Management needs to work in the trenches

You know, it never hurts to take a step backward now and then and remember where you came from. I would love it if my DON would take a shift and work my primary hall with me. I expect I could learn somethings and she might remember what it's like to be in my world. At least for a little bit.

I like idiosyncrasies.

Aside from the care aspect, the thing I like most about this CNA work is the idiosyncrasies of the residents. Knowing that Mr. John likes his cranberry and apple juice mixed at snack time, or that Ms. Jane wants her blankets arranged just so and then just doing it without them having to tell me makes me feel good. I don't know if they notice, but I do. Plus, it enables me to get done faster so I can move on to the next job; never a bad thing.

Happy Thanksgiving!

Wishing everyone a delicious and safe holiday.

Tubes and Insulin

So, the next step for me would be to learn how to do tube feedings and medication through tubes and insulin. They were offering a class, but I think it's out in Weatherford and I don't really want to drive that far.

Having said that, there was some discussion from the nurses "not letting" us do their insulin. "Do you know how fast you can kill someone with insulin?" And all I'm thinking is, yes, but we wouldn't be handling the residents whose blood sugars fluctuate wildly. We'd be handling the ones who occasionally need a little boost of insulin to keep them in line. And surely we'd have the sense to get advice if we were concerned about how the resident had been eating that day or whatever. Also, I'm thinking that the Digoxin we give at noon and the blood pressure meds we give in the evening are just as dangerous.

I understand where they're coming from. Ultimately, the health of the residents falls on their shoulders. I'd just like to be given a little credit for being intelligent enough to ask for help before I overdosed a resident on insulin.

DNR v/s DNT

The "Do Not Resuscitate v/s Do Not Treat" debate came up again last night. The resident in question has been slowly declining over the time I've known them and last night sounded like they were filled with water. The nurse sent them to the ER.

They have pneumonia.

One of the nurses was talking about it. She said, "If their heart stops, I won't do anything. If they stop breathing, I won't do anything. If they sound like they're drowning, they're going to the ER."

Makes sense to me.

Death Cycles

That sounds like the name of a biker gang, but that's not what I intended.

We are decidedly in a death cycle right now. In the last few weeks, there have been five deaths that were directly or indirectly connected with me. Yes, I realize that I work in a nursing home, but one of the deaths was a 26 year old grandchild of one of my residents.

I'm hoping that this doesn't last very long. In my line of work 1.5 deaths each week can add up to a big hole in your heart before you can catch your breath.

On the bright side, death cycles are generally followed by birth cycles. Next thing we know, a bunch of babies will be brought in to the world. At least it gives you something to look forward to.

Death of a Volunteer

Caroline (and I'm embarrassed to say I never knew her last name) was a dedicated volunteer at our Nursing Center. She was friends with one of the ladies and she was in the facility nearly every day. She was always there to encourage the residents to come to the activities, she helped out with Bingo on Fridays and was there nearly every evening to pass out supper trays. Sometimes she was pushy and she could get on your nerves if you let her, but not even the paid help was as dedicated to the residents as she.

We lost Caroline to cancer last night. I guess God needed her more than we did. We sure are going to miss her.

There's a very fine line...

... between "honesty" and "occupational suicide".

Reporting a med error, correctly documenting when meds aren't given, correctly wasting a narcotic are all important and require honesty. Writing behavior comments on the back of a resident's MAR, writing on the back of the MAR that you "didn't have time" to take a blood pressure or pulse or give a medication, while "honest" almost guarantee that you'll get a hand-slap or worse depending on how management is feeling that day.

I'm for honesty. But if you "didn't have time" to do something, you should report it to your charge nurse so she can get you some help. If a resident is giving you a hard time, either wanting their meds early or refusing them, state the facts on the MAR and report it to your charge nurse. Last night I had a resident who didn't want to take their meds. The gal in Social Services was there and helped me talk the resident into it. Problem solved without writing inane statements on the back of the resident's MAR.

At some point, we have to decide if our words improve upon the silence. If they don't, we need to keep them to ourselves or rework the situation to make it work for ourselves and the residents. There aren't enough CNA's out there as it is. Committing occupational suicide through "honesty" is not an appropriate solution.

If working doubles triggers my migraines...

...I'm not going to volunteer for them any more.

Sunday I worked a double on the med cart. I had time to eat both lunch and supper, so low blood sugar was not a trigger, but the weather was lousy on Monday. Anyway, when I woke up Monday morning, Madame Migraine was there with her whips and chains. Nasty old hag.

Anyway, I'm scheduled for another double on Saturday. I'll know Sunday morning if this is going to be an issue or not. I think I'm more of a marathoner (working many days in a row without a day off) versus a sprinter (working doubles) anyway.

What do you say to that?

If a resident who is in extreme pain expresses a wish to end it all, how can you argue with that? Hell, I wish they'd either die or instantly get better, too. Watching someone suffer like that, even someone you don't know personally, is the most awful thing aside from experiencing the pain yourself.

So what did I say yesterday? "Oh," in a tone that meant, "You don't really want to do that." I didn't think it through, it just came out. And it wasn't the right thing to say. Now that I've had time to mull it over, I could have said somethings that were better than what I said.

I could have said, "I'll bet you do. It must be awful to hurt like you do." I could have said, "Healing is the hardest thing your body has to do. It will hurt but it will also eventually get better." I could have said, "Yes, I wish for that, too, sometimes. After I die, me and God are gonna have words and most of mine are going to start with 'f'."

If I could have one new talent, right now, it would be the ability to think quickly and SILENTLY before I spoke.

O/T Brad walked his first 5K.

Pet Helpers is an organization that helps pay to spay or neuter pets when their owners can't afford it. They had their first annual 5K race this year. They also had a 1K, a kiddie run, a dog costume contest and a best dog smooch contest.

Brad raised $59.50 for Pet Helpers. He crossed the finish line in just over 55 minutes. Went there, did that and got the t-shirt to prove it.

Next year, he'd like to run it. Possibly with one of our dogs.