Do the right thing, part one


It’s the middle of the lunch rush and I have a problem. Mrs. A needs to go to the bathroom.
Well, that’s not quite right. My problem is that Mrs. A desperately needs to go, but she’s having trouble standing up. I’m having trouble supporting her; between the two of us, we can hardly get her bottom off the chair. I seriously don’t know how I’m going to her fully upright, or on the pot.
Again, that’s not fully true. The solution to my current problem is obvious…and right outside the door: the standing lift. Unfortunately, it’s a solution that just brings more problems: in my work place, all mechanical lifts are two-person devices. Using one by yourself is considered unsafe and grounds for immediate termination; we’re also a no-lift facility. If a resident requires lifting, we get the lift and someone to help us. It’s a policy designed to reduce CNA injuries, a policy I applaud.
But right now I have no help and a resident who desperately needs toileting. To make matters worse, her son is in the room, impatiently waiting…he’s never been particularly sympathetic or empathetic to us caregivers. I get the impression that he regards us as little more than vending machines of care. Press C5 for toileting needs, B3 for pain pills. Never mind that I’m not a nurse and can’t give out pills.
“All right, Mrs. A,” I say, “let’s try this one more time.” I’m hoping that she’ll stand up just fine, that my last attempt was a fluke or a test of patience, or something.
It’s not. This woman isn’t going to stand up without strenuous help from me. I know that I can do it, physically. I can pick her up in a bear-hug, wiggle the pants down and get her on the commode. It’s not her fault I have no help and she shouldn’t be punished for something she can’t help.

I do the right thing. I take her back out of the bathroom and explain that I’ll need to go get help. I explain that it might be a moment before I find that help and then I leave, avoiding the son’s irate glare.
After five solid minutes of looking, the first person I find is my nurse, hurrying off the hall.
“Hey, can you help me for a minute?” I ask.
“Can’t. Someone just fell in the dining room. Gotta go.”
Well, darn, I think. Just then a chair alarm sounds and I take off. Mr. W is attempting to put himself on the toilet…at least he can transfer, I think. He’s not very trust-worthy about pulling the call-light when he’s done, so I have to stay with him until he’s done.
Ten minutes later, I emerge back on to the hall, just in time to see my hall partner come out of Mrs. A’s room.
“Oh, good,” I sigh. “I’ve been looking for you. Mrs. A…”
“Is already taken care of,” the other aide interrupts.
“Oh, she stood up okay for you? I was having trouble–”
“So am I, working with a damn by-the-book aide. When are you going to learn, May, that you can’t be such a rule-follower if you expect to get the job done? If you have to pick somebody up, you pick them up. By the way, she’s soaked.”
With that, she walks off and I’m left with another problem. Mrs. A is on the toilet, sure, but I very much doubt that the other aide is going to help me get her off.

I’m right again. Not only is Mrs. A’s son visibly furious with me, Mrs. A is just as weak as she was fifteen minutes ago. And in tears. And soaked with urine.
I change her clothes and pull the call-light for help. If I’m honest, I’m furious myself: angry at being called “by-the-book” when I was only trying to protect myself and Mrs. A. I did the right thing, not the selfish thing, as the other aide was implying.
Seven minutes pass before the bathroom door opens.

It’s my supervisor.

9 thoughts on “Do the right thing, part one

  1. hutmas14

    I completely understand what you are saying about doing the right thing. I’ve been through all you just said so many times. Just keep in mind “love my job, love my job. love my job.” It is a good job that dream of for long time “taking care others.” Some people are mean and cruel regardless of what and how you do. Some people are so nice and respectful no matter what what and how you do. This job is like a roller coaster. Not for everyone but for people who love the ride.

  2. minstrel

    You did the right thing. Thank you. In come countries aides may NEVER lift patients/residents who can’t support themselves to assist. I think i’t probably an OSHA violation to put aides in this position (of transferring a non-ambulatory person alone). But we aides are sometimes our own worst enemies. Many experienced aides are very “macho” about this and seem to think it’s wimpy not to sling the resident around from chair to chair/bed/toilet. It is at the very least uncomfortable for the resident and at worse, unsafe. And unsafe for the aide. Until aides have the moral courage to do the right thing (yes, and follow the rules) then nothing will change. And if this takes too long, maybe long-term care operators and owners, and state legislators who make the staffing rules, will realize how unrealistic the current staff-to-resident/patient ratios are.

    1. May Post author

      Too true. The “get it done on time no matter what” attitude is actually enabling the inadequate ratios. Managers probably think: “how bad can it really be? Everything is done!”

  3. Laura

    May, thanks for your great posts. I’m not a CNA but I work private duty with several of them and serve as helper on a care team. I’ve spent a lot of time in nursing homes (with my Mom and with other elderly friends). Hearing your stories, and Alice’s and Yang’s, is really illuminating and so helpful. I have always understood that the CNAs in care facilities were overworked and doing their best. Yet watching the elder suffer both physically and the indignity of waiting or wetting/soiling themselves was so hard. From your perspective, is there a fix? Is this is a system that can work? Is something like the Greenhouse Project the way to go? If you could wave a magic wand and create a system that really works, what would it look like? (Thanks for your patience with all my questions. I’m so thrilled to find your blog!)

    1. May Post author

      First of all, thank you for reading and commenting! It’s very satisfying to know that our posts are resonating with people.
      Your questions are certainly the heavy hitting kind and I would like to take the time to reflect and properly respond to them. Since I haven’t written my post for today yet, I will attempt to answer them in my post later today.
      Again, thank you so much for reading!

  4. Pingback: The Magic Wand - CNA Edge

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