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

Thar She Blows

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

Steve (watch him heave)H.

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

Like A Lemming

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

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

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

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

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

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

Fibril_late;
12/29/09

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

Saving the Code

S.Huff RN

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

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

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

*Thanks Bro, you're the bomb!
ph

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

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

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

A Whizz, Is What It Is

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

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

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

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

Fibril_late;
12/20/09

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

C Diff

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

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

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

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

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

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

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

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

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


Fibril_late;
12/02/09

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

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

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

Made In The Shade

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

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

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

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

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

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

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

Fibril_late;
11/28/09

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

So Much Talk

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

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

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

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

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

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

Fibril_late;
11/21/09

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

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


Shiny New Building

It's a brand new tower

But we're the same old nurses,

It's the 21st century

And we still carry purses,

So don't be thinking something's different

It's the same old song and dance,

Draw the card, “Community Chest”

Or would you rather try at “Chance”?


If only life were fantasy

And imagination real,

All our fixtures made of the purest gold

Instead of stainless steel,

Our patients built of paper

Like the cut-out dolls of old,

We could cure their worst diseases;

Just cut the dotted line and fold.


We'll be doing all the same old stuff

Repackaged, new and shiny,

We'll be the happiest crew you could ever find

With no reason to be whiny,

The wonder-chip from IBM

Will be embedded in our brain,

And if we deviate from the master plan

Expect a ball and chain.


Oh, we're moving to a brand new building

The excitement grows every which way,

It's the hottest new trick since Trauma

Grabbed the headlines, 10 years ago today,

After the public is overwhelmed by our advertising

They'll be crashing Admitting for care,

We'll be praying to go back

To that old rickety shack,

And breathing that moldy old air.


Fibril_late;

11/13/09

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

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

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

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

Condition Yelp

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

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

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

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

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

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

Fibril_late;
11/02/09

Goin' South

Goin' South:

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

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

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

Ready To Go Home

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

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

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

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

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

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

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

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

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

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

Fibril_late;
10/12/09

Ready To Go Home II

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

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

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

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

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

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

Fibril_late;
11/7/09

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

A Fair Compromise

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

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

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

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

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

Fibril_late;
10/11/09

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

George Bush

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

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

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

Fibril_late;
10/1/09

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

Drug Dispenser

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

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

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

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

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

Fibril_late;
9/38/09

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

Don't Like

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

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

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

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

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

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

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

Fibril_late; 9/28/09

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


Polite

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

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

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

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

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

Fibril_late;
9/27/09

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

Like Peter Pan

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

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

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

Fibril_late;
9/27/09

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

Ponder the Consequences

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

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

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

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

Fibril_late;
9/25/09

Gordy, Lordy! WTF?!?

We, (all nurses, in this singularly broad arena of a particular organization) must assimilate, into our already, highly-demanding and the-plate-seems-too-full-and-I'm-stuffed-with-27-things-that-should-never-happen-in-the-hospital events, faced with but another way, that we the bedside nurses, are supposed to increase the odds, that Mr./Mrs./Ms. patient, will be happier than a pig in shit, to recommend our hospital to others, and bother to come back here again.

Look folks, our town is at the "ground-zero" of Managed Care and Capitation. Our clients/patients don't really get a choice regarding where they get care. Who are the powers-to-be, trying to fool. In this community, we have about 5 predominant Health-care insurance providers in place, and if you belong to them, you essentially have been assigned to Hospital A, B, C, or D, whereupon, you will be delivered, to get your infected Gall Bladder removed. This is not about satisfaction and choice.

But perhaps it is all about reportable statistics? Hmmmm, that has a nice sound to it, n'est pas? Oui!

But, because of the way the "business" model works best, there is a filtering down of ideas, to the basic level of care. Thus, the collective we, are faced with, "The Nursing Bungle". Sure, I know that seems a bit odd for a name, but.......well, in fact, that is truly my derivation of what is being passed off as the greatest thing since french-bread with snails, "The Nursing Bundle".

I know this was along harangue, but I'm just letting you know, there will be a bunch of poems to follow, that will address this topic.

Stay Tuned

I’ve got a slew of poems
About the Nursing Bungle,
Stay tuned for the latest
Coming out of the jungle,
The morass of misfired management
It goes all the way to the top,
The hot topic this year?
Patient satisfaction slop.

Fibril_late;
9/22/09

The Nursing Bungle

The Nursing Bungle....
We heard it first,
From the very mouths of babes
Man, it made me really thirst,
The refreshments were okay.
Crackers, cookies, and cheese,
I kept going back to the chef
And begging, “Mister, please”,
Do invite me again
To the next festive event,
I swear, in the meantime
I'll do my best to repent,
For my overt body language
Silently screaming, without a sound,
As I sat pondering all that information
Joe Studer discovered and found.

Look, it's the same old data
Repackaged and pretty,
Shiny mylar balloons
And a parade in the city,
With new benchmarks and measures
Lengthy checklists and more,
Observations by the charge-nurse
Who will stand by the door,
Observing our behaviors
And making check-marks on a paper,
Yes, these are the hallmarks
Of another questionable caper.

The Nursing Bungle it is
The name is so apropos,
Educate ye olde bedside nurse
As if they don't know,
About care and collaboration
Critical illness and more,
Now, it's all about “satisfaction”
When Mr. Patient leaves our floor.

Let's recognize the fact
It's just old stuff renewed,
And management has emphasized
Follow orders, or you're screwed,
Because we have to be compliant
And take on new behaviors,
Avoid 27 new bad things
Then all is well, proclaim our saviors.

It's old and it's new
And we get tired of this,
Every five years, or so
We're told something's amiss,
But the problem really isn't
On the street of our action,
It's just a management perspective
And I call it, distraction.

Someone way at the top
Looks around at the horizon,
Some study results tell him
You're losing money, it's not surprizin',
The economy is down
But you must blame it on people,
Find the guy at the bottom
And impale him on a steeple.

The dollars float up
To the top of the pond,
Mr. ground-cover boss
Wants to wave his magic wand,
And ensure that the fiscal
Prosperity of his being,
Remains all omnipresent
Instead of his salary fleeing.

So the shit slides down hill
To finally find the plateau,
We're inserviced, “The Nursing Bungle”
It's the same old stuff, don't you know?

Fibril_late;
9/23/09

Doubtful Old Man

Call me a conspiracy theorist
Call me a fool with a pen,
Whenever there is a new fangled program
I want to know why, where and when.

Call me disruptive and cynical
Call me a doubtful old man,
Laugh when I'm doing the research
Following the trail of the plan.

I want to know the cause for new action
When management demands our compliance,
When rules and directives are jammed down our throats
Under the guise of some evidence based science.

Fibril_late;
9/23/09

Scathing Words

Oops, I stumbled on some toes, and underwent some body blows.............

Scathing Words

What an experience that was
The power that sits, sat down with me because,
I had ruffled some feathers
Last evening by phone,
I called, old Doctor what's-his-name
And struck a funny bone,
He rattled his saber
About missed communication,
So this morning, I got an earful
In the middle of the nursing station.

I apologized to yonder doctor
And I acknowledged my error,
There was no intimidation
Not a shred or whiff of terror,
Just an agreement of sorts
That our computer documentation,
Leaves a lot of buried orders
An unintended complication.

Last night he was so busy
Over-stressed by demands,
I sought simple clarification
And bought a reprimand,
Uninvited scathing words
Where a simple sentence would suffice,
On-call, is a professional obligation
A pleasant deportment, is my advice.

A couple of salient points
Were hammered home to me,
Be careful whom I call at night
And keep the blaster, on setting #3.

Fibril_late;
9/19/09

Another stab at our digital medical record. Why? Because there are some screwy new terms, that seem like they originated in some foreign country. "Bedfast / Chairfast"...what in the heck does that mean??

Flatus Findings

I've already told the story
Of our new charting ways,
A preponderance of data
Absorbing our days,
Removing us from the bedside
Although our patient's need us more,
The boss of the bosses
Demands adherence to the chore.

There are new terms to contend with
That I don't understand,
Bedfast and chairfast
Initiated and planned,
And other strange items
That demand some rewinding,
Just what is the meaning
Of a Genital Finding.

Am I supposed to chart, "Yes"
I found the appropriate organ,
Or maybe, Miss Betty
Is endowed more like Morgan,
I can't seem to find the answer
And I'm embarassed to ask,
I didn't think that my charting
Would be a sexual task.

Perhaps I'm too old
For this digital charting,
Because, I also noticed
There's a query on farting,
A delicate subject
Regarding flatus of the gut,
In summary, I tell you
It's a pain in the butt.

Fibril_late;
9/17/09