If you don’t get it



The strangest things about training new people is watching them react and then adjust to the work. It’s more than learning the ropes of a new job…more than finding your feet in new place.
Health care is a different world and long term care is a strange corner of that world.
It’s interesting to watch as people who had no previous experience in caregiving learn what it means to be a CNA, the emotional shift that has to happen, the mental hurdles that have to be overcome. It is somewhat like facing your own mortality, or your own fragility, to see human being made frail and helpless by disease and injures. You see in the residents all the horrifying ways your own body might betray you. It’s awkward and uncomfortable and the natural reaction is to distance yourself from all of that. It’s easy to let the diagnosis swallow the person…but if you want to be a good caregiver, you can’t do that. You have to fight to see the face of the person in front of you.
I like to watch for that moment when the green aides realize that, the moment when they break through the strangeness and the discomfort and connect with my residents. The moment when my residents become theirs too. Sometimes, despite my best efforts, there are people who just don’t get it, who can’t make that shift. For those people, the moment never comes and I’m left wondering what, if anything, I could have done differently.

These training experiences leave a bitter taste in my mouth after…during, I often feel like I’m in a plane that’s falling out of the sky. One instance stands out clearly in my memory. It’s near the end of training, after almost a week of trying and failing to teach this young man the job. I’ve been walking him through everything step-by-step for the past few days and in that time he has displayed absolutely zero initiative. If I don’t tell him what to do, he just stands back with his hands in his pockets and looks at me. Only me. Never the residents.
It’s gotten to the point where I’m sick of the sound of my own voice. Maybe I should just record myself and put that on continuous playback…it’s not like I’m saying anything new, just repeating the same instructions over and over. The same basic instructions, one in particular.
“Talk to your residents,” I say again and, if I’m honest, exasperation is creeping into my tone. “Talk to her, tell her what you’re doing.”
He nods…and doesn’t say a word. I’m about ready to scream.
“Look, I’m not just saying this to say it. I mean it: talk to the person you’re taking care of. This is important for two reasons. A, it lets them know what you’re doing and more important, B, it reminds you that you are working on a person. Not a plastic dummy, a human being just like you. You’re not here to wipe an ass, you are here to take care of the person that ass is attached to; so talk to her!”
He nods again. And still doesn’t speak to her, just like he hasn’t spoken to any of the residents during care all week. All of a sudden I have this vivid mental image of reaching across my resident, grabbing his jaw with my gloved hand and forcing it open and closed like a marionette. Instead, I squeeze my eyes shut and sigh.
“I’m not trying to be bossy or mean, but I just don’t understand why this is so hard for you,” I finally say.
“It’s just weird,” he replies stiffly. “I feel uncomfortable with…talking to a person who doesn’t even understand what I am saying. It’s not even on my skills check-off. I don’t get why you’re so stuck on this.”
“Treating your residents like the people they are shouldn’t have to be a list of things to learn,” I grind out between my teeth. “And who are you to say what she does and doesn’t understand? I’m stuck on this because it is the most important part of the work we do. Would you want someone to push and pull you around without ever once making eye contact or saying hello? I sure as hell wouldn’t. So talk to her.”

If you can’t understand the bond that grows between caregiver and resident, if you ‘don’t get’ the importance of interacting with your residents…I humbly submit that you do not need to be caregiver. Compassion, empathy: these aren’t skills that I can teach. At most they are an attitude I can encourage in the new aides I train; an attitude I can nurture in myself.

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