We do Good.
It’s just after 9:30 pm on Friday as I begin the first of many drafts and revisions of what will hopefully become my fourth post to this blog. My shift partner Julia – one of the best and most caring AINs I have ever worked with, have finished our third and last nursing round of the afternoon shift, earlier than usual on account of their being less bowel movements to clean up and less urine soaked incontinence pads to change than is the norm for this round. C-wing is quiet. The forty odd residents are tucked in and asleep, except for the residents who are tied in (physically restrained, as opposed to chemically restrained), and Rosie, the ‘hobbit’ who is wandering the floor in her ragged nightie and bare feet giggling to herself and shouting ‘gedump’
While Julia tidies up, mopping the dining floor, wiping down tables, emptying the pad bins, taking the full linen bags to the laundry, folding and stacking the clean linen bags, etc, etc, I sit on a vinyl dining chair by the bed of Dave Alberts, holding his hand, stroking it softly. Dave is dying, his breath is laboured, his chest moist and I feel his legs twitch against my arm. Dave is a shadow of his former glory. Face gaunt, cheeks sunken.
A loud buzzer goes off, disturbing the evening’s peace. Olivia is hungry. Again. Having an hour ago had four Weetbix and an over ripe banana that Julia has scavenged from the kitchen. Now Olivia wants a vegemite sandwich and a cup of tea made in her own mug (which is of course dirty and needs to be cleaned first) – white with two tablets of sweetener. I head to the kitchenette to see if I can fulfill her latest request. Olivia is in luck. For a change, a jug of milk and half a loaf of bread have been left in the fridge by the ‘Hotel-Services’ staff. When I return with her request fulfilled, Olivia tells me she is in agony, as Bella, the shift's Registered Nurse had made a mistake, giving her at 6:00 pm two Panamax for her twitching toes, when she should have been given two Panadol. “I’m being driven out of my mind, can you ask Norma to give me two Panadol to counter the effects of the Panamax I was wrongly given?”
Bella is sitting at the Sister’s station, wading through the reams of documentation and report writing she is required to complete each shift. I tell her of Olivia’s woes. Bella tries to placate Olivia, informing her that the two drugs are one and the same. “NO THERE NOT!!!” screams Olivia. Here we go again. While Bella is away from her desk, the phone rings. Buffy, the Endorsed Enrolled Nurse (EEN) from B-wing is frantic. One of the night nurses has just rung in sick (ninety minutes before the shift is to begin). Buffy has rung all our casual staff and the staff who had put their names in availability book, but none of them want to do the shift. Is it alright if she starts to ring the nursing agencies? Buffy doesn’t want to feel obligated to do a double shift.
All is again temporarily quiet, except for the annoying hum the external air-conditioning units vibrating through the roof. Bella has given the OK for Buffy to start ringing the nursing agencies (I don’t like their chances – not this late on a Friday night). I sit down beside Dave again, and take his hand into mine. Dave opens his eyes briefly and seeing me (hopefully as a friend and someone who has cared for him) smiling, nods his head wearily and closes his eyes. Softly I speak to him telling him “It’s Ok, just relax and try to go to sleep, I’ll be here”.
When a resident is dying we like to keep their room softly lit at night. On Dave’s bed-side locker sits a cheap table lamp with a dimmish globe. When this nursing home was renovated to meet the 2008 building code specifications for Nursing Homes, new over-bed lights were installed in each room – fancy ultra-modern dual-fluorescent tube units with a longer brighter wattage tube facing upwards to bathe the room in Sahara like brilliance, and a shorter ‘softer’ tube facing down to light the bed head. However, perhaps to skimp on costs, only one light switch was installed to control both tubes. So when you turn the light on, a light source so bright it would do a klieg light proud, is produced. Not good when you attend to a resident’s care needs at night.
Holding Dave’s frail, bony hand softly in mine, I stare at the blotched and crinkled skin on his fingers and back of his hand, hanging so loosely, as if not attached to the underlying flesh. The tip of index finger is missing. His papery skin offers no resistance as I slowly, softly, rhythmically, move my thumb across the back of his hand like a metronome. I think back to just over a year ago when I held my father’s hand as he lay dying in a hospital bed.
On Dave’s bedside table is a framed photo of Bessie, his wife, taken sometime after they were married. She spent most of yesterday beside her husband’s bed, holding his hand stroking his face. The RN on duty yesterday morning had informed Bessie that Dave was dying. At 2:30 pm when I finished my shift yesterday I walked Bessie out of the nursing home to where she waited for a taxi. She wanted to go home to ring her daughters about Dave. I don’t know if Dave was a loving husband or a caring father. And I don’t need to know it. Although I suspect he was by the frequency and duration of visits he receives from his family. We are here to look after Dave.
Olivia buzzes again. This time Julia goes into see her. “I’m almost going crazy, please ask Bellaif I can have those two Panadol now to counteract the Panamax I was wrongly given at 6:00 pm as it’s almost 10:00 pm now.” Bella gets up from her progress notes to see her. “Not until 10:45 pm as you had your last lot at 6:45 pm”
Bella and Julia come into Dave’s room. It’s time to reposition him and Bella wants to give Dave a Panadol Suppository to make him more comfortable. We un-tab Dave’s incontinence pad to find him faecal. I go to fill a bowel with warm water, wasting several dozen litres of valuable Australian drinking water, while I wait for the hot tap to produce a tepid feed. Having cleaned him, Norma gives Dave the suppository and we turn him. He is now facing the other way in bed. I carry my chair round to the other side of the bed. I take Dave’s hand in mine and he stares at me with these big bottomless eyes. They are going right through me and I wonder what he is thinking. I can’t help think of every-time I had rushed through his cares in my daily attempt to fulfill all my shift’s nursing duties
The phone rings again. Buffy is desperate, none of the agencies have any spare staff to do the night shift on B-wing. Would Julia or I like to do a double?
At 10:30 the two night duty nurses an AIN and an EEN walk on the floor to relieve us. I give Dave a kiss on the forehead and say “I will see you tomorrow sir” Julia and I wash our hands, say good buy to Bella who doesn’t finish her shift till 11:00 pm as she has to give a handover to the EEN. Bella doesn’t think she will get out of here until almost midnight because with all the continual interruptions she has still a heap of documentation to do. Walking through B-wing we punch our time cards in the bundy clock and leave the building.
Checking my pedometer I note I have walked almost 14,000 paces. I’m sweaty, I’m sure I smell residents urine on me, there is a suspicious brown stain on my trouser leg, my feet hurt, my legs are tired and my heart is heavy. For an eight hour shift with week day afternoon penalties I earn before tax almost $135.00
While Julia tidies up, mopping the dining floor, wiping down tables, emptying the pad bins, taking the full linen bags to the laundry, folding and stacking the clean linen bags, etc, etc, I sit on a vinyl dining chair by the bed of Dave Alberts, holding his hand, stroking it softly. Dave is dying, his breath is laboured, his chest moist and I feel his legs twitch against my arm. Dave is a shadow of his former glory. Face gaunt, cheeks sunken.
A loud buzzer goes off, disturbing the evening’s peace. Olivia is hungry. Again. Having an hour ago had four Weetbix and an over ripe banana that Julia has scavenged from the kitchen. Now Olivia wants a vegemite sandwich and a cup of tea made in her own mug (which is of course dirty and needs to be cleaned first) – white with two tablets of sweetener. I head to the kitchenette to see if I can fulfill her latest request. Olivia is in luck. For a change, a jug of milk and half a loaf of bread have been left in the fridge by the ‘Hotel-Services’ staff. When I return with her request fulfilled, Olivia tells me she is in agony, as Bella, the shift's Registered Nurse had made a mistake, giving her at 6:00 pm two Panamax for her twitching toes, when she should have been given two Panadol. “I’m being driven out of my mind, can you ask Norma to give me two Panadol to counter the effects of the Panamax I was wrongly given?”
Bella is sitting at the Sister’s station, wading through the reams of documentation and report writing she is required to complete each shift. I tell her of Olivia’s woes. Bella tries to placate Olivia, informing her that the two drugs are one and the same. “NO THERE NOT!!!” screams Olivia. Here we go again. While Bella is away from her desk, the phone rings. Buffy, the Endorsed Enrolled Nurse (EEN) from B-wing is frantic. One of the night nurses has just rung in sick (ninety minutes before the shift is to begin). Buffy has rung all our casual staff and the staff who had put their names in availability book, but none of them want to do the shift. Is it alright if she starts to ring the nursing agencies? Buffy doesn’t want to feel obligated to do a double shift.
All is again temporarily quiet, except for the annoying hum the external air-conditioning units vibrating through the roof. Bella has given the OK for Buffy to start ringing the nursing agencies (I don’t like their chances – not this late on a Friday night). I sit down beside Dave again, and take his hand into mine. Dave opens his eyes briefly and seeing me (hopefully as a friend and someone who has cared for him) smiling, nods his head wearily and closes his eyes. Softly I speak to him telling him “It’s Ok, just relax and try to go to sleep, I’ll be here”.
When a resident is dying we like to keep their room softly lit at night. On Dave’s bed-side locker sits a cheap table lamp with a dimmish globe. When this nursing home was renovated to meet the 2008 building code specifications for Nursing Homes, new over-bed lights were installed in each room – fancy ultra-modern dual-fluorescent tube units with a longer brighter wattage tube facing upwards to bathe the room in Sahara like brilliance, and a shorter ‘softer’ tube facing down to light the bed head. However, perhaps to skimp on costs, only one light switch was installed to control both tubes. So when you turn the light on, a light source so bright it would do a klieg light proud, is produced. Not good when you attend to a resident’s care needs at night.
Holding Dave’s frail, bony hand softly in mine, I stare at the blotched and crinkled skin on his fingers and back of his hand, hanging so loosely, as if not attached to the underlying flesh. The tip of index finger is missing. His papery skin offers no resistance as I slowly, softly, rhythmically, move my thumb across the back of his hand like a metronome. I think back to just over a year ago when I held my father’s hand as he lay dying in a hospital bed.
On Dave’s bedside table is a framed photo of Bessie, his wife, taken sometime after they were married. She spent most of yesterday beside her husband’s bed, holding his hand stroking his face. The RN on duty yesterday morning had informed Bessie that Dave was dying. At 2:30 pm when I finished my shift yesterday I walked Bessie out of the nursing home to where she waited for a taxi. She wanted to go home to ring her daughters about Dave. I don’t know if Dave was a loving husband or a caring father. And I don’t need to know it. Although I suspect he was by the frequency and duration of visits he receives from his family. We are here to look after Dave.
Olivia buzzes again. This time Julia goes into see her. “I’m almost going crazy, please ask Bellaif I can have those two Panadol now to counteract the Panamax I was wrongly given at 6:00 pm as it’s almost 10:00 pm now.” Bella gets up from her progress notes to see her. “Not until 10:45 pm as you had your last lot at 6:45 pm”
Bella and Julia come into Dave’s room. It’s time to reposition him and Bella wants to give Dave a Panadol Suppository to make him more comfortable. We un-tab Dave’s incontinence pad to find him faecal. I go to fill a bowel with warm water, wasting several dozen litres of valuable Australian drinking water, while I wait for the hot tap to produce a tepid feed. Having cleaned him, Norma gives Dave the suppository and we turn him. He is now facing the other way in bed. I carry my chair round to the other side of the bed. I take Dave’s hand in mine and he stares at me with these big bottomless eyes. They are going right through me and I wonder what he is thinking. I can’t help think of every-time I had rushed through his cares in my daily attempt to fulfill all my shift’s nursing duties
The phone rings again. Buffy is desperate, none of the agencies have any spare staff to do the night shift on B-wing. Would Julia or I like to do a double?
At 10:30 the two night duty nurses an AIN and an EEN walk on the floor to relieve us. I give Dave a kiss on the forehead and say “I will see you tomorrow sir” Julia and I wash our hands, say good buy to Bella who doesn’t finish her shift till 11:00 pm as she has to give a handover to the EEN. Bella doesn’t think she will get out of here until almost midnight because with all the continual interruptions she has still a heap of documentation to do. Walking through B-wing we punch our time cards in the bundy clock and leave the building.
Checking my pedometer I note I have walked almost 14,000 paces. I’m sweaty, I’m sure I smell residents urine on me, there is a suspicious brown stain on my trouser leg, my feet hurt, my legs are tired and my heart is heavy. For an eight hour shift with week day afternoon penalties I earn before tax almost $135.00
posted by rbeare at Sunday, November 28, 2004
4 Comments:
thanks for being such a great person and friend
always nelly
Wow, what a shit job. I thought being a glassy was bad. Glassies still get the shit, piss and vomit, as well as crud pay, but at least I haven't seen anyone die yet.
I've never understood what keeps people in your sort of job going. I know I could never do it - I'm too selfish and impatient.
Good luck to you if you can do it though, I guess.
It's a shame that people who aren't in aged care devalue it so much? Of course, it is damn hard work, and underpaid, but I just know from lots of people who are working in it, consider it a privilege, and wouldn't have it any other way.
Having said that, thank GOODNESS for nurses like Robbie and Julia - I can honestly say, it's a privilege for all of us, to have you both working in aged care.
The way you describe 'Olivia' reminds me of many residents where I work.
One particular lady goes home on social leave most Friday nights and comes back on Saturday evenings. Her door is always locked while she is away, but when she returns we all wait for the bell to ring to be told that 'something else' has been stolen from the room while she has been out! We brace ourselves basically for the fallout of her slight dementia. The relatives are all doctors and solicitors but they are now aware of her little stories and the missing items.
I was furious one day when she reported thousands of dollars worth of jewellery and a white cardigan had 'been stolen' from the room while she was away. A written report was made about the incident. Two days later after the initial complaint and all most turning the room upside down....the jewellery was found!
Low and behold it had been wrapped up in tissues and placed in the mini refridgerator right at the back. No cardigan though!!!
God bless her she had done this to keep them safe but forgot she had done it!
When the relatives came that night I told them of the find - but did we get an apology...NO. They just laughed it off in the end.
It is very distressing for staff and the facility to be accused of theft.
Mind you, theft is quite prevalent in nursing homes...I will tell you a story about such a thing some other time!
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