In a previous post (Nov 1), I wrote about symptoms of all kinds........and I'm revisiting the theme conceptualized by the flier for our Vascular Department.
This time, I'm "inspired" by that particular patient, that we see, who ignores even the most obvious and blatant signs of their serious disease: for example, a black toe falling off, before they seek medical treatment. Frickin' crazy!
Just A Symptom: Revisited
Is your leg pain just a symptom
Of some serious disease?
Do your toes seem loose and wobbly
Every time you sneeze?
Do your black and shiny feet
Give you cause to worry?
If you're just a couch potato
What's the rush, no need to hurry.
If your foot pain feels a little
Like an atom bomb exploding,
If your toes smell kind of bad
And it seems like they're eroding,
Do you leave a crusty trail
As you limp across the room?
Don't worry, what's the bother
Get the dustpan and the broom.
If you wake up, Sunday morning
And you can't seem to find your toes,
Maybe you remember, that about 2 am
You had that tickle in your nose,
And then it felt like five little rockets
Blasting off, on both of your feet,
Take a look down there, brother
Two black appendages, looking neat.
Yes, that leg pain could be a symptom
A harbinger of bad circulation,
What the heck, go ask a Doctor
Before you suffer abbreviation.
Fibril-late;
11/30/11
Wednesday, November 30, 2011
Thursday, November 24, 2011
I'm a veteran of bedside nursing; a survivor of the system, and well on my way towards retirement. Do you think I really want to spend extra hours at work, on a whim? Sure, when I was younger, I wanted to tally as many hours I could, all for the bucks. But no longer; my body needs as much rest as I can acquire...........after all, bedside/gurney nursing is labor intensive.
So why is it, week after week, when we tally in an extra 15 minutes (or whatever is NECESSARY) at the end of a busy shift, the "Uppers", reprimand the "lowers" about the "strain" on the budget. And yet on the other hand, they don't applaud us for going home early (not paid)?
It's no mystery, and I know why.....Corporate/Business mentality is at play here. Ball and chain, whips and sour carrots. It's all in the coaxing, right?
Oh ya, how could I forget about "Nurses' Week and Nurses' Month in May"; I guess this is just the waiting period.
Overtime
Instead of giving a reprimand,
How about a clapping hand?
I know it's radical, like any diet
But whuda-you say, we bother to try it?
We know that
Unexpected overtime,
Adds to cost
By nickel and dime,
It makes the bosses
Curse and cuss,
And they point fingers
Right at us.
Reprimanded overtime
Late discharge and departing,
'Tis just my patient-centered care
And the necessary charting,
The beds to clean, the charts to strip
The whiteboard, fill the blanks,
And tally up that billing, mate
Still we're scolded, never thanks.
But when we're saving money
By our unpaid, early, off-time,
No thanks are sent our way
And that feels like caustic lime,
I wasn't paid for H-C hours
'Tis my voluntary loss,
Let's prepare a balance sheet, my friend
And present it to the boss.
How much money do we save
Compared to what we lose,
We will only tally our nursing hours
To keep it simple how we choose,
No thoughts about productivity
That's a management realm, my friend,
I don't want a clap or reprimand
Until this tally-month shall end.
Plus or minus, that's so easy
Hours are dollars, and that makes sense,
Don't scold me for my overtime
Unless you can prove I caused expense.
Fibril_late;
11/24/11
So why is it, week after week, when we tally in an extra 15 minutes (or whatever is NECESSARY) at the end of a busy shift, the "Uppers", reprimand the "lowers" about the "strain" on the budget. And yet on the other hand, they don't applaud us for going home early (not paid)?
It's no mystery, and I know why.....Corporate/Business mentality is at play here. Ball and chain, whips and sour carrots. It's all in the coaxing, right?
Oh ya, how could I forget about "Nurses' Week and Nurses' Month in May"; I guess this is just the waiting period.
Overtime
Instead of giving a reprimand,
How about a clapping hand?
I know it's radical, like any diet
But whuda-you say, we bother to try it?
We know that
Unexpected overtime,
Adds to cost
By nickel and dime,
It makes the bosses
Curse and cuss,
And they point fingers
Right at us.
Reprimanded overtime
Late discharge and departing,
'Tis just my patient-centered care
And the necessary charting,
The beds to clean, the charts to strip
The whiteboard, fill the blanks,
And tally up that billing, mate
Still we're scolded, never thanks.
But when we're saving money
By our unpaid, early, off-time,
No thanks are sent our way
And that feels like caustic lime,
I wasn't paid for H-C hours
'Tis my voluntary loss,
Let's prepare a balance sheet, my friend
And present it to the boss.
How much money do we save
Compared to what we lose,
We will only tally our nursing hours
To keep it simple how we choose,
No thoughts about productivity
That's a management realm, my friend,
I don't want a clap or reprimand
Until this tally-month shall end.
Plus or minus, that's so easy
Hours are dollars, and that makes sense,
Don't scold me for my overtime
Unless you can prove I caused expense.
Fibril_late;
11/24/11
Every nurse has had the experience of encountering an angry, out of control, irate, screaming, cussing, cursing family member, at one time or another. I was lucky this time, it was just a phone conversation, and not a face-to-face confrontation. I can't say that I enjoyed it, though.
Communication Fail
I think I may have flunked
A call-back review,
After a screaming conversation
With a patient's daughter, Betty Lou,
I called her on her cell-phone
What time, to pick up Mother,
She angrily responded
Why, you ugly son-of-a-brother.
Perhaps it was my error
When we had that conversation,
Pick up Momma, at four, today
But that was faulty information,
Learning more, I phoned again
But encountered her cellphone-mail,
Yes be damned I was that moment
'Twas a communication fail.
At four-thirty I answered her call
And she was clearly on attack,
She said a Discharge Nurse had told her
It was time to bring her Momma back,
Saying, “What do you think you're doing
By jacking me around”,
I said, Betty Lou, it's not that way..........
Then she called me a son-of-a-hound
She was screaming, ranting, raving
Yelling and accusing,
I tried calming, caring logic
But that doesn't trump abusing,
From the mouth of an angry daughter
Venting at my expense,
Like a pitbull on a rampage
On the other side of the fence.
We didn't resolve our issues
And I don't care, I'll tell you why,
I'd rather walk on gilded splinters
And mate with a tsetse fly.
Fibril_late;
11/24/11
Communication Fail
I think I may have flunked
A call-back review,
After a screaming conversation
With a patient's daughter, Betty Lou,
I called her on her cell-phone
What time, to pick up Mother,
She angrily responded
Why, you ugly son-of-a-brother.
Perhaps it was my error
When we had that conversation,
Pick up Momma, at four, today
But that was faulty information,
Learning more, I phoned again
But encountered her cellphone-mail,
Yes be damned I was that moment
'Twas a communication fail.
At four-thirty I answered her call
And she was clearly on attack,
She said a Discharge Nurse had told her
It was time to bring her Momma back,
Saying, “What do you think you're doing
By jacking me around”,
I said, Betty Lou, it's not that way..........
Then she called me a son-of-a-hound
She was screaming, ranting, raving
Yelling and accusing,
I tried calming, caring logic
But that doesn't trump abusing,
From the mouth of an angry daughter
Venting at my expense,
Like a pitbull on a rampage
On the other side of the fence.
We didn't resolve our issues
And I don't care, I'll tell you why,
I'd rather walk on gilded splinters
And mate with a tsetse fly.
Fibril_late;
11/24/11
Monday, November 21, 2011
Sure, it has been about 3 months since I had to confront excrement drainage, but it's still a fresh topic, although not exactly. I saw a flier in the breakroom, advertising the latest edition of that wonder-tube the Flexiseal, and once again I was inspired.
Happy Camper
Flexiseal
Oh, Flexiseal,
It has a kind of
Sex appeal.
Just lubricate
And insert with a finger,
It’s up to you
How long you linger.
Inflate the bulb
With sterile N S,
If you warm it first
You’ll be sure to impress.
So,
For Billy Bob’s bottom
We soothe and pamper,
With the new Flexiseal
He’s a happy camper.
Fibril_late;
11/21/11
__ __ __ __ __
WD-40
Flexiseal
Oh, Flexiseal,
The thought of it
Just makes me squeal.....
When I see that tube
I get nervous and antsy,
A preemptive trigger
For diarrhea, Nancy.
It just won't stay solid
My excrement,
But if liquid is bad
What about cement?,
Try coaxing that down
My Flexiseal tube,
You'll need WD-40
And Astroglide lube.
A dilemma for sure
My excrement collection,
The stuff is caustic to my skin
And I clearly need protection,
Please hang that bag, over the edge of the bed
I don't want to view that part of me,
Although I own it, I don't need to see it
In this age of transparency.
Flexiseal
Oh, Flexiseal,
I'm willing to gamble
And make a deal,
Take away my drainage
And protect my skin,
And I promise to abstain
From original sin.
Fibril_late;
11/24/11
Happy Camper
Flexiseal
Oh, Flexiseal,
It has a kind of
Sex appeal.
Just lubricate
And insert with a finger,
It’s up to you
How long you linger.
Inflate the bulb
With sterile N S,
If you warm it first
You’ll be sure to impress.
So,
For Billy Bob’s bottom
We soothe and pamper,
With the new Flexiseal
He’s a happy camper.
Fibril_late;
11/21/11
__ __ __ __ __
WD-40
Flexiseal
Oh, Flexiseal,
The thought of it
Just makes me squeal.....
When I see that tube
I get nervous and antsy,
A preemptive trigger
For diarrhea, Nancy.
It just won't stay solid
My excrement,
But if liquid is bad
What about cement?,
Try coaxing that down
My Flexiseal tube,
You'll need WD-40
And Astroglide lube.
A dilemma for sure
My excrement collection,
The stuff is caustic to my skin
And I clearly need protection,
Please hang that bag, over the edge of the bed
I don't want to view that part of me,
Although I own it, I don't need to see it
In this age of transparency.
Flexiseal
Oh, Flexiseal,
I'm willing to gamble
And make a deal,
Take away my drainage
And protect my skin,
And I promise to abstain
From original sin.
Fibril_late;
11/24/11
Sunday, November 13, 2011
I was reading a History & Physical the other day, and the physician was describing the ongoing health problems. Under the topic of "Substance Abuse", he described this as, "None, other than cigarettes and food". I think he nailed it on the head.
Cigarettes and Food
I saw this in a chart today
Health habits; described this way:
“No substance abuse
Except cigarettes and food”,
Clearly bad enough themselves
To allow illness to intrude.
Many sorts of health issues
Go hand in hand, with hand to mouth,
And if good health is towards the north
These bad habits will lead you south.
Fibril_late;
11/07/11
Cigarettes and Food
I saw this in a chart today
Health habits; described this way:
“No substance abuse
Except cigarettes and food”,
Clearly bad enough themselves
To allow illness to intrude.
Many sorts of health issues
Go hand in hand, with hand to mouth,
And if good health is towards the north
These bad habits will lead you south.
Fibril_late;
11/07/11
Wednesday, November 09, 2011
Unfortunately, I had to have a root-canal done last week, after the onset of acute tooth pain. I was referred over to an Endodontist here in town, and bam-bam, he fixed it in 40 minutes. His office has one of those X-ray devices, where one can see the image instantly on a viewer.............definitely cool. So here you go, Dr. S........you rock!
Pitfalls of the Canal
Dr. S., over on 12th Street
Excavates a quick canal,
Take a photo, shoot some pain killer
There is nothing sloppy or banal,
Regarding his gun-slinger approach
And an office, skillfully staffed;
For Endodontal pitfalls
Visit a master, of this craft.
Fibril_late
11/9/11
Pitfalls of the Canal
Dr. S., over on 12th Street
Excavates a quick canal,
Take a photo, shoot some pain killer
There is nothing sloppy or banal,
Regarding his gun-slinger approach
And an office, skillfully staffed;
For Endodontal pitfalls
Visit a master, of this craft.
Fibril_late
11/9/11
Why do I enjoy hospital meetings, seminars and corporate pep rally's so much? Because there is always so much material to satirize.
Case in point:
Yesterday I finally attended the “must-go” Satisfaction class, at blah-blah hospital. For each table of hospital participants, we had one of those whopping big white paper flip charts to write our collective brilliant thoughts upon. I spent the 90 minutes drawing a cute little doodle-vignette, which included the what-where-when-why-how anagram Bear, the aidet-man super hero, and the nursing bundle dropping from the sky, like a giant turd, in the “no pass gas” zone.
I also keyed in on several hot phrases to turn into satirical poems, covering the hot topic of patient satisfaction. Have a look:
Bust or Boon
H-CAHPS, and Avatar scores
They’re shooting for the moon,
Blasting satisfaction surveys
Will it be, a bust or boon?
We’ll smile and wave to our customers
Hold hands and lookem’ in the eye,
Write two things that they want to do
On the white-board, before they die.
And if that ain’t satisfying
Oh surely, yes we’ve made it,
And thanks to all those trainers
Who taught us how to AIDET.
Fibril_late;
11/8/11
__ __ __ __ __ __ __ __ __ __ __ _
Peanuts and Candy
Always, usually, sometimes, never
Ambiguous terms, this primate lever,
Satisfaction scores, tell it all, aren’t they dandy?
Like training monkee’s in a cage, with peanuts and candy.
Fibril_late;
11/8/11
__ __ __ __ __ __ __ __ __ __ __ __
Satisfaction School
Sitting at the round table
At Satisfaction school,
Another Management exercise
Just who will they fool?
This time around.........
Same old stuff
Brand new wrapping,
Another AIDET revival
With all of that back-slapping.
Fibril_late;
11/8/11
Case in point:
Yesterday I finally attended the “must-go” Satisfaction class, at blah-blah hospital. For each table of hospital participants, we had one of those whopping big white paper flip charts to write our collective brilliant thoughts upon. I spent the 90 minutes drawing a cute little doodle-vignette, which included the what-where-when-why-how anagram Bear, the aidet-man super hero, and the nursing bundle dropping from the sky, like a giant turd, in the “no pass gas” zone.
I also keyed in on several hot phrases to turn into satirical poems, covering the hot topic of patient satisfaction. Have a look:
Bust or Boon
H-CAHPS, and Avatar scores
They’re shooting for the moon,
Blasting satisfaction surveys
Will it be, a bust or boon?
We’ll smile and wave to our customers
Hold hands and lookem’ in the eye,
Write two things that they want to do
On the white-board, before they die.
And if that ain’t satisfying
Oh surely, yes we’ve made it,
And thanks to all those trainers
Who taught us how to AIDET.
Fibril_late;
11/8/11
__ __ __ __ __ __ __ __ __ __ __ _
Peanuts and Candy
Always, usually, sometimes, never
Ambiguous terms, this primate lever,
Satisfaction scores, tell it all, aren’t they dandy?
Like training monkee’s in a cage, with peanuts and candy.
Fibril_late;
11/8/11
__ __ __ __ __ __ __ __ __ __ __ __
Satisfaction School
Sitting at the round table
At Satisfaction school,
Another Management exercise
Just who will they fool?
This time around.........
Same old stuff
Brand new wrapping,
Another AIDET revival
With all of that back-slapping.
Fibril_late;
11/8/11
Wednesday, November 02, 2011
America the beautiful; where even dogs and cats can have dialysis, race-horses are put away for a busted leg, and humans with severe dementia and a danger to themselves and their caregivers, can have a pacemaker to prolong their lives. I am not suggesting that I am self-appointed judge of ethics and morality, I am just a healthcare journalist and there are real-life stories that need to be reported.
What a Drama
She's confused and bipolar
She's a crazy holy Roller,
They give her Haldol
To make sure she stays happy,
She's a demented old lady
With severe Sinus brady,
And she's calling her doctor
My “chappie”.
Now, Dr. O'Heart
That dude's really smart,
And he knows how to charm
An old dame,
Whereas we minor nurses
Bear the brunt of her curses,
And Dr. “Chappie”
Collects all the fame.
The family finds relief
In the midst of their grief,
After all
They thought Momma was dying,
Now she's back in her room
Her dementia, in full bloom,
They're writing letters
“Thank you Doctor, for trying”.
We do our best to be kind
But family members are blind,
They think that we're
Torturing Momma,
Without restraints and a sitter
Watch out – she's a hitter,
Just maintaining her safety
What a drama!
Fibril_late;
11/2/11
What a Drama
She's confused and bipolar
She's a crazy holy Roller,
They give her Haldol
To make sure she stays happy,
She's a demented old lady
With severe Sinus brady,
And she's calling her doctor
My “chappie”.
Now, Dr. O'Heart
That dude's really smart,
And he knows how to charm
An old dame,
Whereas we minor nurses
Bear the brunt of her curses,
And Dr. “Chappie”
Collects all the fame.
The family finds relief
In the midst of their grief,
After all
They thought Momma was dying,
Now she's back in her room
Her dementia, in full bloom,
They're writing letters
“Thank you Doctor, for trying”.
We do our best to be kind
But family members are blind,
They think that we're
Torturing Momma,
Without restraints and a sitter
Watch out – she's a hitter,
Just maintaining her safety
What a drama!
Fibril_late;
11/2/11
Tuesday, November 01, 2011
At work, there is a flier on the wall, advertising the expertise of our Vascular Services. The question posed to the public is this: “Could Your Leg Pain Be The Symptom of Some Serious Disease?”
Now I suppose that is a worthy question to propose to society, but I noticed a nice rhythm and meter to that statement. Also, it caused me to ponder the proliferation of medical advertising that we are pummeled with, every day of our lives. I think just about every flippin' magazine, newspaper, website, radio, TV and even the movies with product placement, are carrying advertising to suck us into the idea that we are all sick, and we need a medicine or treatment.
So here's my take on it all:
Just a Symptom
Could your leg pain be a symptom
Of some serious disease,
Do you have Tuberculosis
Because you have a cough and sneeze,
Do you suffer from Meniere's
'Cause you're a dizzy, dipsy dame,
Do you practice hypochondria
Because you're seeking hospital fame?
Oh, first we had the word of mouth
And then the printing press,
The television and radio
And our digital age is a mess,
Of constant advertising
To your weakness and desires,
Drug companies and device makers
They love it, they need buyers.
Did your lifetime worldly savings
Disappear when you got sick,
Did you chase the cures and medicines
Hoping one of them would stick,
Did you follow healthy habits
Over the decades of your life,
Or did you hope for God's deliverance
When the surgeon cut you with a knife.
Could your life just be a symptom
Of a string of lousy choices,
Don't worry, our industry loves you
You are financing our Rolls-Royces.
Fibril_late;
11/01/11
Now I suppose that is a worthy question to propose to society, but I noticed a nice rhythm and meter to that statement. Also, it caused me to ponder the proliferation of medical advertising that we are pummeled with, every day of our lives. I think just about every flippin' magazine, newspaper, website, radio, TV and even the movies with product placement, are carrying advertising to suck us into the idea that we are all sick, and we need a medicine or treatment.
So here's my take on it all:
Just a Symptom
Could your leg pain be a symptom
Of some serious disease,
Do you have Tuberculosis
Because you have a cough and sneeze,
Do you suffer from Meniere's
'Cause you're a dizzy, dipsy dame,
Do you practice hypochondria
Because you're seeking hospital fame?
Oh, first we had the word of mouth
And then the printing press,
The television and radio
And our digital age is a mess,
Of constant advertising
To your weakness and desires,
Drug companies and device makers
They love it, they need buyers.
Did your lifetime worldly savings
Disappear when you got sick,
Did you chase the cures and medicines
Hoping one of them would stick,
Did you follow healthy habits
Over the decades of your life,
Or did you hope for God's deliverance
When the surgeon cut you with a knife.
Could your life just be a symptom
Of a string of lousy choices,
Don't worry, our industry loves you
You are financing our Rolls-Royces.
Fibril_late;
11/01/11
Sunday, October 30, 2011
Yesterday I attended a Cardiology conference in San Francisco, sponsored by UCSF. One of the topics addressed the equipment associated with non-implantable defibrillators, and for the sake of this discussion, the defibrillator vest. It is generally agreed that the device is currently cumbersome, weighing about 15 pounds, and about 20% of people get bothersome skin rashes from the materials. I figured, that if the manufacturer could team up with Men's Wearhouse, with a slogan like, "Look Your Best, When You Wear the Vest", these things would be selling like hotcakes. I shared my musings with that particular presenter, and got a laugh at least. And maybe, someday in the future, we'll have it that way.
Defibrillator Flirting
Defibrillator clothing
Don't leave home, without the best,
Beneath your tux and tails
Do make sure, you wear the vest,
Sure, it's cumbersome and awkward
But sudden death might ruin your night,
When you're flirting with the hat-check girl
And things are looking tight,
And the wife is somewhere shopping
Down at Saks 5th Avenue and the Gap,
Your defibrillator accessory
Is what makes you a charming chap.
It is better than a vibrator
The whips and chains, and more,
It is better than Viagra
No matter how much you score,
Electric stimulation
It surely trumps them all,
Just flip the switch.....defibrillate!
Yessirree, you'll have a ball;
It's better than anything
That you've ever tried,
A little sex and sudden death
Why it's almost like you died.
Amidst amorous activity
My electric vest is standing by,
In the event of fibrillation
It assures me, that I won't die,
And I tell you, with all certainty
There's nothing quite like this,
When it seems like I am dying
I deny the reapers kiss.
I'm not afraid, it's figured out
From the minute to the second,
The Grim Reaper is by the doorway
And with his hand, I have been beckoned,
But with this vest, I am protected
When death is knocking at my door,
With my girlfriend I can have the best of times
And always ask for more,
And it's certainly a major selling point
In the Cardiomyopathy bunch,
When you wine and dine your secretary
You can have that dessert after lunch.
Fibril_late;
10/30/11
Defibrillator Flirting
Defibrillator clothing
Don't leave home, without the best,
Beneath your tux and tails
Do make sure, you wear the vest,
Sure, it's cumbersome and awkward
But sudden death might ruin your night,
When you're flirting with the hat-check girl
And things are looking tight,
And the wife is somewhere shopping
Down at Saks 5th Avenue and the Gap,
Your defibrillator accessory
Is what makes you a charming chap.
It is better than a vibrator
The whips and chains, and more,
It is better than Viagra
No matter how much you score,
Electric stimulation
It surely trumps them all,
Just flip the switch.....defibrillate!
Yessirree, you'll have a ball;
It's better than anything
That you've ever tried,
A little sex and sudden death
Why it's almost like you died.
Amidst amorous activity
My electric vest is standing by,
In the event of fibrillation
It assures me, that I won't die,
And I tell you, with all certainty
There's nothing quite like this,
When it seems like I am dying
I deny the reapers kiss.
I'm not afraid, it's figured out
From the minute to the second,
The Grim Reaper is by the doorway
And with his hand, I have been beckoned,
But with this vest, I am protected
When death is knocking at my door,
With my girlfriend I can have the best of times
And always ask for more,
And it's certainly a major selling point
In the Cardiomyopathy bunch,
When you wine and dine your secretary
You can have that dessert after lunch.
Fibril_late;
10/30/11
Friday, October 28, 2011
Health-care over the past 33 years............that's quite a memory to carry. We have had such an evolution of change in science and technology, but we humans haven't changed much; we take millions of years, to only change, perhaps one bit of our DNA. As a result, any talk of change in human dynamics, is just that - talk.
Same Old
We're doing the same old things
But with a brand-new name,
Like taking a damaged portrait
And rebuilding the frame;
The oils have hardened
The pastels are faded,
The painter is long-dead
And his relatives are jaded;
So, any efforts to revive
Some of the previous glory,
Will produce the same old results
And that's the point of my story.
Odarepsed;
10/27/11
Same Old
We're doing the same old things
But with a brand-new name,
Like taking a damaged portrait
And rebuilding the frame;
The oils have hardened
The pastels are faded,
The painter is long-dead
And his relatives are jaded;
So, any efforts to revive
Some of the previous glory,
Will produce the same old results
And that's the point of my story.
Odarepsed;
10/27/11
Saturday, October 22, 2011
No matter where you go, if you start a new job, you must endure something called "orientation". I just experienced that a couple of weeks ago, even though I am still, technically, in the same hospital system.
Orientation
Hospital orientation
No matter where you attend,
It always seems to last too long
And you just wish it would end,
After all the many introductions
The Avatar values, right and left,
No one in the audience seems interested
A classical, time-management theft.
Names and departments, and who's the who
And what they are doing, I just don't know,
But the dude from Human Resources
Loves his stories, and it's his show.
So you better look sort of interested
Because, sleepy new employees don't impress,
He has all of the Managers on speed-dial
And I hope he's open to bribery, I confess.
Fibril_late
10/22/11
__ __ __ __ __ __ __ __ __ __
Orientation propaganda always bugs me. I hope it only works on "the first-time" healthcare worker, because for the rest of us, it's old news.
Ancillary Propaganda
They're still selling us “A.I.D.E.T.”
So I guess we haven't made it,
Nursing Bundles and Rounding
….........Discharge phone calls.........
Tell me, how's that sounding?
And now an Ancillary Bundle
For all of you non-nurses,
And lastly the “No Pass Zone”
Oh Lordy, now that's a bundle of curses.
And to think, I've figured this out
Without having yet, gone to the inservice,
This is a well disguised pile of propaganda
And quite frankly, I'm paranoid and nervous.
The trends of Health-Care mismanagement
Have little to do with outcomes and healing,
Rather, patient satisfaction surveys and reimbursement
Keep the managers busy, bargaining and dealing.
Oh, shades of many different colors
Like an old time stage, with shifting scenery and a big curtain,
This is the present day arena we're working in
And like a low budget moving picture show......
The outcome is always uncertain.
Fibril_late;
10/22/11
Orientation
Hospital orientation
No matter where you attend,
It always seems to last too long
And you just wish it would end,
After all the many introductions
The Avatar values, right and left,
No one in the audience seems interested
A classical, time-management theft.
Names and departments, and who's the who
And what they are doing, I just don't know,
But the dude from Human Resources
Loves his stories, and it's his show.
So you better look sort of interested
Because, sleepy new employees don't impress,
He has all of the Managers on speed-dial
And I hope he's open to bribery, I confess.
Fibril_late
10/22/11
__ __ __ __ __ __ __ __ __ __
Orientation propaganda always bugs me. I hope it only works on "the first-time" healthcare worker, because for the rest of us, it's old news.
Ancillary Propaganda
They're still selling us “A.I.D.E.T.”
So I guess we haven't made it,
Nursing Bundles and Rounding
….........Discharge phone calls.........
Tell me, how's that sounding?
And now an Ancillary Bundle
For all of you non-nurses,
And lastly the “No Pass Zone”
Oh Lordy, now that's a bundle of curses.
And to think, I've figured this out
Without having yet, gone to the inservice,
This is a well disguised pile of propaganda
And quite frankly, I'm paranoid and nervous.
The trends of Health-Care mismanagement
Have little to do with outcomes and healing,
Rather, patient satisfaction surveys and reimbursement
Keep the managers busy, bargaining and dealing.
Oh, shades of many different colors
Like an old time stage, with shifting scenery and a big curtain,
This is the present day arena we're working in
And like a low budget moving picture show......
The outcome is always uncertain.
Fibril_late;
10/22/11
Thursday, October 20, 2011
Why do Pharmacy companies make up similar names of medications, or shape identical bottles of different drugs?
Why do Laboratories put names on lab-tests that sound almost exactly like something else, but the test is completely different?
And according to Nat-Pat-Sfty-Goals, we are supposedly trying to reduce medical errors?
Ya, right!
Naming Game
Sound alike, look alike, drugs
Also known as S.A.L.A.D,
Down in Pharmacy central
That's the name of their favorite ballad.
But what about those lab tests
Too many, sound the same,
Look alike and sound alike
Is the Lab-test naming game.
The latest silly example
Of Lab-test naming confusion,
“Anti-X-A Heparin”
Is focused on the infusion,
Of the Heparin drip we know so well
To be measured a different way,
Not to be confounded by that other test
The one known as, “Anti X-A”.
How many times do I predict
The test will be ordered incorrectly?
No one is willing to take that bet
In hindsight, circumspectly.
Fibril_late;
10/20/11
Why do Laboratories put names on lab-tests that sound almost exactly like something else, but the test is completely different?
And according to Nat-Pat-Sfty-Goals, we are supposedly trying to reduce medical errors?
Ya, right!
Naming Game
Sound alike, look alike, drugs
Also known as S.A.L.A.D,
Down in Pharmacy central
That's the name of their favorite ballad.
But what about those lab tests
Too many, sound the same,
Look alike and sound alike
Is the Lab-test naming game.
The latest silly example
Of Lab-test naming confusion,
“Anti-X-A Heparin”
Is focused on the infusion,
Of the Heparin drip we know so well
To be measured a different way,
Not to be confounded by that other test
The one known as, “Anti X-A”.
How many times do I predict
The test will be ordered incorrectly?
No one is willing to take that bet
In hindsight, circumspectly.
Fibril_late;
10/20/11
Sunday, October 16, 2011
A Fabulous Excuse
I'll take a request now and then, to write a poem for someone, for some kind of special occasion. This is for you-know-who, getting a knee replacement. I wish him the best, and expect him to stop limping around; enough with the sympathy ploy, ok?
Actually, the fact that he lasted this long is astounding. Anyway, what every one wants is a good excuse, to get out of stuff..............perhaps this is his.
A Fabulous Excuse
Just another great reason
Oh, what a fabulous excuse,
How to get out of working
After years of abuse.........
I'll just blame it on my employment
Nursing is tough, and everybody knows,
It had nothing to do with motorcycles
Water skiing, or winter snows,
It wasn't rugby or football
Or jumping out of planes,
No, it had to be Nursing
That was the cause of my pains.
Although I limped around for years
And fought the righteous fight,
I had pain with each step
And I moaned every night,
Of course, I thought that was sexy
Laying in bed, next to Suzy,
Until my wife caught the two of us
And shot my knees, with her Uzi.
Well, I couldn't really broadcast
That I'd been cheating on my wife,
Heck, if word like that got out
She'd come after me with her knife,
So, what am I left with
But a damned good excuse,
My old knees are worn out
After years of abuse.
10/16/11
Wednesday, October 05, 2011
After just completing my on-line "Skills Test", I realized I had just been blasted with Nursing jargon. My recourse was to write about it.
Klitchy Jargon
It never ceases to amaze me
Just how jargon defines ones identity,
Each group creates a klitchy language
When we speak together, ahhhh, such serenity,
And exclusive it is...........
You don't fit, if you're left scratching your head,
“Nursing implements purposeful rounding”
Which means we came to your bed.
Pain, Potty, Position incorporates intentional rounding behaviors
You can see, I don't need to fabricate great words to rhyme,
When the care team embraces Patient-Family-Centered Care
Because Nursing writers and researchers, do it all the time.
Fibril_late;
10/5/11
Klitchy Jargon
It never ceases to amaze me
Just how jargon defines ones identity,
Each group creates a klitchy language
When we speak together, ahhhh, such serenity,
And exclusive it is...........
You don't fit, if you're left scratching your head,
“Nursing implements purposeful rounding”
Which means we came to your bed.
Pain, Potty, Position incorporates intentional rounding behaviors
You can see, I don't need to fabricate great words to rhyme,
When the care team embraces Patient-Family-Centered Care
Because Nursing writers and researchers, do it all the time.
Fibril_late;
10/5/11
I don't know about you, but to me, the idea that we are using "Satisfaction Surveys" to guide our reimburesments, seems absolutely ludicrous. I mean, how easy would it be to manipulate the results? Just take a little money out of the purse (or some other attractive trinket, like a free Heart-Cath), offer it to the patient or family, and have the best surveys coming in by the dozens. This will become a boondoggle for corruption, mark my words!
But you know, "corporate" and "big government" love the idea.........Politically Correct Care!
Sadist Faction Scores
Satisfacton surveys
For reimbusement compensation,
Are we the first country to do this
This united nation?
I'm not much of a historian
I only study the here and now,
But apparently Uncle Sam
Is threatening our cash cow.
So, of course your medical repair
Is our ultimate intent,
But does it offer real certainty
Regarding money well spent?,
If your satisfaction-survey
Is returned as a D-minus?
We might be forced to offer prayers
To Saint Thomas Aquinus.
Sister Euphemia
Would never throw those dice,
For patient-satisfaction
She's willing to pay any price,
Which is why this particular nurse
Always offers special care,
Sister Euphemia states
It's time for truth or dare.
By demanding satisfaction scores
That achieve one hundred percent,
If we don't reach those ideal numbers, baby
Rest assured, we will repent,
Because a reprimand from Sister
Is a frightening thing, indeed,
Satisfaction scores, be damned, my child
Get ready for your bleed.
Sadist Faction scores
Correctly named, to be sure,
Whenever Sister threatens
She guarantees her cure.
Fibril_late;
10/5/11
But you know, "corporate" and "big government" love the idea.........Politically Correct Care!
Sadist Faction Scores
Satisfacton surveys
For reimbusement compensation,
Are we the first country to do this
This united nation?
I'm not much of a historian
I only study the here and now,
But apparently Uncle Sam
Is threatening our cash cow.
So, of course your medical repair
Is our ultimate intent,
But does it offer real certainty
Regarding money well spent?,
If your satisfaction-survey
Is returned as a D-minus?
We might be forced to offer prayers
To Saint Thomas Aquinus.
Sister Euphemia
Would never throw those dice,
For patient-satisfaction
She's willing to pay any price,
Which is why this particular nurse
Always offers special care,
Sister Euphemia states
It's time for truth or dare.
By demanding satisfaction scores
That achieve one hundred percent,
If we don't reach those ideal numbers, baby
Rest assured, we will repent,
Because a reprimand from Sister
Is a frightening thing, indeed,
Satisfaction scores, be damned, my child
Get ready for your bleed.
Sadist Faction scores
Correctly named, to be sure,
Whenever Sister threatens
She guarantees her cure.
Fibril_late;
10/5/11
Out here on the left coast, reform of many sorts, seems to come about ten years after the new ideas originated somewhere else, like the East Coast. So here we are, year 2011, and finally, the Circus known as, "Patient Centered Care", has come to town. Here come the meetings, the training, the new jargon, the evaluations, and potentially the remediation (when I continue to screw up). Yes, these are exciting and heady times!
So naturally, I had to research the whole PCC movement, and write about it. To me, it just looks like a new version of an old game..................
The New Bingo
The latest catch-phrase
In health-care bingo,
Patient Centered Care
Is the hot new lingo,
It describes what we do
In this modern age,
In case you didn't know
It's written on the last page,
Of the thirteenth chapter
In the book of new thought;
At the meeting in the auditorium
Come and see what Sister bought.
Sister Euphemia, is crafty
That's for sure,
Regarding the issue of non-profit, profits
She has the remedy and the cure,
Change the name of the business model
Every couple of years, at least,
The dodge and weave manifesto
Is the nature of the beast.
Ten years in the making
This Patient Centered Care,
Proposed in academia
And now it's everywhere,
Heavy handed implications
To manipulate behavior,
Couched in terms of common good
It's the latest health-care savior.
Coming to a neighborhood near you
Meetings, memo's and more,
Roughly, every new decade
They retrain us, what a chore,
We learn bright new terminology
Describing the same old tasks,
Underneath, it looks the same
If you bother to remove the masks.
Just wear your smiley face
Nod your head, and say, “Yes”,
Before long, we'll be wearing hats
And bring back that white dress,
Because apparently our patients
Liked us better back then,
In those horse and buggy days
Good old fashioned, way back when.
Patient Centered Care
Yes, it's the latest new lingo,
Just say all the right stuff
And you'll win the Bingo.
Fibril_late;
10/6/11
So naturally, I had to research the whole PCC movement, and write about it. To me, it just looks like a new version of an old game..................
The New Bingo
The latest catch-phrase
In health-care bingo,
Patient Centered Care
Is the hot new lingo,
It describes what we do
In this modern age,
In case you didn't know
It's written on the last page,
Of the thirteenth chapter
In the book of new thought;
At the meeting in the auditorium
Come and see what Sister bought.
Sister Euphemia, is crafty
That's for sure,
Regarding the issue of non-profit, profits
She has the remedy and the cure,
Change the name of the business model
Every couple of years, at least,
The dodge and weave manifesto
Is the nature of the beast.
Ten years in the making
This Patient Centered Care,
Proposed in academia
And now it's everywhere,
Heavy handed implications
To manipulate behavior,
Couched in terms of common good
It's the latest health-care savior.
Coming to a neighborhood near you
Meetings, memo's and more,
Roughly, every new decade
They retrain us, what a chore,
We learn bright new terminology
Describing the same old tasks,
Underneath, it looks the same
If you bother to remove the masks.
Just wear your smiley face
Nod your head, and say, “Yes”,
Before long, we'll be wearing hats
And bring back that white dress,
Because apparently our patients
Liked us better back then,
In those horse and buggy days
Good old fashioned, way back when.
Patient Centered Care
Yes, it's the latest new lingo,
Just say all the right stuff
And you'll win the Bingo.
Fibril_late;
10/6/11
Friday, September 30, 2011
Regarding our EMR (again).
When we started this thing 3 years ago, there were several layers of experts, trainers and learners. I took a week of training, and became a "Super-User", because I have a bit of computer aptitude. But the guru's of training were called "Red Shirts". Most of them were cool, professionally sharing their expertise, but there was/is a rare bird, that has the obnoxious, "red-shirt egotism", that persists even to this day, now 3+ year in practice. I bumped into one of those birds today, and quite frankly, after her little bit of "teaching", my feathers were ruffled.
O.C.* Agent Three
A dressing down
By Agent Three,
She said, “I’m a red-shirt
So, do like me,
You must chart exactly
The way that I teach,
Because this is is my ocean
And I own the beach.
OK, there’s your way to teach
But seven ways to record,
All of your obsessive details
That eventually get stored,
Into this medical record
In our digital age,
But I won’t guarantee
That it’s on your favorite page.
You want Stepford nurses
Charting perfectly, O.C.?
Go looking somewhere else
Because that surely isn’t me
*O.C. = Obsessive Compulsive
Fibril_ate;
9/30/11
When we started this thing 3 years ago, there were several layers of experts, trainers and learners. I took a week of training, and became a "Super-User", because I have a bit of computer aptitude. But the guru's of training were called "Red Shirts". Most of them were cool, professionally sharing their expertise, but there was/is a rare bird, that has the obnoxious, "red-shirt egotism", that persists even to this day, now 3+ year in practice. I bumped into one of those birds today, and quite frankly, after her little bit of "teaching", my feathers were ruffled.
O.C.* Agent Three
A dressing down
By Agent Three,
She said, “I’m a red-shirt
So, do like me,
You must chart exactly
The way that I teach,
Because this is is my ocean
And I own the beach.
OK, there’s your way to teach
But seven ways to record,
All of your obsessive details
That eventually get stored,
Into this medical record
In our digital age,
But I won’t guarantee
That it’s on your favorite page.
You want Stepford nurses
Charting perfectly, O.C.?
Go looking somewhere else
Because that surely isn’t me
*O.C. = Obsessive Compulsive
Fibril_ate;
9/30/11
Thursday, September 29, 2011
Back in July I wrote about a friend who had a back surgery, and 48 hours of dismal nursing care. Today, I think I wrote the last poem about the debacle. Check it out.
Condolences
They sent me condolences
Addressed to a different name,
So, was the letter truly for me?
Oh, it's such a guessing game.
After all, I was owed an apology
For some two-month old transgression,
A mismatched name to my address
Doesn't leave a good impression.
But perhaps, it's an appropriate ending
Case closed; such a messy ordeal,
I'll never step foot in that place again
And I'll tell all my friends how I feel.
Fibril_late;
9/29/11
Condolences
They sent me condolences
Addressed to a different name,
So, was the letter truly for me?
Oh, it's such a guessing game.
After all, I was owed an apology
For some two-month old transgression,
A mismatched name to my address
Doesn't leave a good impression.
But perhaps, it's an appropriate ending
Case closed; such a messy ordeal,
I'll never step foot in that place again
And I'll tell all my friends how I feel.
Fibril_late;
9/29/11
Wednesday, September 28, 2011
Most of us working at big hospitals are now using some sort of EMR (electronic medical record). I am only familiar with one of them, a product from the company, Cerner.
The complexity, layers upon layers of charting, and often, processes that don't make a whole lot of sense to the end-users, are actually setting the stage for more medical errors. Of course, the buyers of such products, and the sellers of the same, would like the public to think, that every step we take in the digital world, somehow makes their precious lives safer. Not so, and you know it.
Let's take a look at one of the biggest boondoggles, "medication reconciliation".
Reconcile Redundancy
The greater the complexity
The number of steps in an equation,
The more likely a random chance
To make a mistake on any occasion.
It's an engineering problem
Mathematical in a sense,
The more steps it takes to accomplish a thing
A greater opportunity for an offense.
And that is our state of art
In the realm of medication reporting,
The repetitive steps to reconcile
Redundant, reiterative, resorting.
Take a look at our typical patient
Age 62, Diabetic and over-weight,
He has high cholesterol and gout
And he's here, to learn his cardiac fate.
He has three doctors on tap
Primary, secondary and another,
Fourteen medications and 32 pills
All organized by his dear old mother,
Maybe I'm lucky and open the chart
Finding a medication recording,
Although, just how reliable that might be
Nonetheless, it is somewhat rewarding.
Hopefully, the guy is carrying a list
Otherwise, we're totally screwed,
Because I am supposed to record all the details
From this stressed-out, forgetful dude,
When did you take it last, what day, what time
How many milligrams, sir?
Muddled he looks, then he points at his mother
Saying, “I think you better ask her”.
But here comes the crux of the problem
And it really doesn't make any sense,
His home meds will be merged with his hospital drugs
Then we toss them all, over the fence,
Each time he goes to a procedure
Every time he comes back to recover,
We have to perform another reconcile
Like trying to save an old lover.
His fourteen meds, and today's seven drugs
Keep shifting around in the bag,
What are the odds that I'll make a mistake
And select the improper tag,
Pretty damn likely, I'm telling you
When a system is built, in this way,
How many times will I reconcile
Three times, and that's just today.
With all of the hype about Patient Safety Goals
We're battered and bludgeoned with these themes,
If a problem is “solved” with a complex solution
I tell you these are only pipe-dreams,
More problems created, more mistakes out there waiting
Software written and then sold, as the best,
But the engineers writing this nonsense
Are not the ones putting it to test.
So if they come after me, because I made a mistake
I'll point an accusing finger at Cerner,
And ultimately, the exemption that I will claim
Excuse me, I'm just a slow learner.
Fibril_late;
9/28/11
The complexity, layers upon layers of charting, and often, processes that don't make a whole lot of sense to the end-users, are actually setting the stage for more medical errors. Of course, the buyers of such products, and the sellers of the same, would like the public to think, that every step we take in the digital world, somehow makes their precious lives safer. Not so, and you know it.
Let's take a look at one of the biggest boondoggles, "medication reconciliation".
Reconcile Redundancy
The greater the complexity
The number of steps in an equation,
The more likely a random chance
To make a mistake on any occasion.
It's an engineering problem
Mathematical in a sense,
The more steps it takes to accomplish a thing
A greater opportunity for an offense.
And that is our state of art
In the realm of medication reporting,
The repetitive steps to reconcile
Redundant, reiterative, resorting.
Take a look at our typical patient
Age 62, Diabetic and over-weight,
He has high cholesterol and gout
And he's here, to learn his cardiac fate.
He has three doctors on tap
Primary, secondary and another,
Fourteen medications and 32 pills
All organized by his dear old mother,
Maybe I'm lucky and open the chart
Finding a medication recording,
Although, just how reliable that might be
Nonetheless, it is somewhat rewarding.
Hopefully, the guy is carrying a list
Otherwise, we're totally screwed,
Because I am supposed to record all the details
From this stressed-out, forgetful dude,
When did you take it last, what day, what time
How many milligrams, sir?
Muddled he looks, then he points at his mother
Saying, “I think you better ask her”.
But here comes the crux of the problem
And it really doesn't make any sense,
His home meds will be merged with his hospital drugs
Then we toss them all, over the fence,
Each time he goes to a procedure
Every time he comes back to recover,
We have to perform another reconcile
Like trying to save an old lover.
His fourteen meds, and today's seven drugs
Keep shifting around in the bag,
What are the odds that I'll make a mistake
And select the improper tag,
Pretty damn likely, I'm telling you
When a system is built, in this way,
How many times will I reconcile
Three times, and that's just today.
With all of the hype about Patient Safety Goals
We're battered and bludgeoned with these themes,
If a problem is “solved” with a complex solution
I tell you these are only pipe-dreams,
More problems created, more mistakes out there waiting
Software written and then sold, as the best,
But the engineers writing this nonsense
Are not the ones putting it to test.
So if they come after me, because I made a mistake
I'll point an accusing finger at Cerner,
And ultimately, the exemption that I will claim
Excuse me, I'm just a slow learner.
Fibril_late;
9/28/11
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