A couple of weeks ago, I wrote about a guy who was fixated on his bowel function, and how crazy he was regarding that problem. This is just a short sequel.

What A Bother

I don’t need to know about
Your bowel habits, sir,
I don’t need the circumstance
The when, the why, the were,
And no one else, includes
Your children, wife and father,
No one wants to hear about
Your bowels, what a bother.

When you were working your career
An executive, is what I heard,
You must have been the Type-A kind
An obsessive-compulsive bird,
Controlling all of the company crap
And snooping in personal files,
You're retired now, to constipation
With painful, itchy piles.

Now top it off, you’re infected
We call it “contact isolation”,
Every trip into your room, sir
Is like a third-world destination,
Please roll over now, it’s time
For your daily disimpaction,
With smiles around we cater-up
To earn your patient satisfaction.

Fibril_late;
1/13/11

I am quite impressed with two articles in the October and November issues of "National Nurse" the Voice of National Nurses United. The two articles addressed that ridiculous "Scripting and Rounding" that has been shoved down the throats of nurses nationwide, by hospital administrators. If you are uncertain what I am talking about go to the following link:

http://www.nationalnursesunited.org/publications/entry/national-nurse-magazine/

I have been writing about this crap for a couple of years lately, but I am only becoming further incensed with this nonsense. So I'm starting off the New Year with my latest rant:

Violated

We're threatened with HIPPA violations
We're laden with boatloads of rules,
I'm the nurse for two 500 pound patients, and
Administration is stealing our tools.

They disbanded the guys on the lift-teams
A cost effective measure they claim,
Now daily they're stealing our break-nurse
High-census, low-staffing they blame.

Administrators attacking any overtime
That occurs daily in every ICU,
I'd wager, that not one of those bosses
Could accomplish, even half, that we do.

Don't write any incriminating emails
Don't post on any internet sites,
If you do you'll be sued and delicensed
And denied every one of your rights.

With scripting and rounding we're programmed
By the little tin soldiers upstairs,
The hell with our critical thinking
It's driven by money, who cares?,
The Medicare-Medicaid gorilla
Threatens hospitals with financial extortion,
No longer are outcomes important
The scales shift to the satisfaction proportion.

Pushed to the edge of the precipice
Perhaps it's time for the young to step in,
They are faster than me on the computer
And not tainted as I am with sin,
Their bullshit intolerance capacitors
Are so new, they're just out of the box,
We old veterans should hang up our gloves
And send the bosses our sweaty old socks.

Fibril_late;
1/7/11

Here it is December 31 and this is the last poem of the year. Because this is such an auspicious occasion, I am delivering an opus of intrigue and mystery. It’s all hush-hush, wink-wink, in-between the lines stuff. Although I share my writings with my colleagues when it is on the up and up, occasionally I address “sensitive” topics that might ruffle the feathers of the big birds. By posting on this blog, it becomes readable in the public domain, and thus, I must drop to the level of subterfuge, to disguise my message.

And I do like to dabble in nonsense, and see what comes out of it. Happy New Year!!!

Hush-Hush

This might be my last chance
To put this in writing,
I’m past the moment of boldness
But it’s time for indicting,
Exposing the infractions
Wherever they be,
It could have been you
Instead, it is me.

It’s the duty of the press
To find the rarest detail,
Which is sometimes so obscure
You might think you’re in retail,
Coordinating the castoffs
In the dressing room hamper,
Or getting lost like a rookie
In a Winnebago camper.

To dig up what’s hidden
Requires secret knowledge,
In the realm of the professional
We’re talking about college,
You can’t play in this sandbox
Without having some creds,
And the dress code is such
You can’t show up in dreads.

Details so abstruse
You need a submarine,
To fathom the depths
For the truth to come clean,
A buried conspiracy
Fourteen layers deep,
The story of the year
And we’ve all been asleep.

Money on the bottom
Money on the top,
Dollars without sense
On a roll and just can’t stop,
With reams of regulations
And adjustments to the build,
Hush-hush secret meetings
Between the masters of the guild.

Undercover gatherings
Messages in dead-drops,
Who would ever guess
They congregate in head shops,
Monthly new directives
Provided with pearls and pomp,
Wrapped in shameless packaging
And delivered with a stomp.

The story of the year
You must read between the lines,
Like you, I need to stay employed
And avoid those nasty fines.

Fibril_late;
12/31/10

This was the ultimate in obsessive/compulsive disorder. This 76-ish gentleman, was absolutely, astronomically fixated on his ability, or lack thereof, to have a bowel movement (bm, crap, shit, unload, have a dump behind the stump), or whatever you call it. It was the only thing he could talk about. Every conversation, led back to his bowels. Even if he was telling the story of going to Wisconsin for Christmas, he had to include the agony he experienced on the plane, where he felt “under-pressure” in the little airplane restroom, and he couldn’t take a dump. And, that was just the beginning, regarding why his visit to see the grandchildren, was a disaster. His bowels were constipated.

Yes, that might seem a little overboard, but it is the truth. Now, fit the above scenario, on a fellow with severe, end-stage Pulmonary Fibrosis, COPD, and Asthma, who needs BiPap with 100% Oxygen at all times, just to keep his saturations above 88%. And then, all he can do is talk about his inability to take a dump. Yowza!

Constipated

Collectively, a complicated psychosis
Overwhelming, was his halitosis,
Never had I met someone, so fixated
So sensational it was, as if iron-plated,
Telling his story, to anyone that was near
Incredibly, like it was his career,
Plausibly, it was a legitimate condition
After awhile, it became a long, boring rendition,
Then he revives, and tells me once more
In fourteen different ways how he just can’t score,
On the bedside throne, even though he has been thoroughly Kaexalated
Nothing seems to help, he’s totally constipated.

Fibril_late;
12/30/10

What happens at work, stays at work. We can thank Hollywood for that observation. I write about work, weaving and twisting the experiences, and then share it on this blog. Of course names are changed to protect the perpetrators.........because I don't want that bucket falling on my head. Anyway, here's the latest on the topic.

Always Fresh

I don’t write about work much
Unless I’m there in the flesh,
My mind percolates like the coffee pot
Brewing grounds that are always fresh.

The glaring inconsistencies
Are only obvious when I’m there;
Once I’m gone for three short hours
It doesn’t matter, I’m no longer aware.

So I keep the voice recorder
On hand, in my golden chariot,
To capture those thoughts that are running loose
I’m ready with my lariat.

Once I’m home and sleep commences
I cleanse my mind with dreams,
I’ll return to work another day
To write about new themes.

Fibril_late;
12/29/10

Just so you know, when I write about nurses, whether I use the masculine or feminine (he or she), usually is dependent on the word I need to rhyme with. So, although I previously wrote about the “3G Nurse” who was on her smart-phone too much at work, here I am once again picking on “her” because of the basic need to rhyme properly.

Now, I know that sometimes 8 hours, or 12 hours at work can seem like torture because the patient is a whacked-out crazy man, or a person with no short-term memory, but still, it's important to keep in mind, that we have a moral duty to relieve human suffering. I've had countless nights like that and you probably have, too. Try to keep in mind.......it's only 12 hours.........surely, I can remain calm and kind, for just 12 hours. Of course, it's courteous to answer the call-light promptly.

On The Moon

I’m kind of upset
About that nurse over there,
Her patients are calling
And she just sits in her chair,
Checking her email
And talking with others,
Looking at Facebook
To see her sisters and brothers,
Who remain in her homeland
Which is so far away,
Now she’s checking the airlines
To see how much she’ll have to pay,
To travel back home
Six months, next June
While her patients are screaming
It’s like she’s on the moon.

I’m answering those call-lights
And doing her duties,
Both patients are in isolation
And covered with cooties,
But still they have needs
And this is our career,
Where our clients are needy
And not always in good cheer,
They are often in pain
Or they need to take a crap,
Maybe they’re bleeding and vomiting
And it lands in your lap,
Yes, I know it’s disgusting
To have to deal with this wet-work,
But you’re paid to be here
So get off that social network.

With 12 years of experience
Her resume’ looked great,
But she cares more about her social life
Compared to the patients fate,
Now there’s an administrative edict
Regarding use of the computer,
But this chick just doesn’t get it
So, we might as well shoot her.

Fibril_late;
12/28/10

Time for that end of the year review, sort of thing. What do I remember best? What sticks out in my memory...............

Case Of The Year

Most memorable case
Of the year, who knows?
It might have been that fellow
With the dead, gangrenous toes.

I came on that evening
After a "minor surgery" in the room,
His foot was wrapped like a mummy
And there was a cloying smell of doom.

The day nurse was reporting
"Oh, by the way, please don't forget,
Send the dead toe to the Laboratory
I'll be temporarily in your debt".

I gave him a look, in the usual fashion
Right......; you could have had this done,
But why raise a fuss in the moment
When we can all share a bit of the fun.

What kind of packaging
And where do I send it?
Double-bag it, please
And try not to bend it,
It's a special collection
A pathological piece,
Don't place it on ice
And don't send the fleece.

So I got a couple baggies
The red specimen style,
Threw that toe to the bottom
Sealed it, and kept it a while,
Quite the conversation piece
"Hey, look what I've got?"
Billy-Bob's toe
And it's as ugly as snot!

Well, after all the jokes
About the toe-truck, and such,
I sent it to the lab
For that toe's final touch,
A specimen like no other
An unsightly black lump,
What does the Laboratory do?
They call, asking about the stump.

The dead toe scenario
Has a dismal outlook, indeed,
The odds are, the foot will follow
All the way up to the knee,
I've seen men lose two legs
And two arms, before it was over,
After surviving the beaches of Dunkirk
And leaping the cliffs of Dover.

Fibril_late;
12/27/10
_________________________

Revolving Door

Attack of the largest in life
2010 was memorable for sure,
Those super-sized clients of ours
Weren't coming to us for a cure.

But rather, some kind of repair
A secondary causation, due to weight,
Without reducing the underlying problem
We knew they'd be back at a later date.

Bettyjoe Bilotnik
Was admitted four times, I recall,
And it really, was quite surprising
That all of her children were small,
Her mother was built like a toothpick
While Betty's husband was shaped like a blimp,
Pushing Betty in the wide-bottomed wheelchair
Poor old Chester, had a heckuva limp.

Jimmy Johnson from Modesto
Got an ear infection, and an abscess in his neck,
Sepsis knocked him on his can
All 500 pounds of him, on last check,
“Wait, he's just twenty-eight
How in the heck, could he be so sick?”
That's what his sister said
When we had to intubate him real quick,
Because of respiratory failure
He was a smoking asthmatic, to boot,
Oh, he's always been a little heavy
But it never amounted to much; shoot.

Yes, we surely operate
A revolving door of care,
Without our frequent-flyers
I'd hardly know what to wear.

Fibril_late;
12/27/10

Working with the super-sick people, it's easy to lose sight of the breadth of the healing process. Additionally, when working my typical one day on-two off, it's only the one out of twenty patients that sticks around more than two days. Now, as I ponder the dichotomy of my existence, sitting here with a boot on my leg for 8 weeks, the life-cycle of the healing process, unfolds before my eyes.

Healing

Healing progresses
In its own good time,
More than a nickel
But less than a dime.

The days go by
Kind of slow and boring,
Like the baseball game
Where nobody’s scoring.

Hit the ball, catch the ball
Beat the runner to the bag,
Like a double dose of Ambien
Or Chloroform on a rag.

But who needs excitement
When bones are on the mend,
It’s like the new Spring garden
With little vegetables to tend.

Watching them grow
If you sat there all day,
Would be slower than snot
Is all I can say.

The mending of bone
Takes much longer than expected,
You can’t really feel it growing
But it must be protected.

In that respect, my foot
And lower leg, as well,
Should I fall over or stumble
It will surely hurt like hell,
So I keep it secure
Like hiding my loot,
What used to be a cast
Has now become das boot.

So I busted some bones
To earn an eight-week sleeper,
But I’d rather do that
Than meet the grim reaper.

Fibril_late;
12/25/10

I admit it, I haven't been very productive lately. Part of the reason is that I joined the ranks of the injured, when I walked into an open drain hole in a sidewalk, in the dark. That's right, so lay on the sympathy please. Anyway, that story is being told over at (http://odarepsed.posterous.com/) which is my altered ego site. Anyway, it could have been worse.

Hummer

Getting injured
Is a bummer,
But, better to fall in a hole
Than be thumped by a hummer.

Fibril_late;
12/16/10

How many shifts in the past week where I have not had time, nor have there been enough staff on hand, to have breaks at work? I talked to a family member of a patient one night, who couldn't quite understand, how a nurse could be so busy, as to not have time for a break. She said something to the effect, that break-time was "mandated" in California, so of course, we must certainly always have time for a dinner-break. I think I finally got through to her, that an unstable patient, might trump my need for a food break, if there were no other nurse available to fill in.

Well anyway, this job is horribly stressful at times, despite my training in spiritual enlightenment practices and black magic.

No Immunity

Encountering another ridiculous
PTSD opportunity,
I'm once again reminded
I have no professional immunity,
To protect me from experiencing
Overloaded situations,
Despite my secret talismans
And psychic affirmations.

Like a passenger in a canoe
In some Class-5, crazy water,
Some nights at work I feel the same
As a lamb led to the slaughter.

Fibril_late;
11/24/2010

We all know by now, that Nursing is not getting any easier. It is way more complex than when I touched my toes in this turbid pond, 27 years ago. Heck, back then I had been an RT, and that discipline is incredibly more complex too.

I know so much more now, but I am ever the more frustrated with all of the crap we have to put up with in terms of management policies (or lack thereof), bureaucracy and regulatory agencies, medical equipment designed by cloistered lab engineers who don't know Jack about real-life usage, and so on. There is plenty to bitch about.

At the same time (and all wrapped up in our daily experience), I know we perform amazing feats of caring and healing, which are interwoven and incorporated into the very fabric of our lives. And that's the clincher; it's difficult to “come down”, after successive days at work, to process all of the experiences, frustrations, successes and losses, and merge smoothly into the ordinary home-life. I believe that this is a common theme among the public service industries like Nursing, Police, Fire, Military and the like.

Sometimes just a bitter cup of coffee, helps me to cross the bridge back to reality.


A Cause and a Curse

It's my usual way
After two crazy days
To unwind at the local brew shop,
Skimming the papers
While jotting down words
Disengaging my feelings with a chop.

It's that Karate killer instinct
Trying to sort, slash and bury
The experiences of this overworked nurse,
Saving people who are dying
And babysitting the rest
It's a career with a cause and a curse.

Fibril_late;
11/1/10

Working in a Medical ICU these days, it seems like 45% of our patients are admitted with Sepsis. That means that almost every day we are fighting to keep up somebody's blood pressure with Levophed and generous IV fluids. True enough.

However, there are people walking around with some sort of autonomic disturbance, where their blood pressure is dangerously low, and they need daily medicine to somehow support and sustain, cerebral perfusion. You might be thinking, hmmmmm, it seems like I've heard of that, but what the heck, is the name of it? Well that's the crux of the matter; it has never had a good, catchy name. That is, until I discovered it!

Hypertension Deficit Disorder

I have named a new disorder
According to my think,
We were discussing low blood pressure
And it came to me in a blink,
As if a cursor were brightly flashing
Within the deepest recess of my mind,
Several concepts were bouncing around
When all at once, it was clearly defined.

Rarely do we ever examine
That hypotensive son of a gun,
There are a lot of good reasons a BP is low
Like the planets revolving the sun,
But more commonly, our major statistics
Are driven by those hypertensive fools,
Yes we know these bloody freaks so well
They're the drivers for all of our tools.

And as a result, the naming
Of this barely known, uncommon disease,
Has gone for eons without its own title
It's more like a sniffle, than a sneeze,
So let it be known, upon this day
October twelve in the year twenty-ten,
Hypertension Deficit Disorder
Has now been transcribed by this pen.

Wielded by this one very author
And posted on this world-wide-web place,
If you wish to hijack this naming
I'll throw my copyright into your face,
You see, I need to rake in some royalties
My autumn years will come quickly to hand,
I'm open to grandiose ideas and schemes
It's a part of the future I've planned.

Hypertension Deficit Disorder
Is a well-defined disease, to a few,
In the many long years of this nurse
I remember just a couple I knew,
Who were prescribed high-salt in their diet
And proposed to render higher emotions,
Because we know in retrospective analysis
These are evidenced, and reliable potions.

I am thinking of publishing my data
Though it's a narrow, small selection research,
I'll set up a booth and a table
On Sunday, outside of your church,
When it's one-hundred degrees 'neath the shade tree
The parishioners will be dropping like flies,
Hypertensive Deficit Disorder
Will be easily proven, no surprise.

Fibril_late;
10/12/10

Here comes the holiday season, lot's of good eatin' and sure-as-shootin', there will a bunch of choking going on at the dinner tables across America. So, I got to thinking about what the statistics might reveal.

Choke

Who chokes more
The woman or man,
Fat or skinny?
Ask the statis-tishan,
Anecdotal evidence
Is a bit unreliable,
While restaurants worry
If they will be liable.

The Heimlich maneuver
Will save quite a few,
But some choke so bad
There’s not a thing you can do,
While they retch and they rasp
With hands clutching their throat,
The medical examiner will say
“Buddy, that’s all she wrote”.

Fibril_late;
10/4/10

Cell-phones, smart-phones, etc. People are creating complications in their lives, and the lives of others, with the out-of-control, ubiquitous usage of these gadgets. Sure, I own one, but I don't take calls when I'm driving, and I leave it in my locker at work. We all know how mentally distracting they can be if used while driving, but what about "constantly" checking your personal phone at work (plus all of the network distractions too).........could that have a potential downside, say, like the car accidents attributed to cell-phone use? Of course!

3G Nurse

The 3G network
Keeps him connected,
He feels so special
As if he was selected,
From a multitude of many
One of the chosen few,
Without his ever present iPhone
He wouldn't know what to do.

Like Adam of the Bible
Tempted by the fruit,
This electronic gadget
Is his tether, his root,
He can't seem to be without it
It's always close at hand,
What's the problem with that?
He can't seem to understand.

At work in the midst
Of the dying and infirm,
His iPhone is his master
It dictates the term,
Of his short attention span
For critical thinking,
He's woefully unaware
When the ship is sinking.

Like the cigarette smoker
And the alcohol sipper,
The airplane-glue huffer
And the heroin dipper,
These always-on gadgets
Of our modern age,
Are just another addiction
And the latest rage.

Do they belong in the workplace?
Not really, because,
Just like drinking Jack Daniels
It would violate the clause,
Of, no intoxicants at work
It just isn't allowed,
To have one's mental acuity
In an alcohol cloud.

What is the solution?
Disconnect from the grid,
Have a policy in place
Enforce and forbid,
No use of these devices
Unless medically related;
That you can use it in the break-room
Is understood and clearly stated.

There are issues of privacy
So we must set the tone,
Big Brother is watching
Some will argue and moan,
HIPPA laws are clearly posted
For us and our clients,
So, enforce and forbid
To create workplace compliance.

The 3G network
Keeps him disconnected,
From bothersome vital-signs
After the drug he injected,
Into Billy-Bob’s PICC-line
In room eight-twenty-eight,
Yes, his attention to Facebook
Will seal Billy-Bob's fate.

At first bradycardia
And then hypotension,
An allergy to Toradol
That the wife didn't mention,
And while his buddy on Facebook
Had the greatest surprise,
Billy Bob Brady
Took a trip to Paradise


Fibril_late;
9/21/10
_ _ _ _ _ _ _ _

Further thoughts on the matter, after "sharing" the above poem..............

The Lottery of Babylon

Raising junior
Raising shackles,
A barn-raising community
With hens that cackle.

Rules broken by few
While shared by the many,
I could get rich I suspect
If evil thoughts paid a penny.

Statistical analysis
The power in data sets,
In time, will identify dangers
Are you willing to place your bets?,
I’ll take wagers on inattention
While we hold our collective breath,
Who will win the lottery of Babylon?
Where the reward is a negligent death

Fibril_late;
9/24/10

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