25 times,

It sounds kind of exciting

And even though it rhymes,

I wouldnt recommend it

To any kind of friend,

Because 25 expulsions

Makes for a sore bottom end.

Diarrhea

25 repetitions,

Like some kind of penance

From a priest with weird ambitions,

Exploring my fortitude

Amidst the storm in my colon,

Like a conveyor belt of garbage

At the dump; it just kept rolling.

25 trips

To the johnny isnt fun,

Quite often one must canter

Or even, flat-out run,

To avoid public embarrassment

And the horrid, proverbial "Oops",

Your pants show the evidence clearly

You lost the handle on your poops.

25 rounds

Of emptying, got old,

Im feeling so vacant

Like my intestine was sold,

To the junk man down the street

Collecting bottles, rags and cans,

But wait, theres more, Im just saying

This wasnt part of my weekend plans.

Fibril_late;

4/29/13

Trademark

If you trademark a name

Does it make the product any better?

For example, "Intelligent Surveys"

Examine each vowel and letter,

Are these the best-ever surveys

More intelligent than all the rest?

I pose this trademarking is a gimmick

No more and no less,

Saying, "We are intelligent"

Smacks of superiority attitudes,

HCAHPS, Unadjusted Avatars

And other gobbledygook platitudes,

Quite frankly, Im not impressed

I dont need to incorporate it into my practice,

This is more corporate subterfuge

Their attempt to redact us.

Fibril_late;

4/19/13

CV, Again

Electrical cardioversion, oh my!

Was the 10th time the best?

Well, lets ask the guy.........

The good man on record

With the most persistent A. Fib,

Ten times hes been zapped

Without busting a rib.

Oh, CV again

His claim to fame,

From Palm Springs to Maui

Working on his golf game,

Then he comes home to Cali

For a breather, and Bam!

While resting on the weekend

His heart dances flim-flam.

Yes, CV all over

And over again,

Ablations times four

Electricity times ten,

Yet still, he maintains

The best outlook, and why not,

Golf needs to be played

To the very last shot.

Fibril_late;

4/22/13

As nurses, the day comes when we see the person who announces their badge of "Disability", waving it proudly, as if they served in some kind of liberating war. I am not talking about those actual military veterans, but rather, those persons who regale us with their stories of medical problems, and how, they cant possibly work any kind of job, because they are disabled. To me, its like the folks that stand at the Freeway-ramps, begging with a sign, and they have two good arms, two functional legs, they are not blind or deaf, and in other words, they seem able and functional enough, to perform some kind of labor so they are contributing to society (and possibly the economy), rather than sucking down resources like a storm drain. No, they would rather snooze and play.

I felt it was time to do some research, in respect to the "No Pass Zone" directives, that I wrote about a week ago. It appears that once again, the East coast got the jump on this idea (in roughly 2010) and then we cliff-hangers on the West coast caught on a couple of years later. Its always like that, so dont complain. Still, I am astounded that I am the only person bringing to light, the potential for liability, damage, Sentinel Event, and so on, with the initiation of policies of this nature.

Dont get me wrong; I am not advocating that we ignore patient call-lights. In fact, I am advocating for the Safety of all of the patients in the hospital. But I know what the bottom line is..............its all about "patient-satisfaction" scores. The questions that are asked of patients, after they have been discharged, are carefully scripted. If I call Mrs. Jablinzky, and ask if her call-light was answered in a timely fashion, she might say "Yes, ever since they started that No Pass Zone thing". But if I also ask her, "Did you mind it when the stranger in the blue and black uniform, appeared at your bedside at 2am, (when you had rolled over onto your call-light), asked you in a gruff voice, "Can I help you, Maam?" She would probably admit, that he scared the bejeezus out of her. And this probably begs the suggestion, that during the night hours, only the Nurse, CNA or MD, enter patient rooms.

The more research I do, the more disappointed I am with our Medical Corporate entities and the nonsense decisions they make, all for the improvement of patient satisfaction scores. Or is there some other reason that I havent caught on to?

Do tell.

http://www.healthleadersmedia.com/page-3/PHY-268393/15-HCAHPS-Buzzwords-Every-Provider-Should-Know

http://www.healthleadersmedia.com/content/NRS-250810/Nurses-Find-Simple-Ways-to-Improve-Satisfaction

http://dr.beaumontphysician.com/News/Pages/No-pass-zone.aspx FIBRIL_LATE; 4/11/13

This week, another round of regulators are heading our way; The Joint Commission. Ah, if only they would pass out some joints as a reward for good behavior, because there are times when marijuana has some very worthwhile features. I mean, after all, dont these Regulatory officials just make everybody really nervous and tense? Hot damn, they sure do, and some mj, would be good for all. Hmph, I can only wish.

These forays of FUBAR are always accompanied by a one sheet page of "helpful tips", just in case one of us is accosted by a surveyor. We earned a list of eight key points, and Ill address a couple.

Demand #1. Gloves can not be worn in the hallways by anyone.

Response:

*

First, does this include visitors too? Even the sweet and refined elder members of our local society, who sometimes wear lacy gloves when they are out and about? Do I contact the Security Officer, to report a glove-sighting, and perhaps he can issue a citation?

*

Second, what about me, the RN, when Im transporting a patient via a common hallway, who may have a propensity for bleeding, coughing, vomiting, or spewing some other type of bodily fluid? Per hospital policy and OSHA regulations, I am required to wear protective clothing or gloves. If I am not wearing gloves, and the patient begins to bleed, am I allowed to let this continue, until we arrive in a patient-care area, where gloves are now allowable?

*

Third, Joe-Bob, the Joint Commission Surveyor, slips and falls in the hallway near the lobby, smacks his face on the safety hand-rail and is now hemorrhaging, in view of fourteen other visitors. Nurses and other emergency responders leap to his side to assist and resuscitate (if necessary)............and suddenly realize, they are not allowed to wear gloves on their hands in a hallway.

This is hilarious isnt it? Once again, I propose we bring Risk Management, Infection Control, the CDC and anybody else with a lick of common sense to take look at this proposed nonsense.

Demand #2: Check all doors to assure that locks are working and securing sharps.

Response:

*

First, Im not sure if that is a complete sentence.

*

Second, "Sharps" I guess, have to do with the sharp and pointy things we wield on occasion, usually in proximity to a patient. Does the memo refer to all doors and all locks? If, at the end of my shift, when we are closing up for the night, why cant I just lock the doors of the room; why must I also lock the cabinets. It stands to reason, if Billy-Jo the thief has the know-how to break into the room, he will also know how to bust into the cabinet where sharp, pointy things are held. So why all the locks? (Cabinets and doors, windows and drawers). And technically, the "Used-Sharps" boxes are not truly locked; any person could easily reach inside with a small hand, or with a hemostat, to pull out all the sharps they wanted. Seeing as this "lock up the Sharps" program is designed to reduce the opportunity for bad people to steal good needles, one might suppose those same people dont really care if the needle is clean or not. I say, let them have the dirty ones at their own risk.

Well, once again I’ve had my fun!

ps:

On my previous post regarding the “No Pass Zone”, you may recall the theme of that directive, was that ANYONE is expected to enter a room where a call-light has been triggered. Now we have yet another demand for the proverbial ANYONE................ “can not wear gloves in the hallways”. This is just another perfect example of all those idiotic “Zero-tolerance” edicts, currently being shoved down the collective gullets of Americans. Good-bye to common sense!

Fibril_late;

4/10/13

From the "Hot New Idea" Department:

For our valuable patients and attentive, loving visitors, we bring you the "No Pass Zone". We are telling each and everyone of our esteemed employees, that they may not pass by a room, if they see a call-light triggered. The only exception, is if they are currently transporting a patient somewhere else in the facility.

You will love being our patient, because when you need help and put on your call-light, Anyone can help you. Yes, we mean everyone and anyone. (We even told that scary guy who looks like Rasputin, that he should respond to your plea for help, too.) All he needs to do, is to tell you his name and what department he is from and he will help you. Heck, nobody is a stranger at Sister Euphemias joint; when you become our patient, you join a family of thousands of unknowns.

Now, since Anyone can help you, that includes the freak who delivers the Pepsi-cola to the hospital, because he is wearing a uniform that looks just like the outfits worn by our own, helpful Engineers. Of course, you wont know that, nor the fact that he hasnt undergone a background check. He isnt even an employee here, but he does love helping vulnerable women who are in hospital gowns.

Yes, that is the homey atmosphere that we are trying to create.

The "No Pass Zone".

Yes, this is a dandy new policy, thats for sure. You will have all of your needs attended to, lickety-split, by someone you have never seen before and the odds are, youll never see them again. And then, maybe you will remember the good old days when you really got to know your Nurse, even though sometimes she couldnt come immediately to your bedside. When she came, you recognized her and it was comforting and you felt safe....well, those simple carefree days are long gone.

Yep, now we are applying the modern concept of crowd-sourcing, to patient-care.

_ _ _ _ _

Now team, how about some communication scripting, to help you get off to a good start with our new policy?

"Call-Light" on:

Joe Janitor just finished his "No Pass Zone" training and he is ready to put it to work. He has just finished unplugging a toilet, when he notices the light on, in room 434-B. He understands he must stop and offer some help.

JJ: "Hello ma’am, I am Joe the Janitor. I saw your light on, how can I assist you?"

At this point, the patient wonders too, because she needs a stool-softener and this guy said he was a janitor and she is so embarrassed, that she mumbles something about making a mistake that she bumped her call-light.

Lady: "Who are you? You dont look like my Nurse and I think you ought to leave."

_ _ _ _ _ _ _ _ _

This policy creates an open door invitation for any deviant, predatory nut in a uniform or professional attire, to walk into a patient-care area, in the ruse of answering a call-light. How soon will this propagate a "Sentinel" event?

"No Pass Zone"!.................= ............."Insanity!"

If my wife or child was in the hospital, and any Tom, Dick or Scary-Mary could walk into their room without invitation, or appropriate purposeful cause, merely because a call-light is on, I would be very suspicious of their stated intent. An RN, CNA, Monitor tech, MD, Physical Therapist, Dietician etc., these are appropriate. They comprise a group of typical caregivers, and are easy to keep track of. But to have a hospital-wide policy that invites and authorizes Anyone, to respond to a call-light, is absolutely ludicrous, irresponsible and potentially negligent!

We have left in the dust, the bygone days of good, personalized Nursing care. In exchange our employers offer the present day version of an outsourced, fragmented, "who was that guy in my room" open-invitation, free-for-all, toss the chainsaws in the air and let them drop, kind of corporate attitude.

And for that:

I give it a "NO PASS"!

If you are a gunslinger Electrophysiologist, its easy to make the claim that your Atrial Fibrillation Ablation is going to be 100% successful (never fail), but unfortunately, that usually just refers to the day that the procedure was performed. Percentages drop off to about 50% long term success, for having just a single ablation procedure (for long-standing chronic A. Fib). Sooner or later, those guys who have had their 2nd procedure and three or four cardioversions are bound to bump into each other on the golf course and begin to compare notes. Thats when they can talk about that new dance step, the Atria Wiggle. Atria Wiggle Keeping up with the Joneses The Odgates and Behringers, High minded folks And all packing derringers, Success with their passions They love wines and juicy rib, Find they all do agree They dont like A. Fib. This singular phenomena The fibrillating heart, Strikes many, over fifty Causes vary, a la carte, And a few of that bunch Will find no particular reason, Their atria wiggle On a whim and a season. It is easy to blame On many health conditions, Hypertension and heart attacks Abnormal valves, in addition, Holes in the atrium That were present at birth, Overeating that results in Uncontrolled girth. An overactive Thyroid Or metabolic issue, Alcohol, and tobacco And stimulants on a tissue, Sick Sinus syndrome And diseases of the lungs, Rapturous chanting With speaking in tongues. Prior heart surgeries Viral infections, Sleep apnea snoring And emotional affections, Anger and arguing Or a near-death event, Atrial Fib is so sneaky It is hard to prevent. Genetics or heredity? That surely, isnt clear, Perhaps, as a side-effect Of those diseases we fear, But one thing is certain If youre in this family crib, Everyone does agree That they dont like A. Fib. Fibril_late; 3/7/13

Core Measures and what they truly mean. Core Coercion Core-measures tracking As it was explained, you will see, Mr. Billy Bob goes home Without some med-orders..... So blame me; The nurse that did his discharge After only four hours of attention, Regardless of his three day stay Doctors write med-orders, did I mention? At first I thought, it was the duty For Doctors to handle this thing, Or, maybe Case-Manager nurses Like a score, that they love to sing, No, its a dumber-than-dirt doctrine Appoint the job to the last guy in line, Instead of the Doctor in charge of the care Bureaucratic nonsense again, working just fine. How easy our bosses point their fingers "Dont you know this could affect our reimbursing?" In an ominous tone, as if to scare me "Im not ready to be fired, are we rehearsing?" "Oh, nothing like that Bo, youre a valuable asset Just do as we say, its all good" Coercion and extortion, are heavy-handed concepts But not unusual in this neighborhood. Fibril_late; 2/14/13 http://www.clinical-insights.com/resources-Apr09CoreMeasures.html

Dont press too hard, on the ancient Bard. Lemons and Limes I was traumatized Im telling you, First vasovagal And then, Code Blue, But we pulled him back Before he fell off the cliff, Though he was gray as a ghost And partially stiff. I was doing a groin press Family at the bedside, When his heart began to cruise Towards the dead-side, I said, "Please step out There is something we must do", Then, two minutes later We launched Code Blue. He did pass out Gave up his breath, And without blood pressure He was contemplating death, But we dont allow that In our garage, Though we performed about a minute Of Cardiac massage. Close to the edge Counting heavenly sheep, This old codger thought He only went to sleep, Actually, quite surprised With the crowd around his bed, His family, the worried ones That Uncle was almost dead. "What the heck just happened" Queried, Doctor Who, "Last time, I saw my patient He didnt need Code Blue", So I ran the blow by blow I told him several times, Sometimes you get sour lemons When you think youre buying limes. Fibril_late; 1/29/13

At work, we are undergoing another Infusion Pump swap. The pumps that were acquired about four years ago (another vendor), turned out to be finicky chumps. And as always, new products demand user education. Nowadays, educators for nurses, are typically a nurse pulling an extra gig, in addition to their job back home. This can be kind of fun; a change of pace, a broadening of ones resume, and so on. However, I suspect that the majority of these trainers do not undergo any (or little) professional-speaking training, to prepare themselves for this "Clinical Educator" excursion. So, once again, I was forced to become a victim of another, grammatical-phraseology crime. DTMS* * [Does That Make Sense] Professionals at a class Do not need to hear, Repeating over and over Stupid phrases, to the ear, "Does that make sense?" Each sentence-ending posit, Forty-seven repetitions Before I threw him in the closet. Plus, he had some mannerisms Likely, patterned from his work, He said, "Im a NICU nurse (A tiny-baby clerk), Hed say, "Never, never, do this Because, its bad, bad, bad, As if speaking to his child This moronic, half-wit Dad. Product educators, please take note Do train, for professional speaking, Repeating the same thing time and again Sounds like a rocking chair squeaking, "Does that make sense?"; repeated over and over At the end of each sentence, yes, forty-seven times, Reveal youre a victim of popular culture And just another perpetrator of grammatical crimes. Fibril_late; 1/14/13

Im starting the New Year with a hot tip!...........$4 that is, for some damn good nursing care. Tip I was handed a tip After a pacemaker redo, My Five-star attentiveness Was a four dollar coup. A new battery acquired Could make her older than a century, And a nurse accepting money? They might throw me in a penitentiary. A four dollar tip To refuse, would be rude, "For a cup of coffee", she suggested Good aroma, steamy brewed. Fibril_late; 1/9/13

As a parent of 3+3, and as a Nurse of thousands, I am shocked, appalled, and deeply saddened by the recent death of innocents at Sandy Hook School, in Connecticut. There is no such thing as closure, to those directly affected..........but sadly, we will hear that term bandied about in days to come. There is merely recovery, and moving on. That is what one does, when your child or loved one is abruptly taken away. Not being one who is directly involved, but only a person over-inundated with what we pass as "news reporting", I must speak out in the way I know how.......and I will continue in this theme for the week. Senseless Another day of tragedy East Coast, West Coast And in between, Horrific stories Rapidly unfolding One more bloody Media scene. NPR, jumps on it "Substitute all our programming today", The sad and somber music Appears so scripted and ready to play, And I wonder, are we so inured To the senseless tragedies That unfold, with such regularity, That even NPR Already has a musical score To accommodate solace and clarity. ; 12/14/12 _ _ _ _ _ _ _ _ _ _ Children Children, as reporters Of tragedy In the aftermath, Victims of media Those vultures Of a bloody bath..... Children, the innocent Victims Of disaster, Reporters will Rape their souls To collect the news, so much faster. "How did you feel Were you frightened And scared?", "The monster Was hunting us I wondered, would we be spared"............ But these are not the words That a six year old speaks, No, he was prompted by adults Who are media freaks. Six year old children recorded On YouTube and Twitter, Their words and faces remembered Amidst the gore and the glitter, Of newsworthy lights And Connecticut mayhem, Stored on distant massive servers In societys brain stem. What are we creating With our instant-news mentality? Just more photo-op disasters And some over-the-top fatality. Children as reporters? In of itself, a style of crime, They need love within a cocoon Not celebrity and prime-time. 12/15/12 _ _ _ _ _ _ _ _ Days of Mourning Days of mourning A nation at a standstill, Soul searching silence Like ghosts in a landfill, Wondering, "Why are we here Amidst garbage and decay?", These are the ways of guns And their time-fuse delay. Bought for protection Purchased for fun, Even I do remember Being in the woods with a gun, But now, as an adult Im aware of their danger, Held in the hands Of an unpredictable stranger. Just who is unpredictable? That is the crux, What should be done about it? Answers that would fill trucks. There is no pure solution Our Constitution allows, For each and every one of us To bear guns and not plows, As crazy as that might seem The 2nd Amendment, declares it so, A guarantee for times of mourning And burying on the plateau. Odarepsed; 12/16/12 _ _ _ _ _ _ _ Eulogies Eulogies for the children And the school staff, who died trying, Moved me to tears Like my own family dying, In essence, this truth Is one I wish to embrace, Children and their teachers In innocence, show their face. Innocence, what is it? Tis but, purity in action, Surrounded by complexity Where innately, those distractions, Cloud our vision and purpose Till our children show the way, Innocence is their guiding light Lets not forget this precious day. Odarepsed; 12/17/12

I couldnt make this one rhyme; just consider it prose. Staff Mandates This week at work we are advised of the new policy regarding the recording of IV Infusion Start and End Times: 1.) Safe Patient Care Mandates That We Document Our IV Infusion Times. **: This is confusing to me, as it is not clear whether "mandate" is being used as a verb or a noun. Is "Safe Patient Care", in of itself, the name of some policy, or what? It seems to me, there might be some important punctuation missing in the above statement; perhaps a comma after Care.........who knows? 2.) In Order To Receive Payment And Credit For What We Do, IV Start and Stop Times Must Be Documented. **Ah, now Im less confused. This memorandum is less about safe patient care, and more about BILLING. And we sure know by now, that Billing is a true reflection of safe care, right? (hardly). In other words, we take your money and now you are safer? Furthermore, this suggests that our patients are less safe, if we didnt document, and more safe, if we Bill them. 3.) We Are Currently Losing > $1 million dollars in Revenue, Per Year, By Not Documenting Our Stop Times. **Further proof, that this policy is not about safety and patient care; it is all about the Revenue. Mandate: * NOUN: THE COMMISSION THAT IS GIVEN TO A GOVERNMENT AND ITS POLICIES THROUGH AN ELECTORAL VICTORY * NOUN: AN AUTHORITATIVE COMMAND; ESPECIALLY : A FORMAL ORDER FROM A SUPERIOR COURT OR OFFICIAL TO AN INFERIOR ONE. * NOUN: A DOCUMENT GIVING AN OFFICIAL INSTRUCTION OR COMMAND * VERB: ASSIGN AUTHORITY TO * VERB: MAKE MANDATORY Fibril_late; 12/15/12

I was trying to read the latest monthly satisfaction scores, posted on the wall in our break-room, but it was like Greek to me; too many acronyms, avatars, percentages and mumbo-jumbo. Who cares anyways? The "boss" (who?) always highlights with a yellow maker, the score that shows how were screwing up. Boy, that sure is encouraging isnt it? What a morale booster! Morale Medicare wont pay us Because you didnt smile, Mrs. Smith said you were grumpy When you were wiping her piles, Because it just doesnt matter That we cured her Leprous sores, Reimbursement rules hospitals With satisfaction scores. Medicare wont pay us? Quite naturally, our Chief, Knows his bonus is in question Along with the Chardonnay and beef, Anxious and worried He sends out letters forewarning, Lets improve those satisfaction scores Or careers will be in mourning. With numbers to guide us One might think wed be the best, But personally, I dont understand The breakdown of the test, Percentages and Avatars Of statistical reporting, After sniffing at the details Im left sneezing and snorting. How is it good for morale To keep reporting how we fail? Highlighting the low scores This news, soon goes stale, It might be better to emphasize All those things we do best, Proud and happy warriors Work stronger towards their quest. I know this represents A paradigm shift, And its obvious that health-care Hasnt adjusted to the drift, Where employees are honored Each and every day, Instead they threaten and bully us And it just doesnt play. Most certainly unwanted Reprimands and scolding, Reminders of our failures Praise and bonuses, withholding, Telling us, that were the cause Of reimbursement losses, No, our highly paid leaders Just arent the best bosses. Medicare wont pay us? I dont give a damn, But Ill do the best in my job Because thats who I am. Fibril_late; 12/09/12

Editorial: Streamline Sustain our Mission Thats what the CEO says, Celebrated by streamlining reductions Please take a complimentary PEZ, On your way out the door Well miss you, Honey-Pie, Have your family send us a memo When you shrivel up and die. Employees are expensive Cull the ones that are trouble-makers, Keep the ones who generate income The movers and shakers, Those young Nurses Friendly, attractive and skilled, Sell them on our family value benefits Family-leave, a free car-seat; theyll be thrilled. Retire the old curmudgeons Yes, anyone over fifty, With twenty years in health-care They are unpredictable and shifty, Troublemakers, each one of them They could rip us to shreds, Sending letters to the local news Regarding short-sheeting our beds. The takeaway message as always; trim the sails Tighten our belts, lets get more efficient, Always spoken by the man in the pulpit The guy at the top, hes omniscient, With a compensation package Pushing nine million, well-paid leader, Urging austerity with a twinkle in his eye Light some candles; burn the incense and cedar. Fibril_late; 12/2/12

Patients acting badly; yelling, screaming, cursing, hitting, biting, scratching, downright dangerous. And then, thirty minutes later apologizing, as if their scientific medical diagnosis is to blame. Give me a break; thats just a very lame excuse to accommodate bad behavior. Stepped in a Puddle Dementia Just aint what it used to be, You scream, bite, scratch and snarl I can charge you with assault and battery, Then, later on, you come around And apologize for your bad behavior, Telling me, "Its because I have Alzheimers Im a sinner, Im nobodys savior". Twice in the past month Patients acting like nasty creatures, Post-operative ugly, rabid attitudes All kinds of undesirable features, Then later on, sweet as a peach Apologizing, pandering for my attention, Declaring, "Ive got mental illness" As if they deserve some honorable mention. Its all too touchy-feely for me Im supposed to say (per the Huddle) "Thank you, for letting me be your Nurse", Sure, I smile and wave, even though You were a mofo-monstrous, Godzilla curse, While your outside-caregiver shrugs shoulders Sitting there at the side of the gurney, If I could satisfy my secret thoughts By god, I would need a cidal-attorney. They dont talk about that in our Huddles Its just as well, how I hate that whole construct, Although I love the words that might rhyme With chucked, plucked and bile duct, Which coincidentally, reminds me of last night Where I was subjected to your spitting and cursing, Huddle me, fuddle, I stepped in a puddle This is the bane of good Nursing. Fibril_late; 11/28/12

One day recently, at about the 8th hour of work and just before my dinner break, I had an episode of Atrial Fibrillation. Newsflash: this doesnt go well with work No, I pretty much had to sit down, and wait for it to go away...........which it did about an hour later. One Forty-One Atrial Fib at work It isnt much fun, Doubling my heart rate To one forty-one, I took a Toprol Drank some fluids, took a seat, But as soon as I got up The same irregular beat. Its not conducive to working When its banging away, Blood pressure shoots up I need a break and delay, Hoping the medication Will kick in and perform, Then maybe, after dinner Ill return to the norm. What was the trigger? Im not really sure, A long busy day It went by in a blur, Some aggravating encounters Contributed, I suspect, Of these modifiable risks I must shield and protect. We educate our clients "Take your pills, exactly how", Because ninety percent of them Dont know Pepcid from puppy-chow, Whereas, I adjust my meds To keep my pulse regulated, The value of that Can not be over-stated. Fibril_late; 11/17/12

Virus vs. Bacterial At home, everyone has the usual first-of-the-season viral cough and sneeze. Several of those guilty, are not so careful with their hand washing and what not, despite my observance and counsel. What can ya do? Me, I managed to capture my own, nasty bacterial bug, (probably at work), and lodge it in my lungs. Subsequently, it fermented and percolated for 3 days, and then KaPow!!! it slammed me down with a vengeance. Three days of fever, short of breath, wheezing and malaise. Ive had to endure the nastiest antibiotic ever, Doxycycline (very tough on the GI tract). Oh well, it actually works, so I can only whimper. All in all, I was one sick cat. Sick Cat Oh, woe is me How ill, I was, I hang with sick people Just because, I chose healthcare In the unemployment line, Now thirty years later Im spitting up brine. Causality A case in point, Stories begin At a universal joint, A bend in the road Allowing straight, to twist, Now Im hacking up loogies As big as my fist. I saw the Doctor, after that Quite frankly, I was one sick cat, It felt like fur balls in my throat He said it looked, like a cashmere coat, He asked if I was purring I stated, I was wheezing, Although, I didnt have A runny nose or sneezing, I had a 2-view X-ray Which naturally was clear, But luckily my doctor Reads the literature each year, He nailed it on the head A need for antibiotics, I wasnt one of those malingerers The sinus psychotics, They ask for "just a Z-pac Because it always works", Of course it does, you fools Thats a simple clean and jerk, The remedy didnt do a thing Placebo, thats the name, Appease the masses with a pill Thats the pharmaceutical game. Sick cat feels a little better Day after day, No more fur balls in my throat But too tired to play. Fibril_late; 11/9/12

Persistent Atrial Fibrillation is the most common arrhythmia in persons over the age of 50. Current practice addresses either rate control or rhythm control, meaning that some people are relatively asymptomatic, and if they cant be converted to Sinus rhythm, then, keeping their heart rate below 100 is seen as a reasonable approach. However, they require anti-coagulation. Anyway, there is a small subset of patients who are very symptomatic, fail drug therapy, and are referred for an electrical ablation procedure...............sometimes over and over and again. No fun when you are only 58 and otherwise, extremely healthy. Persistent Hail to the man With the most persistent A. Fib, He returned once again To visit our crib, He missed us, he stated Were like family, so dear, The best place to be shocked Yes, thats why Im here. Dr. ONeill is so happy To see you again, He loves a good challenge Which is common in men, Of the Irish persuasion From the Emerald Isle, He resides as the Judge On this most tedious trial. Handmaidens and bards Stand by, as you beckon, They are all placing bets On that shock, I do reckon, Such consummate professionals This likeable crew, Saying prayers, fingers crossed Hats off, saluting you. Fibril_late; 10/25/12

ADMISSION DATA-BASE I bet that a lot of nurses just hate having to fill in / data entry / interrogation forms, whatever your hospital calls it, ours being the Admission History. Tedious, tasking, and terrifically boring questions...............oh wait, I think its a Demographic Survey, now days..........My advice...........just get creative as all get out! Halt the Queries Our clients typically visit For a twelve hour time, Yet, we interrogate their lives Like they committed a crime; How many times do you pee Do you dribble or leak, Did you have a "BM" today, sir Or was it, way back, last week; Who really needs to know this Yes, what is the rationale? That I have to question what is leaving Every bodily canal? Many cultures, are offended When we pose these inquisitions, An embarrassing interview Regarding sensitive positions, So, I make the answers up And document what I wish, Does it matter if his BM Was today, or yesterish? And then, we have to document Medicines taken, time and date, I ask them, what the day was And I choose the hour eight, Whether morning or night Once a day, or more, This saves me a bunch of time In this grossly, boring chore. And half of the time, these folks Dont have a clue about their meds, The stress of needing an angiogram Is screwing up their heads, And yet, Bob and Betty nurse Will perseverate and persist, Confusing this octogenarian Until, he slugs them with his fist. Did you have the death of a loved one Are you suicidal today? How would that adjust my care? Are you packing, I might say, We dont want an angry wing-nut Shooting up an operation, Although that clearly does suggest That we deliver good sedation. Whats the point of all these questions I dont know, so I modify, Your bowel status hardly matters If youre about to die, And I shouldnt waste your precious time Delaying care and intervention, There are times to halt the queries And really pay attention. Fibril_late; 10/24/12

Just a little silliness................but, Im thinking even you have had a patient that was just a little attractive......isnt that so? Dont Call Me Jacqui In the 11th hour On the eve of the 11th day, We still had too many patients And that means double-time pay; A woman admiring her Pacer incision A guy, preparing for home, One fellow waiting for heart-cath And Betty with mirror and comb. "Its important to always look good", she said After lying all day on this frickin hard bed, I hope my arthritic knees and titanium hip Dont lock up when I stand, and cause me to slip; That would delay my departure, my driver would hiss Hes a snake of a man, but he has a good kiss, So, please let me up, and sooner if you can I like you as a Nurse, and hope youre a good man". I did all that I could, to please that fine lady I escorted her to the Ladies room, despite Sinus Brady, And when we were finished, her heartbeat was tachy She said, "Thank you young man, just stop calling my Jacqui". Fibril_late; 10/18/12

I think this is how quite a few of our patients feel, when they have just received the news that they have Left Main disease, and they might drop dead if they go home................ P Urgency vs. quantity Thats the cat in the bag, Like the K-Mart blue-light-special When youre waving the yellow flag. Six hours of bed rest "Are you crazy, thats insane?" I cant pee lying down Thats not how they do it in Spain; Yes, I should have just stayed there And not come to visit my daughter, Im telling you, I feel just like The lamb led to slaughter. I raised them, way back when Times were different, and thats a fact, Im just on a three month visitation It hasnt been all that its cracked, Up to be, Im telling you Arent you listening? I only came to the United States To see a Grandson, to attend his Christening. And now, here I am In swaddling clothing, in this hospital bed, The team of doctors are telling me I need surgery, or Im as good as dead. Urgency vs. quantity It takes on a whole new meaning, Im told my options are limited And thats kind of demeaning, For a visitor in this high tech country A leader in so many parts, I would think that by now They could just give me a new lambs heart. What a predicament I cant make the decision, Im going home and screw all my risks Im not interested in an incision, But I still have to pee So bring me that container, I dont want to pee in the bed And thats a no-brainer. Fibril_late; 10/18/12