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

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