Tough love

This has got to stop, I think. My mental voice does not sound firm enough, so I try it again. Firm and un-arguable–that’s what I want to sound like.

I stride up to the bed and say in a loud, hopefully firm voice: “Good morning! It’s time to get up! The nurse says I need to get your weight.”
“Sleeping Beauty” is good, but not good enough to fool me; watching intently, I catch the split second when her eyes crack open, focus on me and then snap shut.
“No, you are getting up today,” I say sternly. There’s a fine line here between insistent encouragement and forcing her; residents have the right to refuse, after all. On the other hand, Sleeping Beauty’s been in bed for five days now and she’s growing more depressed and withdrawn. Enough is enough, I decide, time to break out the tough love.
“Look, I have to get your weight. They have to have it for your medical records…I mean, you’ve barely eaten in the past week and the last time you did this, you dropped five pounds. So, we’re getting up to get your weight.”
I’m interrupted by a suspiciously well-timed snore.
“Tell you what,” I continue, “after I get your weight, if you want to go back to bed, I won’t stop you. I won’t be happy, but I won’t stop you. Deal?”
“Fine!” she grumbles. “Long as you be quiet. Always talk, talk, talk. Why don’t you ever shut up?”
I ignore this and go about gathering her clothes.
“No,” she says.
I raise an eyebrow and my hands settle on my hips in a fairly good imitation of my mother–funny how easily we revert back to childhood impressions of Authority. “You want to go halfway across the building in a hospital gown?” I inquire.
A string of grumblings, but no clearly stated refusal answers me, so I proceed with my plan. She doesn’t try to stop me, but she also doesn’t help me in the slightest. Clearly, she thinks that since this is all my idea, I can do all the work; if she’s trying to punish me, she is succeeding. I’m sweating buckets by the time the erstwhile Sleeping Beauty is dressed and in the shower/weight chair.
She’s silent on the trip to the scale in the way that only a passive-aggressive person can be. I slid her and the shower chair on the scale, deduct the weight of the chair and inform her of her weight. She has the right to this information and I want her to know that her most recent episode of playing possum has made her loose four and a half pounds.
She’s silent on the back, but a different kind of silent: thoughtful, reflective. Still withdrawn, but not belligerently so.
I go to put her back in her bed and she stops me with a hand on my arm.
“No,” she says, “wheelchair.”
Quit while you’re ahead, I think and I don’t comment on the change of attitude. I do, however, strip the sheets from the bed once she’s in the wheelchair–it does need to be changed and if it takes me a while to remake it, well, it wouldn’t be the first time.

I don’t see Sleeping Beauty again until much later in the shift. She’s sitting in front of the dining room windows, face tilted up and sunlight pouring around her. She looks peaceful and happy.
She cracks an eye open and focuses on me; a huge smile lights her face up.
“Hi,” I say, a little surprised.
“Thank you for getting me up,” she tells me. “I’ve been in bed so long and wouldn’t get up but you didn’t give up on me. You can make that bed now, I’m not going back in it until bed time. You didn’t give up on me, so I’m not going to give up on myself,” she finishes with a determined nod and turns back to the window.

As a CNA, I always have so much to do that sometimes it’s just easier to go along with the refusals, to mark an “R” in my charting and walk away. I’m glad I made the time today.

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