Did you ever use the Nerve-stimulator for testing the "Train-of-four", in respect to the use of neuromuscular blockade agents?

The latest teaching tool at work prompted me to think hard upon this topic.

Nerve-Stim

Hanging on the wall at work
We have a brand new poster,
It describes the nerve-stim test device
And it works just like a toaster.

It runs on 9-volt batteries
And you clip it to the skin,
Then turn it up to level-eight
And take it for a spin.

One twitch of yonder finger
Is a hit, but you want more,
Double up the milliamps
And tally up the score.

It's fun to use at parties
To check intoxication,
Or a prod to wake up Nurses
When they're sleeping at the station.

And also recommended
By the manufacturer,
For the dysfunctional erection
It promises a cure.

With the nerve-stim applicator
Success is a guarantee,
Promotions will come easy
Zap the boss, and he'll agree.

Fibril_late;
7/21/10

I'm on a memo theme...........because we are inundated with them in our workplace. Here's the latest rant.

Crispy Paper

A remarkable notation
Of a memo, just last week,
Was released before officials
Had authorized a peek,
Regarding tons of wasted paper
Found by stealth and bold intent,
Enough reams of stored reminders
To cover the walls of a circus tent.

Agenda's on a rampage
A diarrhea of dispatches,
All that crispy paper
And I forgot my matches,
It's a travesty of a sham
A plethora of waste,
Hell, if this was a 5-Star restaurant
Then baby! We've got the taste!

Every month a Doctor Roster
Is posted on the wall,
So we can spot a bold impostor
And exactly, who'd we call,
It's the nature of our business
Where deceivers in our ranks,
Are selling fancy cures and potions
And collecting all the thanks.

But that Doctor-Roster, who's the impostor?
Is also posted to the computer,
If we had their monthly photo's
We would know if we should shoot her,
Because it's easier to match a face
Compared to names with vowels and letters,
Imagine a crowd of Beagles
And amidst the group: an Irish-Setter.

We could save those reams of paper
To pass it on to our CEO,
He could use it to print more money
To bankroll this golden show,
Replace the wallpaper with moving video
And save some blessed trees,
And with a handshake and his smile
Collect some tidy kickback fees.

I'm expecting some of that chump-change
After all, it was my brainiac flash,
And I know there's factual evidence
Our CEO has lots of cash,
Buried, in deep pockets
Of the man who would be King,
I'll share it with my team-mates
And you'll hear our hallways sing;

"Oh, it's wonderful to be here
Just twelve-hours at the most,
Don't clock in any overtime
(That's according, to our host),
Keyboard-stroke those digital documents
Till carpal-tunnel cramps your style,
Then punch that waiting time-clock
And join the rank-and-file."

There will be raucous celebrations
When we rip them from the walls,
The last memo's of the millennium!
And dancing in the halls.

Fibril_late;
7/17/10

Our Staff-Restrooms and our break-room are becoming plastered with memo's, reminders, administrative directives, notes from the CEO, etc., ad nauseum. There is no haven of repose anywhere in our unit. This is an outrageous case of invasion of privacy, and I'm fighting back!

Memo's Forever

Memo this
Reminder that,
Document new stuff
In fifteen seconds flat,
Over and a'over
And let's do it again,
Have no doubt, there's always more
Don't ask why, nor query, when?

Memo this
For recording that,
The charts became thinner
But they're digitally fat,
Layers upon layers
Of drop-dead menu's,
The Ad-Hoc dominion
Is like a Grand-Central venue.

Memo's forever
In the throne-room on the walls,
You can count on stuff to read
When Mother-Nature calls,
Worry not about the dilemma
If the toilet paper was swiped,
Just grab the latest memo
Or a couple, and you'll be wiped.

Memo's on a rampage
We're still killing trees,
The paper chart is history
With memo's flapping in the breeze,
It's just a game of substitution
We're still cranking out the copies,
And don't imagine that it's safer
It's on the hard-disc and the floppies.

Memo this
There is no purity,
PHI is found on Google
It's a joke, our famed security,
Despite threats of wagered fines
Financial damages and the like,
Take a note, it's the 21st century
Cracking the code, is like riding a bike.

So read the memos, take your notes
Tell your family, friends and neighbors,
We swear to honor your secrets;
But we're rattling hollow sabers.

Read the reminders, scribe the details
Every day there's something new,
And for fun, describe our memo's
When you float to ICU.

Fibril_late;
7/9/10

I think you'd have to be living in a cave, if you haven't heard about the "Rapid Response Team". The concept has been around for at least 10 years, and has been proven to be an effective mechanism to help prevent bad things, from happening to good people. It works for bad people too, but anyway, intelligent hospital leaders, know the "RRT" can be utilized to intervene when a patient is going south, in the direction of respiratory or cardiac failure, or a similar dire situation.

Here at Sister Euphemia's joint, there was a task-force, some committees, and a few meetings..........and then there were dollar signs. The upshot outcome of all this headbanging, is what I call the Rapid Response Unpolicy. Just overhead page, "Rapid Response in Room XXX and an ICU RN and Respiratory Therapist will show up. Of course, why ask the Hospitalist to respond, he's probably catching some zzz's. Oh, by the way, the Nurse is not authorized to give any drugs, (oops, isn't Oxygen technically a drug?, the RT can't intubate..........No, we're just the arrive in a hurry and observe team (AHOT).

Enough blah, blah, blah.

Won't you please welcome...........

The Rapid Response Unpolicy

A nurse will respond
But not a doctor,
That's like a take-home exam
Without the proctor.

Along with the R-R-N
The Rapidly Responding Nurse,
Will be the R-R-R-T
Oops, I stutter when I curse.

Yes, the Respiratory Therapist
And the Rapidly Responding Nurse,
Will make a determination
Call the Coroner, or a hearse;
Because Billy-Bob Borko
Is icy cold with rigor mortis,
At least that's my first impression
Of this stone-dead old tortoise.

A differential diagnosis
Might reveal some hidden truth.
Maybe he's been like this
Ever since he was a youth,
Reportedly he was a hard man
That was according to his wife,
She tried to stab him seven times
But she always broke the knife.

In the end, as in the beginning
He was deader every minute,
We got the ziplock custom morgue bag
And put that gomer in it.

So you see, it's not too bad
The Unpolicy works, just like always,
Please tell us if it's Isolation
And keep the equipment out of the hallways.

Fibril_late;
6/5/10

Visiting Hours are Over

I've worked nightshift for the majority of my Nursing career. Under some circumstances, family members/visitors are welcome to stay, particularly when the patient in question is confused or anxious. Often though, when it's a family member who just wants to stay over, for their own unexpressed emotional vacuum, it's usually more of a bother to the Nurse, and ultimately, the patient recieves less rest.

Sometimes the visitor just won't listen and won't accept, that it would be better for all concerned, that they go home! Critically ill people need defined periods of zero stimulation. I, as the nurse, can control my actions and activities, but having family there 22 hours a day, is usually a detriment.

Visiting Hours

Visiting hours are over
So, get the hell out of Dodge, we do ask,
Nothing is easier than leaving quite promptly
Do I need to explain this simple task?

Visiting hours are over
We've had quite enough of you now,
Leave now or suffer the consequences
Or I think, I just might have a cow.

Visiting hours are over
We overhead paged so politely,
We would like you to leave in a hurry
Or suffer a night with Golytely.

Visiting hours are over
We anxiously await your departure,
This is our one last sweet warning
Vamanos!, or we're calling the archer.

The memo was sent, the rulebook delivered
We explained it all clearly, I'm sure,
Leave now, you're no longer welcome
You're like a disease with no cure,
A thorn in our side, you're causing us pain
Your presence unasked for; uninvited,
The faster you leave, isn't quite quick enough
Disappear and we'll be so damned delighted.

For Visiting Hours, we flex our powers
Leave our building at night, or you'll pay,
We'll honor your return in the future
You're welcome to return, the next day.

Fibril_late;
5/28/10

Sometimes I get a little too proud regarding my poetic endeavors. And then I'm shot down by my buddy Steve, and his hilarious tales of Nursing mayhem. If you don't laugh and fall to the floor with this poem, you're a stone-cold chump!

Holy Senokot!
 
His abdomen was large,
His pants fit tightly,
The doctor had ordered
A jug of Golyteley.
 
After drinking a few cups
 He loudly proclaimed,
“I can’t drink any more
And I’m not one bit ashamed.”
 
“This stuff tastes like seawater,
 And it’s making me sick”,
So, I got on the phone
And called really quick.
 
“Hello Doc, about Mr. Johnson,
He can’t drink any more,
His belly is hurting
And he’s sick to the core.”
 
"He says there’s no reason
 For him to stay,
If to clean him out
There’s no other way."
 
“Can he swallow a pill?”
 The Doc asked with a snicker,
A pill would work I thought
And be a whole lot quicker.
 
So he ordered Senokot
A good drug indeed,
“15 Senokot PO now”
Just how much did he need.
 
Yes, I gave the patient
Those fifteen little pills,
Then I got some towels
As I knew there’d be spills.

And I called the pharmacist
“Did you do the approving,
Of fifteen Senokots
To get this man moving?”
 
 She said, “Holy crap”
I said, “That I will second”,
She replied, “That is a lot”
I said, “That’s what I reckoned.”
 
And the fireworks began
It was quick and abrupt,
The diaper bulged out
As he began to erupt.
 
The elastic in the legs
Didn’t hold it at all,
Poop shot from the diaper
All over the wall.
 
Mr. Johnson ran in circles,
He became all confused,
He looked like a sprinkler
I wasn’t amused.
 
Poop flew from his diaper
Til it finally blew off,
The smell was ungodly
I choked and I coughed
 
With a very loud sputter
In a big lake of brown,
I just about screamed
When his bowels settled down.
 
I wiped off the toilet,
I wiped off the floor,
I wiped off my scrubs
And I wiped even more.
 
I sat him on the toilet
And he kept on going,
In a boat with no paddles
Somehow I kept rowing.
 
So I called back that doctor
Just to say thanks and such,
“Doc, about that Senokot
WELL, 15 IS TOO MUCH!”

Steve Huff
5/9/10

Reading the previous post (below this one), you'll understand that I endure a stressful job. Sure, you say, tough luck, that's life. But I think it contributed to my current condition, the allergy attack that became a sinus infection. This story is about a little lump of mucus.

Lumpy Mucus

A lovely bit of lumpy mucus
Launching from my lung,
Came bouncing through my oropharynx
And landed on my tongue,
Its' origin, a putrid particle
Inhaled in room eighty-eight,
Has been festering for a week now
Near my laryngeal gate.

The taste is indescribable
The smell upon my breath,
As if two million viruses
Met untimely death,
And rotted in the warm and dark
In regions moist and wet,
Infectious mucus, I am thinking
What do you want to bet?

A lumpy glob of mucus
Is flying through the air,
I launched it with some gusto
As bystanders gasp and stare,
They're reaching for their cellphones
Snapping pictures of the rube,
Spitting nastily in public
Check it out, on “Mucus-Tube”.

Fibril_late;
5/14/10

Give Me a Break

This is the last poem for the day, which includes the post's you can read, further down the page.

Our "new" 20-bed unit just gets crazier every day. I willingly step in as "Relief Charge", because I'm a closet-megalomaniac. Ya, right....in any rights, I'm technically a masochist, because this place is nutso. In the first four hours last night, we admitted 5 ICU players, transferred another, and sent another to a buddy hospital, and the northwest corner player had to get emergently intubated. I took about 50 calls on my Commander phone during the shift. Sure, I got a little testy at times; who wouldn't.

During my 20-minute drive home, I dictated the following tale:

ADUD

It was a dud, again
It was, it was,
And I ask myself why?
Because, because.

Assignment Done
Under Duress,
No matter how much I scream
It doesn't impress,
The powers that be
And the powers that don't,
It's a dud again
And I wish, but I won't

We were slammed
Pinched and scrambled,
I made some side-bets
But I've never gambled,
With odds such as these
Who could possibly win?,
It's a dud again
And I lost some skin.

An Assignment Done
Under Duress, I swear,
Twelve hours go by
And I've lost some more hair.

While the Boss in her bonnet
Is asleep in her bed,
Twelve, over-worked nurses
Are raising the dead.

And a dud is developing
On yonder north corner,
After raising the dead
We've discovered a mourner.

The Night-Supervisor
Calls me seventeen times,
With fourteen ideas
I can turn into rhymes.

An unwitting accomplice
To the power of words,
Creating seven new stories
About chattering birds.

A dud by another name
Is a dud by the same,
Assignment Done Under Duress?
Is the same cheatin' game,
I'll do all that I can
For the mission and the plan,
Just know, that I was under duress
And I'm not Peter Pan.

Fibril_late;
5/13/10

Every once in a while, it all comes together in just four, short lines. I thank a current Medscape highlight for the inspiration.

Taste It Before You Waste It

"New Targets For Pre-Diabetes Treatment"
That's what I read today, in the journal,
Measure the sugar in the urine
"Taste it, before your waste it"; your urinal.

Fibril_late;
5/13/10

I think I discovered the source agent of "restaurant syndrome", that all-to-common, food born illness.

Special Ingredient

If they ask for the special ingredient
We include it, for a thank you and please,
They don't know that the special ingredient
Comes from a cough and a sneeze.

Fibril_late;
5/13/10

A few weeks back: this patient was 55. She was an osteopathic mess. Multiple back surgeries; arthritis, some chronic inflammatory problems, and plenty of reasons for pain. She had become addicted to multiple medications like Norco, Dilaudid, Methadone and so on. She might not classify it as an addiction, but she had clearly developed a high narcotic tolerance, and the number of meds required to reduce her pain (“as stated, according to the patient”), was mind boggling. She was incredibly debilitated, and I suspect it was somewhat self-induced.

But, oh well: I don’t judge the pain or the victim. In ICU, pain is the 17th vital sign, and by golly, I’m like Robin Hood with his arrows. Where there is pain, I shoot the drugs.

Brittle and Broke

She's busted and rusted
She's brittle and broke,
She's on so many pain meds
It's almost a joke,
She has morphine for breakfast
For lunch and for dinner,
With a methadone side-dish
Baby, that is a winner

She has a long list of meds
It's an alphabet soup,
There's a bucket of pills
She keeps on the stoop,
And every year on the holidays
She gives them away,
Plus a few for little Bobby
To go out and play.

She's broken from pokin'
A needle into her arm,
She believed her first dealer
He said it would cause her no harm,
Now as a regular customer
It doesn't matter any more,
Being hooked on narcotics
Is the name of the score.

Fibril_late,
5/11/10

On the journey to work, traffic patterns and snoozy, smart-phone owner addicts, test my emotional barometer. Why can't "they" pay attention to the task of driving?

Places To Go

I can go from complacent to impatient
In the wink of an eye,
If you stall at the green-light
I'm thinking, "Buddy, you're about to die",
I know that seems a little harsh
But I've got places to go,
Get out of my way and off of the road
You don't belong here and that's what I know.

I'll beat you off the starting line
Nine times out of ten,
I've got places to go
And I know exactly when,
The light is about to change
I watch the other traffic, you see,
So don't wait on the green light
If you're the car in front of me.

I'll lay on my horn
Before you can gasp a single breath,
I've got places to go
And things to see before my death,
I don't like waiting at traffic lights
While you're yakking with Bobby, on the phone,
Pull off the road into that parking lot
And take care of your personal life, alone.

Sometimes I really wonder
If the guy in front of me is sleeping,
The light just turned green, it's a simple machine
But his car hasn't even started creeping,
No forward motion
And no acceleration,
If he doesn't get moving soon
There may be an assassination.

I'm heading to work
The traffic flow is quite unreliable,
I can't waste my time going slow
Arriving at work late, just isn't viable,
So I expect that all other drivers
Should be awake and alert just like me,
I've got places to go
And that's the most important decree.

Fibril_late;
5/5/10

I don't know about you, but sometimes all the flippin' memo's, decree's, announcements, reminders, JCAH crap, rules and regs, P&P's and so on, end up plastered all over every spare freewall in either the employee restroom, conference room or break-room! Enuf, damn it! We deserve some friggin space where we're not being reminded to do some new, stinkin' thing! Sheesh.

Restroom Repose

The restrooms of our unit
The private, employee loo,
Should be a place of repose
Not a forum of, "You must do"!

Let's save the professional memo's
For the walls of the conference room,
Where we gather Q12 hours
For the daily groom and doom.

A recent Reuters readers poll
Affirms by group opinion,
Leave the memo's off the walls
In the loo-dominion.

Dear leaders, don't find insult
With the comments I opined,
They are but ramblings of my repose
In this room, where all unwind.

*(Loo = Toilet or Restroom)

Fibril_late;
5/2/10

Regarding floating to another unit.

The Luck Of The Draw

I was floated
And it was all good,
As any old, unexpected float
Really should,
Two patients were mine
Of the genre' I know best,
My float didn't have to be
Some kind of crazy test.

It could have been worse
Oh yes!, it surely could,
The Charge-nurse in this place
Was actually good,
Because everybody knows
What is the baddest of the bad,
When 12-hours goes by
And you depart really mad.

Now sometimes the float
Turns into a real whopper,
When the nurse that floats in
Is an undercover copper,
And they warned me about this
But I already knew the score,
I would never reveal secrets
Like that undercover whore.

Because I know, that when I'm floating
I'm like the cousin of a guest,
It's my whole hearted duty
To perform at my very best,
And I know that assignments
Can be sour, sick or worse,
Because the luck of the draw
Can mean you're a winner, or you're cursed.

Fibril_late;
4/29/10

Several days ago, and 3 poems down, I wrote about the cardiac arrest victim, who looked like she had an anoxic brain injury, but really, she was just in alcohol withdrawal.

Here is another look at the treatment:

Beelzebub's Bride

After so many days
Of craziness, that chick,
Finally convinced someone
She was legitimately sick,
And the sickness was alcohol
Or the lack, there of,
She might straighten around
If we provide her with love,
Absolut-ly said her mother
That's just what she needs,
Supply her with vodka
Before somebody bleeds.

A fountain of nastiness
She flung four-letter words,
With every breath that she took
She was spitting out turds,
But now that she's medicated
On Vitamin V,
With a shooter of Paxil
She's as happy as can be.

Sometimes we have to surrender
To the demons inside,
Or face up to the consequences
With Beelzebub's bride.

Fibril_late;
4/9/10

Maybe because it is Springtime and allergies are in full bloom out here in the Golden State, that I was once again inspired to write one of those slimy, adolescent anthems.

Be what it may, I have a special talent for making rhymes of the grossest things.

Yes, I think I will read it at dinner, sometime this week.

Slimers on Wheat

After working with snot
With mucus, and phlegm,
You can easily tell the difference
Between a rock and a gem,
It is similar to the contrast
Comparing slime and a booger,
One is like Nutrasweet
And the other, pure sugar.

At our delicatessen
Called the Slime Sucking Snorter,
Our favorites menu
Tends to be shorter,
Than those jolly good offerings
At Billy-Bobs Booger,
Because we specialize in flavor
Without all the sugar.

We're open twenty-four hours
You can come day or night,
Get a beverage and pretzels
While we cook up a bite,
Of your favorite entree'
Perhaps “Slimers on Wheat”,
With a side dish of loogies
It's way better than meat.


Fibril_late;
4/8/10

Getting old, up in the big years, life can be a slow, downward spiral; particularly, if you were in such a hurry during your adult years.

Getting Too Old

Getting too old
With so many diseases,
Nothing feels good
It only displeases,
Piece by piece body parts
Fail, one by one,
Getting too old
Doesn't seem very fun.

Approaching the grave
Can be a slow painful creep,
If you hurried while living
This hill will be steep.

Fibril_late;
4/4/10

These days, it seems like some people survive a cardiac arrest, much better than one would expect.

Take the case of Betty Boop; age 67, normal bmi, not diabetic, no history of heart disease or hyptertension. Retired, active volunteer, loves to play tennis. Mild COPD, and asthma, retired smoker. She's playing a round of Bridge, and wham, has a V. Fib arrest. Down-time at least 4 minutes with no CPR. Post-code first 12 hours, unresponsive, comatose, on a ventilator. But within 6 more hours, she's following command and nearly ready for extubation. She had another short episode of V.tach, but we shock fast and clean.

But the kicker is, that 2 days into the ordeal, she is so far out in left-field, that she's on the exit ramp outside of the stadium, in full-blown delirium-tremens, courtesy of her daily vodka routine. Totally loopty-loo. She'll probably go home in a week, and claim she met Jesus on the other side.

Loopty-Loo

V. Tach, V. Fib
Get shocked and bust a rib,
No oxygen, a four minute wait
And now she makes a heckuva date.

She woke up lucid
Like a lucky charm,
As if, V. Tach, V. Fib
Could cause no harm,
But now she's seriously
Loopty-loo,
Because she sucks down vodka
Like Mountain Dew.

Fibril_late;
4/2/10

As the nurse ages, he sees more and more patients of his generation lying or dying there in the bed. It does give pause to ponder.

Bad Habits Deluxe

Lately I've been pondering
My own mortality,
I've been taking care of the morbidly sick
Who are just as old as me.

I imagine that I own
Some magical health protection,
A barrier to sick and evil diseases
Courtesy of divine selection.

I purport that my meatless diet
For 30 years and more,
Is the secret to my longevity
My key to the healthy door.

And I'll claim that the genes I inherited
Don't stack up to the usual condition,
Of diabetes, heart disease and stroke
I'm protected by selective rendition.

But who am I kidding with this ridiculous story
Each one of us thinks, it will be the other guy,
Either bad habits deluxe, or a squeaky clean life
Flip a coin, I could be the next one to die.

Pondering my immortality
Is a better wager I think,
So many lifetimes of adventure
Gone in the eye of a blink.

Fibril_late;
3/29/10

I recently interviewed for another classification and apparently there were three other applicants too. We all got the cut, so I guess it's back to the Minor Leagues. Anyway, I wasn't very attached to the outcome, so I'm not really disappointed. I know I'm going to stay in the position with less stress, so that's probably a good thing.
But essentially, I'm off the bus.

Off The Bus

We interviewed
The four of us,
And then they left us
Off the bus;
It wasn't moving
So, it was gentle,
But I guess, too much talent
Can be detrimental.

I interviewed
'Twas a lengthy affair,
Two separate times
In the victims chair,
The jury's decision
Was just executed,
And like a computer
I've been rebooted.

My grandiose dreams
Of wealth and power,
Lasted for only
About one hour,
Now I must return
As the horse with no fable,
Just chewing my oats
In the Nursing stable.

Fibril_late;
3/18/10

The story tells itself.

Dubious Science

I'll gladly be a trumpeter of evidence based practice
But come on baby, light my fire, it has to make sense,
If you show me statistics, and meaningful methods
I'll jump on your bandwagon, and gladly play defense;

But show me a policy, with the most dubious science
Like stopping the tube feed, when I lower the bed-head,
There's no single iota of technical value
Unless you're smoking some reefer, with Jerry the deadhead;.

A tube-feed that is running, at even 60 mils per hour
Is only dripping, at one mil per minute,
How will that alter the outcome of head-down
This policy has no sense within it;

Let's say, we laid him down, for 10 minutes of bath
That's tube-feed times ten mils, that we added to his gut,
There's no kind of physics, to predict any peril
Except to those of us standing, at the back porch of his butt;

The aspiration risk, to Snoopy Dupe Jones
Has nothing to do with a dripper,
This is dubious science to the maximum mondo
It reminds me of reruns of "Flipper".

On one hand we practice, some hot-damn good science
While in our books we brag about more,
If the policy date, is more than 10 years late
I don't advise that you bet on the score.

Fibril_late;
3/10/10

There is a flier on the wall, indicating that the good Doctor D. would soon be performing some cutting edge surgeries. I was wondering if that meant, that only some of his surgeries are cutting-edge, and then he has another side, where he performs say, some blunt dissection surgeries too. It's that word some, that is throwing me off.

So naturally, I had to write "Cutting Edge".


Cutting-Edge

Some of his surgeries are cutting-edge
While others are strictly smash and grab,
Historically, a few are just a nip, tuck and slice
For the removal of moles, scars and flab.

Cutting-edge surgery, is the name of the game
Blunt dissection, is a thing of the past,
With the help of a couple of robotic arms
Good golly, Miss Molly, he's fast.

Hardly anyone bleeds more than one pint of blood
He cauterizes with the light of a laser,
And if you complain, about your half-missing brain
Watch out, he is packing a phaser.

He's a cutting edge surgeon, with the sharpest of edges
He acquires his knives, by the crate,
Don't wiggle or squirm, he might cut off your worm
He'll declare, it's your cutting-edge fate.

Fibril_late;
3/9/10

I've written about good and bad doctors. Fortunately, most are good characters, both personally and professionally. Here is my latest story:

He Rules The Roost

Dr. Murphy.......
He still rules the roost,
I think, our move to the new unit
Has given him a boost,
He arrives in the morning
By the crack of oh-seven,
Like he just dropped in
From his corner of heaven.

He regales the nursing staff
With his plans and his dreams,
He encourages the patients
Despite their moans and their screams,
In his spotless white coat
And his tidy, trimmed hair,
Why, no one has the nerve
To occupy his chair.

We all leap, jump and scramble
When he utters a suggestion,
He won't harbor fools
If you respond with a question,
And, pre-gather all your data
And pertinent facts,
If you can't be concise
Baby, you'll get the axe.

He's a good natured sort
And his humor is bent,
But don't tarry or lag
Because his time is well spent,
Not to be frittered or frattered
On frivolous fluff,
He may humor you for a moment
But enough, is enough.

Dr. Murphy...............
He still runs this joint,
If he ever departs
Who will we anoint?

Fibril_late;
3/4/10

Times have changed over my career. (30 years)

There was a day when one might work in a "pure" Cardiac unit, where one saw primarily persons with just Myocardial Infarcts, Heart Failure, etc., and their various treatments. Now, those places are few and far between. Sure, the patients had other problems, but most just dropped in for 2 or 3 days, to receive treatment, for just their heart problem. Thus, all the nurses in the unit became Cardiac experts over time. Fast forward to now, with people living longer, getting more health problems over the years, with a greater degree of complexity, and we critical-care nurses, must become near-experts in whole-body medicine.

Essentially, what I described above, undoubtedly represents the maturing of the nurse-individual over a long career. I guess I share that distinction, yet I remain highly interested in the diseases, therapies and arrhythmia's of the heart; that's what I bring to the table. Luckily, I work with many other highly educated and vastly experienced nurses, and together we form a powerful force of good, for the patients that we care for.

But still, I poke a finger at us and try to make it funny.............go figure?!?



The Battle Of The Brady's

'Twas the battle of the Brady's
Jousting in the corral,
Was it caused by poisoned water
Like the famous Love Canal?

Were they age-related impulses
Unclear just how to work it?
Or knotted myofibrils
In the conduction system circuit?

Was the SA node too sickly
Or the AV node too slow,
Were the atrial motor pathways
On the stop and not the go?

Well, I opened up a chart or two
And discovered other answers,
There was a Digitalis suicide
And the other, a heroin dancer.

He was a boyish seventy-fiver
She, an ancient forty-sixer,
She'd mix heroin, cocaine and crank
Thrown together in her KitchenAid mixer.

He was despondent and lonely
His investments had gone down the drain,
So, why not take thirty Digoxin
And say "Goodbye, bon voyage", to his pain?

Now parked in a critical-care place
Where cardiac experts are few,
It's ho-hum when the heart-rate hits thirty
Quite frankly it interferes with the view,
Of Bobby-Joe showing his photo's
On Facebook, Picasa and Flickr,
"Oh look now, there's Bobby-Sue's baby"
And the local chums, giggle and snicker.

But here in the 21st century
We juggle mysteries like the jesters of old,
Knowing that illusions are paramount
For selling the goods in the hold,
We manage such multitudes of misery
Looking like mavens of medicine,
Caffeinated nurses got it covered;
We'd be the envy of good Thomas Edison.

Hence, the battle of the Brady's and Boomers
Neck and neck, at the end of the night,
The Brady's were beating at twenty
While the Boomers were ready for flight.

Fibril_late;
2/21/10

Either we're getting really good, or some people don't die easily. This patient was a Type 1 Diabetic. For lack of insurance, she hasn't bought Insulin in 2 months. She was found down at home. Upon admission her pH was 6.8, a glucose over 700 and an unmeasurable bicarbonate. In any population, that is considered so near death, as to be considered as virtually waiting before the pearly gates. Now it's 24 hours later and she's talking about little Muffy her dog. Like I said, some folks just don't die easily.

Diabetic Curse

The diabetic patient, can
Be their own enemy, my man,
If they don't follow their diet orders
Their blood sugar will go beyond the borders.

Or say, they're on the Insulin shot
Two times a day, whether cold or hot,
But then they stop for a month or two
Surprise, surprise, their death comes due.

We try to save that unfortunate mate
Whose blood pH is 6.8,
And a glucose of one thousand two
Of the many we treat, we save but a few.

It's a foolish death, but survival may be worse
And that's the diabetic curse.

Fibril_late;
2/20/10

There is a job opening, and I figured, better to hire the local guy who knows the ropes. Too bad, I can't tie a decent knot.

Interview

I was interviewed
And it was good
Like any righteous grilling should,
Interrogated
By, just the Boss,
I had prepared myself
With mental floss.

It took place
In the hospital venue,
And followed the tried and true
Interview menu,
To pose ten questions
About this and that,
To find out where
My head is at.

To ascertain
My sanity,
Did I seek the position
For vanity?
Do I want to rule
With an iron hand?,
And will I do
What the boss has planned?

All in all
I think it went well,
Like a well cooked pot-roast
With that barbecue smell,
And now I must wait
On bended knee,
Wondering, "Who will be chosen
That other guy or me"?

Fibril_late;
2/16/10

Just a Waiter

Am I a Nurse or a Waiter / Waitress? Last night it seemed like I was a Waiter, but I sure didn't get any tips!

I'm A Waiter

Tonight, I'm a waiter
Tomorrow, I'm not,
What is the difference?
I won't be here in this spot,
Catering to
That man with a switch,
He makes an announcement
"Hey Buddy, I've got an itch".

But he's not really helpless
He worked 5 weeks ago,
He didn't break any bones
He had an earache, to show,
But it morphed and it broiled
And seeped into his neck,
Now he's landlocked and bedded
The train crashed, he's the wreck.

Twenty minutes times three
That's 3 calls an hour,
He's 27 years old
And he must have more power,
Than the strength of his thumbs
Dancing Salsa on the call-light,
"Yes sir, what do you need"?
It will be a long night.

Fibril_late;
2/12/10

The world is so weird, that I have an endless supply of ideas to tap into. Take the story I read that was posted in the newspaper, "Telegraph" from the U.K. The writer reported how in China, there are unscrupulous vendors who are marketing a diet pill, that actually contains viable eggs of the Ascaris Tapeworm. Well, hot damn! I guess that will cause you to lose weight......among other things, especially when one understands that they can produce 200,000 eggs per day. Yowza! That's gross.In fact, it makes me squirm.

It Makes Me Squirm

Because it's in China
It's the reason I believe,
I've heard they'll eat most anything
What an accomplishment to achieve

Yet, despite this foreknowledge
These things that I learned,
I'd think there'd be limitations
That even Chinese, would have spurned.

So imagine my surprise
That turned to horror
When I read it,
There's a brand new crazy supplement
You can buy with cash or credit,
To assist the overeater
Shed those pounds
They need some help,
After failing with the Exlax
The Colace and the Kelp,
The concept, the idea
It really makes me squirm,
What kind of crazy dieter
Would swallow a worm.

A tapeworm at that
The Ascaris parasite,
They lay a hundred thousand eggs
Every day and night,
But don't worry, it's safe
If it's on the Internet,
Guaranteed truth in advertising
Are you willing to take the bet?

The Ascaris tapeworm diet pill
Is a winner, there's no doubt,
Don't believe the medical experts
They don't carry any clout,
And don't worry about nasty side effects
The worms are always pure,
Infestation is the way to go
It's the latest obesity cure.

Fibri_late;
2/10/10

Young, large, seemingly getting along ok. He holds a job, still lives at home, drives a car. What could go wrong? It's not unusual to have Otitis Media, but an abscess in the neck, can cause swelling and compromise the airway of just about anyone. However, if one weighs close to 500 pounds, the potential sequelae of an invasive infection, well that's quite another story, indeed.

500 Pounds

500 pounds
With an infection in his neck,
It swelled his airway
And what the heck,
He couldn't breathe
And all hell broke loose,
Now he has a trach in his throat
And his bowels are loose.

500 pounds
27 years of age,
His weight is a shackle
In the obesity cage,
He thought a simple ear ache
Was just a bother, with some pain,
Now with respiratory failure
He might be easily slain.

500 pounds
His skin is wearing thin,
Septic emboli and toxic shock
He's rotting deep within,
His gut is sloughing out
Drained with a tube and bag,
His family hang by the bedside
Waving their hopeful flag.

500 pounds
It's a horror and a curse,
It's a premature invitation
For transport in a hearse,
Not a typical expectation
For one so young and in their prime,
Trapped by morbid obesity
Is the sentence, to the crime.

Fibril_late;
2/3/10

I was out of work for 3 weeks because of some alien organism that seems to have taken up residence in my right throat and ear canal. It's still there, but I've gone back to work. A lot happened at work during my missing weeks. Our "Cardiac Care Unit", has morphed into the Medical Cardiac ICU. Now I'm really more than glad that I work night shift, because most of those surgeries are recovered on Day-shift. That's right, and we stlll get paid more on the night shift. Talk about hidden benefits!

Anyway, going back to work after the unit has been broken-in a bit, has revealed new topics of business that I can write about, so I hope you enjoy this new journey.

Here again, I address a big topic; bariatrics. It's just a ruse. It's really about corporate spending on big projects, and the end-user impact.

Slalom Sleds

These hot new Bariatric beds
Are like super mondo slalom sleds,
We pull the patients up Q1 hour
They slide right down under gravity power.

The hydraulics seem a little weak
I'll explain it now, just let me speak,
When we lower the bed, head-down under feet
It's easy to reposition, all slick and neat,
But to return the head, upright beyond 30
We strain our backs, lifting down and dirty,
By physically hoisting the head of the bed
Another “safety” device, liable to make me dead.

These are new tech beds for the super heavies
Supposedly better than Sacramento levies,
Holding back the 100 year flood
But I'm not sure about Billybob's bud,
He weighed in at 225 kilo's
And we weren't even weighing the pillows,
On beds that are rated to 500 pounds
We're approaching that number in leaps and bounds.
Beds with all the bells and whistles
Not suitable for an ICBM missile.

The beds can rotate side to side
It's really quite a pleasant ride,
But here again, this weight thing irks
If you're really heavy, it barely jerks,
There's a tendency for big boy Jimmy
To get stuck on one side while the bed just shimmies,
Wiggles and strains, to pump air through the bellows
I wonder, “where is the lift team, I really need those fellows?”

There are lifts on the ceiling, with slings down below
When Jimmy's feeling better, we can swing him real slow,
Into the chair by the window to improve his outlook on life
Then the bed will be vacant, for his long suffering wife,
Her kilo's are many, her cankles are like stumps
I'm praying to Euphemia, “Dear Sister, bless these chumps”
Don't let either the one of them, have a cardiac arrest
Our defibrillators aren't prepared for that test.

We've got negative airflow, isolation rooms
And those lifts on the ceiling, on super-strong booms,
But honestly, I'm wary about the safety of it all
Bad things happen, when big people fall,
Caregivers damaged, lawsuits are brewing
When the dust has all settled, corporate is screwing,
Around with the numbers, statistics and more
The science of big, is a titanic chore.

Please, don't misinterpret my harangue on what's big
It's really an expose on the bureaucratic jig,
Million-dollar decisions, from dubious advice
High cost vendor contracts at an unbelievable price,
End-users suffer, at the whim of corporate decisions
Are Workmans' Comp injuries, in the provision?

This light-hearted muse, ended heavy and dark
But the business of healthcare, is no walk in the park.

Fibril_late;
1/29/10

I worked in the new tower for 3 days and then I came down with some weird illness, where the right-side of my face feels like I got too much Novocaine at the Dentist office. Also, some of my taste buds quit, so food tastes really weird. Hey, maybe I could blame it on "sick-building syndrome"?

Anyway, I get a bunch of days off, and I figured I better prove that I can still pen nonsense.

Like Cancun

Any one of you with Addisons
Come on down to Auburn and Madison,
Check out our billboard
Take a look at our sign,
Glance at our fine menu and
How you will dine.


We have a shiny new tower
And a new Chef, to boot,
We welcome the gang-bangers
Who maim, stab and shoot,
We are non-prejudicial
Because everybody bleeds,
We're ready to serve
Our community's needs.


It's a fine looking billboard
Yes, it really caught my eye,
I'm thinking, that's where I want to be
When it's a good day to die,
And maybe Sister Euphemia
Will comfort my soul,
With her help I can avoid
That fire-belching hole,
Where I'm probably heading
After writing poems like this,
Poking fun at the nuns
Is like a sacrilegious kiss.


This is all about expansion
Up, sideways and down,
We're one hundred beds bigger
And in this hospital town,
It certainly is necessary
To appeal to the living,
As a non-profit joint
We depend on them giving,
Bundles of dollars
And cases of cash,
Or Sister Euphemia
Comes down with a rash.


It's a heck of a sign
On the outskirts of Carmichael,
If you're in a plane or a car
Or even on a bicycle,
It seems almost as big
As the real thing, I swear,
And if you look at it long enough
You'll crash and end up there,
As a bonafide patron
A victim, per se',
Where you had planned for a visit
And now you will stay.


New rooms and equipment
New Nurses and more,
Shiny, bold elevators
And locks on the door,
Beefed up security
And an incredible view,
You'll feel like you're in Cancun
With nothing to do.


Yes, our ambience was tested
By professional slackers,
Free drinks on the veranda
Toasted oyster on crackers,
And they gave us high-fives
Back-slapping and more,
The new McCauley tower
Got the highest darn score,
Way better than Sutter
UC Davis and Kaiser,
If you bring your business to us
You'll prove that you're wiser,
Than all the other folks
Who catered to our competition,
When they get their bills, they'll suffer
Extraordinary rendition,
Yes, buyers remorse
The equivalent or worse,
They know they should have chosen Mercy
And now they are cursed.


We have the coolest billboards
Plastered all over town,
If you give us a call
You'll get a free gown.


Fibril_late;
1-14-10

East Coast Steve, is at it again. A definite rival in crap poems, that's for sure. And so fitting here in the end-times.

Thar She Blows

What’s that smell coming from my floor.
Oh no, I think it’s from room sixty-four.
I wouldn’t mind it if I float today
To escape the smell of bowel decay.
 
C-diff, it could be, I don’t know
With blood mixed in, let me tell you bro’
Every time he poops, he fills the bed,
And I swear it smells like something’s dead.
 
I know nurses are supposed to take this in stride,
But when it smells like something died
My eyes, they water, my head will swirl,
And before too long, I start to hurl.
 
The pregnant nurses won’t go near
That smelly, leaking, dying rear,
The other two nurses are on the floor,
So Your’s Truly, gets room sixty four.
 
I have some Febreze, I spray like mad.
I have Glade for every plug, too bad.
I spread the Vicks beneath my nose,
I Scotch-guard everything from neck to toes.
 
I’m really thinking Flexi-Seal
Two fingers in, it’s no big deal.
Just hope that stool ain’t too thick.
If it is, I know that I’ll be sick.
 
So lube it up, and in it goes.
Holy Cow cause Thar She Blows.
He farts a big one, the shit, it flies.
I need a shower before it dries.
 
Why did I think this would cause no harm?
I now have poop all over my arm.
When I said “She Blows”, he really blew.
I’m going to cry, these scrubs were new. 
 
There’s doo on my glasses, and I swear
There’s something sticky in my hair.
And when my head begins to throb,
I know that I have done my job.

Steve (watch him heave)H.

The two first nights that I spent in the new tower (the unit opened 3 days ago), I was so-o-o-o- lucky to be Relief Charge nurse. Yikes! Both nights would have been considered crazy busy, even in the old unit, but now we're running around like Bob the chicken, who survived decapitated for 8 months.Naturally it got me thinking about the real state of affairs, that we're in. Easy enough: new tower, new equipment, same old jaded crew of over-experienced nurses. Oh, to top it all off, new stuff started breaking with "real" nursing care going on; Go figure!

Like A Lemming

Returning for one more night
Seems a little crazy, for sure,
But we are the answer people
Offering the cheap thrills cure;
A great deal of frustration and angst
Is just water beneath the bridge,
Although sometimes I feel like a Lemming
Being forced over the next plunging ridge.

Long hallways, new closets, and storage rooms
Yes, plenty of places to hide,
Maybe it's better, than it looked from the start
Like a husband reviewing a new bride.

Admissions, on top of admissions
Rapid response, Code Blue and the like,
If you do this for twenty-plus years
Why, it's just like riding a bike;
Careening down the side of Pike's Peak
On a single-track, dark and rainy night,
Survival means, bloodied and bruised
Rejoicing with the mornings first light.

Taking on the role of Relief-Charge-Nurse
I'm paid an extra one-buck-per-hour,
After just two nights this week
It felt like a slap on the cheek,
The smallest of sweeteners, turned sour.

Topping it off, the bosses decided
That Ward-Clerks are at best, obsolete,
For no-bucks-an-hour, the Registered Nurse
Can add all those tasks to their sheet,
Along with the endless new regulatory rules
"Just one more thing" added each week,
It's easy to predict, the next numbing edict
But quite frankly, we're ready to shriek.

Two hundred and twenty million dollars
Give or take a few clams in the mix,
Sister Euphemia is gambling on goodwill
To support all of her magical tricks,
Showing a good face to the community
With a shiny new chapel to boot,
Asking God for obedient employees
And extreme unction for the ones she can shoot.

Fibril_late;
12/29/09

Like the Christmas present I wasn't expecting, Steve RN in Virginia (we worked together, years ago, although we're brothers thrice removed), sent me his latest "typical" experience for a nurse.

Saving the Code

S.Huff RN

The I.V.’s running
The foley’s patent,
I smell infection,
But for now, it’s latent.
 
The code is done,
The heart still beats,
Most of the nurses
Are back in their seats.
 
He has a rhythm,
His pressure’s stable,
For now, we’ve kept him
Off the table.
 
But have we done him
Any favors?
This role we have
As, lifesavers.
 
He breathes for now
Due to a vent,
His infection held intact
By Vanc and Gent.
 
His pressure kept up
To perfuse his brain,
While the rest of him
Goes down the drain.
 
This poor man,
It’s such a pity,
I think its time for
The Ethics Committee.
 
So I call them in,
Just like I should,
They say they’d do something
If they could.

But the doctor had
To show his might,
And insisted he,
And he alone, was right.
 
And mighty doctor
Had his way,
He took me to
The family that day.
 
He proclaimed aloud
So all could hear,
This nurse thinks we
Shouldn’t treat your dear.
 
He’s convinced that
Granddad is already gone,
He thinks his soul
Should be moving on.
 
And the family looked
At me with eyes of red,
How dare you think
My dearest dead.
 
The doctor is God
For all we know,
And when Gramps is back
It’s you he’ll show.
 
So they took me off the case
As well they should,
Poor Gramps was given
To a nurse that “could”.
 
And, nigh, another night
Went by,
And down the hall
I heard them cry.
 
Poor Gramps had gone
In ALLLL his glory,
Despite the doctor’s
Convincing story.
 
What was I to do,
The family now was low,
Should I rub it in and
Say, I told you so? 
 
Or should I say “He was doing fine”
Just like the doctor said.
Or say the doctor was full of shit
And has mush inside his head.
 
Or should I approach the crying girl
The one that’s a real moaner,
And say if Gramps was in such good shape
Do you think he could be a donor? 
 
Nah, I sucked up all the insults
I took them all in stride,
I looked at each one earnestly
I said I’m sorry that he died.
 
I told them that the doc was young,
And often optimistic,
But in my mind I really thought,
Our actions were quite sadistic.

S. Huff, RN
Va.
12/19/09

*Thanks Bro, you're the bomb!
ph

I don't usually go 3 weeks without a writing, and especially at Christmas. A bunch of stuff was going on at home to arrange a big trip overseas, is what I will say was the cause. Anyway,

We're almost about to groove over into the "new tower". I expect it will supply me with an abundance of inspiration over the early part of year 2010, as we settle in. We will be taking on the Surgical Service ICU patients, so that will be interesting, as we have only had to do that "cut and sew" recovery stuff, only once in a while. So, apparently, you can still teach an old dog (and his extended family) some new tricks, after all.

Now, on the virtual cusp of the ribbon cutting, the final Health Dept. licensing and so on, here is my latest endeavor, regarding the new Tower:

A Whizz, Is What It Is

It's a brand-new tower
With carpeted floors,
A closet for the Nurses
And locks on the doors,
Spacious waiting rooms deluxe
For John Q. Public and his crew,
Who gape with wonder and amazement
'Cause all the furniture is new.

There are a couple more bathrooms
With a mirror for viewing,
As I stand there and pee
I can watch what I'm doing,
Now, if that ain't modern progress
Just tell me what is?
Could there be a hidden camera
To record what I whizz?

The kitchen is tiny
The Nurse's break room is small,
It's cleverly hidden
Somewhere down the hall,
The Doctors have two rooms
And larger, of course,
Though we do all the lifting
They have all the force.

It’s a wonderful new building
A new system to boot,
Sister Euphemia is dancing
In a her new tower suit,
Each time she clicks her heels
The cash register is ringing,
While the angels on high
Harmonize their singing;
Hosanna, hosanna
Let’s open this new banana,
Break out the new Chapel
And the rose garden cabana,
While the CEO, (that good boy)
Is serving up the tea,
Hosanna, on my new tower
Catherine McAuley, set us free!

Fibril_late;
12/20/09

Someone, roughly my age, noted a strange similarity, in respect to, the Dick & Jane books of childhood, with that common starting line.........."See Spot; see Spot run". It was something about a dog that was probably smarter than D & J. The similarity in question, was about the other "See" which we unfortunately are accustomed to............C Diff. Thus was born a new, sickening poem.

C Diff

C Diff
C Diff run,
Saturating linen
Its flow is never done.

C Diff
Is certainly the worst,
Use lots of soap and water
Or your hands are cursed.

C Diff
Its cloying sour smell,
Clinging to your uniform
Like a perfume from Hell.

C Diff
Odor atoms in the air,
You scrubbed per protocol
But what about your hair?

C Diff
Cleaning is a hopeless endeavor,
Just take a whiff
It stays in your nose forever.

C Diff
Oh, I'd rather not,
I'd rather wallow
In a bucket of snot.

C Diff
A room, by yourself,
Piles of linen
Fall off the shelf,
Friends and visitors
Wear protective gowns,
They smile and say, "How are you"
And leave with crappy frowns.

C Diff
Endless liquid stool,
Flexi-Seal stat
It's the perfect tool,
Make sure you change the bag
Before it bursts its seams,
Or you will surely suffer
C Diff nightmare dreams.

C Diff
Stays around for several weeks,
The smell is overwhelming
The atmosphere; it reeks,
No perfume eradicators
Will annihilate the odor,
You need an air-evacuator
With a mondo-turbo motor,
To suck the fumes away
Before they ever reach your nose,
And should C Diff ever splash on you
You better find a hose.


Fibril_late;
12/02/09

In the vicinity of our metropolitan area there are a number of prisons. Is this a curse, or a boon to business? I am not sure. However, I guess we can consider it a boon to Hospital revenue, because just a couple of the local hospitals, have the good fortune to having garnered the prison-care contract. That includes us at Sister Euphemia‘s joint.

Thus, I figured it was high time I took a look at the topic, and no better a time, than just having spent 3 nights administering to a bonafide felon from the notorious, Folsom Prison.

I Googled, “Folsom Prison Famous” and here is the following website, for those of you who are curious -
http://www.myfolsom.com/famousinmates.shtml

Made In The Shade

A prisoner from Folsom
San Quentin or Ione,
They love our soft beds
And their own custom phone,
The cable television
Music, movie, 50 channel,
The sheets from Bed & Bath
And the Ralph Lauren flannel.

Yes, a medical prisoner
Has it made in the shade,
Free, taxpayer paid insurance
And their own private maid,
To fluff up their pillows
And deliver their dinner,
Why, it makes it all worth it
To be a cold-blooded sinner.

Mr. I-Didn't-Do-It
Had a headache and blurred vision,
Apparently he had experienced
A head-floor collision,
After fighting with Bubba
For some contraband tobacco,
Not the best choice
Because, Bubba is a whacko.

The medical doctor
On site, at the slammer,
Had seen injuries like this
Like, head versus hammer,
And since the prison now out-sources
All their medical care,
We are the receivers
Of all the felons out there.

Most prisoners are cool
They know they've got it good,
Just smile, and say thank you
Like any locked up fool would,
When they know we have the power
To cause pleasure or pain,
Why even a rat understands
With his little rodent brain.

One or two ankles
Are shackled to the bed,
Two armed guards sit
Bored out of their heads,
It's a cush-job, always overtime
No part of it is hard,
Merry Christmas to all
Life is great, for a medical guard.

California prisoners
Fake an illness now and then,
To get a luxury bed in the hospital
Better than any, in the pen.

Fibril_late;
11/28/09

Yes, the talk of the town, and the rumblings of gossip all revolve around the building of the new tower/wing. When will it open? Who will work there? What version of ICU will occupy the new 22-bed critical-care floor? Of course, since we're nurses, the rumor-mill is hitting about 200 mph by now. Heck, even the rumors are spawning children. Anyway, I have some ideas about what's really happening, but as usual, it's just So Much Talk.

So Much Talk

It's a brand new tower
And there's so much talk,
About the circles and arrows
And colored chalk,
The fancy new beds
With the bariatric lifts,
Which Sister Euphemia claims
Are the most blessed gifts.

There are all kinds of new gizmo's
Both high-tech and low,
There are new communicators
That track where you go,
There's a lock on the doors
So the thieves don't get in,
And Sister Euphemia claims
It will protect us from sin.

There are mumblings and grumblings
Regarding which I-C-U,
Will stake claim to the veranda
With the most wonderful view,
While powerbrokers gamble
With buffalo chips and more,
The bookies in Vegas are
Handicapping the score.

Seniority claims
And back-slapping buyouts,
Brownie point redemptions
And cheerleader tryouts,
Ballot box stuffing
To influence their score,
Everyone bargaining
In the back of the store.

Sister Euphemia consoles
With a positive focus,
Casting prayers right and left
With a little hocus-pocus,
All will be well
As ends well, she states,
Now, just get back to work
And don't test the fates.

It's a brand new tower
But it's not open yet,
Who will win the right to work there?
Is anyone's bet.

Fibril_late;
11/21/09

Every,every day, the hottest topic is "the new building". As in, "when are we going to move in", and I wonder if we'll stay full, so we don't have to float.

I don't know, or particularly care, as I know it will be soon in dust-mite years. But, it's still the talk of the town!


Shiny New Building

It's a brand new tower

But we're the same old nurses,

It's the 21st century

And we still carry purses,

So don't be thinking something's different

It's the same old song and dance,

Draw the card, “Community Chest”

Or would you rather try at “Chance”?


If only life were fantasy

And imagination real,

All our fixtures made of the purest gold

Instead of stainless steel,

Our patients built of paper

Like the cut-out dolls of old,

We could cure their worst diseases;

Just cut the dotted line and fold.


We'll be doing all the same old stuff

Repackaged, new and shiny,

We'll be the happiest crew you could ever find

With no reason to be whiny,

The wonder-chip from IBM

Will be embedded in our brain,

And if we deviate from the master plan

Expect a ball and chain.


Oh, we're moving to a brand new building

The excitement grows every which way,

It's the hottest new trick since Trauma

Grabbed the headlines, 10 years ago today,

After the public is overwhelmed by our advertising

They'll be crashing Admitting for care,

We'll be praying to go back

To that old rickety shack,

And breathing that moldy old air.


Fibril_late;

11/13/09

Occasionally at work, there is a new Nursing Policy (or is that a new edict?), that seems so flippin' ridiculous. That means, any nurse that reads it over, stops, and emits a very loud, WTF? But then, when the boss says the cause of it was the "Joint Commission", we shake our collective heads and sigh. But after that, when the boss stumps that they wrote the flippin' edict, there's a distinctive head shake, eye squint and lip lift, and again, WTF-OMG!

The Joint Commission; band of brothers, or band of thieves? Who knows.

But, "National Patient Safety Goal 16", is something to do with making sure patients and families, have a method to "summon extra help". And so, at our hospital, this will be known forever as, the "Condition Help Policy". No, I'm not making this up.

Well actually, I did make up the poem you are about to read, in response to the latest flim-flam edict.

Condition Yelp

If you need urgent attention
Because you are concerned,
Your meatloaf was moldy
And the poached eggs were burned,
We now have a program
For help right away,
Condition Yelp is the answer
Any time night or day.

If there's a medical change
But we didn't notice,
Or you sent us a letter
But we ignored what you wrote us,
We now have a system
For hot buttered care,
Condition Yelp is always ready
Anytime, anywhere.

How do you do it?
Just listen and learn,
Dial "O" for the operator
And then wait your turn,
Because we are predicting
An onslaught of calls,
From every Tom, Dick and Harry
Out wandering the halls,
Complaining about the stupidest
Crap in the book;
Condition Yelp guarantees
The Charge Nurse will take a look.

I can hardly wait to be
A designated responder,
One more task to undertake
As the Charge-Nurse, over yonder,
Never knowing when the phone rings
If I have to leap into action,
It's a heavy responsiblity
This Condition Yelp distraction.

When the Satisfaction Surveys
Are tallied and scored,
It will all come up roses
So that we can afford,
To send the chief's on vacation
Or some high-end retreat,
While the minions of peons
Keep walking the beat.

Condition Yelp is the solution
To any problem that could be,
And the cost to the patient?
Hot damn! It's always free,
It's just a part of our
Hot, smoking package of care,
Dial "O", give a Yelp
And a Nurse, will be there!

Fibril_late;
11/02/09

Goin' South

Goin' South:

Last night I had two patients, one 55 and the other, 71. They both were "cardiovascular disasters". The younger one had just had his second MI in 6 months, and had the absolutely worst Left Ventricular Dilated Cardiomyopathy that I have ever encountered, and in essence, was in cardiogenic shock. His ejection fraction is 10-15%. He had Diabetes, an AICD with a biventricular pacemaker, and had a history of a cerebral bleed 5 years ago. What he needs is a heart transplant, but isn't on a list for some reason. Cardiogenic shock has roughly a 55%-80% in-hospital mortality (current estimates). He actually looked improved, compared to 16 hours back, when he was admitted.

Mr. 71, was recovering from a GI Bleed (accidental Coumdadin overdose, when his prescription was delivered in error, to read 12mg daily, prior to admission). He suffered an MI, secondary to volume depletion; Heart-failure secondary to volume resuscitation, which lead to respiratory failure, and a few days on a respirator.
He has cardiomyopathy with an ejection fraction of 20%. He had prior revascularization of both carotids, and an Aorto-bifem bypass. A left femoral graft repair with subsequent graft infection, with need to replace graft, and at that go-around, he developed a Pulmonary Embolus, and had an IVC filter placed.

Today, he was hoping to go home. That went south at about 6am, when he said his right foot was painful and cold. At the start of the night, he had weak, but palpable pulses. The cold foot didn't even have a doppler pulse.
I paged and notified, those-who-must-know, but frankly, I felt pretty bad about the whole thing, knowing that his departure from the hospital, had just hit a major pothole on the road of his recovery.

Ready To Go Home

Ready to go home
What could possibly go wrong?
Don't ask me to sing it
It's a treacherous song.

First, you survived Sepsis
Cardiac Failure and more,
Diabetes Insipidus
And a high APACHE Score.

Your liver shut down
With your kidneys soon after,
We were preparing the pine box
Stored above on the rafter.

But like a cat with 9 lives
And the horse with no name,
You were the grand finale winner
In your survival game.

Then this morning at six
After you awoke from your slumber,
Your right foot was painful
And colder than a cucumber.

Bad tidings indeed
On that double bypassed leg,
If the gods had a solution
I'd be the first one to beg,
For some blessed reperfusion
And a miracle cure,
The vascular surgeon told me
We can't operate, that's for sure.

Because the man is a vascular
Disaster in person,
We repaired the graft in June
And in July it did worsen,
Infected it was, we had to pull it
And replace it,
I'm the surgeon who fixed it
And now I'd rather not face it.

Mr. Ready-For-Home
Poses a problem and a riddle,
We need to open that leg
But he's not fit as a fiddle,
His morbidity and mortality
Are at an all time high,
No matter what we do or don't
It's quite likely he will die.

I felt like an accomplice
But it was nothing like that,
I checked on him often
Every two hours for a chat,
And not till this morning
Till he moved to the chair,
Was there a hint of a problem
Of disaster in the air.

It's my day off, as I write
And I won't be there tomorrow,
I'm worried and concerned
For his pain and his sorrow.

Fibril_late;
10/12/09

Ready To Go Home II

Ready to go home
What could possibly transpire?
Let me first warn you
My predictions are dire.

Mr. Cardiomyopathy
Didn't stand a chance,
His 900-cc ventricle
Had done it's last dance,
After waxing and waning
A couple of days or two,
He kicked the bucket quietly
There was nothing we could do.

His wife and kids looked on
To the future, without the man,
His lifestyle choices
Take some of the blame,
They helped him kick the can.

Mr. Pulse-less foot
Had a rough couple days,
Vascular surgery attempted
Several, last ditch effort plays,
But the end result was removal
Of his leg below the knee,
Sometimes there are no winners
In the game of life, you see.

He went home a crippled man
But he's still alive for some good tomorrows,
Prosthetic engineering can help him
To waylay his endless sorrows.

Ready to go home
At the end of the night, I am,
Sometimes this healthcare business
Seems like, nothing but a scam.

Fibril_late;
11/7/09

Even in the workplace, or perhaps that is the only place where this topic arises, there might be a discussion whether what is best, to leave the toilet seat up, or down, following it's use. Let's examine that once again:

A Fair Compromise

Toilet seat up
Or toilet seat down?
There are different opinions
In hospital town.

Like an open-faced sandwich
Or a pan that's too hot,
Some like the lid up
On their chamber pot.

While others will argue
The lid should be seated,
And hey, while we're at it
Why not have it heated?

It's a quandary and conundrum
All rolled into one,
And no agreement or bargain
Shall likely be done.

I propose, year by year
We choose one or the other,
A fair compromise
For sister and brother,
But on that off year
When it's lifted again,
Be careful, in a hurry
That you don't fall in.

Fibril_late;
10/11/09

Don't get me wrong; I like the Day-shift. The crux of the problem? I don't belong there. Why? The 3-meals, the numerous Discharges, the numerous Doctors, Imaging tests to travel to and more. It ain't my gig, and everybody knows it.
So, when I have to hang out longer than my usual 12 hours to Chart, well, I get to write a poem too. So please don't take any of this as a personal slight, ok? After-all, I named it after my least favorite president.

George Bush

Charting, charting, charting
Q-four-hours, it's a bitch,
My arthritic joints are aching
And my butt begins to itch,
'Tis the same old stuff I chart each time
It's really such a chore,
But they told us George Bush wanted it
No wonder, it's a bore.

Charting, charting, charting
It's oh-eight hundred, I'm still here,
My friends have all gone home
There were laughing, in good cheer,
It seems I had to trouble-shoot
The IV pumps and charting,
Now I'm surrounded by those day-shift freaks
My defense? I sit here farting.

They stay away from me, they do
Afraid, they'll make me linger,
As I pluck away at the keyboard keys
I offer them the finger,
Their fault, it is not mine to blame
I'm old and thus, too slow,
But the best of them, will always wish
That they could buy, all that I know.

Fibril_late;
10/1/09

Who doesn't love the idea of walking up to a dispensing machine, and being able to withdraw, whatever drug sparks your fancy? It's a thing of genius; almost.

Drug Dispenser

The computerized drug
Dispensing machine,
It's a thing to behold
And must be seen,
Just enter your password
And a special code,
Open the door
And collect your load.

Choose the drug
That fits your mood,
Like a restaurant
With your favorite food,
Come back for seconds
If you need some more,
There is an endless supply
At the drug-dispenser store.

If there is a queue at the machine
Take a number and wait,
Come back in a while
For a drug selection date,
You won't be disappointed
It's like the candy shop,
Get some extra samples
Your friends might want to swap.

There are many clever features
Like keeping track of your transactions,
Though I suspect the obvious
Big Brother, knows our actions.

But there are always ways to cheat
Though I can't reveal them here,
Meet me after work, with a case of Bud
And I'll gladly bend your ear.

Fibril_late;
9/38/09

Sometimes I'll write nonsense (or something close), just for the fun of it. There might be some fact, but this is more for the sake of the rhyme.

Don't Like

I don't like wounds
And I don't like youth,
I don't like severe pain
And that's the truth.

I don't like big
And I don't like fat,
I have likes and dislikes
And that is that.

I don't mind pee
But I don't like poop,
Whether teaspoon size
Or one large scoop
And I don't like snot
Nor boogers, nor phlegm,
I'll gladly leave it
For the rest of them.

I don't like anything
That ends with ostomy,
Because I always find
It has to much cost to me,
I'll like your language
If you know what's common
Pain, money and toilet
Water and Top Ramen.

I don't like opinions
Other than mine,
I don't like disagreements
Or if you whine,
I don't like arguments
Unless I win,
And please don't tell me
What you think is a sin.

I don't like religion
Unless you keep it in your blouse,
If you would like to reveal it
Just come over to my house.

I don't like this poem
But it was fun to write,
I don't want your feedback
That's my undivided right.

Fibril_late; 9/28/09

So memorable are the times, where Mr. Patient, uses the call-bell at least every 15 minutes, for the littlest thing, even though each time before I leave his room (again!), I ask him, "Is there anything else I can do for you?". No, he says, and "thank you so much". Just minutes later, after disrobing the isolation garb, scrubbing my hands with hand cleanser, and I'm trying to sit down for a teensy bit of charting,
ding-a-ling, I hear his call bell again, he wants his pillows adjusted. I redress, enter the room, and there is his brain-dead brother at the bedside, asking me to fluff the pillow. Two pods from the same pea, I guess.


Polite

How polite you claim to be
But polite, you're really not,
You're on your call light every minute
For a drink, a wipe, and a shot,
You told me how your parents
They raised you properly,
But for a guy who's 62 years old
There's no evidence to see.

You say that you're so thankful
For every bit of our care,
But you claim you're too damned weak
To even part your hair,
You can't even hold the urinal
So you pee into the bed,
But you can find the call bell 50 times
And cry, "I'm almost dead".

I just left your room 2 minutes ago
And before I left, I queried,
If you needed any pillows, food, or
Medications carried,
No, you thanked me from the bottom of your heart
While I shed my isolation gown,
Then you nailed that call-bell 15 times
Before I made it back to town.

Your sibling came to visit
He treated you like the royal brother,
He even used the call-bell
For a pillow, a blanket and another,
"Cup of ice, please, can't you bring it
When you come back to the room",
Then he nailed me with a nasty attitude
When I failed to bring a broom.

I should thank your blessed parents
That you were raised the proper way,
Because, after visiting your room those 50 times.......
It really made my day!

Fibril_late;
9/27/09

These days, we're constantly bombarded with "celebrity" news. Even if you're not the slightest bit interested, you just can't avoid knowing about all the idiotic antics of the temporarily rich and famous. Take Peter Pan for example...........

Like Peter Pan

When I'm irritable, aching and tired
And feeling down like a double-deuce,
I know exactly what I need
Some of that celebrity MJ juice;
Some prefer to call it Propofol
And others Diprivan,
Just please inject it into my vein, right now
And I'll sleep like Peter Pan.

When my little ones were babies
It helped them when they were teething,
Despite the fact, that I had heard
It might affect their breathing,
Then I began to use it
When I couldn't get to sleep,
My private doctor delivers it
And frankly he ain't cheap,
Which proves that he has ethics
At least one or two, I'm sure,
For a one hundred thousand bucks a month
He guarantees a cure.

It reminds me of my mothers milk
As a baby, I drank it often,
Now, please don't bother me, I need to sleep
In my hyperbaric coffin.

Fibril_late;
9/27/09

I went to a well-attended meeting a couple of days ago, and when I left, I felt like I was the only guy going home with a sunburn. And that's tough to accomplish, in a room with no windows, in the evening, just past 8pm. I'll take my parasol next time, along with my bug spray.

Ponder the Consequences

I went to a staff meeting
Dominated by a speech,
Regarding a new fangled program
Someone wanted to teach,
And I guess my body language
Conveyed my doubts and concern,
Thus, that lecturing nurse
Figured I had something to learn.

She halted her dissertation
To bring attention to me,
Directing every one
To take a look and see,
Recognize that his body language
Signals objection and disbelief,
So succinctly laid out
In front of our Commander-in-Chief.

How fortunate she was
That I forgot to bring my pack,
With my favorite weapons
For an unexpected attack,
My cat-of-nine-tails
And the latest new Taser,
The brass knuckles, and sap
And my straight-edged razor,
Typical tools
For streetwise protection,
If you're going to call someone out
Be cautious with your selection.

On my way out the door
She loudly asked for my suggestions,
If I were a fly, I’d set her up
For enzymatic digestion.

Fibril_late;
9/25/09

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