Saturday, February 28, 2009

Remembering who we work for.

When I get frustrated, which is often, I usually get zapped in the behind by whomever is in charge of reminding me why I'm here. God, Goddess, the One, the Source, the Divine...whatever.

We reduced staff recently which means my workload as a medication aide increased by 50%. On the bright side, this should net us more CNA's to work the floor. On the not-so-bright side, this means that someone is always getting their medication later than they should. As I was lamenting this one day, I had a resident thank me for taking care of them. I didn't do anything special, just pulled them up in bed and adjusted their pillows. Still, scoring a "thank you" and the glow of pride that goes along with it, is worth the guilt I feel at being late.

Management thinks they know what I do, but they don't, really. Frankly, I don't work for them anyway. My bosses are the residents. My one year anniversary was yesterday. When I get my review, it will be from management, not from my real bosses. The "thank yous" are worth more than any monetary reward or hollow "atta girl" I might get from them anyway.

Thursday, February 26, 2009

Better Living Through Chemistry...

...or chemical restraint?

Using chemical restraints (giving medication to a resident for the sole purpose of making them easier to handle) is illegal. However, there is a very fine line between treating a resident and using a chemical restraint.

Case in point: Resident A is screaming. I mean SCREAMING. Not because they are in pain, but because they are unhappy about their meal choices and no one is able to go purchase a meal from Sonic for them, including the resident's family members. The hall has about 30 residents on it and every one of them is getting more and more upset as this goes on for more than an hour. Nothing the kitchen can make is good enough and all the cajoling in the world is not making the situation better.


Said resident is due for a routine pain pill. They also have a PRN order for a "relaxing pill". This is a new order from the doctor and the resident has not taken one yet. The "relaxing pill" is given along with the resident's routine meds which include the pain pill. Within thirty minutes, the resident is quiet. When I reach the dining room to finish passing the meds for the five o'clock, the resident is sitting at one of the tables, chatting with the other residents. This is not normal behavior for this resident. Usually, they eat in their room. The resident eats about half their meal, all the while being pleasant. The next thing I hear is singing. "I found my thrill...on blueberry hill..." After supper, instead of going right back to their room, the resident sits in the TV room for about an hour and then politely asks to be taken to their room.


So, was this better living through chemistry or chemical restraint? The resident wasn't given anything that was not prescribed for them, but it was given for the purpose of quieting them down. The other twenty-nine resident's on the hall were certainly thankful for it. All of the nursing staff was grateful as well. This was likely the nicest evening this resident has spent in a long while, so I imagine they were happy as well. As with most things ethical, the line is so fine, it's often nearly invisible.

Saturday, February 21, 2009

Let's talk about sex...

...and other sins of the flesh like smoking and drinking. All legal, but possibly immoral depending on your personal beliefs.

I have always maintained that if a resident wants to smoke, drink and/or engage in consentual sex, they should have the freedom to do it. However, if they have given power of attorney to a relative, the relative gets to make these decisions, not the resident.

We can argue back and forth all day about whether the resident is in their right mind or not, whether it could kill them or not and whether it's moral or not. The bottom line is this: if it was you, wouldn't you want the freedom to do what you wanted as long as it wasn't hurting anyone else?

Thursday, February 19, 2009

ISP trouble

Been having 'net trouble for most of the week. I'm hoping to get back on track with posting soon.

Wednesday, February 11, 2009

Good Advice

Last night, one of my residents kept asking if I needed any help. I was passing meds, so there wasn't really anything they could help me with. Sometimes, if we're working the floor, we can find something for the residents to do: fold towels or pillowcases, push the linen bin from room to room, etc.

Later that night, the resident was my last med pass. I went to their room and they asked if I had time to visit. So, I sat down with them and scored an excellent back rub and some advice.

"Now, when you go home tonight, go to bed. Don't do all that stuff you usually do. Let them do for themselves. They work, but you work, too. In fact, you give them a little back rub and then have them give you one, too."

This from a resident that has severe dementia and occasionally violent behaviors. Good advice is good advice regardless of the source.

Monday, February 9, 2009

O/T Patrick's 20 years old today.

And just how did that happen? I don't feel twenty years older, but I guess I am, too. Looking forward, it seems like a long time. Looking backward, it seems ridiculously short.

New topic: Andrew Haden went back to Iraq after a 15 day leave. Please send good thoughts to him. He should be home in June or July.

Saturday, February 7, 2009

A little good news

Currently, our facility doesn't offer medical insurance. It's a "discount plan" that doesn't pay for major medical in any way. I don't have it. Frankly, if I'm going to pay for "insurance", I want to be covered if I have to have surgery or something else expensive.

Yesterday we found out that we may be able to qualify for insurance through some state run deal. If we qualify, it will be a plan run by Blue Cross/Blue Shield. We're supposed to know for sure by April.

I hope this goes through. If it doesn't, then I'll still be covered by Brad's insurance eventually. After he's been in the Union for a year, he can add me to the plan. Still, sooner is always better than later.

Nice to get some hope for a change.

Thursday, February 5, 2009

Birthdays and Birthrights

So, a year ago today, I stepped into the classroom for my first day of CNA class. I've learned a whole lot in the last year and I still have a whole, whole lot left to learn. There's more to this than picking out permed hair and wiping bottoms.

Today is also my mom's birthday. She would have been 61.

Mom was an LPN. I remember seeing her in her white nursing uniform. I don't remember if she still had to wear a nurses cap back then. I can't imagine having to run around and keep a hat on my head. Most days I'm glad to have my hair left when shift is over.

I used to have a picture of my Grandma, who was an RN, when she graduated from Loyola University in Chicago. Like most things I used to have, it's been lost over the years. My sister is "the keeper". For me, it's a good day when I can find my ass with both hands.

Birthright is defined as any right, privilege, or possession to which a person is entitled by birth, such as an estate descendible by law to an heir, or civil liberty under a free constitution; especially the rights or inheritance of the first born. I don't know that you can say that being in nursing is my birthright, but it seems like that's where I belong. Even on a bad day, something always makes me smile. The joy I get when someone is comforted by my actions is worth everything to me. The paychecks I receive are important, but not as important as going home knowing someone feels better because I was there that day.

Our lives are bigger gifts than they appear to be. Not just to ourselves, but to everyone around us. Even the lives that are cut short or seem to have no good purpose are gifts. It's hard sometimes to remember that, but the truth is the truth regardless of how strange it sounds.

Monday, February 2, 2009

Just another crazy night

I don't know what was going on last night, but no one was acting normal. I had people who don't normally want to go to bed, ask to be put to bed. I had residents in loads of pain for no apparent reason and I couldn't get past one room in less than ten minutes while passing meds. I even ended up helping on the floor a little because the call lights were bonkers.

I wonder if they were drowning in the staff's stress last night. It was pretty high because the schedule was changed and folks weren't told like they should have been. Unfortunately, when we're upset, even if we don't say anything, the residents can still tell we're not happy. We need to do a better job of leaving our baggage at the door and picking it back up on the way out.

Sunday, February 1, 2009

Working with a Migraine.

Yesterday was one of the few times I've wondered if I should just call in sick. My head was on fire, my stomach was upset and I was DIZZY. I couldn't even eat. But I went to work because I know a migraine isn't contagious and maybe it would let up as the day went on.

It did. A little. But then work was rough. Only two med aides when we're used to having three. I ended up doing one long med pass from 1545 to 2200. No breaks, no supper. I made it through the day on a half a piece of dry toast, half a can of diet Pepsi, thirty-two ounces of Gatorade and four graham crackers. I did eat some Mexican appetizer thing-y's with salsa and sour cream after work, so I probably had enough calories after the fact.

I'm better today and though I did make an error, it wasn't resident affecting. We just had to destroy a narcotic that I punched in error. I started crying anyway, just because I was stretched so thin. But the nurses teased me back to center and I made it through the night.

A person needs a strong constitution and thick skin to do this job. Maybe that's why so many people drop out of this career to do "easier" work.