Excuses and reasons

 

May

Every time I’ve got gloves and…other stuff…on my hands, my face starts itching.

I’ve no idea whether it’s simply that I notice the itching more when I’m unable to do anything about it, or whether it’s fate playing a cruel joke on a poor CNA. Most days, I’m inclined to suspect the latter.

I suppose that it doesn’t matter, either way. Even the persistent, annoying itch in my eyebrow is small potatoes compared to the fact that I have five minutes before I am “officially late” to the meeting (I’m “actually late” already). I try to hurry as best I can, though I’m rather thinking that a cork, rather a wipe, would be appropriate for this situation.

Eventually, there comes a time when you stop wiping and call it enough. I fasten the new brief, turn her on her side and pull the covers over her.
“I’ll be back soon, okay?” I tell her as I snap off my gloves and turn on the water to wash my hands. This resident hasn’t spoken in weeks, but I swear she doesn’t need to power of speech to express her doubts about the “soon” part. Her eyes continue to bore into my back until I leave the room.
Two minutes later, I’m quick-marching down the hall in that not technically running that I’ve perfected in my time as an aide. It’s one of the ways I got over my green-aide days, by cutting down the time it took me to get from one resident to the next without invoking my administrator’s distaste for “running around in an unprofessional manner”.

Despite my not-running, I’m one of the last to enter the meeting room. I hope for a minute that this at least means I’ll get a seat in the back of the room, but no. Seating is first come, first serve and apparently, we started in the back today. Lucky (late) May gets to sit in the first row, right in front of our special guest. And the DON and administrator, who both raise their eyebrows over my late appearance. I shrug in a half-meek, half-cheeky manner and slide into my seat.

Our guest today is a middle-aged man, dressed in an impeccable fashion. Well, impeccable if he were attending a board meeting; here, he rather sticks out. His suit fits him perfectly and nothing about him is out-of-place. Under his blazer sleeve, I see the glint of a gold watch and his brown shoes are so shiny that I can see my reflection in them. I wince.
In the sleek, expensive leather, my reflection is not flattering. My scrubs are old and faded; my shoes cheap and scuffed. I’d actually done my hair and makeup this morning, but you can’t tell now. Sweat has washed off the makeup and revealed what I was trying to hide: the pale skin and large bags under my eyes, courtesy of two doubles this week. I don’t look professional; I just look tired.
I can’t help the thought: I’d have to work a lot more doubles before I could afford a similar outfit. I try to stop the thought: I know better than to judge someone based only on appearance…but I also know that you dress for who you are trying to impress. Everything about him screams that this man is not really here for the CNAs. In this setting, his clothes do not so much impress and set him apart from us.
I glance around me and I know I’m not the only one who’s noticed. Grumbles sweep the room: there are a lot of us who hover on the poverty line, lots of single mothers working themselves ragged to provide a good life for their children, a lot of us trying to scrape enough to save for school and pay the bills.

Resentment is an ugly thing, but hard to shake…prejudice, even more so.

He clears his throat and begins to talk. I try to stop thinking. He’s here to discuss “time management and job efficiency”. Apparently, ours suck. He doesn’t say it quite like that, of course. He starts with a story about how his office is cluttered and how this ‘negatively affects’ his job performance. Somewhere along the way, he makes the connection between offices and time: how a cluttered office is like misused time. Just like we need a well-organized office to properly do our jobs, we need to manage our time.

Office? I work on the floor–closest thing I have to an office is a bathroom. I shift in my seat, stifle a yawn and think his examples are a bit odd, considering his audience. I’ve never had an office in my whole career. I’ve never had a desk, or a filing cabinet or even a chair. I do have scrub pockets, though.
He goes on at length, citing studies and tying them back to time management policies. He tells us how much room for improvement he sees for us “on the books”.
But that’s all he does: cite studies and tell us what we are doing wrong. He doesn’t give any relevant examples or any insights on how to apply these principles to the world of the floor–where residents crap a ton, tumble out of wheelchairs, slap us in the face, get confused as to we are and where they are. All he does is stand there in his fancy suit and offer us generic slogans and cookie-cutter criticisms.

Oh, crap. I forgot to lay down Mrs. T. I can see her in my mind’s eye, leaning over the right side of her wheelchair, leaning towards a tumble. How did I forget her? Oh, yes, I was dealing with the never-ending squirts. Now there’s a time management conundrum: if you only have ten minutes, do you change the soiled resident or do you lay down the fall-risk? Suddenly, I am all impatience for this meeting to be over, so I can lay down poor Mrs. T.

My attention is jerked back to the meeting by an aide behind me speaking up.
“All that is well and good,” she says drily, “but it ain’t practical. How’s it my fault that I got six people to get up and only an hour to do it in? And you want me to be doing all this other stuff in that same time? Ain’t gonna happen. If that’s mismanagement, it ain’t mine.”
“Well, you will just have to try harder,” he says. “You just need to stop thinking it can’t be done. All this can be done…I’ve been to hundreds of facilities and you’re telling me that this one is so different from all the others I’ve been to?”
Resentment flares up from all corners of the room. Come again? She made a valid point, I thought. At least valid enough to be discussed instead of being dismissed out of hand.
I’m speaking before I’ve half-made up my mind to say.
“Some days, you’re right and we do have time. But she’s also right: good quality care takes time. You can’t tell us to only provide the highest quality care–but be snappy about it. It just doesn’t work that way; especially on the days when we are short-staffed–“
“So you’re telling me that there’s nothing you can do to improve your time management?” he interrupts. “Nothing at all? You are perfect? Because this isn’t going to reflect on me; it’s your job performance that is going to be judged. And being short-staffed is just an excuse, young lady. Just an excuse to not do your best.”

I’ve got so much I want to say that they all get wedged in my throat. Of course there’s stuff I can to ‘improve my time management’. I could not sit with Mrs. W. while she cries–that’d save me ten minutes at least. I could just randomly check boxes when charting instead of accurately recording my shift–that’d be huge time saver! I could cut out the part of my day when I wash everyone’s face…I could not pee for eight, twelve, sixteen hours, whichever one I’m told to work on any given day.
A higher-up clears her throat. “I think what May means is that we do have really crazy shifts and it’s hard to focus on how else we can be doing things when we’re already so far behind. And May, he’s not trying to be mean or harsh. You’re just…tired.”
Tired?
Behind my back, I can feel the heat of resentment washing up from my coworkers. Tired? We’re all tired! And yes, exhaustion does affect our job performance. Sorry about that.
Maybe we shouldn’t be talking about time management. Maybe we should be attending a seminar on how aide fatigue affects the residents’ quality of care and what we can do about it. How we can resolve the problem, in this facility and elsewhere. But according to this expert, these are just excuses, not reasons. Complaining, not cause-and-effect.

I glance at the clock and I don’t say any of the things that are boiling inside. I need to get back to the floor and I’d be wasting my time trying to argue my point. This man is not open to listening to me and honestly, I’m not open to listening to him right now, either. Anything I say is going to get tossed in a box with the label “tired”. Funny things, labels and boxes. “Tired”, “disgruntled”, “angry”, “uneducated”: easy ways to categorize statements without sifting through the bath water to find the baby. I guess it’s easier to treat the symptoms than to cure the disease. Truth is almost always messy and multifaceted: it never fits into a neat little box.
Though, that cuts both ways. I wish this meeting had happened at some other time than during my hectic shift, some time where I had the mental energy and actual time to listen and weigh his words. I still don’t appreciate his attitude.

The last thing I hear as I leave the meeting is another higher-up talking to the special guest.
“I think a softer approach might have been appropriate. I mean, didn’t you see how tired they all are?” Her voice is quiet but hard. Displeased.
Well, they’ve noticed. No, not “they”, I remind myself as I slowly walk back to the floor…sitting still for so long in the middle of my shift has sapped my energy. The people in the offices aren’t one collective being, no more than aides are a faceless mass of cheap scrubs. At least two of the office-workers have noticed how exhausted I am, how exhausted we all are.
It’s a start.