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