiscing the past,
Time condensed into this moment
Until death, shall it last.

Fibril_late;
5/12/09

SNF - We pronounce it like the word "sniff". The abbreviation translates to "Skilled Nursing Facility". Sad to say, but long-term care facilities are commonly colonized, along with their patient population, by a vast variety of infectious, communicable cooties.

The C-diff Song

She came from the Sniff
With a case of C-diff
We weren't surprised
By that occurrence, not a bit,
Oh, but that smell, it did offend
Forever, without end
Just imagine 12 hours of that shit;

Any Nurse worth their salt
Would surely, ponder the gestalt
As if some evil apparition, dogged their trail,
Just by walking in the door
At eighteen-hundred, forty-four
They'd be dealt, the shit assignment, without fail;

They realize, it all depends
On humble beginnings and horrid ends
Who's in charge, the night they both will work together,
Because crappy assignments, seem to follow
With smiley platitudes that all ring hollow
It's just another night to bear the cross and leather;

Gown and mask, booties and glove
There's nothing better, when you're in love
Enjoy it, over and over, all night long,
When you get home, and notice the booties
You will feel like you're covered in cooties,
That's the way it goes, when you dance the C-diff song.

Fibril-late;
5/5/09

It has been a quiet stretch. Work has overwhelmed me with writable dilemma's; however, it took a walk through academia to spark my muse.

*Look, I don't make up sentences like the following.........I leave it to my peers - read within the brackets: (I only respond in rhyme)

["In consideration of our current shortage of nurses and consequent heavy workloads, we cannot afford to adopt new practices, unless they are evidence based"]
and furthermore,
["Evidence-based guidelines can serve as a catalyst for knowledge translation to the clinical arena"].

Come-on, what the FUBAR, are these bumps talking about regarding "knowledge translation", huh? Just think a while on it......

Evidenced Based

Evidenced based
HooRah, HooRay,
Do what the experts say
Tomorrow, today,
They are the ones
Who decide what we do,
But I don't really know them
Any better than you.

Quality control
Based on the best,
They said, they did more than
One thousand plus test,
Who am I to question
I'm just the nurse,
If it screws up, what then?
Of course, I bear the curse!

Evidenced based?
They didn't ask me, not ever,
Perhaps, 25 years
Was not enough to say I'm clever,
After all, I'm not a researcher
I don't have the degrees,
I'm just an AA, RN
Gesundheit! Did you sneeze?

Evidenced based?
It carries some meaning,
Although, I am not sure
Just exactly who they're screening,
The Nurse, or the patient
It's not terribly clear,
I guess, I will know
If I'm fired some year.

Fibril_late;
5/4/09

The Joint Commission is on the way. Hide the food and coffee cups. Cross your eye's and microdot your tea. Resistance is futile.

JC Blues

The Joint Commission
Is now in session,
Waiting to hear
Our collective confession,
Of all our mistakes
The foibles and flaws,
With a justified punishment
For every cause.

The Joint Commission
Is a devious delegation,
Recording secret notes
Derived from information,
We so generously shared
In the spirit of humanity,
Historically, their pickiness
Borders on insanity.

These cretins from JCAH
Will be changing their name,
They sought counsel above
With a bigger player in the game,
They’re wearing white collars
And counting sandalwood beads,
Come children, to Joint Confession
We’ll absolve your evil deeds.

Fibril_late;
4/21/09

Oh bother; here comes ye olde Joint Commission, on their rounds again. Hmmmm, wouldn't it be wonderful if they were what their name implies? A commission dealing with joints? You know........weed, marijuana and the like.

A Giant Doobie

The coming Joint Commission
Will look for your omissions,
In other words
If you don’t commit,
The Joint Commission
Will give you shit.

What I’d like to see
From the Joint Commission,
Is a giant doobie
To smoke, while fishin’,
Because that is what
Their name implies,
Some righteous weed
With burgers and fries.

Fibril_late;
4/18/09

Emergency Departments the world over, are dangerous places to be. Heck, if you're in California, you just might want to drive over the hill to Nevada; no sales tax and more.

Just Stay Home

When you’re lodged in the ED
For hours and hours,
And the Doctor won’t order
More than one whiskey-sour,
The thing you must do
Is to claim you see bugs,
They’ll think you’re in DT’s
And they’ll give you some drugs.

For one reason or other
People seem to get worse,
In that dungeon of an E.R.
It’s an unholy curse,
And in this litigious time
Of frivolous law,
You’ll have everything scanned
From your arse to your jaw.

My advice, to Joe Public
If you’re sick, just stay home,
Put on a pot of tea
With a dash of mondo-foam,
You’ll be floating to Nirvana
With all your parts intact,
If you insist on coming to the hospital
Your system may be hacked.

Fibril_late;
4/17/09

Sometimes it's easy to understand why Nurses drop out of their career, and don't look back. One of those reasons, revolves around one's "bad luck" in the assignment of care, for the days work. Frankly, this is a testy subject, because it may seem like your Charge Nurse is a bully, or just plain brain-dead; a person who doesn't give a snot about how heavy an assignment they are dealing you, for your 8 or 12-hour shift.

Or possibly, you are enlightened like myself, and figure, it must be due to some cosmic, astrological, karmic, evil-mojo-spirit-demon, hovering just behind my back, and stabbing me repeatedly, with an ebola saturated cactus spline, into my first chakra. Then it all becomes perfectly clear; kill, or be killed!

Assignment Misalignment

Certainly, there will be times
When you question your assignment,
You will ponder your earthly Karma
And your astrological alignment,
But any actions beyond that
Are but, futile wasted motion,
One round of work, is like a drop of rain
In your entire Nursing ocean.

Like the travails of early explorers
With tests of other-worldly endurance,
Horrendous shifts of reckless mayhem
Have a cyclic frightening occurrence,
You never know when your number is up
Though some attest, they can feel a vibe,
From finely honed, critical thinking skills
And genetic memory of the tribe.

About the time, when you’re thinking
You've had your very worst night,
The Grim Reaper is chuckling
Think again, you’re in for a fright,
Because I have recently cooked up
The worst, frickin' assignment,
After tonight, you'll know misery
And need a karmic realignment.

Your shift will be so horrid
Like a nightmare you're dreaming,
And after only two hours
You'll be silently screaming,
One hour more, you'll be cussing a blue-streak
Four-letter words, by and large,
Promising heaps of bad mojo
Upon the head of the Nurse who's in charge.

You wonder if there was a memo
From your commander (who lacks all refinements),
During 2009, give old BillyBob
The most god-awful, frightening assignments,
Test his mettle, let's see if he's breakable
After all, he's a pain in the neck,
Yet you know, beyond a reasonable doubt
They're expecting you to pick up the check.

Fibril_late;
4/16/09

You don't want to know what drove me to this........................it is too horrid to tell.

The "Slime and Phlegm Triumvirate"

1. Slime and Phlegm

Slime and Phlegm would hang out
At Billy-Bob's on Main,
Mucus-Masters in their own right
Always poised to slime your brain;

You could never accuse those bad boys
Of ever carrying a decent scent,
In fact wherever Slime and Phlegm were found
Their buddy, Mal Odorous also went.

Could any redeeming qualities
Be found, amongst these two?
Well if you can imagine those by-gone days
Before the discovery of Super-Glue,
And the Industrial complications
When two surfaces wouldn't adhere,
Versus the serendipitous clinginess
When Slime and Phlegm were near.

Indeed, those were the incubation days
For the mother of invention,
It all began in High School
Where the rowdy bunch met in Detention,
For flinging phlegm and slimers
At young ladies, in their class,
And the seeds of ingenuity
Were bubbling out their ass.


2. They Were Known

Some thought Slime and Phlegm were twins
But that's not the way it was,
Some proposed they were from the same neighborhood
Exactly why, who knows, or just because,
They both were known to slink around
Dark alleys or outback places,
Dropping in unexpectedly
Upon unsuspecting faces,
They were known to keep company
More with adolescents or kids,
With a general lack of untidiness
What was sliding, would be on the skids.

Slime and Phlegm were best of friends
But at times, they wished for three,
Easily bored, they'd scream at each other
"Oh Bro', you are boring me";

Now both, do look back fondly
Remembering the wonderful day,
They were hanging out at the putrid pits
When Snot came out to play,
You couldn't have picked a happier bunch
This slippery, sticky trio,
Whether in Pelican Bay or Folsom
San Quentin or Camarillo.


3. Nothing Left To Chance

It's really hard to say
If yonder Phlegm is my friend,
Surely, he's a sticky kind of guy
But you never know, how it will end.

Can one posit a preposition?
The superlatives, the pro's and cons,
About the subtraction or the addition
The historical figures in nickel-bronze,
Because there must be some deeper meaning
Some enduring value, in its place,
Perhaps there are some redeeming features
When it's stuck all over your face,
Possibly, it is no coincidence
That in the middle of your face, is your nose.
Shielding you from the wicked winds
And brutal ice and snows.

And once again I've detoured
On the road, that's called my journey,
Kind of like planning to be a Doctor
And ending up as an Attorney,
Parallels can be found
And this is one of them,
I've ended up with Slime
When I started out with Phlegm.

Some will find the topic
Too gross to contemplate,
And admonish me, dear Sir
Don't you know that I just ate,
I will apologize sincerely
But continue with my dance,
When you deal with Slime and Phlegm
There is nothing left to chance.

With retrospective analysis
You could say their point is well made,
Slime and Phlegm are so unique
And so few would dare to trade,
But those of us, who are in the know
Revere them in abject wonder,
Slime and Phlegm, can not be trifled with
Or surely, you will rue your blunder.

Fibril_late;
4/9/09

Even in 2003, Administrative Nursing held no vision for me.

Not For Me

Administration
Is not for me,
Too much
Paperwork, you see.

Fibril_late;
2003

The doorway into the infinite, ya, just another name for room 2988. Sister Euphemia, thinks differently:

Paradise Portal

Two men died
In the course of 8 hours,
They had a destination
Beyond our paltry powers,
To maintain the slightest grip
On the leash that held their souls,
Poised at the edge of eternity
We held the minor player roles.

Both of these final exits
Shared the same departure room,
Notoriously superstitious
A Nurse will claim, a vibe of doom,
A mysterious lurking power
Inhabits room eighty-eight,
They want to call the hospital Shaman
To exorcise, this psychic gate.

Sister Euphemia, holds a different opinion
More positive, in the heavenly light,
We all must depart this earthly plane
And let our souls take their ultimate flight,
This hospital, offers a timeless service
A pathway, for departure immortal,
"We invite you to visit, our V.I.P. suite;
Sister Euphemia's Paradise Portal".

Fibril_late;
4/5/09

A close friend was in the hospital, suffering from too many specialists. Here is her story.

They Were Specialists

Imagine, if you will
Her dilemma, in this dominion,
There were 14 assorted doctors
All with a different opinion,
Supposedly, they were specialists
But she had a rare disease,
They said, "Come on Honey, we know what's best
Sign the paper; let us do what we please.

Surely, you jest, Dr. Dudes
I'd laugh, but first let me cry
Yesterday you told me a different tale
About a transplant, and how soon I might die,
Today you are saying, I just need a valve
And tomorrow, I wonder what's next,
I think I'll go home, while you make up your minds
Don't bother to call, send a text.

Discharge me, they did, in such record time
The Ward-Clerk, was given a plaque,
When I landed at home, dear Sam and Elizabeth
Plucked all of the knives from my back,
Some doctor will call, in the next day or two
To tell me, the latest great plan,
In the meantime I think I'll just knock back a shot
And hideout with my best canine-clan.

Well, that was a story, with bad sound and fury
Oh Shakespeare, a tragedy for sure,
17 specialists can't make up their minds
Though they claim, they just found the right cure,
In the meantime, convalescing in the comfort of home
Her condition, still advances with time,
Reluctant she waits, for Dr. Dude's invitation
To return to the scene of the crime.

Fibril_late;
4/4/09

A couple of weeks ago, Brother Coot, had an aborted MI, with a life-saving stent to his RCA and one jolt of electricity to remind him of the good things in life. Here's the latest follow-up.

Concerns

The old coot has done well
Though I'm not surprised,
Between his colleagues and family
He was certainly well advised,
And the Attorney, that he is
One could easily assume,
He could gather enough information
To fill up a room.

Now these days, your doctor
Just isn't the one to ask,
Their business today
Is like an overfilled flask,
Spilling with patients
Like wine at the brim,
There's no time for answering questions
It's just a diagnosis skim.

Gone are the days
When our doctors sat down,
To truly listen to our concerns
Without a hurried frown,
Rather, we must rely on
The Internet and friends,
To get reliable information
Before our life ends.

Like I said, the old coot
Is doing quite well,
But I'm 2000 miles distant
So, what can I tell?

Fibril_late;
4/4/09

This is gloomy, but I made the mistake of reading the news this morning. Current events, are tomorrow's, horrid history.

Citizen Terrorists

Who needs Al Qaeda
With a gun country like ours,
More citizens are slaughtered
During daylight hours,
By loved-ones and hated ones
Family friends and foe,
Real terrorists, in our homes
People that we know.

We don't require religionists
Whacked out, with interpretations,
On suicide missions
In our gun toting nation,
No, we have home-grown angry folks
With automatic guns,
Shooting women and children
Fathers and sons.

The threat of death and mayhem
Is an industry we foster,
No matter, how good your background check
There's a nutcase on the roster,
Probably sitting on a comfy couch
Festering with personal frustration,
Dreaming of bullets and bloodshed
To assassinate, the aggravation.

With a chip on your shoulder
Or the wrong glance your way,
You go home for a weapon
Just to make it my day,
Without preemptive warning
Or psychiatric clues,
Ten thousand citizen terrorists
Who need to pay their dues.

Fibril_late;
4/3/09

Another trip to the Dentist..........Heck, I see my Dentist way more often than my Primary Care doctor. It's almost like were family. She always offers me choices, when it come to pain relief, and this time was no different, but how could I know she would offer me Betty?

Lip-Lock With Betty

As I was relaxing upon yonder bench
Eagerly awaiting, the arrival of that wench,
Who would soon be probing instruments, of exactitude and pain
Aiming for the pleasure center, deep within my brain,
She asked me - (with her sexy voice)
Dear sir, you can make a choice,
A cocktail shot, of sedatives and drugs
Or a lip-lock with Betty, and a couple of hugs,
Before I excavate and prod and poke
Some people like pain, and that's no joke,
So let me know, your pleasure, sire
Because the iron's hot and in the fire.

Well, I had secretly admired, dear Betty
That's for sure,
And a lip-lock with her, would surely, be the cure,
To any suffering, I might endure today,
Bring it on, my Dental Hygienist.........
I'm ready to play.

While Betty was plastered all over my lips
That Dental Hygienist, was sharpening her tips,
Preparing a target, from X-rays last week
She had an eidetic memory, and didn't need a peek,
At any old records, for this mouth of mine
She was just waiting her chance,
To scrape, buff and shine.

As usual, at the end of this pleasant recreation
The in-house Master Dentist, came to make her observation,
View the scene of the crime; the battle at the front
Go for the end-run, or settle for the punt,
The message that she offered, would be my walking papers
More emphasis on flossing, and fewer sweet-tooth capers.

Fibril_late;
3/29/09

It's kind of fun finding old writings. First, it brings back old memories. Second, it allows me to see, if my writing ability has changed much in 20 years. In this case; clearly not. In fact, I can see, I was a bit of a word-elitist, even way back then.

What I'm presenting here, are 5 poems, which I'll call, "Tri-City Stuff". That was in 1987-88, when I worked one year, at Tri-City Hospital, in Vista, California. I think there may be other writings from that year, but these are just some poems I discovered today, in box 92. This was a time, when "The Underside of Nursing" had yet to be created; these were mere seeds of psyche, fermenting in a warm dark place.

Let's have a go at it, OK?

1987 - 1988:

A Life of Leisure

Cathy, I regret
To inform you on this day,
That I'm leaving this establishment
And traveling on my way.

I assure, in all honesty
'Twas nothing said or done,
A valuable experience
Indeed, I thought it fun.

As nurses, none compare
To this crew, you deftly hired,
Believe me, when I tell you
I was professionally inspired,
So much, I stay awake now
While the night turns into day,
With such stimulating colleagues
I could choose no better way.

Which sums it up, I guess
The memories that I'll treasure,
Now, I'm heading for the mountains
To lead a life of leisure.

Fibril_late; 6/88


The Runner-Band Revolution

The rubber-bands were flying
Like bees about the hive,
It was war in CCU again
Will replacements, soon arrive?
The Chief is working overtime
A master of defense,
This war is getting on her nerves
She’s soon to take offense.

It’s been a long and hoary battle
With participants, too many,
To count the sundry causes
Of this infraction; are there any?
Who knows, who do we ask
Who do we hire, for this task?
Let’s find some folks, down in the city
To come together, in a committee,
To ask some questions and find some answers
Hire a task-force, of dirty-dancers,
Come on folks, let’s get professional
Have a seat in my confessional,
Pass a rumor, go for broke,
There’s a few of us
Who just can’t joke.

What the Hell
It’s been a lot of fun,
For a few of us
But, not everyone.

And........after all is said and done,
I’m glad we gave it
One good run.

Fibril_late; 1988


I’m Sure I’m Not Dead

Too cold, for the living
Just right for the dead,
Now I’m chilled to the core
I just want a warm bed.

Move over, people
And give me some covers,
I’m freezing, you heard me
It don’t mean we’re lovers.

How about some coffee
Or warm soup and bread,
I may look catatonic
But I’m sure I’m not dead.

Too late...........life is flashing
Like a sleigh, across the Arctic,
My boat just came in
And I finally parked-it.

Fibril_late; 1987


A Testing Ground

Can you believe this water-situation
Once again,
It makes me squirm to think about
The germs upon this pen,
Let alone, the creepy crawly things
That habitate this room,
You know, I think this water thing
Is a plot, to bring our doom.

For months, I have suspected
That the night shift is the place,
A testing ground for maniacs
That run the human race,
They think we will not notice
Because our eyes are almost closed,
And by the morning, what’s the difference?
......I don’t know, I must have dozed!

Fibril-late; 3/88


Queen of the Monitor


At night, there sits upon this floor
A wondrous person that guards the door,
And protects us all from dire doom
Yes, peace doth reign, when she’s in the room.

On the mighty scale, of worthless jobs
She’s at the top of all the slobs,
And a credit to members of her sex
She’s Queen of all the monitor techs.

So, roll out the carpet
She’s out in the hall,
Bow down to the queen
Or her axe will fall,
And she’ll torture you till
The morning sun rises,
Then you will understand
How her stories, have won prizes.

Fibril_late;
4/1988

Even when crisis strikes as close to home as a sibling, (perhaps, more inspiring), a poem leaps forth.

The Jury Is Still Out

I'm a little concerned
About the old coot,
His RCA occlusion
Nearly gave him the boot,
But that isn't all
He's not out of the woods,
He has a tight LAD
Compromising the goods.

An acute MI
After a great game of squash,
The jury is still out
Who won? 'Twas a wash,
For the gentleman in question
On court forty-two,
'Tis not the time to argue
Because it could have been you.

Despite the unexpected nature
Of the outcome or the score,
Our favorite plucky protagonist
Welcomes conflict, bring on more,
He's an honest, fiery competitor
Renowned at the D-A-C,
Watch-out; he's already making claims
"Convalescence, ain't for me".

His family, walks on gilded splinters
Nervous-Nellie's, in their right,
Poppa, had a heart-attack
A life-threatening, kind of fright,
And though he looks good on the surface
Who knows, what lies beneath,
They would rather, chuck the Squash games
To avoid,"Will and Last Bequeath".

It takes a while for the novelty
To wear, in this situation,
But it's an everyday occurrence
In the American heart-attack nation,
The Cardiology science
Is so advanced, to save your life,
But there's not a big enough Valium
To calm the kids and wife.

Fibril_late;
3/15/09

(* D-A-C; A Health Club)

About every 5 years I add another notch in the belt of Care-Plan contempt. With nurses thumping their chest about "evidenced-based" therapies and such, I have yet to see any evidence of the inquisitive eyeball, taking a close look at this ridiculous construct that we know as a "care-plan". And now that I've gotten it back on the cutting board, I feel better ranting about it.

Charged With Contempt

For 26 years I've held firm
Staunch with my solid beliefs,
That a number of nursing-care actions
Were created by big-headed chiefs.

I've scribed miles of ink in futility
Writing care-plans of meaningless platitudes,
Created by nose-lifting academics
Entrenched with their superior attitudes,
They tried to create a special language
To set us apart from the medical,
Too bad that they missed the whole point
Convoluted communication; (paranthetical).

I've known long and forever my radical views
Are considered seditious or more,
But who gives a crap about plan notes and such
Another tedious, tiresome chore,
And frankly, I have cause to worry
If summoned to read a care-plan in court,
To attempt to describe, with the crazy language of our tribe
They might charge me with contempt or selling short.

Fibril_late;
3/2/09

Here is an idea, that I thought would lead to a story about Bertha, but instead became another hue and cry, regarding the weighty issues of the day.

Buxom and Girth

Oh Bertha, with the buxom bosom
Had sepsis, pneumonia and shock,
To keep her alive, we infused 30 liters
Adding four-stone, yea, ad-hoc.

Each turn in the bed for her skin care
‘Twould take the muscles of 3 mighty nurses,
Pausing to share a reflection
And sort out their favorite curses.

With a gnashing of teeth and straining of spine
The three groaned in triplicate unity,
Knowing quite well if they busted their backs
The hospital would deny with impunity,
Claiming, we have the equipment
To help move dear Bertha around,
Instead we were rash, we hurried and gnashed
Now they’ll bury us deep in the ground.

Suffice to say, we nurses are tougher
From the keel-haul, we had this past decade,
Throw anything at us, and we will just cuss
We don’t succumb, to the brute or the blade,
Better to back Nurses, than Wall Street
Unlike a mortgaged account, we add worth,
Protect the nurses, the backbone of the workforce
In this arena of buxom and girth.

Fibril_late;
3/1/09

Regarding ageing and the tendency for body parts to stretch and sag, as the years roll by.


Eternal Life

Getting old
Is surely hell,
The teeth will rot
And the body smell,
What once was upright
Sags down below,
Where it will stop
Can anyone know?

Now Billy-Bob
In room seventeen,
Can't remember the last time
His privates were seen,
They are buried below
His pendulous gut,
Whereas, there is no mystery
Regarding his butt.

Considering, Berthalinka
In room two eighty-nine,
They say, "When she was young
Oh, she was so fine",
But eighty years later
Her bosom has expanded,
Close-up? You'll be thinking
The Martian's have landed.

Now, open your mind
And rap on this thought,
During youth, we're caught up
In some appearance, we've sought,
But later with ageing
There is a sagging and swaying,
No matter, your discipline
Your flesh is betraying,
Overwhelming your efforts
To camouflage time,
After 70, your body
Will sag in its prime.

Some youth, will be thinking
Eternal life is for me,
Not realizing the possibility
In two-thousand and forty-three,
Where the answer, for immortality
Will be in a Cracker-Jack box,
Declaring, "You must first live
Seven decades on the clocks."

Sure, you can live forever
Amidst the sagging and swaying,
Some will ponder the universe
While others will be praying,
For the answers to live
With each pendulous part,
Eternal life, reconsidered
Buffet, or a' la carte.

Fibril_late;
2/21/09

Vegetative state; locked-in syndrome, etc. There are many names, and fewer mansions. Six years like that, from age 62 to 68. A wonderful husband, brother and daughter. Tube feeding via a passage in the stomach wall. She looked at peace and she was enormously loved, but she didn't move voluntarily. Allowing her to die, should her heart or breathing cease, would be the best for her, because any resuscitative measures, would very likely cause her pain and suffering, and unforgivable emotional anguish to her loved-ones. And merely designating her a "No-code", would in no way, hamper the love and compassion that had supported her all this time.



Vegetative Valentine
 
An alternate universe
By any other name,
A vegetative state
They are one and the same.
 
Locked-in syndrome
Trapped within the mind,
No outward sensibility
Eyes open; are they blind?
 
It is easy to be fooled
That there is an occupied awareness,
And so simple to nurture hope
For the family, in all fairness,
As they gasp when there is movement
Of a toe or a hand,
They will argue, “See there’s proof
You just don’t understand,
But we know that Momma
For sure, will get better”;
They all share the delusion
Down to the letter.
 
We don’t try to discourage
And we offer every amenity,
Your Momma’s not in pain
She’s the picture of serenity,
And with Momma taken care of
There are issues to address,
Let’s talk about you
You’re an emotional mess.  

We’ll call in a chaplain
A shaman or a priest,
A rabbi, or a Wiccan
And we'll bow to the east,
To help you come to terms
With your guilt and your need,
But quite frankly, folks
Why let Momma bleed?

We're compassionate beings
We suffer with your pain,
And a locked-in syndrome
Is a prison in her brain,
If she should cardiac-arrest
Her survival might be worse,
Then your loving support
Will be an emotional curse.

A vegetative state
For six years is quite long,
When she said, she wanted everything
It probably wasn't this song,
Playing day in and day out
At 45 RPM,
There's a disconnect somewhere
With the rest of her brainstem.

Why not embrace
A "No-Code" designation,
It doesn't mean "give-up"
It's just another radio station,
Giving Momma more songs to sing
In her silent, smiling way,
You'll still love her, till that moment
If not more, every single day.

Fibril_late;
2/15/09

Nursing provides so many opportunities for mirth and laughter.........otherwise, we wouldn't survive.

The Rear Approach

She wasn’t given Lactulose
She hadn’t taken immodium,
So what the cause was, I don’t know
When she farted at the podium.

She was talking to her ancestors
Who were apparently next to the bed,
Her farting gas was so toxic
They were thankful, that they were dead.

Mr. Ed and I, were changing her sheets
And I was positioned, at the rear,
Leaning forward, to place the fresh linen
She blasted one, right in my ear,
Luckily, she was only shooting blanks
My ears rang, but nothing was squirted,
I survived without an Incident Report
An industrial accident averted.

If you’re a new nurse and fresh out of school
Please take my words, as a warning,
Cautiously approach the rear of your patient
To avoid any premature mourning.

Fibril_late;
2/3/09

Who hasn't heard about "Tree-man" of Indonesia? He's the fellow from somewhere who has fungal growths that look similar to tree roots, or maybe, the worse possible alien form of toenail fungus on the planet Arcturas!
Well now, even in our fair village, we have our own local Treeman too.

TREEMAN


You may have heard about "Tree-man"
Of Indonesian lore,
His fungal growths so crazy
He can't get out the door,
A scientist from Britain
Has taken pity on the man,
And promised that poor fellow
He'll do whatever he can.

The other night at work
Imagine my surprise,
I saw something in the hallway
I could hardly believe my eyes,
A tree-man kind of fellow
Being admitted to our floor,
His skin was like the bark of Oak
But baby, there was more;
His legs like massive stumps, they were
His hands like wooden platters,
His arms were gnarled, knotted limbs
What else? It hardly matters.

And like the famous weeping willow
He had weeping wounds, galore,
Now he’s the odds-on favorite
To never leave our floor.



Fibril_late;
2/1/09