Another CNA poster

Check out Holly's blog for more CNA goodness:
http://darndesthings.blogspot.com/

Dementia = No acceptance of change

Not that you didn't already know this: Folks with dementia cannot bear even the smallest change. A change of room, even on the same hallway, sends them for a loop. And not a good one. Not only will they need to be constantly shown where their new space is, they'll refuse to take their medicine which makes them even more confused. Even if the room has the same set up as the old room, they won't be able to find the restroom. Need I say more? All the sympathy and kindness in the world is not going to make this better. What little stability they had has been taken away. At this point, I don't know if moving them back to their old room will make a change for the better or not. If I were a scientist, this would be interesting. As a caregiver, it's distressing as hell.

Days off are a gift.

Off today. It's been a couple months and I'm still amazed at how sore I can get after just 4 or 5 days of work. Most days now are OK, but last night all my joints were screaming when I hit the mattress. When I realized that I was hurting, I should have taken some ibuprofen, but I didn't want to get out of bed.

Speaking of which, it was COLD here last night. Wind chill in the 30's. The wind switched to the south today, so it should warm up nicely this afternoon. Maybe I'll even get to open the windows again.

Jet Propulsion

If you've been a CNA (or NA or LPN or RN or whatever) for more than a week, you know that people pass gas and usually very loudly. I figure that it's just part of being a mammal and I don't comment on it.

What's funny is how many of the residents find it hilarious and comment-worthy.

"I pooted," said one resident when she farted while I was helping her out of her recliner. I heard it, but she needed to announce it. I told her it was just jet-propulsion helping her out of her chair.

The one night I was walking past a room. There were several residents in the room talking and one of them belched very loudly. There was silence for about two seconds and then they all erupted into laughter and congratulated the perpetrator on a fine burp.

I'm pretty sure we're all twelve years old mentally until the day we die.

Does it matter? Really?

If my lifestyle is not the status quo, but I show up and do my job everyday, does it really matter?

We all have idiosyncrasies. Some of them are more obvious than others. But if you need the bedpan, does it really matter what god I believe in or who I'm sleeping with or how much alcohol I consume?

I heard a resident's daughter trying to explain an aide's sexual orientation to her. Why she thought that was necessary, I don't know. If the resident didn't notice it, why tell her?

Last night, I thought it was cute. This morning, I have a headache and it doesn't seem quite so funny any more.

Full staff again! And being an old fart.

I may stop commenting on the full staff. The last time, I believe I paid for it by having to work an extra shift in the following days.

Aside from free food, nothing makes me happier than having enough warm bodies around. I like looking out a resident's door for help and being able to call out to someone instead of actually having to run around to find someone or to ask one of the nurses to help me.

Which brings me to another point entirely: being forty has it's advantages. While I realize that the nurses have more education than me and different responsibilities, I have no qualms about asking them for CNA-capacity help. Only once was I denied, and that was by a nurse who had injured her back and was not supposed to help lift. Now I just ask if they are allowed to lift before I ask for help if I don't know them. I know some of the younger CNA's are nervous about asking for help just because the nurses are older and "wiser" than they are. Meh. I'm older than some of the nurses.

Playstation 13

Right now, we have cable TV in the nursing center. One of the ladies was telling me that an "old woman can't be without her remote" while we looked for it in her bedclothes.

I think my generation will require computers with internet connections in each room.

My son's generation? Playstation 13.

"I'm 89 years old, darn it...

...and I shouldn't have to do something if I don't want to!"

And he shouldn't, as far as I'm concerned. If I don't want to take a bath, I don't. If I'm not hungry, I don't eat. Deciding where to draw the lines is an ongoing process. Everyday a resident teaches me something.

If a resident is a danger to himself or others, those decisions are easy. If I'm offering to help a resident to bed just because I have time at that moment, but they don't want to go, that's easy for me, too. They don't have to go until they're ready.

But what about the resident who doesn't eat well in their room, but finishes at least half their meal if they go to the dining room? They don't want to go, but their health may decline if they don't. One solution might be to sit in their room with them while they eat, but that's rarely possible. My ten minutes in the Twilight Zone with no call lights has only happened once. I'd need at least twenty minutes to make an effective stab at this. It's hard to know how to help without being overly intrusive.

When I'm 89, I think I'll take the advice I got from one of the ladies last night while my partner and I were helping her to bed. She didn't want to be moved from her chair and she looked at me and said, "Tell that s.o.b. to go to hell."

Full Moon Fever

My understanding is that the moon affects us for three days while waxing to full and then also for three days while waning from full.

Allow me to add my hand to those upraised with anecdotal evidence.

Every day I have worked since Thursday has been wrong. Last night was no better. From the time I got on shift, I was running to answer lights. Usually this happens when there's been an activity that's just ending or if they are starting one just as we come on shift. Yesterday, there was nothing going on. Then at about five o'clock, there were ten full minutes where no one in the entire place was on their light. I felt like I was in the Twilight Zone.

Our residents with dementia were more combative than usual. One of the ladies was angry with me because she had pulled her emergency light in the bathroom and I came in to turn it off. Mind you, I always knock before entering their rooms and explain why I'm there, but she was angry anyway.

Another of the residents has been getting up out of her wheelchair when she can't really walk without falling. We tried putting her in the walker so she could wander around safely and she immediately tried climbing out of it.

Also, our residents with chronic pain have been suffering more than usual and the pain medication isn't working as well.

Geez. I hope I only have to work one shift tonight. I can only imagine what it would be like working a double under these conditions.

Daughter of Kali

Another resident passed over. I was on shift when it happened, but I wasn't in the room. I wasn't even phased by it. Maybe this is my calling. To be in the place where people go to die.

I've thought of myself as a Daughter of Kali for about 4 years now. If I had known who Kali was when I was a child, I would have acknowledged her by the time I was 14. All my life I've been followed by Death. Sometimes it's amazing how things make sense when you look behind you.

Not a full staff!

Last night was my first experience working with a full staff. I didn't know how to act. I still ended up helping out on all the halls, but I got to take a real dinner break for a change.

Sometimes you just can't be grateful enough.

Death is unavoidable.

None of us are going to make it out of this life alive.

I think I've always had a healthier view of death than the average person. There's nothing you can do to stop it. You might be able to delay it, but that's all. People sometimes talk to me about dying and I wonder if I am comforting or frightening. Mostly, I just try to listen.

I hope that when my time comes, I'm able to look into the darkness without fear and welcome my next adventure.

It's not for everyone

I wonder how many folks who enter healthcare find it's not really for them, but stay on because they've invested so much time and money into the process?

From my limited perspective, working in healthcare is the hardest job out there. Your customers are always in some kind of pain (physical and/or otherwise). Sometimes in order to help them, you have to add to that pain. In the process of helping them, you may be hurt (physically and/or otherwise) yourself. In healthcare, this is an everyday experience. None of my previous jobs involved this level of suffering.

On the other hand, if you can focus on the good you do and experience everyday, it's worth every bit of effort you put into it.

Smileworthy

Some of the ladies were doing the Macarena last night in the dining room. About 15 minutes later they were playing the piano and singing "Amazing Grace".

You never know what you'll get to see over an eight hour shift.

The first step.

I've been thinking more and more that I need to get control of my health before it really starts controlling me. The first step is to improve the diet.

There's no problem getting enough calories, but the quality is poor at best. I'm increasing my fruits and veggies and reducing my bread. I don't believe in the low carb/no carb stuff, but I do think that bread isn't something that I need at every meal. I won't be giving up pasta just because I love it so much.

I've been unable to find any resources on the 'net that talk about healthy living for healthcare workers. While at it's core it's probably the same as everyone else, I think our jobs are more like what a construction worker does everyday than what an office worker does. Most of the diet and exercise advice online assumes you work in a relatively sedentary job. Being a CNA is everything but sedentary.

I'll let you know how it goes.

The things that give me joy.

• When a resident who hasn't spoken much starts talking to me.
• When the LPN on shift thinks I've been a CNA for more than 5 weeks.
• When a resident improves and gets to go home.
• When a resident who is suffering passes on quietly.
• When a resident teases me. Especially when they haven't in the past.
• Feeding a resident their dessert first when they need to be fed.
• When a resident laughs at something I've said.
• Hearing a resident laugh for the first time.
• When the shift ends and my residents are the same or better than when the shift started.

Wanna lose weight? Become a CNA.

As of this morning, I've lost 11 pounds in the last 5 weeks. If you need to lose weight, start working as a CNA.

Which makes me think I need to pay more attention to my health. I've also had one especially miserable migraine and some nasty virus that I caught from one of my son's friends, a.k.a. "Typhoid boy". I'm also noticing a lack of flexibility in my spine with regard to curving backward. Probably because I spend so much time bent forward at work.

I guess I should clarify that I have been slowly losing weight since October 2007 and I'm more than halfway to my goal. But it's definitely been easier since I started working at the Nursing Center.

Never underestimate the power of a smile

Smiling can get you out of a lot of things.

For example, the time I was told to stick a water glass and a can of pop up my butt when the resident got frustrated with me. Instead of ignoring him or being rude back, I smiled and said, "Well, I'll see what I can do about that. If you need anything else, let me know" and I left the room. He smiled at me before I left. I'm not sure if he thought he had scored a point or not, but at least he thought he was happy.

My few experiences with dealing with unreasonable residents have ended better if I stopped and smiled at them first. In the cases where I didn't, I failed at getting them to do what I needed them to do.

Hugs from a resident

I'm amazed by things that happen at work. Actually, I'm amazed at most things, most of the time. But that's another story.

We have a resident who isn't able to communicate any longer. He spends all his time in bed or in his geri-chair. He will often try to grab and hold on to anyone and anything that comes close to him. Getting him to let go of you is a challenge.

The other day I was helping to dress him for dinner. After we got him settled and ready to go, he held his arms out. I thought, "Oh, what the hell" and I hugged him.

Know what I got for my efforts? A hug and several kisses.

I don't know who he thought I was. But it was worth going to work that day just for that.

There's also another centurian gentleman who hasn't spoken much since he arrived. The last time I helped him onto the commode, he just started talking to me. It made my day.

One lady apologized to me for being short with me. I told her she didn't need to apologize, that she was hurting and I wasn't moving fast enough. Still, it was nice to hear.

Each day something happens that makes me want to go back the next day.

It's a double.

Working a double is hard but do-able. The problem I have is with why I worked it.

No Call No Show

I won't bother to explain why this is a hideous practice. I will say that karma will eventually catch up with this person. We may not get to enjoy watching it happen, but happen it will. Three times three.

In other news, the resident who thought we were running a whorehouse remembered where he was again. More or less. He's still a little confused, but at least he's not angry. Word to the wise: take everything a resident says seriously, unless they wink, smile, or laugh first. If they are being serious, you laughing is a bad, bad thing.

Last night

I remember that something funny happened at work last night, but I cannot remember what it was. How sorry is that?

It was crazy busy and we were short-handed for several hours while one of the CNA's accompanied a resident to the hospital. All turned out well as they got back in time to help the residents get to bed.

The nice thing about nights like that is that they go by fast.

I will eventually start writing posts with more substance. Now, I'm still getting my bearings and don't feel like I have much of value to say.

Honeymoon's over

Had my first real frustrating shift last night. Nothing I did was correct or good enough. Even for folks whom I had helped before successfully. And, I wasn't aware of it before now, but I am running a whorehouse. Damn. I wish I'd have known.

On the bright side. I did get 7 baths done which helped out first shift.

Part of the problem yesterday is that I went in blind. I didn't do rounds because I wasn't assigned to a specific floor, so I didn't know who was going through what yesterday. Won't happen today, you can bet. I'm going to corral someone as soon as I get through the doors.

Coffee pot's calling me. Maybe I'll have a better perspective on this in a couple of days.