Night Shift

Nurses who have worked night-shift for years (the ones that like it), often find that even when they have reverted to normal daytime living, their body still easily shifts back into the "stay up all night" mode, without much fanfare. When my mate leaves town, I stay awake at night for hour, even if I have to work the next day.............it just seems natural.

Night Shift

Massage school

I stored it within,

I'm not a Massage therapist

Is that a sin?

Specially trained

To ease your aches and pains,

I wouldn't have lasted a month

My hands would have flopped

Thank goodness, for my brains.

Yes, I happen to have several

I use them on different occasions,

For example right now I am writing

Listening to the Rolling Stones, those Eurasians,

A band quite renowned

For crazy antics and wild living,

But still they make music for the world

Five decades of giving.

The crux of the problem?

I'm a night person, deep inside,

Ever since age 14

I read to 3am, that was my ride,

Into the ideas of countless writers

Far better than me,

I took up the typewriter at that time

As if the words would set me free.

But the night-time thing

Is nothing to scoff at,

Supposedly night shift workers

Find it easier to get fat,

But as a long time player in that realm

I argue with that silly notion,

Becoming overweight isn't nocturnal

It is an all day, full time vacotion.

A lot of skinny people work nights

I worked fifty hospitals, I declare,

Overweight nurses?

Sure, they were there,

But night shift didn't do it

And that is a fast-food fact,

A lot of stupid things to blame

But night-shift isn't the act.

How did I get to this point anyway

My mate is out of town, that's the thing,

After two days I revert back to night shift

My biorhythms feel cozy and start to sing,

A song about writing and music

Cavorting with ideas sprouting like flowers,

I start projects, write and doodle

The night wiles away past the hours.

And then yowza!, I realize that morning soon beckons

Am I working?, I'm not really sure,

Thank goodness I don't report till 10:30

Four or five hours of sleep is the cure.

Massage school

Was a great learning, indeed,

I don't use it much as an Outpatient Nurse

But at least I can chant Om, when they bleed.

Fibril_late;

6/26/13

Ugly Stepchild

If you work in the hospital, you have been up close and personal with stool. We are nurses, we mess around with the stuff.....lots of jokes to simmer down the nastiness. But when it happens to me (or you) it's time to feel the suffering. So, although this is about me, it's a universal suffering. 

Ugly Stepchild

Gurgle-gut

Is still acting up

Three months later  and more,

Not diarrhea and `

Not constipation,

But certainly

A bothersome chore,

Colitis or IBS

Or one of those irritating cousins,

I guess if I went to the

Medical books,

I would find

Variants in the dozens.  

Norovirus

Is something to shake a stick at,

C-Difficele's ugly stepchild

The odds are I won't be getting fat,

Eating seems completely undisturbed

Cramping, comes early in digestion,

The ever-present gurgling noises

Herald an upcoming decongestion.

Gurgle-gut

I thought it would go away

In a month or two,

I think the scorched-earth policy

In my colon

Was overkill; don't you?

Similar to Agent Orange

Defoliating, that Asian swamp,

Norovirus seems to have decimated my GI tract

During its historical romp.

Fibril_late;

6/30/13

Gobbledygook

My best buddy nurse pal of 24 years, died suddenly this week, quite unexpectedly. She was brilliant, knew so much, and thank goodness we spent a wonderful day together, just two weeks ago. We worked together from 1989 to 2001, and then emailed, phoned, visited, went on local adventures (any outing with Linda was unique) and basically, she felt like a sister. I think many others feel the same way about her.

We had countless conversations on medical topics, particularly Cardiology, our shared interest. And we talked a lot about Nursing in general; the good, the bad and the ugly. Usually after I would post something on  the internet, she would write me and comment about it. Back in the days before blogging, when the "Underside of Nursing" was in print, Linda was physically present for many of those rhyming vignettes that I wrote about, our shared experiences in the CCU.

She would have enjoyed this poem:

Gobbledygook

I never met a care-plan

That made any sense,

Inventors of care-plans?

Please don't take offense,

You were feeling downtrodden

Like you didn't have a voice,

You invented the care-plan...

Not the best choice.

Perhaps you were jealous

Doctors wrote all the orders,

Directed the care

And fired the mortars,

And you wanted to shout

“Hey, what about me?”

The nurse doing the work

Our pay?, almost free.

Now look what you've done

You cluttered our day,

With gobbledygook

We must point-click away,

That later will be audited

To keep nurses on track,

A care-plan, indeed

It's a smoke screen; a hack.

Surely this wasn't

Original intent,

You wanted nursing to have a presence

Inside the medical tent,

But to do it this way

With such a pile of words,

Is like trying to fly with eagles

Little chattering birds.

In our current EMR

Care-plans are a POC,

There are hundreds of them

And it's really no shock,

That no nurses love them

It's just a tedious task,

Another auditing tool

“Oh, please pass me the flask”.

That nurse inventor of care-plans

Should have a statue or a plaque,

The kind that pigeons love to roost on

Leaving guano on the back,

A suitable honorarium

Like the birds in Pershing Square,

It seems like they own the place

Cluster-bombing on your hair.

Wouldn't task lists have been better

Just check them off, as the day passed by?,

Did the infant wet the diaper?

How many times did it cry,

Why call it, a variance in digestion

Or a disturbance in elimination,

Babies pooped their pants for a thousand years

Until care-plans called it an alteration.

Those nurse inventors wanted their own language

Without a care how stupid it would read,

Alteration in fluid volume status

That was Joe-Bob, oh man, did he bleed!?!

And then he had an alteration in perfusion

His brain cells were left gasping for air,

Too bad his bedside nurse didn't notice

She was charting on 14 care-plans, over there.

Christ on a crutch, this gobbledygook

Has tangled up Nursing forever,

Another 20th century invention

Truly an Albatross Award endeavor.

Fibril_late;

6/14/13

Crackers

Once again, another “new build” set of dubious documentation improvements has been downloaded and delivered to our digital disaster known as Cerner. Why didn't I realize that I needed to do more documentation.........that it would lead to enlightenment and Nirvana? I should have meditated more, and perhaps that is why, I am now, certifiably crackers.

Crackers

I've been storing up

I have lots to say,

About all the hospital nonsense

Going on today,

Regarding digital

Documentation and more,

Every three months

They keep adding a chore,

As if hospital workers

Had nothing better to do,

Than to poke at a keyboard

Instead of caring for Betty Lou.

When processes are lengthened

Smart workers are tempted to cheat,

Finding work-arounds and back doors

To get the job done, nice and neat,

Managers and System Analysts

Rail against rebels and hackers,

But why should we care?

They only feed us crackers.

Fibril_late;

05/31/13

25 Times

Healthcare workers getting sick? Yup, we ain’t no more special than the rest of you blokes. My affliction, appeared to be some variant of food poisoning, or “intestinal bug”. Frankly, a 48 hour trip to the loo, won’t be high on my list of exciting recommended excursions. However, as I speak, it was prolonged enough to earn me a day of paid-time-off.

On another note, I certainly empathize with those numerous patients, who had C-diff, or other similar afflictions, requiring frequent linen changes.

25 Times

Diarrhea

25 times,

It sounds kind of exciting

And even though it rhymes,

I wouldn't recommend it

To any kind of friend,

Because 25 expulsions

Makes for a sore bottom end.

Diarrhea

25 repetitions,

Like some kind of penance

From a priest with weird ambitions,

Exploring my fortitude

Amidst the storm in my colon,

Like a conveyor belt of garbage

At the dump; it just kept rolling.

25 trips

To the johnny isn't fun,

Quite often one must canter

Or even, flat-out run,

To avoid public embarrassment

And the horrid, proverbial "Oops",

Your pants show the evidence clearly

You lost the handle on your poops.

25 rounds

Of emptying, got old,

I'm feeling so vacant

Like my intestine was sold,

To the junk man down the street

Collecting bottles, rags and cans,

But wait, there's more, I'm just saying

This wasn't part of my weekend plans.

Fibril_late;

4/29/13

A Liquid Insurgency

At times I think

I'm pretty tough,

But 25 trips

Was quite enough,

8 Hours had passed

I thought, now I am free,

The last chapter played out

On my diaree.

Not so, said my colon

There will be no relief,

Today is day 3

And it's time for more grief,

Let's have more of the same

Your condition didn't pass,

We tricked you for a while

When you only passed gas.

But I was feeling better

And finally ate some dinner,

I slept all through the night

Thinking I was the winner,

But later, after breakfast

There was a rumbling in my gut,

Then a liquid insurgency

Was departing my butt.

I'll hold out till day 4

I'm a tough nut, you'll see,

Then I'll ask for advice

From Doctor McDee,

He might have some insight

On this intestinal issue,

Or consider it a prompt

To invest in toilet tissue.

Fibril_late;

4/29/13

_ _ _ _ _ _ _ _ _

Gurgling Gut

Diarrhea, Day 8 - Final

I was so damned sore

I needed a spinal,

But that condition waxed and waned

And finally quit,

Thank goodness!; my colon

Had quite enough of it!

Now thirty days later

I still have gurgling gut,

After that scorched earth clean out

Stripped my colon to a rut,

So now I'm rebuilding

New intestinal tissue,

A recommendation?

Don't make this your issue.

Fibril_late;

6/1/13

Trademark

I saw a memo the other day addressed to nurse-management people. They were directed to show all the HCAHPS (hospital survey, patient perspective of care......http://www.cms.gov) reports, fliers, rah-rah posters and so on, in our break-rooms. This is the place where we are allowed to relax, kick back, raise a non-alcoholic brewsky, attend to our bodily functions, and so on. Why force us to read this gobbledygook? We’re the frickin’ people busting our butts, trying to do an impossibly great job, with too few resources. This is FUBAR! Show the stinkin’ results in the Lobby, if you must, so the consumer public can feel good about coming here.

Trademark

If you trademark a name

Does it make the product any better?

For example, "Intelligent Surveys"

Examine each vowel and letter,

Are these the best-ever surveys

More intelligent than all the rest?

I pose this trademarking is a gimmick

No more and no less,

Saying, "We are intelligent"

Smacks of superiority attitudes,

HCAHPS, Unadjusted Avatars

And other gobbledygook platitudes,

Quite frankly, I'm not impressed

I don't need to incorporate it into my practice,

This is more corporate subterfuge

Their attempt to redact us.

Fibril_late;

4/19/13

CV, Again

Would you be willing to undergo ten cardioversions and four separate ablation procedures, including a MAZE procedure, to stay out of Atrial Fibrillation and Atrial Flutter? Some people with Persistent Atrial Fib, who are treated with anti-arrhythmic medications, never feel good, and that was why they opted for Ablation (potentially several). I think the last resort, is to have the AV Node ablated (annihilated) and then, have a pacemaker inserted. How sensible does that sound?

Thus, once again, between rounds of golf, Billy-Bob had another CV, again.

CV, Again

Electrical cardioversion, oh my!

Was the 10th time the best?

Well, let's ask the guy.........

The good man on record

With the most persistent A. Fib,

Ten times he's been zapped

Without busting a rib.

Oh, CV again

His claim to fame,

From Palm Springs to Maui

Working on his golf game,

Then he comes home to Cali

For a breather, and Bam!

While resting on the weekend

His heart dances flim-flam.

Yes, CV all over

And over again,

Ablations times four

Electricity times ten,

Yet still, he maintains

The best outlook, and why not,

Golf needs to be played

To the very last shot.

Fibril_late;

4/22/13

Snooze and Play

As nurses, the day comes when we see the person who announces their badge of  "Disability", waving it proudly, as if they served in some kind of liberating war. I am not talking about those actual military veterans, but rather, those persons who regale us with their stories of medical problems, and how, they can't possibly work any kind of job, because they are disabled.

To me, it's like the folks that stand at the Freeway-ramps, begging with a sign, and they have two good arms, two functional legs, they are not blind or deaf, and in other words,  they seem able and functional enough, to perform some kind of labor so they are contributing to society (and possibly the economy), rather than sucking down resources like a storm drain. No, they would rather snooze and play.

Snooze and Play

Here's what I discovered

When I examined your medical file,

You've been alive for 50 years

But you've been dying for a while,

You can place some of the blame

On each beloved parent,

But please, examine your lifestyle

It is decidedly aberrant.

Genetics certainly played a part

But you abused, as well,

Heart repairs times three now

And you quit the drugs from Hell,

You laugh and joke and talk too much

Are you fourteen going on fifty?,

What a carefree life you lead now

Seems you love it, it's so nifty.

And another thing, my friend

Are you working, and why not?

Oh, I'm on permanent disability

Good looking, and I'm hot,

You could ask my lovely wifey

But she's working hard today,

After all, we need her income

So I can snooze and play.

I'm only 50 years old

My wife's best friend is my driver,

She tells me Jesus loves me

She's my right-hand, pal-advisor,

Sitting at my side in bed

Acting like, my loving wife,

Who is hard at work in the Nursing home

As I whistle on my fife.

What is wrong with this picture?

Nurse-me, I ask the wall,

I have a best-friend transplant recipient

Working hard as a nurse, and all,

While Joe Bob with his heart repairs

Sure looks like he could work; it's a fact,

Another abuser of medical welfare

His disability is surely an act.

Fibril_late,

4/11/13

No Pass Zone Research

No Pass Zone Research

I felt it was time to do some research, in respect to the "No Pass Zone" directives, that I wrote about a week ago. It appears that once again, the East coast got the jump on this idea (in roughly 2010) and then we cliff-hangers on the West coast caught on a couple of years later. It's always like that, so don't complain. Still, I am astounded that I am the only person bringing to light, the potential for liability, damage, Sentinel Event, and so on, with the initiation of policies of this nature.

Don't get me wrong; I am not advocating that we ignore patient call-lights. In fact, I am advocating for the Safety of all of the patient's in the hospital. But I know what the bottom line is..............it's all about "patient-satisfaction" scores. The questions that are asked of patients, after they have been discharged, are carefully scripted. If I call Mrs. Jablinzky, and ask if her call-light was answered in a timely fashion, she might say "Yes, ever since they started that No Pass Zone thing". But if I also ask her, "Did you mind it when the stranger in the blue and black uniform, appeared at your bedside at 2am, (when you had rolled over onto your call-light), asked you in a gruff voice, "Can I help you, Ma'am?" She would probably admit, that he scared the bejeezus out of her. And this probably begs the suggestion, that during the night hours, only the Nurse, CNA or MD, enter patient rooms.

The more research I do, the more disappointed I am with our Medical Corporate entities and the nonsense decisions they make, all for the improvement of patient satisfaction scores. Or is there some other reason that I haven't caught on to?

Do tell.

http://www.healthleadersmedia.com/page-3/PHY-268393/15-HCAHPS-Buzzwords-Every-Provider-Should-Know

http://www.healthleadersmedia.com/content/NRS-250810/Nurses-Find-Simple-Ways-to-Improve-Satisfaction

http://dr.beaumontphysician.com/News/Pages/No-pass-zone.aspx

Fibril_late;
4/11/13