The Why’s

I do not understand why anyone would continue in this career if they don’t have a love for what they do. It’s not the money. It certainly isn’t the respect. I cannot tell you how many times I’ve heard a nurse offhandedly tell a caregiver that being a nurse is hard, that there are so many responsibilities; The unintentional implication being that we don’t know how good we have it. And I don’t doubt that the nursing field has challenges and rewards that I haven’t experienced as a caregiver but unless a nurse has experience as a CNA in a Long Term Care facility, the reverse is true as well.
I have developed a set of ideals, skills and standards that I consider both invaluable to being a quality caregiver and highly overlooked by the system at large. None of these skills include excellent hospital corners or perfectly folded laundry, both skills with which I could use improvement. It’s not that I consider those parts of the job without value; it’s just the least important of the skills we need to provide quality care and often the first noticed when the hall is inspected by supervisors.
“Did you make the bed in room 237?”, demands an imaginary boss I created to express this point.
“No not yet. Agnes is freaking out because she thinks Ida stole her dog and she’s refusing to let anyone but me in her room…let me just…” make-believe me replied.
“Are you kidding me?! The OWNER is on his way and he wants this hall to LOOK perfect. Leave her. She’ll be fine. Go make sure all the beds are made.”
Now, I made that scenario up. I’ve never actually had anyone named Agnes or Ida in my care. But I have had countless experiences with some version of the above situation; enough for me to know that the priorities in these facilities are WAY off the mark.
The residents come first. It is up to us as caregivers to make certain that is not just lip service. And let’s be really honest here, the top of the hierarchy in these facilities view it as a business. The amount of money it costs a month for an apartment here is mind boggling. I work in a really nice place that almost no one could afford. That is the sad truth. I’m not implying that these corporations shouldn’t take in a profit and I’m not saying that the one in which I work isn’t a decent place. What I am saying is that in the ten years I’ve worked in this field, with varying degrees of severity, the issues in each facility have always been the same; have always branched from the same root. Everyone pays attention to playing their own instrument without considering what it takes to create a symphony. So we end up with a cacophony of noise instead of harmonious music.
I’ve learned through the years that I personally understand the value and necessity in what we do better than the state surveyors. The seem to have a very limited scope of what is deemed important. So I don’t limit myself to their standards, many of which seem silly and misplaced and others that do not reach nearly far enough. It’s as if they have one fixed idea of who lives in these facilities and no ability to get to know the vast array of individuals living with a myriad of challenges, both physical and mental. No interest or time to get to know the residents or those of us who care for them. So I don’t flinch when they arrive to dot some “I”s and cross some “T”‘s.
I am in this gig because I SEE people. There has been much I’ve had to learn and skills that I’ve had to improve upon. My ability to see beyond an age or disability to the person beneath is not one of them. For whatever reason, that part of the job is innate for me. I love seeing bravery in action. I love the stories. I love going to sleep knowing I make a tangible difference in the life of others. I love that I’m never bored. I love that there will always be something new to learn. With people, there always is. These are my whys. Because I know them, have defined them for myself no one can devalue my job. I am not confused why I’m in this field and that has made all the difference. It’s prevented frustration from turning to resentment. It’s inspired me to continue to try to improve the system. It’s opened the door to be both teacher and student and has saved me from becoming jaded from burn out. I defined my career. I didn’t allow someone with little knowledge of it to do it for me simply because they had a degree on the wall. So I would like to know your “why’s” readers. Whatever role you play in the long term care system, what motivates you? What keeps you coming back? And how do you think we can work together to fix what’s broken?

2 thoughts on “The Why’s

  1. minstrel

    Another amazing comment, Alice! You bring up so many important points about the priorities of the various parties involved in long-term care—from the caregivers to the owners to the state surveyors who are supposed to safeguard the quality of care. I read the beautiful mission statements on the beautifully designed websites and I think “Really?” Because the reality in the care homes is so different. Long-term care communities don’t provide enough staff to give residents the care they need and deserve. They don’t pay their caregivers enough to have a lifestyle that allows that ‘self-care’ we’re always hearing about. (“Remember to take care of yourself first so you have what it takes to take care of your loved one!”) Too many caregivers come to work too burned out to care for anyone else, let alone six or eight others who need so much from us every minute of the shift. And organizations whose goal to improve care seem to be spinning their wheels as much as I feel I am. What are we really changing?

    What motivates me? First (I hope), compassion. Here are human beings who are totally dependent on someone else to look after their needs. And so, Will I spend my days shopping or watching Netflix or chilling out with pizza and beer (Reader, fill in your own blanks with your favorite escape routes), or will I try to live in a more meaningful way? I know how I want to answer this question, and I know the answer I live isn’t always the answer I want it to be because I get so discouraged I just want out.

    What keeps me coming back? The residents. The residents. The residents. I love them and feel loved by them. I need to keep this in the front of my mind, because lately the unit nurses who should be my biggest support feel like my biggest enemy, giving me instructions that go against every principle of person-centered care, making me feel like an outcast, or at least an outsider, because I want to prioritize the residents’ needs for care and attention. (And I think, even pray, Let me never make another aide feel inadequate…)

    “And how do you think we can work together to fix what’s broken?” Wow. Replying to this question will take more thinking, Alice.

    I get so discouraged and feel so alone in this. But when I see ‘CNA Edge’ in my inbox I know I have an ally out there. I’m not alone in this. Thank you, Alice.


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