abuse, administration, aggressive, Alzheimer's, CNA, combative, confused, coworkers, dementia, elderly, evening shift, geriatrics, Health, healthcare, housekeeping, mental health, nurse aide, Nursing, Nursing home, Nursing management, resident, understaffing, workplace violence
While my religious and personal beliefs have recently been reconciled, thanks to the encouragement of several of my readers, my personal life remains in a rut. This post is a bit off topic from the usual topics I write about less about Goddesses and Filianism and more about the practical realities and ethics of healthcare, particularly geriatrics and mental health. Names and identifying information will not be given in order to protect confidentiality of all involved. Feel free to skip over today’s post if that is not your interest. I won’t be discussing anything metaphysical or spiritual, as given my current frustrations it is difficult to see anything beyond the immediate unpleasant realities of my job as a nurse aide, though I would greatly appreciate insight from a metaphysical/spiritual viewpoint regarding my circumstances. Practical advice is also welcome.
When I got my first nurse aide job at an Alzheimer’s nursing home back in July, I was overjoyed. I started working second shift on Fridays, Saturdays, and Sundays. I had tried applying at several nursing homes and hospitals in the area, but despite having completed my nurse aide certification, I didn’t have any experience under my belt and so many employers wouldn’t even consider me. Getting my foot in the door was my first accomplishment toward my career in nursing.
When I first started out, I enjoyed it. The work was difficult and my muscles were not yet accustomed to doing the type of heavy labour I was now required to perform, but I was still in the honeymoon phase of my job. It was new, different, and I felt like I was making a difference in people’s lives. I ignored the obvious shortcomings of the facility and focused on everything positive.
Unfortunately, the honeymoon phase didn’t last long. I have been working for the company for three months now and I dread every weekend. Almost every night, I come home emotionally and physically broken. If no one calls out (which never happens, someone calls out every weekend), I have 15 residents in my care on Friday, 12 on Saturday, and if we are very lucky, 10 on Sunday. Most of these people require skilled nursing care, and several of them are combative/aggressive, not only to the workers but to other residents and even to visitors.
My coworkers are helpful some days, but some days not so much. Last weekend, I searched in every room on every hallway three times and could not find anyone to help me. I even checked in the break room and there was not a soul in sight. I kept asking the nurses if they had seen any of the other CNAs, and they said “Nope”. This went on for 15 minutes, until finally another CNA showed up to help. His excuse was that he must have been in the bathroom when I was going up and down the halls looking. But what about the other two? Where on earth do these people go, is my question? Outside on smoke breaks?
I try my best but I never feel like my best is good enough. The under-staffing issue makes attending to the special needs of residents who suffer from dementia nearly impossible, but the administrators who leech off the company’s money want to squeeze as much work out of as few of workers as possible. I feel I am not able to provide the same quality of care I could provide if there were adequate staff, and its very depressing for someone like me who had big dreams of a career in nursing. I thought nursing was about care and compassion to people who needed it most, but apparently its not. As one nurse “You don’t really have the aggressiveness a nurse needs to have,” and recommended I change my career track to physical therapy instead. Since when does being aggressive make a good nurse?
There is also no housekeeping staff on evening shift. They go home a little after day shift leaves. That means that if a resident decides to spread their diarrhea all over their bathroom and track it all over the room into their bed or take a leak in the dining room, it is our responsibility to clean it up. One day at the beginning of my shift, I was going to help a resident into her house shoes and I felt that the house shoes were very saturated. In a nursing home this is never a good sign, so I go to the bathroom and find that day shift had left me a big puddle of urine on the floor to clean up. I ask the nurse what I should clean it up as I had already figured out that housekeeping is gone by this point and the nurse told me “Go get a couple of towels and wipe it up.” No disinfectant, no bleach. The diarrhea incident happened one night after second dining and the mess was so horrendous that it took me 35 minutes to clean the diarrhea mess up, when I had 14 other residents to get into bed. That wasn’t the first or only time this resident has spread diarrhea everywhere (“But honey, it’s just fudge”), but was by far the worst incident.
In regards to combative/aggressive residents, I was always told “If they become aggressive, just walk away and try again later.” Unfortunately, they may work with some residents, but others will not let you do anything to help them if you take this philosophy to heart. I will give last weekend as an example. The charge nurse wanted me to change the brief of a confused resident who uses the bathroom on his own but leaks on his brief. The resident in question is well-known for being combative, and so both the charge nurse and a male coworker tried talking to the resident and distracting him while restraining him from hitting me while I changed his brief. The distraction technique did not work and the resident was flailing about. I pulled his pants up once, but the resident pulled them back down once he was released and started walking through the hallway. The male CNA and charge nurse both held onto the resident again while I pulled his pants up and buttoned them. This time the resident ended up kicking me in the stomach twice, because I had to button his pants from the front as they were very difficult to fasten. I was physically upset by the whole ordeal. The charge nurse asked if I was okay, and then said “This is your first time experiencing a resident beating you up, isn’t it? It’s okay, you will get used to it.”
Little did the charge nurse realize, I have been beaten up numerous times before the incident he witnessed, both professionally and personally. Personally, I was beaten several times by my ex lover to the point that I suffered a fractured arm, and professionally I have come home nearly every weekend with bruises all over my body from being punched, kicked, pinched, and scratched by confused residents. I have never gotten used to being beaten up or physically abused, no matter how many times it happened. Is abuse something that you are supposed to get used to?
I feel very disillusioned with the healthcare system. From listening to CNAs who work in other nursing homes, my experience does not seem too far from the norm. My story is a personal story about a disenchanted health care worker who works an 8 hour shift and goes home afterward, but the residents who have to live there 24/7 are the people my heart goes out to. Many families throw their residents into the nursing home and forget about them. Even families who do visit often don’t realize the extent of what sort of unsanitary and unsafe practices go on inside nursing homes. These elders worked their best years slaving away on a job in order to provide for their family and look forward to a happy retirement, only to have their memory and personality stolen from them by a silent killer known as dementia.
I question my own life, my own purpose. What am I living for?