Bad Boss Part 1: “Work Harder”

Sunflower

May

Note: This, like most of my posts, does not tell the story of recent events. I try to chose stories that are a few months (or years) old, although I am usually inspired by recent events or conversations which remind me of the story in question. 

All I get is a whispered warning in the hall: “Watch out for so-and-so [a person of unspecified authority in the nursing home who shall henceforth be called VIP]. She’s on a bit of a power-trip today.”
“Great,” I sigh back. This bit of information has two possible meanings:

  1. The other aide is having a Bad Day, very possibly got talked to about some deficit of care and now thinks everyone’s out to get her or
  2. VIP is actually on a power-trip and I’m going to have to try to be invisible as in addition to being everywhere at once.

We’re already working short today, and seeing as how the next shift is also short, there’s a good possibility I’m going to either be asked or ordered to work a double shift. Again. I really don’t have the energy for any more drama, I really, really don’t.
“May!”
I swing around, startled and resist the impulse to shout: “Speak of the devil!” However applicable the phrase, I fear the wording would not go down well.
“I need to see you,” VIP says. She’s dressed to the nines today, I notice and mentally calculate the cost of her outfit and accessories to be roughly a month’s worth of my wages. With, you know, the usual amount of overtime thrown in.
“Okay,” I say, bracing myself for anything.
“May, I don’t want to hear anyone saying that we are ‘short-staffed’ today or any iteration of it,” she says. “We are not. We are still within acceptable and legal ratios.” Well, technically, in our state there’s no safe staffing requirements for direct care workers/CNAs…that might very well be legal, but it’s no help on the floor…no requirements that I can find, any way. She might as well say “It’s after breakfast” when asked for the time; it’s perfectly true and very little help in figuring out if you’ve missed your favorite show. “If I hear anyone saying ‘we are short today’, or any iteration thereof, or even a mention of how difficult it is today, I will be writing up that person. Understood?”
“What am I supposed to tell my residents when they ask why I’m taking so long to get to them?”
“You’re just going to have to do your best and not let them even notice,” she says. “We do not need to be adding to their burdens because you have a few extra people today. They shouldn’t even notice a difference, it’s only four people more per group. Understood?”
I nod. Well, I’ve only been forbidden to say a few phrases: how rough can it be?

As it turns out, the only thing worse than working short of staff is being forbidden to mention this factoid.
“May, I put on my call light half an hour ago, where have you been?”
“May, this person is soaked. Why haven’t you changed him?”
“May, why isn’t this person up for the meal? What do you mean, there’s nobody available to help you with the hoyer?”
“May, why can’t you help me right now?”
“Where the hell have you been, you lazy bitch? I’ve been waiting for my shower for an hour!”
It’s chaos. I rush through my shift, begging for understanding from my folks and unable to explain why it is taking me so long to get to them. Words have always been my best weapon and I suddenly feel shackled, having been forbidden to use my words to coax or cajole patience and empathy from my folks. And I really don’t think just coming out and saying “we’re short today” would be a great shock to the increasingly frustrated and soiled residents. They’re not stupid and (for the most part) they can still count. They can see how quickly I’m running between rooms, that I haven’t stopped for a break yet, that nobody has shown up to help me. Oh, trust me, they know and my refusal to admit the truth is making some of them angry.
They aren’t the only ones. I’ve always been emotional and today has strained my control. I’m running myself ragged, haven’t had a chance to stop and breathe and for my efforts I’ve been screamed at, insulted, cussed out all day. I can’t even blame them, sitting in soiled clothes for almost an hour while I try to take care of everyone who has put on their light first. In a rather disturbing turn of events, I’m apparently having the walking-talking kind of melt-down…perhaps because I don’t have time for the actual sit-down variety. That is to say, tears are leaking from my eyes, but I haven’t stopped working and, rather bewilderingly, I’m still speaking in a semi-normal voice. I’m rushing around, doing my work in fast-forward and all the while, my sweat and tears are mixing on my cheeks. This day can’t get much worse.
I really should know better by now.

I round the corner and VIP is waiting for me. “May,” she says without preamble, “what’s going on? Why is it such chaos today?”
“…” I stammer. What can I possibly say in explanation that won’t get me written up? “I can’t keep up when it’s just me on the hall, okay? There’s just too many of them and I can’t do everything at once. Which is when they want it.”
Her eyes flash…but I never actually used the words “We’re short-staffed today.” This feels so unfair. How can I explain myself after she tied up my words and laid threats against my job?
“May, these residents deserve to have a good day without having to deal with all of our troubles. They’ve earned your best, even under challenging circumstances, so calm down, put on your big girl boots, dig a little deeper and work harder.”
Work harder? What the freaking hell does she think I’ve been doing all this time, sitting on the bathroom floor and crying my heart out? I wish! Oh, how I wish. I’m about to say something that will get me written up for sure, when a call light goes off in the room behind me. Seizing upon this gift from the heavens, I blurt out “Excuse me,” and dart in the room before VIP can say anything else. The resident in the bed looks extremely grumpy.
“May, I asked to get up an hour ago.”
“I’m sorry,” I start to say, but she doesn’t let me finish.
“May,” she says in a very different tone, “are you okay? What’s wrong? Are there not enough of you girls to take care of us today?”
“I’m running behind, but I’ll be okay,” I reply, conscious of VIP on the other side of the door. It’d be just my luck today if she had her ear pressed against the door! My resident doesn’t look like she believes me. I can’t say I blame her: faced with the evidence in the mirror over her sink, I don’t believe myself.
“You’re not okay,” she says firmly, but kindly. “You need to take a break.”
“Don’t have time.”
“Did I ask for your opinion? Did I call for a vote? Now sit down and take a minute to pull yourself together. If anyone asks, we’ll say I had to shit really bad.” That sliver of concern, of human compassion breaks the last of my control and I start to sob in earnest, out loud and quite noisily. I sink down to the floor, half-hidden by her bed, bury my face in my arms and proceed to rage and storm at the injustice of it all.
Who the hell does she think…no, that’s not it. VIP isn’t wrong in what she said. She’s actually got a good point about what my folks deserve…but under these “challenging circumstances” I don’t know how to give them what they deserve. Does she think I want my folks to soil themselves? Does she think I like having my residents sit in their own urine for hours? Does she think I’m not trying my damnedest to push through these challenging circumstances?
She isn’t wrong. She’s got a good point…and yet, it’s hard to hear the words “Work harder” from someone who is calm and collected while I’m weeping silently and uncontrollably. It’s hard to accept criticism from someone who is wearing roughly a month’s worth of my wages on her person, when I’m decidedly not looking my best. I looked at her, then I looked at myself and all I saw were the differences that divided. And I hate that. I hate thinking in binary terms, us and them, the powerful and the powerless. I hate looking at her and seeing only the wealth she’s wearing, the power she holds over me. It shouldn’t be like this. We’re both persons. Everything I believe in says we are equals…but I’m so stressed I can’t even hear my own beliefs in my own head. I hate that the only words reverberating in my mind are those that scream: “She’s on a power-trip and I’m the pavement she’s pounding.” It comes down to trust and right now, I don’t trust VIP to have my back.
Okay, calm down. Breathe in, breathe out. I’m not thinking straight and it’s likely I’m misconstruing her motives or projecting my turmoil onto her. I can’t do that. She’s got a good point, the residents shouldn’t have to bear our burdens…it’s just her approach to the problem was a bit half-baked and she didn’t consider how an overwrought CNA might take her words or choice of expensive accessories.
Calm down. Pull yourself together, if not for her than for your residents.
Because if there’s one thing in this whole mess that I have reason to be upset over, it’s that between a staff member with [unspecified] authority and a resident, it shouldn’t have been the resident who made the sacrifice to give me the time I needed to pull myself together.
When my ten minutes of rage and tears are over, I rise and splash cold water on my face. My resident still looks concerned, but she allows me to get her up and together we leave the room. Back into the chaos, but this time, I am master of myself.

<oOo>

I have been blessed: while I have had experiences with bad bosses (as detailed above), I’ve also had good bosses and, more frequently, decent bosses who were neither great nor terrible. It’s not all horror stories. It’s even mostly horror stories.

But what makes a bad boss? What combination of stresses and personal flaws combine to make a nightmare experience for those who work under these people? Sometimes it’s hard to remember, especially in the moment, that a bad boss is still just a person and not evil incarnate…a flawed human being, same as yourself. It just so happens that their flaws have the power to make your life a living hell while you labor under their authority.

The Legend

photo

Alice

She was one of the more”challenging” residents. I met her eight years ago, when I first entered the weird wild world of Long Term Care as a housekeeper. Whatever preconceived notions I may have held about nursing homes and assisted living facilities were quickly smashed as I moved from room to room, mop in hand.
I had heard rumors about the lady in room 207. She was the only resident who was allowed a pet, a mean little dog that would snap at strangers and bark CONSTANTLY. I was surprised that this was allowed. The caregivers explained that she had worn the administrator down by sheer force of will. She refused to give up her dog and management refused to give up the money that came from her living there. They turned a blind eye until the dog snipped another resident and then, with very little warning, they kicked her and her little dog out.
Fast forward three years: one whistle blowing experience, two owners and three administrators later, I was back in that same facility, this time as a caregiver with much more knowledge and experience in how the system works…there she was! Back again, with all her feistiness but without her dog.
“I remember you!”, she snapped, almost spitting the words at me.
“I remember you too”. I looked through the ADL notes: Refused shower. Refused shower. Refused shower. Two weeks straight of shower refusals.
I had just started working that particular hall…it was the assignment that no one wanted. At first, I was intimidated.  Having worked mainly on the memory care unit, the idea of working with the combination of physical and mental illnesses in this group was daunting. Still, I liked a challenge and seeing a familiar face made it more comfortable. I walked into her room, sat on the edge of her bed and asked her the first question that popped in my head,
“So why do you hate showers?” She looked up in surprise as if the question had never occurred to her. She thought about that for a moment.
“I don’t”, she mumbled. Ok. We’re getting somewhere.
“I just don’t like being told what to do.”…ahhhh. That I understood. So I explained about shower schedules. She could not care less. I cajoled and pleaded and attempted to redirect to no avail. Finally, I settled for bribery. I would buy her a Dr. Pepper. With that, she cheerfully followed me to the bathroom.
She was a force of nature; a fighter who had little use for most people. Over the years, the bond we formed early on over a Dr. Pepper deepened. I knew it was she who pulled the fire alarm during a rain shower, forcing us to evacuate the entire facility when she felt she didn’t get her coffee in a timely manner. I hid my amusement as I firmly explained that this was completely unacceptable, though I never reported her for it. I didn’t have the heart. The time she snuck an entire cup of soap and dumped it in the whirlpool causing a flood of bubbles that spread from the bathroom to the hallway, the times she would “borrow” sodas from her roommate causing veritable riots…she was legendary.
When I left the facility for a job in private care, saying goodbye to her was one of the most painful moments. I told her I loved her, promised to visit and told her to not terrify the new girls. Trust was so hard for her and I knew that she felt abandoned. She told me as much. I made certain to visit as often as I could, but life gets busy. Between my new job, writing, recovery and volunteering, my visits slowed down. There are only so many hours in a day and I kept telling myself I’d visit after New Orleans, after I settle back into work, tomorrow, next week…
I got the call from a friend last week. It was unexpected. She had been sliding downhill slowly but she went into the hospital and died suddenly.
Loss is a part of our job. It isn’t easy but without an acceptance of that fact, it would be impossible for me to continue in this field. My way of coping is to remember each and every one of my folks and the impact that they made on my life. I get attached and that is what works for me. Others set strong boundaries and they are equally effective in this field. There is no one way to cope with the more difficult aspects of our work. I have found it to be an intensely personal and subjective matter. There is no wrong way to find peace in grief. Still, this one hit me hard. I thought we would have more time.
I went to visit the facility shortly afterwards. I had made the decision that any time wasted feeling guilty would be much better spent visiting my former residents. I walked in and greeted everyone and it was like coming home. Residents and staff embraced me and as I walked the halls, I listened. Everyone had a story to share about my friend in room 207. They spoke of her spirit and her fight. Funny, touching stories that spoke to her courage and refusal to simply roll over and play dead. I was filled with a sudden peace and deep gratitude. She may be gone, but it was clear that in this facility her legend will never die.

Comfort and Joy

FB_IMG_1453111718856

 

 

Minstrel

At the end of my first year of work as a CNA, when it came time for my job evaluation, I was asked what my job goals were.  I wrote, my goal as a CNA was for my residents to go to sleep smiling.  Whatever the rest of the day might have been like, bedtime belonged to me.  I wanted each resident to fall asleep feeling loved.  As we did the bedtime ADLs I played lullabies on my IPod.  I hoped that some positive feeling would stay with them through the night.  

How horrible it must be for a person’s last experience of the day to be one of distress because someone rushed them, tugged at them impatiently, scolded them to hurry.  Didn’t smile.  Didn’t speak to them by name, maybe hardly made eye contact. Didn’t wish the resident goodnight as they left the room.  (Didn’t kiss them goodnight!)  Dementia can be a world of isolation, confusion, fear. 

Confusion and fear, or love and joy: which will be my residents’ last companions of the day?  We all know what kind of aides we want to be.  But we let ourselves be pushed by ‘the system’ into being the kind of aides we ourselves don’t like.  Don’t!  Giving even just an extra two minutes to each resident, what a difference we might make at the end of their day.  

There must be joy!  For the sake of our residents.  And for the sake of our own joy-seeking souls.

Among Kindred Spirits

DSC00999

 

 

Yang

In today’s post, I would like to share my thoughts regarding our participation in the 2016 Pioneer Network Conference.

To begin with, this was the first opportunity that Alice, May, and I got to meet each other in person. What a pleasure. After working with my co-contributors via the Internet for over two years, I knew that they were both talented and creative writers who shared my core values as a caregiver. But in getting to know them in person, I discovered two witty, well-read, and sincere individuals who were just fun to be around. It was easy see how their passion and dedication for their creative work as writers blends so well with the compassion and dedication they have toward their elders. This was evident in our conversations and in our presentation at the conference.

As special treat, we got to meet our sometime contributor and much appreciated supporter, Minstrel. This was a huge surprise, because we had no inkling that she was going to attend the conference. It was great “talking shop” with her and getting to know her a little better. Meeting her was definitely one of the highlights of the conference for us.

The conference was a surreal and wonderful experience for us. We were very well treated, not only in regard to the accommodations, which were first rate, but in the support and encouragement we received from the Pioneer Network Conference staff. Public speaking is not exactly our forte, but we felt like we were in the hands of pros, and their guidance and preparation made us feel as comfortable and confident as possible.

Alice, May, and I were given the honor of speaking to the opening plenary session of the 2016 Pioneer Network Conference. CNA’s have presented in previous conferences, but this was the first time direct care workers have addressed a plenary session. While we were thrilled with the opportunity to share our work and were very well received, it became clear after spending a few days at the conference that our invitation to appear said a lot more about the Network and the direction it is heading than it did about us.

The Pioneer Network is at the center of a culture change movement that recognizes the significance and power of the caregiver-resident relationship. While the movement has always placed this relationship at the heart of culture change, there is a growing sense that caregivers must become more active within the movement itself. Last year, only five percent of the attendees at the conference were CNAs. I’m not sure how many caregivers were there this year, but I expect it’s up from previous years. And I think it’s only the beginning.  

In coming years, I would not be surprised to see increased efforts by conference planners to reach out not only to caregivers, but to any class of workers within Long Term Care who have daily direct contact with residents. Moving away from medical and institutional models, and toward person centered models means that how elders perceive their experience in Long Term Care is paramount.  Central to that experience are the bonds they form not only with caregivers, but with housekeepers, maintenance workers, food service personnel, physical therapy aides, activity therapists – anyone, in fact, in the “neighborhood” who has daily personal direct contact with our elders.

There were times before, after, and even during our presentation that I had a sense of preaching to the converted. Obviously, this was friendly territory for caregivers who share the vision and values of the Network. At the same time, the genius of this movement lies in its acute self-awareness. Those at the center of it understand that the movement must perpetually remake itself based on the actual experience of elders and those closest to them. The movement wants and needs to be challenged, lest it become irrelevant to the people it purports to serve. If culture change means a shift in attitudes and behavior of caregivers toward those for whom they care, it also means the development of a deeper awareness on the part of policy makers – and on the part of advocates for change – of how caregivers actually experience the work. I hope that our effort to enhance such awareness did indeed serve as a challenge to the movement.

Of course, through the sessions and just talking to people, we learned a great deal at the conference ourselves. We hope that at least some of this will be evident in our future blog posts. As this movement evolves, we as individuals will have to grow with it.  New ideas emanating from practitioners at every level ensure a steady supply of new and creative approaches to old problems. Personally, I was humbled by how much I still need to learn.

Perhaps what struck me the most was how quickly we felt at home at the conference. While it was a surreal and wonderful experience, there was also something very familiar about the people there. These were kindred spirits who believe in the same thing we do. It was an honor and a pleasure to be among them.

The Wheelchair Test


May    Sunflower

 

The first time I went job-hunting as a CNA, I didn’t have a clue what I was doing. But that was then and now? Now I at least have a clue. Two years experience has at least given me that.

“Hello, this is _____ Healthcare, ____ speaking. How may I help you?”
So far, so good. The woman’s voice is pleasant and friendly and she doesn’t sound like she ready to rip somebody’s head off.
“Hello, my name is May and I was wondering if you could tell me what your base pay is for CNAs? Um, on first shift?”
There’s a small silence on the other end of the line, then the other woman says, “Give me just a second and I’ll find out for you. Are you looking for a job?”
“Yes,” I respond, still marveling at my decision. It’s been a long time coming, but it still doesn’t feel real. This isn’t an “I’m so fed up I’m reminding myself I have options” kind of call, such as I’ve pulled in the past…no this is the genuine article. I’m leaving. On some level, it feels like a betrayal to feel so relieved.
The receptionist’s voice cuts across my thoughts, pulling me back to the present. The figure she names is decent, slightly below average national pay, but more than my current pay…especially since my current pay includes shift differential! Hello savings account, you might not remember me! I force myself to calm down. The other place I called offered similar pay and a crap-ton of stutters and excuses instead of an answer to the next question on my script. Speaking of…
“And can you tell me what your resident-to-aide ratios are?”
The other woman laughs. “At the risk of repeating myself, give me a second to check.”
This time, the pause is longer. I can’t help but spring to my feet and start pacing the room. My thoughts pound out in rhythm to my steps: please, please, please. For years now, I’ve heard the same mantra thrown at me, “If you leave, you’ll never find as good a place as this.” At first it was reassuring. Then it was annoying and now I’m praying that it’s not true. I don’t want to have to decide between the money it will take to have a good life and ratios that allow me to take pride in my work. Please, please, please.
“Well, our staffing person is not answering the phone, but I just talked to one of the CNAs and she said she’s got eight people today, if that helps.”
“That’s very helpful, thank you,” I reply, trying and failing to keep my glee out of my voice. “Just one more question: are you hiring?”

It’s dangerous to accept a job sight- unseen, so I continue to check my rising excitement until I actually walk through the doors of the facility the next day. To my surprise, the receptionist recognizes me from our phone conversation as soon as I ask for an application. She’s seems as friendly in person as she did on the phone. That’s good.
As I fill out the application, I take time to look around me. It’s not quite as opulent as my current place, but there’s a friendly functionality at work. There’s also no odor that I can detect, no harsh scent of ammonia and urine. I can see aides moving quickly on the halls and some nod at me or wave. They look busy, but not hassled. A few residents are lined up by a nearby nurse’s station and I examine them closely. Men and women both are neatly shaved and groomed, there are no food stains on their faces and they all appear engaged with their surroundings. Quite a few of them are looking at me quite as intently as I’m looking at them. I hand in my application, wondering if I’m about to become their caregiver.
The receptionist asks me if I want to schedule my first interview for today, warning that it might be a bit of a wait. I say yes. I want to get this ball rolling, get this transition over with.
As I wait, I do the last thing on my list. It’s not something I’ve pulled off the Internet or asked other aides about, unlike everything else on my list or script. This is something I came up with on my own, a pattern I’ve noticed in my own experience. I like everything else I’ve seen and I almost don’t want to look. But as I wait, I walk up to a resident and start talking to them. Our conversation is mostly an exchange of names, but it gets me close enough to the wheelchair that nobody looks at me like I’m crazy when I squat down to put myself more or less on eye-level with the resident in the wheelchair. Nobody even notices when I duck my head down for a quick look at the underside of the wheelchair.

See, when you’re short-staffed or overwhelmed, somethings slip through the cracks–things like washing wheelchairs, for example. As an aide, I’m…not exactly okay with this, but I understand it. You can only do as much as you can, and when you’re running late on time and short on energy, primary care comes first. Better to make sure your people are clean than to make sure the wheelchair looks nice.
We’ve all had those shifts. Everyone, no matter how good the facility, has had that kind of day, and a good facility can rally. If one shift slips, the others can still catch up around it. The wheelchair gets washed the next go-round and all’s well.
But if that facility is in crisis mode and has been for a while, if every single shift is short…there’s no catching up. That wheelchair goes unwashed shift after shift, week after week. There’s a big difference between a bad day once in a while and a string of bad days; I’ve learned to tell the difference in the state of the wheelchairs.
And this one is mostly clean. There’s a bit of grime and dust on it, but it’s only a single layer. There aren’t layers upon layers of bad days coating the underside of the wheelchair.
Okay, I can work with that. I don’t expect perfection, but I’ve come from a place that’s been in crisis mode for almost a year and I can’t take it anymore. I’ve learned too many bad habits, too many shortcuts and there’s a bitterness in the air I just can’t breathe anymore. I need a clean break, a new place to make a stand…and I think I’ve found it here.

Wants vs. Needs

photo

Alice

I do not want to do this. I AM TIRED AND I DO NOT WANT TO TACKLE THIS!…those were my thoughts as I tried to come up with the best way to explain to my client that it just isn’t possible to attempt a planned outing at five in the evening. It was hot. It makes me nervous to drive her car in rush hour traffic. Her mobility was off all day. She was having stomach troubles. A “politician” who’s name I will not mention because I adamantly refuse to give him the satisfaction of free publicity on our blog was having a rally in town, guaranteeing the nuts will be out on the roads in droves, plus I was on the last day of a long stretch of back to back twelve hour shifts and I was tired…at this point in the day it was just a bad idea all around…and then I saw the expression on her face. Sigh.
“Ok. Let’s DO this!”
We had made plans for the outing two days before, when we found out that her husband was going to the rally of “He who must not be named”. It seemed like the perfect opportunity for one of our “Girl days”. We’d go to Belks, and she wanted to try on some new orthopedics at the shoe outlet, maybe hit Starbucks and grab dinner at a restaurant nearby. We could spend the whole day out and still make it home in time to read a few chapters of Little Women (a book she has never read and we are both thoroughly enjoying)! I knew she had been feeling cooped up for awhile and this would be good for her.
I arrived at work prepared and excited for the day’s adventures! She called out a cheerful good morning as I got the coffee brewing and went in to get her up for breakfast. As I helped her transfer from the bed to her chair, I noticed that her mobility was a little off. That happens. Some mornings take more effort than others. I wasn’t too concerned. Besides, she was chattering happily about the day ahead. I pushed her to the table and set up her breakfast: Greek yogurt, Cheerios and as an extra treat on our special day, some fresh peaches…it was those damned peaches that started the domino effect that would threaten to ruin the day.
I lost count of how many times I cursed myself for giving her that devious fruit. Now ordinarily, I would be thrilled that her engines were running so smoothly. One of the side effects of her pain meds is chronic constipation, but on that day, it just wiped her out completely. I watched as the hours went by, counting the trips to the bathroom. Noon, 1:00, 2:30…still no end in sight. By 3:30, her pain level had flared up. She thought if she could just rest in her recliner for a minute, she would feel better, so I transferred her, elevated her legs, sat down next to her and folded the laundry as she rested. 3:45, 4:00, 4:30…Ah well. The best laid plans of mice and men. I knew any chance of fulfilling our goals for the day were shot, so you can imagine my surprise when I heard her say with great determination,
“I feel better now. I’d like to go out now. I’d like to try…”
I didn’t want to go at that point for the reasons I mentioned above. They were all valid concerns. Loading her car with the wheelchair, walker and various other sundries alone takes at least thirty minutes…I would be at work FOREVER and I was supposed to get off at nine. And it’s not as if we would be able to accomplish any of our plans. What’s the point? Besides, she would do better to rest…but one look at her face put all of that nonsense in my head to rest.
When an elderly lady who had a stroke in the prime of her life and manages to keep up her spirits says that she wants to paint the town red after a day of what could only have been hell for her, who am I to complain, even to myself, about a little heat and loading a car?! So we loaded up and off we went. And it WAS hot and there WAS traffic and it WAS difficult…but it was also wonderful. We went to the shoe store and she got shoes that may ease some of her foot pain and we sat in a restaurant and enjoyed a leisurely dinner, just the two of us. For a few hours, she felt perfectly normal and it did her a world of good. It did ME a world of good.
It occurred to me that absolutely everything that matters in my life has been a direct result of facing things I didn’t think I could and doing things I didn’t want to do. I didn’t want to put down the bottle but in doing so, my life was not only saved but put to good use. I didn’t want to be a housekeeper, but that job in a facility led to my caregiving. I was terrified of blowing the whistle on a terrible facility, but doing so taught me how to effectively advocate and eventually led me to writing for this blog and the remarkable experience with the Pioneer Network in New Orleans. I didn’t want to go out with my client so late after such a challenging shift, but in doing so I was able to make a wonderful woman happy and feel a sense of accomplishment that no amount of money could buy. Sometimes, we confuse what we want with what we need. It turns out that adventure is exactly what I needed on that day. I stopped watching the time and enjoyed the moments.
After we made it home and I tucked her into bed, carefully adjusting the pillows around her, she hesitantly asked if I would read her a bit of Little Women if I wasn’t “too tired.” I settled down in the cozy chair beside her bed, opened the book and began to read,
“Your father, Jo. He never loses patience, never doubts or complains, but always hopes, and works and waits so cheerfully that one is ashamed to do otherwise before him.”…and I quietly slipped from her room after she fell asleep.

 

Back to the Floor

May.                          Sunflower

It would appear as though my residents missed me.
To show how much they missed me (or perhaps to convince me never to go away again), they’ve apparently decided to throw a call-light party, complete with a few alarms…you know, just to complete the experience. The party entertainment seems to be in the form of the guest of honor, aka me, running around like a chicken with its head cut off. I’m running from room to room, sweat dripping off me and breathing hard; it’s been non-stop all day long–and the day is still young. This shift ain’t over yet and I already feel as though I need another vacation. No sooner do I answer one light than five more go off.
This is getting ridiculous.
I swing into the next room, turn off the call light and ask (in a slightly breathless voice): “Whatcha need? Are you ready to get up now?”
“No,” says Mrs. H. “Not ready to get up yet.”
“Okay then, ring again when you’re ready, good to see you and bye!”
“Stop!!” she shrieks. “Come back here!”
I stop as ordered, skidding forward just a bit from excessive momentum. Thankfully the door frame is there to help me redirect back into the room. “Yes?” I ask.
“Sit down,” she says, or rather, orders. “Sit down and tell me about your vacation. I haven’t seen you in a week!”
“That’s why you put on the call light?”
“Well, duh! I heard your voice out there and figured you were back. So sit down little girl and tell me all about your trip.”
I glance out in the hall. There’s only one other call light going off and I catch a glimpse of my hall partner heading towards it…so I close the door and sit down as requested/ordered. “It’ll have to be quick,” I tell Mrs. H. She nods and settles back against her pillows, eagerly awaiting my story.
I grin. Ah, yes. The best and worst of my job were waiting for me today: everything I can’t stand and everything I love both wrapped up in this one shift, my first back from vacation. Still, it’s good to be back.

If I had to pick one word to describe the Pioneer Network Conference, I would have to go with “thought-provoking”. (Then I’d have to argue that yes, that is one word thanks to the hyphen, thank you very much, Grammar hounds.)
Over the course of four days, I had so much information thrown at me, engaged in so many conversations, asked and answered so many questions…it was a lot.
I learned new things.
I received confirmation for ideas I’ve long held without any proof.
I heard things that made me change my mind on certain issues.
I listened to arguments for certain things that did not change my mind, but showed me how other people were convinced.
I walked away with a thousand ideas for change, and 30 or so blog post ideas.

It was rather odd, sitting shoulder-to-shoulder with administrators, DONs, ombudsmen, policy makers, and other people whose spheres of influence are much larger than my own. It was odd, noticing that we took notes at the same time during a session. I guess I had rather expected to feel small, sitting with the movers and shakers, but I didn’t. Different, maybe, but not smaller. Perhaps that was the best part of the conference: hearing other people’s perspectives and actually listening. Having other people listen to my perspective.
My sphere of influence might be comparatively small, but it does have the advantage of being personal. I can’t change whole long term care facilities, or alter policies or build new facilities based on new models of care…but I can adjust my own personal style of caregiving to better suit the needs of my folks. I can take the big picture things I’ve learned and use them to make the day-to-day lives of my residents better. I can use what I’ve learned to stretch my own assumptions and perspective, use them to formulate and articulate new blog posts.
It might only make a difference to a few people, but it will make a world of difference to those few…and that’s totally worth it for me.

In the end, it’s the people who are important. The system should serve the people, not steam-roll them into molds with labels slapped on top. For me, the system will only be fixed when it empowers people to do and be their best whatever their role, whether it be resident, CNA, DON, RN, administrator or policy makers. For me, the best system is the one that encourages connections between people, no matter their social status or job title.
Systems break down, technology becomes outdated, but those personal connections?
That’s always been the thing at the heart of caregiving. It’s certainly why I do what I do.

What it’s all about

DSC00999

 

Yang

 

I’m going to post my thoughts regarding our time at the 2016 Pioneer Network Conference in more depth next week. Today, I would like to address an incident that occurred during the conference orientation on Sunday. It was a little unsettling and it affected me in a personal way.

It happened as Barry Barkan of the Live Oak Institute and one of the founders of the Pioneer Network, was closing the orientation with what he described as a “solemn ritual” that went back to the early days of the Network. In a gentle and reverent tone, he instructed the group of a hundred or so orientees to form a circle around the auditorium. As we linked hands in anticipation of a prayer or a pledge or some version of Kumbaya, Barry bowed his head for a moment, then looked up and did this:

Put your right hand in,

Put your right hand out…

Oh, that.

Let’s get something straight:

I don’t do the Hokey Pokey.

I don’t put my whole self in

I don’t put my whole self out

And I certainly do not “turn myself about.”

But I did on Sunday.

Barry Barkan, Miracle Worker, got me, a life-long anti Hokey Pokier, to perform this absurd children’s dance. And I liked it.

It wasn’t the social pressure. A good portion of the group chose not to participate and I could have easily joined the ranks of my brother and sister Hokey Pokey objectors and not have suffered any of the awkwardness of being the lone dissenter.

I did it not just because Barry is an instantly likable person …

I mean look:

Solidarity through Hokey Pokey

Solidarity through Hokey Pokey

I did it, and I liked doing it, because his approach, the buildup and the subsequent surprise (Humor 101), was utterly disarming. It allowed us to drop our social armor and just have a bit of fun.

The moment was made possible by an understanding of how we were perceiving the situation, the use of humor to lighten the mood, and the reliance on an indirect approach. Had Barry taken a direct approach and told us to get in a circle for the Hokey Pokey because it was the designated time for the Relax and Have Fun portion of the orientation, I would have indeed “put my whole self out”… of the room. As soon as I navigated the one-way traffic jam at the door.

This really is “what it’s all about.” A person centered environment means that as we approach and respond to our elders, we pick up on the cues that provide us with an awareness of how they as individuals are perceiving the situation and use this as the context for our interaction with them. An unhurried and indirect approach with a light touch creates an atmosphere of cooperation and reassures our elders that they are in control.

I didn’t have to do the Hokey Pokey. I wanted to. And I would do it again, reserving of course, my right to refuse.

Alice in Wonderland

The thoughts flit through my mind at a dizzying pace, a kaleidoscope of colors and frenzied impressions that dance around the idea of what could be and what already is. We are in New Orleans. The Big Easy. A city that has no shortage of whimsy and magic in its own right but to be here to present to the world our writing? To be given a platform in which we can shout our truths in the hopes of reaching others on our path to deep, meaningful and lasting change?…that’s surreal.
It wasn’t an accident that I chose “Alice” for my pseudonym. As a child, Alice in Wonderland was my least favorite fairytale. It made no sense. I much preferred Robin Hood. Now THAT was a story I could sink my teeth into. So, it came as a quite a surprise to me that after a great amount of life experience, I awoke one day in my mid thirties only to realize that my LIFE was wonderland and I am indeed Alice.
Call it fate, providence or synchronicity, I never believed it was an accident that I crossed paths with Yang and May. The odds of meeting two like minded caregivers across the country with such an amazing talent for writing and dedication to expressing truth and impacting change would be slim in any case, but the fact that we have worked together fluidly for two years without meeting one another until this week? The fact that our different styles and voices flow together in a way that is harmonious rather than clashing? The odds of us being offered such an opportunity by the Pioneer Network to speak out and reach others? No. That is more than coincidental.
Sir Arthur Conan Doyle said that if you eliminate the impossible, whatever remains, however improbable, must be the truth. The truth, as I see it, is this: We are on a path that is uniquely suited to us. We have not only the opportunity but the obligation to follow through to wherever this journey may lead and in doing so, we will impact the lives of the most vulnerable among us for the better. We will impact our OWN lives for the better and what we learn on the way will forever enrich us in ways that we cannot imagine. This I know to be true.
Lasting change may not happen on my timeframe but it does happen. I cannot properly express how grateful I am to the Pioneer Network, everyone involved and all who attended, for seeing in us the message that fits so perfectly with their vision or Yang and May for being such a vital part of my life or how much hope our collaboration has brought me these past two years. I only know that the three of us will continue to speak our truths, shouting it when necessary and as much as we can, be the voice for those locked in this deeply flawed system. We will never give up. Of that, I am absolutely certain.
As I sit outside, watching this whimsical city in all its wonders, I feel bittersweet about leaving in the morning. This conference has been the biggest and most fulfilling achievement of my life and it’s sad that it’s almost over. But in my heart of hearts I know it is but the first step of a journey that is sure to be a thousand miles and I am so excited to be a part of whatever comes next. In the meantime, we will continue to write and remind you, our readers…our friends, that each and every one of you matter and each and every one of you can and do make a difference. So don’t ever let the world convince you otherwise. Shine on, my friends!

Ghosts in the Room

Sunflower

May

So this is different. I’m become used to being a picture of a sunflower on the Internet, the unseen hands typing away on a computer…or more often than not, my iPhone between shifts and errands. Being here, at Pioneer Networks Conference is…way, way different. It’s awesome, and pretty scary. My hands are shaking so badly I’m beginning to rock the music stand holding my script. It’s part nerves…and part something else. I take my hands off the music stand and clasp them behind my back.

Smile was hard. In rehearsal, I burst into tears because that resident…that woman who sat on the commode and broke through her own aphasia to remind me to smile…she’s gone now. She died a few months ago, and that moment, that memory is so precious to me. It’s been the moment and the memory that I relive each time I think about quitting this job or this field. (Yes, even I have those moments.) And now she’s gone. She won’t ever speak again to me, won’t ever tell me to smile. And experience has taught me that in a year or so, I’m not going to remember her face. It will blur and while I will hopefully never forget her, her face will fade until one day it won’t be her face I see. I hate it, but that’s the truth.

I’m so sorry, I tell her in my mind. I’m sorry that I made you feel bad that day and I’m sorry I won’t be able to perfectly preserve your memory. I sorry HIPAA didn’t let me capture your image so I could always remember your smile, your eyes. But while the details will blur, you will always be part of me…and you’re here in this room now. I carry your ghost with me everywhere. All of us caregivers have ghosts.

I look up from my script and look out over this crowded room and I wonder…how many ghosts are here today? How many silent residents stand behind the people sitting at these table, how many lost loved ones are watching them, watching me? I’ve got well over one hundred myself. How many do they have, these people watching me?

Ok, ya’ll, I think, turning my script to how do you say goodbye? This one’s for you guys, all you ghosts filling the spaces and the hearts in this room.

Oh, boy. And I only thought the room was crowded before I remembered you were here!