Nursing Home Nurse....

I worked in an old, nursing home right out of school for a few years.  To say it was a trip is an understatement.  I wish I could be more professional and label it something else but that is what it was.  I have to emphasize this because in the end I reported the facility to the state for abuse.  I worked night shift and only saw the aftermath of the abuse.  Mostly bruising.  It seemed excessive but every time we would speak with our supervisors we were met with anger and denial.  One coworker called the Sate of Oregon to report that a resident had informed her of abuse by another staff member.  The resident was so scared and when the state investigator questioned her, she denied saying anything.  The abuser was actually promoted and the staff was threatened.  The owner said "if I find out who wrongfully accused this employee of abuse, your employment will be terminated.  We will not stand for gossip and false allegations anyone who engages in this will be let go."   So, the abuse continued.  Then one day a medication aide said "can I talk to you?"  She told me everything.  She had seen most of the abuse but was too frightened to say anything.  I didn't tell my boss, I called the State of Oregon.  The State of Oregon called the State Police and then I spent hours reconstructing the schedules the abuser worked, the sections of the building he worked in, matched nurses notes and incident reports to the days he worked.  At the end of the initial investigation I worked with a forensic investigator.   Then the attorneys for the families.  Even though someone saw the crimes, I was the chief witness because I was the nurse who could pull all of the pieces together into one picture.  During the time of the initial investigation, our bosses removed incident reports out of the building and they asked the receptionist to shred information.  When I found out I called the State Police.  Search warrants were served on their individual residences and the paperwork found.  The facility lost it's license, families won huge lawsuits, the abuser did 3 years of jail time and the abuse stopped.  It was an experience I will never forget.  The strangest thing was folks were angry at me for calling the State Of Oregon.  The other weird thing is the owner to this day believes it was all BS.  The Director Of Nurses went on to teach CNA classes and work in another nursing home.  During the time this was going on I found my way to the place I work now. 

Do No Harm

I promised in my heart when I was going through Nursing School, I would "do no harm". Three words but amazing depth. Harm can be purely negligent or it can be something small. For example walking by a patient/resident quickly because there was a phone call waiting, and not saying "hello". This simple act may have caused the patient to feel sad and unappreciated. To me that is harm.

I talk to our caregivers about a heart to heart connection. I now believe on some level that if people don't have it with our residents, they will not be successful in their job. How do you instill that feeling? How do we open their eyes to the fact that caring for another person is the most precious gift they can give.

I was sitting in church one day. (you rarely find me talking about religion here but bear with me) I was late for work and the service was running over. My mind was wandering and I was probably thinking "hurry up, hurry up". Then the pastor said "you are serving God though your labor". Of course I sat up and paid attention. He spoke about work and how we serve God if we work with our hearts connected to our heads. I thought "wow, he is right". How else better to serve than take care of the meek, the frail and sick?

Death

I recently was sitting in a resident's room while she was dying. I sat on her couch between her son and a friend. Strings of Compassion harpist played while she slowly fell into rhythm with the notes. Also in her room were two other residents and a caregiver. I sat there just feeling so much love and inner peace that I had a smile. Where did this come from? It happened about 8 years ago. I had been present with many folks who had died. Then there was a shift. I attended a Hospice Conference sponsored by Washington County. It was amazing and I realized halfway through the conference this was a calling. I felt so privileged taking care of a person who was dying, as if God placed them in my hands. Someone once pondered the question "what would you assume if you saw a woman in labor without seeing the end result?". "Death is a labor, a process and we never get to see the end result." As in labor in delivery, labor in death could also have a miraculous end.

Clarity amidst chaos

I loved science. Biology, Chemistry, Anatomy and Physiology etc. The coursework for nursing was enjoyable. The problem was I had no idea what kind of nursing I wanted to specialize in. I was determined not to work with the geriatric population. My great grandmother had died in an old nursing home. It was horrific to me. A once proud woman who was chastised for not drinking her cranberry juice. She had to sit in the dining room alone well after breakfast while the CNA threatened her she couldn't leave until she finished it all. She had finger point bruising under her arms because they lifted her roughly. The place was old and smelly. They lost her dentures so her food was pureed. What a miserable place I thought and I swore I could never, would never work in a place like that.

The first patient I was assigned in Nursing School was Bertha Malhaney. I was to get a full set of vitals and review her chart the first day. My assignment the second day was to get her roommate into the shower.

When I walked into Bertha's room she was seated in front of her bureau applying lipstick as rouge. She then dusted on Coty face powder to set the makeup. I had watched my great grandmother in this same routine for years. Bertha turned around and as she turned I saw a picture of she and her girlfriends above them was a banner "Girls of 68". I said to Bertha, my great grandmother belonged to that group. It turns out they knew each other and were great friends. Bertha had memory loss, so she kept forgetting my great grandmother had died and I stopped reminding her. I spent time with Bertha listening to stories.

The next day I was to give Bertha's roommate, Helen a shower. Helen was quite frail and very sweet. The next morning I walked in the room both ladies were up, dressed, hair combed and makeup applied sitting side by side waiting for me. I knew Helen was not physically able to complete her tasks by herself. I also realized since I arrived at 6:30 am both of these ladies must have gotten up very early to get the jump on me. Bertha and Helen sat very proud both with the twinkle of mischief in their eyes. I questioned the staff and found out Bertha was the one who got Helen ready for her day! She must have had her hands full! They both looked great and got a pass on their showers for the day. (I can almost imagine the two ladies high fiving it when I left the room)

It was through my encounter with Bertha and Helen I realized, it didn't have to be the same way it was for my great grandmother. I could and would make a difference.

Nursing School

I started taking core nursing classes at 20. Previously I had been taking business courses. My father thought a career in business would be fantastic for me but I was terribly bored with the course work. Then I started to entertain nursing. I had no idea what nursing involved but I loved the science classes. I got married and nursing school was on hold. My husband at the time and I moved four times in three years and then I got pregnant. If we landed in a place long enough to squeeze in some classes I would. I took classes at night and during my maternity leave. Finally after 5 years I returned to school full time and enrolled in a nursing program in Sioux City, Iowa.

Iowans are tough. I think it must be the cold winters and heritage of farm, work ethics. The school was hard core, weeding out many students within the first month. By the third week of school we were doing clinicals in a nursing home. It was our first taste of real life aging. When my preceptorship rolled around I went back to the same nursing home and worked in the memory care unit. It was so fascinating. There was a couple who thought they were husband and wife. They would reminisce and since neither of them knew any different they believed they owned the memories and moments from the past as husband and wife. There was also this little man who really liked me. He came right up and grabbed my hand. It was then I remembered he had broken the finger of a nurse not only two nights before because she tried to free herself from his grasp! He held my hand and we walked and walked. A demented woman came up to us and started yelling at the gentleman and me. She slapped me three times across the face before I could blink! He continued to hold my hand but with his free hand punched her in the face. She then went after him. It was shocking! One of my instructors was in the unit at the time and I asked her for help. She said sorry kiddo you are on your own and left. Finally a nurses aide came along and took the woman away to her room. I turned to the gentleman and thanked him profusely for "saving me" and gave him a big hug. It was at this moment he let go of my hand and in that moment I realized folks with dementia will often times go along with what feels natural. The hug felt natural and familiar and he felt "ok" to let go. I went home feeling a sense of relief and I knew I had learned a lesson.

Close to Home

My grandmother had a form of dementia. It was not Alzheimer's, rather dementia coupled with strange behaviors. I was young and didn't get it at the time. We would take my grandmother with us to Minneapolis. It was about a 6 hour drive to my great grandmother's house. My grandmother did well until she felt pressured. If confronted with having to make a decision she would "act out" to avoid the decision and focus her anger towards the person who was asking her to decide. I remember one day my mother wanted to go shopping. My grandma couldn't decide if she wanted to go shopping or stay with my great grandmother. My mother kept saying "come on mom, it will be good for you to get out of the house." My grandmother went along but it was very tense. She then announced as we got to the store "I s&%# my pants". Horrified my mother became angry and said "well I believe there is newspaper in the backseat. You need to sit on that until Jennifer and I get done shopping. You are not coming into the store." We left my grandmother with her pants full of BM, sitting on newspaper in the car parked outside the store. Once back at my great grandmother's house, I heard voices coming from the bedroom and there was my grandmother standing in front of a mirror as if showing off a dress. She was talking into thin air, smiling and laughing as if in front of a room full of admirers. Time went on and her dementia grew worse. She could remember the past and piece together the present with speculation. She knew me and my mother until the end. Even though she could recall who we were her timeline was gone, the days, months and years melted together. It was difficult to talk with her because I had no idea who the people were she was talking about. One day I stopped by the grocery store and bought iced sugar cookies. I took them over to her and just listened, I added to the conversation once in awhile. I think that visit was the best we ever had.