CNA v/s CMA

Well, I've gotten to work the med cart for three nights in a row. I might get to work it tonight, too. And which job function do I like better?

CNA. Hands down.

What I'm hoping will happen is that I'll get a chance to do a couple days of each every week. I'm already getting more efficient at passing meds and as long as I keep my hand in that pie regularly, it shouldn't be a problem. But helping folks is what I really like to do and passing meds is just that: passing meds. Important, but lacking that "touchy-feely" that I like.

In any event, I have a job where I'm needed, whether it's passing pills or helping folks get ready to go to supper. The way the economy is, this is a very good thing.

More pain than you can know.

Sometimes people complain about the residents being "whiny" or "babies". I'll tell you what. The worst pain you've ever experienced doesn't come close to what some of these folks go through every day. All their pain meds do is dull the pain. It doesn't make it go away.

While I can understand being impatient, especially when the resident doesn't know what they want, we should never, ever pass judgement on them. If we're lucky, we'll never experience what they're going through. If we're unlucky, we'll end up in the same place and gain understanding that we wish we never had.

"Wake up! It's not your time to die!"

I guess I'm lucky that I lost my parents young and quickly. I went to bed and in the morning they were gone. The longer your parents are around, the harder it must be to lose them.

The resident being spoken to above can't hardly get out of bed. Rolling them over makes them cry. They're on heavy duty pain medication and have been under hospice care for months. And yet one of the children needs to try to fight off the Angel of Death anyway.

Brad says that if it were me lying in that bed, he'd do everything he could to keep me here. I told him that I loved him enough not to let him lie there and suffer any longer than God wanted him to. Death is not necessarily worse than life. We're just afraid of being left behind.

Old Man Winter...

...just crashed the party.

We knew it was coming. We would have known even if the weather folks hadn't told us. We were giving out PRN pain pills like they were candy.

Last night it was warm, not much breeze, just a nice evening. This morning, the wind is howling out of the north and I imagine it's COLD. (I haven't gone outdoors yet.) Hopefully, this will afford the folks some relief. Of course, the ones who hurt when it's cold out will still be hurting today.

"Cold" is relative. We've been enjoying days in the high 70's. Today it's not supposed to get to 60. Not cold for Chicago, but cold for Oklahoma.

This is a temporary win for the frosty dude. It's supposed to get back up to 70 in a couple days.

"Well, she wouldn't stop screaming."

And that, said in a very reasonable voice, was the explanation for why she slapped her. Of course, she was screaming because the "slapper" had a hold of her arm and wouldn't let go. So the "slappee" screamed and got it right in the kisser. And then she screamed again.

If the incident had happened in a vacuum, it would have been funny. My problem with it is that the other resident's who witnessed it were upset. The two residents involved will probably not remember it this morning. The other residents will and will probably still be talking about it at breakfast.

I asked the nurse if it constituted a trip to the psyche ward to level out the "slapper's" meds. Because it didn't escalate into an uncontrollable situation, they won't send her. Unfortunately, folks, this is what happens when your brain shrinks. And it will, just because it's part of the aging process. How much it shrinks depends on so many factors that there's no way to control all of them. Limit your alcohol consumption, exercise, eat your veggies, and hope for the best. And try not to scream in mixed company.

You can never get "too attached".

We lost a resident yesterday. One of the CNA's was crying and said, "I'm gonna have to quit this place one day. I get too attached."

"If you don't get attached, you can't do a good job," I told her.

I think that's true. In a nursing center, you are there to keep people as happy, comfortable and healthy as possible. But, let's face it, the bottom line is that the majority of people who are in a nursing home are there to wait to die. Once in a while we get someone in who just needs some rehab and then will go home, but not often. You can't be standoffish with these folks. Many of them want their hands held, want to get hugs and want the occasional smooch. Denying them that does nothing but make their "not so great" existence even more miserable. And you can't do those things if you're not "attached".

Don't even talk to me about spreading germs. Unless we put them all in solitary confinement, germs are going to be spread. Hugs and kisses aren't going to make one iota of difference except maybe to make them happier and that alone helps boost their immune systems.

In any event, I'm for being attached. So what if you cry when they are hurt, sick or pass on? We have emotions so we can express ourselves. No one wants to live a monotone life and no one wants to be around someone who does.

How many pills do you take?

Working the med cart for a day and a half has been a revelation. I have a couple residents who are on more than 15 different pills. Granted, two or three of them are vitamins, but... wow. Can you say over-medicated? Furthermore, the ones with the most pills don't seem to be functioning any better than the ones who only have a few. However, the amount of suffering they would go through to wean them off the pills might precipitate a stroke or heart-attack, so the doctor's are hesitant to make any changes. And I can't blame them. I wouldn't want to deal with an angry family, either.

The key, I think, is to be aware of this and control it while you're still relatively healthy. If you let the doctor's prescribe you a pill for every little thing, you're going to find yourself taking more pills than you know what to do with. No wonder folks get put in nursing homes because they can't remember to take their pills. If you had that many prescriptions, you couldn't remember when to take them all, either.

And should we talk about cost? I'll bet the street-value on some of these medications would be enough to fund a small family for six months. No wonder folks have to get government help to pay for their meds.

Ultimately, we're responsible for our health. Better living through chemistry is not the answer unless you have a money-tree out back somewhere. If you have a loved one who's on multiple medications, it wouldn't hurt to have their primary care doctor review their meds and slowly make changes to reduce the number of pills they're taking.

Bomb Threat

One of the other nursing centers in town got a bomb threat yesterday. I'm told that the local newspaper has the details, but I'm thinking I really don't want to know.

What I do know is this:

• Everyone is OK.
• The residents were successfully evacuated to the VFW building.
• There was no bomb.
• It happened as between third and first shift so third shift had to stay on duty until the drama was over.
• The son of a bitch who made the call needs to be lynched.

Seriously. What is the purpose of phoning in a bomb threat to a nursing center? The police think it's a disgruntled employee. This is one for the Karma book. Three times three.

I've been accused...

...of castrating one of my residents.

Yes, castrating. I know. I was stunned and amazed myself, but there it is. This was several days ago and I'm still laughing about it.

Now, had the gentleman cried out in pain, I wouldn't have laughed. But all that happened is that his "equipment" got tucked under his leg while we were helping him to bed. Apparently, this amounts to castration. I didn't know it was so easy to do and I'm not sure that it was information that I needed in the first place.

Good thing most of my residents are women.

It isn't the residents...

...that burn us out. It's our co-workers and managers.

Three things would make my job easier:

• Communication
• Communication
• Communication

If someone has to leave early, everyone on the floor should know about it. Then we can make sure the residents are taken care of. If only one or two people know, then when the shit hits the fan, we're all in a tizzy trying to clean it up and repair the damage.

I'll be the first to acknowledge that I'm not as flexible and forgiving as I could be. I figure if I can work all my shifts, so should everyone else. However, I realize that not everyone is made of the stuff I'm made of and everyone's home life is not as good as mine is currently. I need more patience, I guess.

But if you have to go home, at least let me know.

Flu Shot

I signed up for my first-ever flu shot yesterday. I figure that I don't want to be the one to infect the residents and I sure don't want to bring it home to my family.

One year, about eight years ago, we all got the flu. At that time, I was walking three miles a day most days of the week. After being down with the flu, it took me more than three months to build back up to those three miles. Brad and Patrick were even worse off than me. Right after they recovered, they came down with bronchitis that required antibiotics to cure. Granted, I am healthier and in better shape now than I was then, but I sure as hell don't want to go through that again.

Days off.

More than any job I've ever had, this one requires days off. When I hear about these aides that work 12, 15, 20 days in a row, I can't understand how they do it. The most I've done in a row was 10. It was incredibly hard and I was impressed that I made it through. To work more than that would have pushed me over the edge, probably into sickness.

I'm trying very hard not to catch the cold that's going around. I'm eating my fruits and veggies and taking vitamin C every day. Did I mention that the aide that worked the 20 days in a row has the cold?

There's nothing wrong with working an extra shift here and there to help out, but to work yourself into short-temper, injury, or illness isn't good for you, your family, your co-workers or your residents.

The weather, it is a-changing.

Last night I worked the floor. It was nuts. We are noticeably heading into fall this week. Everyone was in pain, sick with a cold that's going around, or both. It was one of those nights where the call lights were on until we finally did last rounds. Phew.

Tonight, the rumor is that I get to work the med cart, but I'm not betting on anything.

To be or not to be...

...should be our choice.

One of our residents who has aphasia and a PEG tube, tries to pull the tube away from us when we are administering their medication. To me, this is them telling us that they are refusing their medication. If you have to have a CNA hold the resident's hands and basically force the medication on them, they are refusing. However, this resident does not have power of attorney over their health care any longer. What does this mean? Even though the resident wants to stop treatment, the grandchild, who has power of attorney, is going to keep this person alive until the bitter end.

To top this off, the nurse told me that even if the resident still retained legal control over their health care, we could not take this as a refusal because the resident has aphasia and can't "tell us" that they don't want their medication.

Let this be a lesson folks, make a will, make it early and make sure you are very specific about how you want to be handled in case you are incapacitated or else you might end up in a museum for live corpses.

Nothing funny happened last night...

...and nothing interesting. For once, it was what I'd consider a "normal" shift. We were only short one person in the Med room, we had enough nurses and enough CNA's. Everyone got taken care of and most of the shift went smoothly.

I have, however, started keeping a log of the shifts I'm working. Anything that does happen, I'm making notes of and writing it down in full when I get home. It takes extra time, but I think it will be of help to me in the long run. I know I should have started this earlier, but I just didn't see the benefit in it. The more responsibility I get (being in the med room) the more I feel like I might want something to use as back up in case something goes wrong. Plus, it makes a good mind dump after I get home, so I don't go to bed thinking about work.