Tag Archives: caregiver attitudes

A Break before a Breakdown ; a moment to reflect


Alice
I get so tired sometimes. I want to shrink from this world that seems to subsist and thrive on anger, panic and fear. Has it always been this way and I’ve just been oblivious to the fever of it or is this some new beast fueled by everyone’s absolute certainty that they are right? The days of context and nuance seem to be gone for the moment and shades of grey no longer exist. Black or white. Right or wrong. Bottom line thinking for an end results world.
I am never very certain about very much. In my experience, that way lies madness. I have certain ethical guidelines and passions that anchor me and I try to keep my mind open to learning from others who have different points of view. Work has been vital for my sanity in this social climate where people seem to be filling some inner need by yelling at one another and coming up with shallow, half-hearted and blame-filled excuses to the deep and complex problems that our society is facing. I guess that’s easier and less satisfying than putting aside anger and wounded egos in order to come together and effectively work toward common solutions. We currently live in a world where everyone wants to be the boss but no one wants to lead.
Those of us who work in Long Term Care are no strangers to the damage such a management style causes. It’s flat out ineffective. The best supervisors are the ones who roll up their sleeves regardless of who is watching. If I only see you when state is in the building, I’m less likely to trust you around those in my care. I have more respect for an LPN who will help me calm a resident who is lashing out in fear than a career administrator with degrees on the wall who’s first solution is Ativan because she’s about to give a tour to a potential new client and wants the hall orderly. That is the difference between a leader and a boss. Because I find my own personal standards of quality care to be much higher than what is expected of us, I have no need for a boss. I learn from leaders, however, and that makes them as invaluable as they are rare.
I decided to step back from Facebook for a little while. Every other status I read is angry. Every article posted has completely different facts cherry picked to enrage or validate you depending on what side of the given position you take. They all agree that everything is the absolute worst. The only difference is who they believe is to blame…and all of that is crap. Cynical, self serving crap wrapped in a bow made of ego.
But, Alice! Aren’t you concerned about the state of affairs?! Of course I am, possibly shocked and appalled reader, but here’s the thing…this is NOWHERE NEAR as bad as it’s been. In my years in this field I’ve cared for people of color who actually lived through the civil rights era. I’ve cared for a Vietnam vet who lost his sight, and a WWII vet who lost his leg. I’ve cared for people who were children during the Great Depression and for people who lived through the Cold War. I’ve had women in my care who lived in a time when it was more socially acceptable to be an abused wife than a divorced woman. Collectively, we survived all of that. As a society, we have faced our worst behaviors and bit by bit we have grown from them; progressed step by painful step forward. I refuse to believe that this…this angry, entitled, backwards thinking reality we are all actively creating is going to stick. I have more faith in us than that.
Individuals are all more than one thing. Are my residents simply their Alzheimer’s disease? Or prostate cancer? Or schizophrenia? Are they not bigger than that? Am I not more than my political affiliation? Is it not beautiful that we are all people who bleed the same? It is a combination of different ideas and individual experiences that gives life it’s richness. When did we decide that we should only surround ourselves with those who look, think, believe and behave exactly like us? How can we possibly come up with and solutions to vastly complex issues without the benefit of diverse ideas and the freedom to dissent without fear?
So I would like to thank every single person who has ever been in my care for teaching me gratitude and perspective. Life is too short to waste on fear and anger over troubles that we create or stir up in our minds before they even occur. I would also like to thank you for living through adversity and sharing your stories so I know what courage looks like. I would like to thank my fellow caregivers who adapt to the reality on the floor rather than the one we are told to expect. We come together to make the most of what is rather than complain about what should be…ok to be fair sometimes we do both but for the most part we are about action. It is a diverse world on the floor, full of people from all walks of life with a variety of skills and reasons for being in this field. Despite what some may think, we cannot all be painted with one brush and for that I am incredibly thankful. This field has honed a strength in me that would not have developed otherwise and directed a passion for purpose toward a path where it would be put to good use. I get tired, but I’m one of the lucky ones. I get these reminders at least five nights a week. I can step back from the combative and fear filled world online and reorient myself to the world in which I live.

The Why’s


Alice
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?

To Change the Things that I Can


Alice
I could hear her shuffling down the hall again. She was having a restless night, up every two hours hoping that it was morning. She slept too much during the day and it’s thrown her for a loop. Mentally, she was in that grey in-between place. She is cognizant of the fact that her thoughts are becoming murkier. She is aware that chunks of time slip by unnoticed and she is sharp enough to realize that she is not as sharp as she once was. I can’t imagine anything scarier and yet she handles it with both wit and rueful acceptance. At least I’m not ready for the hole. At least I’m not locked in that cage you call a unit.
Truth be told, I was grateful for the interruption. It was an unusually quiet night and I was on one of the easier halls. At first, I was grateful for the break, having worked several nights straight on memory care. I knocked out the laundry and cleaned the floor’s kitchen. I even threw in first shift’s laundry just to keep busy. I had the time. Soon I had done all there was to do other than hall checks every two hours. In between, I decided to catch up on the news. That was a bad idea. I stumbled into the comments section under the articles. That was an even worse idea.
The whole world is yelling at one another. Honestly, it didn’t matter the topic of the article or what side of the argument the yelling people were on because they all sounded exactly the same. I read the term “butt-hurt” twenty-three times in the comment section. I COUNTED it! Do you know what that means (other than the fact that whatever drive that motivated me to count it in the first place may be somewhat warped)? It means that twenty-three fully functioning adults from both sides of a debate felt that a perfectly appropriate way to express an idea or debate a thought was to call another person butt-hurt. Or snowflake. Or fascist. Or stupid.
Suddenly I was hit with a wave of deep sadness. Because there is nothing I could do about all the anger, the racism, the dumbing down of our society to the point where name calling is the best we have to offer in terms of open discourse. I can’t convince a world of people thriving on panic and smugness that life isn’t anywhere near as terrifying as they think it is and we have faced much more difficult times as a society. Maybe it was the 3:00 AM blues. Maybe I was just tired but it put my head in a dark space.
Suddenly I was thinking about my residents from facilities in which I worked in the past who didn’t make it or were “evicted” when their funding ran out. I was thinking of people I knew who ended up in assisted living as a direct result of untreated addiction issues or undiagnosed mental health struggles. I was thinking of the client I had to walk away from in order to work here. Before I knew it I was entangled with a combination of genuine emotion mixed with misguided self-pity over how powerless I felt to do anything about any of it. When I was a kid playing make believe, I never imagined adulthood to be full of bullies anonymously screaming “butt-hurt” at each other as they angrily debated the presidency of the dude from the Apprentice. It just wasn’t a reality that I envisioned. I certainly didn’t think those in power would cut the funding for the most vulnerable. Would cut the regulations designed to protect them.
All of this was dancing an awful tango in my head when I heard the steady thump thump thump of her cane as she came down the hall. Relieved at the interruption to my traitorous mind, I jumped up to meet her. There she was, decked out in earrings, bangle bracelets glasses on her head and a velour track suit, the top of which she somehow managed to put on inside out and backwards. The laugh escaped me before I could stop it. Her face fell. She thought I was laughing at her.
“The damn top is tricky. It’s hard to get dressed in the dark.”, she said defensively. This. THIS I can do something about. As she continued to try to explain why she had a rough time putting her shirt on the right way, I quietly bent down and rolled up both legs of my scrubs. Her voice trailed off mid-excuse. Her eyes widened and a smile spread across her face as she stared at my ghostly legs. My left leg was clad in a striped knee sock pulled all the way up and covered in smiley faces. My right one had a black and white polka dot ankle sock. Her smile became a chortle that quickly grew into a belly laugh that filled me with joy for what I do and chased away the last of the cobwebs in my mind.
“Now THAT’S a damn shame!” She sputtered between laughs. I was howling right along with her. Whether it was luck or providence or procrastination of my own laundry that had my socks so completely mismatched, I don’t know. I only know that it saved that shift for both of us. It reminded her that she’s not alone and it reminded me that the little things over which I do have power are maybe not so little. You can’t put a price on a genuine laugh, after all. That is something and in that moment it made all the difference.

The Witching Hour


Alice
I’m sure in the light of day, this facility is charming. I can’t quite remember the impression I had of the building in which I work during my two day orientation, which took place in the bright sunshiney hours. The relief and excitement I felt about the new job opportunity dimmed my keen powers of observation; the same Sherlock Holmes level of visual acuity that prevents me from getting into the wrong car and trying to start it more than twice a week. So I can’t say for certain that in daylight it’s a charming, lovely place. I can only assume. At night, however, there is no more fitting a descriptor than “creeptastic”.
Let’s start with the huge portrait of an incredibly stern looking man above the fireplace. His eyes seem to follow you everywhere and then there are the clown pictures and blood red carpets and creaks in the floor and the overabundance of wind chimes…all of which may add whimsy and class to the joint in the day, but at night? No. It feels like the environment of a stereotypical horror movie that would be panned for being too predictable.
I say this with great affection. It’s exactly the sort of strange and surreal experience that I’ve come to appreciate in my life. It’s anything but ordinary but after this weeks stretch on memory care, I realized that buildings are not the only things haunted at night and there is only so much I can do to chase away another person’s inner demons.
It makes sense, really. When does my mind spin the most, picking apart the day and chasing my own imaginary fears? When is my own anxiety at its peak if I had a rough day? Right before bed. And if I can’t sleep? Forget about it. My mind runs wild. Why would I expect any different from those in my care?
At night in the quiet, dimly lit halls of the memory care unit, my night owls pace. Sometimes they are just confused about the time. That is easy to redirect usually. I explain to them my days get topsy turvey too, we share a chuckle, I tuck them in and off to sleep they go. I can do that all night without losing patience. No, it’s the other situations that get to me.
I call them the “night dreads”. When one of my folks has a rough night, it’s very different than what I experienced when I worked the day shifts. Sure, there was any number of challenging behaviors and there was less time to redirect in the day but it was different. Maybe because there were more people around and the extra stimulation kept them more alert. They seemed less…haunted. Nightmares can be hard to shake off. A vivid enough one can muddy my perspective for awhile but when I’m awake, I’m awake. This is not how it is for my residents. A nightmare will shake them to their core. They don’t always understand the difference between their dreams and waking life. Often they will wander up and down the halls, looking for lost loved ones. Where is my mother? Where is my love?…letting them know they aren’t alone and are safe seems to help. I put them back to bed and sit with them for awhile. Sometimes I sing quietly. I make certain that the bathroom light is on.
More often than not, I will be repeating that throughout the night but each episode seems to be just a little easier. Each time the resident seems a little less scared. Usually, right as the sun is coming up, they are able to rest more deeply. Those nights are the hardest; the ones when I can’t chase away the ghosts for them, I can only put them at bay. They leave me exhausted, sad and a little scared at the idea of anyone having to live through the night dreads and little frustrated that the best I can do is walk with them through it.
Thankfully, tonight was free of that. Tonight there was mostly laughter. I have a resident who without fail leaves his room wearing the oddest combinations of clothing: long johns with a back brace and a red ladies hat with a purple flower (no telling where he picked that one up) was today’s fashion choice.
“Is is time for coffee?” I managed to keep a straight face for five seconds when I saw his get up.
“No, buddy. It’s 3:00 in the morning.”
“Ok. I’m going back to bed then. Don’t forget me in the morning!”, he called over his shoulder.
“Never, my friend.”, I assured him. You know what? Today, I’m going to make a conscious effort to see how this place looks in the sun. Most things are clearer in the light of day.

Kindness Doesn’t Cost a Thing


Alice
In all my years in this field I have never had a person in my care who did not respond better when approached consistently with kindness. Never, not one single time. My most resistant residents have been more willing to be an active participant in their own care when they didn’t feel invisible. My most confused residents had less anxiety clouding their minds when I have been able to coax a laugh from them. Kindness doesn’t cost a thing. It takes no more time to be kind than it does to be resentful and impatient and it takes far less energy.
“You’re going to spoil them”.
“Now they’re going to expect that from everyone.”
“Don’t get that one going. She’ll talk your ear off if you let her”…To which I politely smile and go about doing my job exactly as I see fit. Treating my folks the way I’d want to be treated is not “spoiling” them. It’s being good at my job. I give my best effort regardless of what it causes other people to expect. Quite frankly, I don’t care if that raises the bar or not. My work ethic does not include doing less for those in my care so they don’t expect it from other workers. And I don’t mind having my ear talked off. Why should my night owls feel lonely? If they want to talk and I’m not in the middle of a task, I have no problem listening.
The idea that the people in our care are tasks to be minimized and tackled begrudgingly has to be changed. Not every caregiver treats the job with such apathy; not even most, but there are more than enough that do. Rightly or wrongly, the majority of hard working and dedicated caregivers are stigmatized by the behavior of those who are not right for this field.
We are the frontline of Long Term Care. We are the faces most seen. When something goes wrong, we are the easiest to blame. People see the bad behavior of the caregiver and not the broken system that spawned it.
There is grace, value and purpose in this field. We are needed and trusted by those in our care. There is something sacred about that. If the system has beaten you down to the point of resenting those in your care and basic human kindness is too much to ask, then maybe it’s time to consider another field. As workers we don’t like to feel disposable or invisible so why would we treat our residents as little more than a burden? We can do better. We HAVE to do better…any lasting change that matters will begin with those of us who work the floors. We are the closest to the residents and we have a deeper understanding of the world through their eyes. All improvement begins from within, though, and before we change the system we have to change our attitude toward those who live within it.

Minding My Business


Alice
“I’ve had it! Second shift ALWAYS does this and now they want to put an extra shower on OUR shift. I’m going to the office.”
“It’s not like anything will come of it…”
“They left the bed pad in the drier AGAIN!…”
“Don’t do first shifts laundry, Alice. They’ll come to expect it…”
Sigh. Here we go again. It seems that regardless of the facility, the shift, or the home in which I work there is one constant and faulty idea that drives people: a problem can be solved by bitching at it and blaming others.
When I first started in this field, I simply tried to avoid those conversations. It’s difficult but not impossible to do. I would change the topic or find something else to do. A few years into this career, I was hit by the superhero bug. Somehow, not getting drawn into the toxic drama was not enough. I would FIX it! I felt comfortable with my co-workers and got along with all of them. It was only reasonable to impart upon them my worldly wisdom. Being “the Great Reformer”, I was surprised that my long winded and preachy speeches on the value of open communication and a sense of community were met with eye rolls rather than inspired applause and immediate action. What was WRONG with people?!
It turns out that I was asking myself the wrong questions. While blame and finger pointing never solved a problem, neither did dismissing the frustration and very real emotions that those involved in the situation may be feeling. A problem can’t be solved without acknowledging it either. So I started listening without offering solutions. I let go of what my co-workers were doing and began focusing on what I was doing. If I had an issue with a co-worker, I addressed it privately with that co-worker. If I have extra time and there is another shifts laundry to be done, I do it quietly. I know what it’s like to work first shift and any help is welcome. I make myself available to those who may need an extra set of hands when I am able. I make certain that I am consistently trust worthy. I don’t engage in gossip just to feel like a part of the group. I don’t seek approval. In other words, with varying degrees of success, I work according to my own standards. I put my money where my mouth is and let my feet do the talking. And it’s worked!
People work differently with me. They stopped bringing gossip around without my having to ask. If I need an extra set of hands, someone shows up. They know by my actions that I wouldn’t take advantage of them and that if needed, I’ll be right there with them too. The other shifts are friendly and grateful. They listen to shift report and I take my time rather than rush through it. There is a synergistic energy that stems from mutual trust.
Once I freed myself from the cage of minding other people’s business, I was better able to focus and improve upon my own. That is the simple and quiet path to actually making an impact on the world around you. Change is inspired by consistent and sometimes humbling steps forward. It isn’t about what you know and how loudly you know it. It’s about what you DO and how consistently you DO it. It’s a valuable lesson I learned from working the floor that I hope to apply off the clock. Society as a whole could use it right now.

Contempt Prior to Investigation


Alice
As a caregiver, I cut my teeth on first shift memory care. For years that was my world. Fast paced, short staffed and unpredictable, first shift was nonstop action. I remember thinking it was ridiculous that there was a pay differential for third shift. After all, there work load was so much lighter than ours. It just didn’t seem fair. I thought along the same lines about private care. One client? How hard could it be? Why were they paid so much more than those of us in facilities? Their job was a cake walk in comparison. Of course, at the time I had no experience with private care or third shift but it seemed like common sense to me. I was wrong.
Contempt prior to investigation. My thinking at the time can best be described by that simple concept. And we are all guilty of that from time to time; Viewing people, events, and moments solely through the lens of our individual perception without the benefit of direct knowledge. If the past few years have taught me anything, it is that the remedy for such thinking is actual experience.
Private care was not easy street. In many ways, it was much more challenging for me than working in a facility. Sure, I occasionally lamented the pace and amount of work we had to accomplish on first shift in my facility, but truth be told, that is when I’m at my best. It was harder for me to pull back and refocus my energy than I expected. The hours were long and it was difficult for me to set work boundaries without the guidance of an agency. It could be very lonely and at times I felt very isolated. The flow of the shift was entirely based on other people’s moods and level of pain. There were also amazing aspects of private care. I loved the family. All of them. I loved the freedom of working independently and having the time to really get to know my client. I loved being involved in bringing holidays back into the house and making her laugh. I loved the deeper connections I was able to forge because my focus wasn’t split eight ways to Sunday. That also made it very hard to leave when a new opportunity arose. My two year journey into private care has enriched my experience in this field and added skills, abilities and insight into my work that I would not have gained had I not taken that path for a little while.
Though I’ve only just begun my jaunt into third shift, I’ve already made some realizations. I understand why they offer a shift differential now. It’s true that the work load is much lighter but that is all I was right about. When I worked first shift, I ran hard. I bled for the job, but when I clocked out for the day I was able to leave work at work. For the most part, anyway. Not so on third. So much of my time in the day is spent trying to effectively work sleep into my schedule so I can be awake and alert through my shift that even when I’m not at work, I’m thinking about work. Or thinking about sleep. And everything else has to be worked in between those two things. The extra money isn’t about what happens on the clock. It’s about the willingness to rearrange life off the clock in order to work when the worlds asleep. It’s about the toll that takes on your mind and body. Sad to say, I would not have connected the dots on that had I never taken this position.
So I am very glad my experience in this field has evolved and hope it will continue to do so. These experiences will remind me not to engage in the “shift wars”. We do not need to tear each other down, ESPECIALLY without having the first clue as to what it’s like from first hand experience. I consider it a lesson well learned.

The Difficult Resident


Alice

“I KNEW you’d be back with your stupid smile on your stupid face!”
I bit the insides of my cheeks to keep from laughing as I quietly slipped into her room to assist her to the restroom.
“Well, Alice, at least this time you were prepared.”, I thought to myself, trying hard to keep my face neutral as my resident hurled a steam of inventive and diverse insults in my direction. Thankfully, she was able to walk and talk at the same time. Physically, she did fairly well on her own but she was just unsteady enough on her feet that I didn’t feel comfortable leaving her to her own devices.
I had been warned. From name calling to throwing soiled briefs, this resident was a challenge. Maybe it’s because I had been in private care for awhile or maybe it’s because I had worked so many years at my last facility that I had a deep and loving relationship with all of those in my care, but I thought there was no way she could be that tough a case or that maybe there was a touch of dementia or mental illness involved…WRONG…SO wrong. Her mind was fine. Sharp as a tack, actually, if her comedic timing and penchant for hitting hard with the verbal blows were any indication.
“You DISGUST me. Every one of you! Women are nothing but TRAMPS nowadays”, she kept ranting through the partially closed bathroom door. I stood just outside waiting for her to finish up, still trying my damnedest to keep from laughing and maintain some semblance of professionalism in facing the wrath of…well of the meanest woman I had ever met, quite honestly.
“STILL smiling?!”, she grumbled as she shuffled toward her bed, “you ought to run away with the circus!”, she hissed. She literally HISSED at me.
“Well, I wanted to when I was a kid! But I realized that I was way too clumsy to be an acrobat and I don’t like clowns. It’s not that I’m afraid of them. I just don’t think they’re funny”…while that was all true, I was surprised to hear the words fly out of my mouth. Apparently so was she because her mouth dropped open in utter surprise. I took the opportunity to quickly cover her up with the blanket and make my escape.
The rest of the shift flew by and I felt utter relief as I pulled into the driveway in the early morning light. I went in the house, tossed the keys on the counter, made my way up the stairs and collapsed onto the bed. My boyfriend woke up and asked how my shift was. I groaned and went into great detail on how difficult and mean this one resident was. He listened to me rant for a minute and then pulled me close to him.
“You’ll find a way to reach her. You always do”. He kissed me softly on the forehead and I smiled to myself. The one thing I had forgotten, at least momentarily, was one of the biggest reasons that I am in this field: To reach people so they know they are valued and not alone. No one is born that mean. And with his reminder and his kindness, I knew that I would try again with her tomorrow. And the next day. And the next…

What do you do for a Living?

 

Lynn

The other day I was in a resident’s room getting ready to administer a nebulizer treatment.  Her TV was turned to the Game Show Channel with “Family Feud” going on.   My fellow care givers can attest “Family Feud” is a staple in the LTC environment with Turner Classic Movies a close second.  You can’t walk down a hall without hearing at least 3 different versions of “Family Feud” blaring out of multiple residents’ rooms. 

It was the beginning of the show where the host, Steve Harvey, has each of the family members introduce themselves before they provide an answer to the question he is asking. I wasn’t paying much attention to the show as I am busy getting the treatment ready and assessing my resident’s shortness of breath.  I am vaguely aware of Steve Harvey talking to the first three family members.  I didn’t hear their names, what they did or the answers to the question.  The fourth family member made me stop and look at the TV screen.   I half heard Steve Harvey ask her, “What do you do for a living?”  It is difficult to explain the fullness of what happened next.

She said, “I am a CNA at a long term care facility.”  It wasn’t the words she spoke as much as her tone of voice that made me whip my head around to look at her.  I see and hear so many CNAs when asked what their occupation is a sort of apology tends to follow.  “I’m a CNA but I plan on (insert a perceived better career choice here)…” or “I work as a CNA while I figure out what I want to do.”  The body language that accompanies those statements relays uncertainty, self-consciousness, and/or humility.  

This woman on that game show was different.  Those brief seconds she was on the TV screen showed a confident woman who was proud of her career choice, proud to be a CNA.  Everything about her body language supported the self-assured tone of voice in which she spoke those words.   “I am a CNA at a long term care facility.” End of sentence.  The words “courageous”, “bold”, “empowering”, and “confident” all ran through my brain in those few precious seconds.  She offered no apologies or explanations.  She stood tall, looked Mr. Harvey in the eye and declared her right to be proud of herself, of her career and those in her care.  I am proud of her, too. 

CNAs, be proud of your career choice. Do not ever, not even once, apologize in any way for working as a CNA. Stop feeling like you have to rationalize being a CNA with sentences like “I’m a CNA but…” You don’t have to do that.  Part of changing the LTC environment and other health care settings involves how we speak about ourselves and each other. Talk about your job with pride, with confidence.  What CNAs do is challenging, emotionally rewarding and taxing, sometimes all in the same day.  Not everyone can do the work. It takes a special kind of talent and perseverance to be a CNA for 2 years, 5 years, 15 years.  The more each of you declare with confidence and pride in your voice, “I am a CNA” the more empowered you will become.  The more empowered you are, the more others will want to hear what you have to say. Be bold; declare with confidence your career choice just like that wonderful woman on a popular game show did.  Be confident in yourself. Be proud to be a CNA.  I am proud of you, too.

Uphill Battles


Alice
The alarm clock cut through my dreams, it’s deceptively cheery jingle jarring my consciousness awake. I groaned, fighting the urge to hit the snooze button just once more. I had to go in early. No more time to snooze.
As I ran about the apartment in my pre-work routine of craziness, grabbing coffee, hunting my keys and making sure that I was wearing the same shoes on my feet, I mentally reviewed the day ahead. It was going to be an uphill battle.
Uphill battles are nothing new to me in this field. Both my experience in facilities and in private care have come with their fair share of obstacles. Not being one to shy away from adversity, more often than not I relish the challenges. It’s when I begin to view life as NOTHING but uphill battles that the trouble begins.
As a caregiver, I deal with a lot of loss. We all do. Death is inevitably part of our job. I’ve learned to view it not as a tragic necessity but as an inevitable conclusion. There is joy and peace in knowing that I have a part in making the last chapter of someone’s life as pleasant as possible, making certain that those in my care never feel alone. It is why I do what I do and that part of the gig I consider sacred.
As a woman in recovery who volunteers at a behavioral health center, I deal with a lot of loss as well. That kind of loss is different somehow. That kind of loss comes with a sort of survivors guilt that makes me choke on my own powerlessness. Why do I get this when others don’t? What could I have said or done differently that may have prevented another’s death or insanity or consequences? The answer is nothing. I can’t force a moment of clarity on another person. I can only share my experience.
I tell you guys this because I know we all have our baggage and we work in a field that can skew our perspective. Because I have to be vigilant, I recognize that change as it’s happening. When I start obsessing over the two people I was unable to help rather than the ten that I was, I know I need to check myself.
I cashed in all my “give up” chips years ago. Now as long as there is a breath in me, I will…I MUST keep moving forward. There is so much I want to do in life; so many people I want to reach and help. My fellow caregivers, my residents, anyone and everyone who feels lost and alone…we all have those shared experiences. I was given a second chance. I do not have the luxury of wasting it.
As a caregiver, I have the privilege of seeing the face of courage every shift. People who have survived cataclysmic and life changing events. People living with dementia, addiction, AIDS, strokes, PTSD, cerebral palsy; people of all ages and I SEE them…the very essence of who they are as individuals shine through their disorders. Their personalities, sometimes difficult personalities, may have been informed by their challenges but they are not defined by them. They laugh and cry and occasionally rage but they face their uphill battles every single day. They have no choice. Neither do I.
My keys were in hand, the same shoes were on my feet, my lid was tightly on my coffee cup and I was ready to face the day. I took a deep breath as I opened the door into the bright sunshine and reminded myself that it was uphill battles that made me who I am today. For that I am incredibly grateful.