Why haven't I written for almost two months?

Injured

I injured my arm
But I wasn't bitten,
So that doesn't explain
Why I haven't written,
In over a month
In this Nursing journal,
I can blame my trauma
On that hundred-liter urinal.

I busted my bicep
A strain in my arm,
The patient was OK
'Twas the nurse who had harm,
Now I'm in recovery
It's a twelve-step regime,
With my own Physical Trainer
She's so hot, I could scream.

No, unfortunately, I'm joking
This isn't 24 Hour Fitness,
These Trainers are pit-bulls
As god is my witness,
And returning to work
Will be a welcome event,
They're prepared to release me
When I apologize and repent.

I was damaged
(Some would say, long ago),
But the future is hopeful
I'm letting you all know,
My advice, for those considering
Having an injury, too?
Make sure it happens on the job
So Workmans' Comp works for you.

Fibril_late;
9/15/10

You know it's organizational when the attack of the acronyms is underway. Here's just a sampling:

It’s 2010 and we have been informed about the following program (guided by the Guru’s of Pharmacy):
M. E. R. P. – Medication Error Reduction Plan

Now, other Departments want to jump on the acronym bandwagon too. Thus, consider the following other M.E.R.P. renditions:

H.R. Employee Benefits: Mandatory Employee Rest Period

Finance: Miscellaneous Expenses Rarely Paid

Respiratory Therapy: Mucus Extraction Raunchingly Putrid

Dietary: Meal Enjoyment Rendered Promising

Physical Therapy: Manipulating Extremities Really Painful

Cashier: Money Extraction Realized Profit

Neuro-Surgery: Mental Excavation Risky Proposition



The folks in the G.I. Lab figured they should have a B.E.R.P………….
Barium Enema Rectal Pain


No doubt the rest of the hospital will soon follow suit!

Fibril_late;
7/25/10

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