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.
I took a deep breath as I entered the human resource building for orientation. That was new. I’ve never worked at a facility with a human resource department. It was a small building nestled in the back of the sprawling campus.
“Facility” seemed to be a misnomer. The property of my new employer stretched easily for a mile. There were several houses, each with a separate living environment complete with their own restaurant style dining area, an onsite rehabilitation center, a gym and indoor pool with access for both clients and employees when off the clock, and the assisted living building in which I would be working, complete with a memory care unit. It looked like a town more than a long term care facility. There was even a map included in our new hire packet.
Focus, Alice. Just breath. I listened as the HR representative discussed the medical benefits and company policies. I tried to ignore the tiny voice inside that whispered all the “firsts” that I was about to face. This place had technology that I have never used before. This place was bigger than my entire apartment complex. I have never worked third shift. For two years now, it’s just been me and the families in my care.
I tried to quell the fear and embrace the excitement of another new opportunity. I reminded myself that I’m a quick study and a dedicated worker, that it’s always uncomfortable to be somewhere new and that in my experience all growth, professional and personal, has started by walking through those emotions.
This new job opportunity is in a facility that is beautiful and clean and peaceful. There is art on the walls of the hall and windows so the sunlight just pours in from all angles. There are pet birds in the main lobby and it could not look less like a “nursing home”. It’s the sort of environment I would like to see made available to all our elders and those living with disabilities, regardless of income. I’ve never been a part of a company that seems so invested in the happiness and well being of their employees. The turnover is much lower than average and the results show. For the first time since I’ve started my journey in caregiving, I don’t feel the need to fix, elevate, educate, or problem solve on a large scale. Maybe this time, in this place, my role is simply to learn. What they have accomplished appears to be working for workers and residents in a way I have not yet experienced. So, tonight, I will walk into my first ever night shift at 11:00 PM with an open mind, grateful heart and use what nerves I experience to fuel my desire to do well.
Underneath our scrubs beat hearts that celebrate each success and bleed for each loss of those within our care. We know that our time with them is limited and we can not cure them. We can’t turn back the hands of time and we can’t change the situation that led them to our care. But we walk with them. We do what we can to improve their quality of life. We tell them they are not alone. We try to coax smiles from weathered faces worn down by time and experience. We listen. We translate. And when they pass, we grieve.
Underneath our scrubs are muscles that ache from running up and down halls or up and down stairs as we do the work of three people because of short staffing. Sweat runs down our face as we prioritize needs on the spot in order to provide the best care we can in an imperfect situation. Carefully compartmentalizing the very real frustration that comes from being overworked and underpaid; constantly facing impossible situations and feeling unappreciated, as if what we do is of little value. As if we are disposable. And isn’t that how those in our care feel? Invisible? Overlooked? So we run harder. Try harder. Uphill battles become our bread and butter.
Underneath our scrubs are souls of true grit. Whatever we look like, whether we wear it on the inside or out, we do not give up. Caregiving does not stop for holidays or inclement weather. It is not nice and neat. The most important and necessary tasks fall between the lists of activities of daily living. We face our own mortality every single shift. We face worst case scenarios and see the people beneath; see the strength and courage of those living through them and their strength fuels our own.
Underneath our scrubs, we are tired. We are weary. We are disgusted with the poor pay and misunderstanding of what we do and why we do it. We are tired of being dismissed. Tired of those in our care being misunderstood and dismissed. Tired of “it looks good on paper” mentalities and tired of people with little experience on the floor and no real world knowledge of those in our care deciding what is best for them without our input. We deserve better. Our residents certainly deserve better. And until we get better, we will be relentless and consistent in speaking our truths.
Throw me in the trenches. Put me in the most challenging situations; places that no one in their right mind would stay for any length of time. Throw me into a household where the family’s ideals are vastly different than my own and my client’s husband needs almost as much care as she does. Let it be a reminder to me that we are all more than one thing and I don’t pick the traits or opinions of those within my care. My job is to foster their independence, not to dictate what that should look like.
Surround me with those who have lived so long believing that they were broken that they have lost hope so that I can remind them of who they are beyond their disorder.
While it’s true that I have my moments when I wistfully wonder what it would be like to work in a well run facility where everyone is treated well from the residents on up or for an agency without the complications that arise from being an independent home caregiver solely responsible for setting my own work boundaries, I know in my heart of hearts that is not where I am meant to be…at least for now.
I cut my teeth in caregiving in a facility on which I later blew the whistle. It was there that I saw the deep flaws in the Long Term Care system. It was there that I learned the value and depth to be found in our field. It was through trying to improve that particular facility that I realized that the problems were much bigger than one place and that creating real and lasting change would be a marathon, not a sprint. It was through my journey into private care that I was forced to set work boundaries. It’s given me the freedom to really explore the depth in which good quality care can impact not just my client but also her family. There are times when the long hours in a small environment with only my client and her husband test my patience, but it has also strengthened my ability to redirect and listen on a deeper level. It has forced me to think outside of what I know in order to be a better and more effective caregiver.
The truth is I don’t want to forget. I don’t want to be so far removed from the problems that I forget why I began this journey in the first place. So, for now, I choose to stay in the trenches. It’s where I can do the most good. Some people can’t see the forest for the trees. Some can’t see the trees for the forest. I see the forest and I will spend my life in a variety of ways and levels trying to improve it, but I must never forget that it is the individual trees that make up the forest who inspired in me the will to fight in the first place.
“Oh! I’m so sorry!”, I said to the woman behind me in line at the food court. I accidentally whacked her with my client’s folded up walker as I switched it to my other shoulder. She looked at me with pity, completely unaware of the fact that I was celebrating a personal victory.
I wasn’t certain how my first shift after this election was going to be. The result left a wound in me that seems to be incomprehensible to those who voted for our new president elect. They don’t understand that for many of us, it’s not about the man as much as it’s about what we are willing to overlook or embrace as a nation in the name of “ending corruption”. It’s the ideology that’s so painful.
Be that as it may, I had a job to do and doing it well matters a great deal to me. Still, it would be a real test. Do I love the family in my care more than I despise and fear their ideology? In this environment, would I be able to detach from my own deeply held convictions for twelve hours of non-stop coverage followed by commentary by my client and her husband? I honestly didn’t know and, for the first time in a long time, I dreaded going into work.
I took a deep breath as I stepped through the door and immediately felt a shift in my thinking. Without any effort on my part, the caregiver in me rose up and took over. Outside that house, I’m Alice, free to feel and do whatever I see fit whenever I see fit, but once I stepped through that door, I had job to do and I knew in that moment that it was well within my power to do it.
As I assisted with ADLS, prepared meds and breakfast, I listened to my client chatter happily about the election results. To my COMPLETE surprise, in that moment, I found myself grateful, not for the current state of the nation, but for a moment of genuine excitement for my client. I was happy to hear the hope in her voice without agreeing with the reasoning behind it. I was able to put that in perspective because her being happy in that moment was more important than me being right. That didn’t mean I had to sit in that house and listen to it, though.
I needed a win. I desperately needed to feel like good could be accomplished in the face of all the chaos that has taken over this country… the chaos that had taken over my mind and heart. I needed a win and my client needed an adventure. We were going to Belks! Not just any Belks, either. The big one in the mall all the way across town, where she could get her hair done before she browsed the store.
Now, this was a big undertaking. It takes about an hour and a half to gather all the necessary paraphernalia and requires several tricky transfers. From the wheelchair to the car, to the wheelchair again and then to the salon chair, hair washing chair, back to the salon chair, back to the wheelchair, back to the car and finally back to her wheelchair at the end. It means that I am carrying a walker, tote bag with emergency supplies, her purse and my purse as I push her through the mall. It is every bit as exhausting as it is gratifying for both of us. That day, it was completely worth the effort, maybe more for me than for her.
That day came with a lesson that I hope to always hold close. The best way I know to protest the unacceptable is to not allow it to rob me of who I am; to apply the very same ideals that make this election result so difficult to swallow in every walk of my life, even when it’s difficult. I’m a caregiver first. I do not get to choose who is placed in my care. I do not get to dictate their opinions. However,I do get to hold on to my own and use them to motivate me to do my utmost best for them, regardless of the circumstances. I can lead by example and hold tight to the belief that, in the end, love always wins. While I’ll admit that is far less satisfying then ranting in the comment sections of news articles, I like to think in the long term, it will be more effective.
It’s my day to post. I don’t want to write. I don’t have any words right now because I am still shell shocked from the results of the election.
This is a blog by caregivers about caregiving; about our experiences and perceptions working within a broken system. It is not based on partisan ideas or politics. I get that. Still, I have always viewed what we do through a wider lens. What am I learning and how do I apply the lessons from what we do in our work to life as a whole? I write about that often; how working in this field has enhanced my ability to connect with people from all walks of life, on and off the clock. Maybe that’s why I feel so blind-sided. Maybe that’s why I feel the need to address it here. If you, our readers, will give me the leeway to stray from our typical topics and delve a little deeper, maybe I can find the words after all.
Merriam Webster defines a caregiver as a person who provides direct care (as for children, elderly people, or the chronically ill). It’s a fairly straight forward definition. We take care of people. For me, this is who I am every bit as much as it is what I do. I don’t suppose it’s an accident that I ended up doing this for a living.
When a person is hurting, I try to ease the pain. When people are lost, I use my own experiences to show them that there is always a way out. When people are scared, I try to offer comfort. I find the reasons to laugh and when life seems dark, I whistle until it passes. It’s what I know and it was the compassion and love I was shown that pulled me from my own dark times.
I see life through stories and moments, be them my own, my friends, people for whom I’ve cared, or anyone else who has left an impact on me. I see shades of gray instead of black and white. I seek truth and solutions rather than sitting in the problem and surrounding myself with people who will validate me, but I woke up this morning unable to see past the results of this election, which I personally consider catastrophic for so many people whom I love, and my heart just breaks.
I am so sorry. I am sorry, my friends in the LGBT community. I’m sorry that you will have to walk through discrimination that was finally fading, slowly but surely. I am sorry for my friends of color and am embarrassed that the man who ran with the support of white supremacists without disavowing them in disgust is now the leader of our nation. I’m sorry to all the little girls who will be affected by the legitimizing of sexual assault and the little boys who are being shown that such thinking and behavior is just “boys being boys”. I am sorry to all of the Hispanic community who will be looked upon with suspicion simply because of their heritage. I’m sorry to Muslim Americans for being labeled as “terrorists” because of a small segment of extremists. I certainly wouldn’t want all Christians to be labeled because of the atrocities committed in Nazi Germany. I’m sorry for our veterans, those living with mental illness, the disabled, the elderly…I’m sorry to all the people who have been and will be in my care for what I fear is coming. I’m sorry to all who blindly voted against your own self interests out of fear. You will end up paying the price too, and I imagine it will be hardest on you because of your misplaced faith and misguided allegiance. I didn’t realize how far off the tracks of humanity we had flown.
I don’t know how to take care of people in such an atmosphere, but I don’t know how to give up either. Writing this seemed as good a place as any to start. Later, I will share my experience with a group of people in the hopes of reaching others in need of help. Tomorrow, I will go to work and do my very best to care for my client and her family, regardless of who they supported. I can care for them and love them without agreeing with them. If I couldn’t, I would be no different than the people who are responsible for the outcome of this election. I will tackle each task in my path to the best of my ability and try to lead by example and learn as I go. My residents and clients taught me that. My co-authors, Yang and May, show me that. All caregivers everywhere remind me of that. We work within impossible situations every single day and we do not flinch. That does not change because of election results.
One of the more unnerving discoveries on my journey in private care has been that caregivers can be very territorial. It makes me incredibly uncomfortable. Maybe it’s because I spent most of my career in facilities where there is a sense of unity and teamwork even when it’s felt begrudgingly. Circumstances force people to work together and even the most likely of partnerships tend to foster a sense of protectiveness as we work together with the common goal of providing the best possible care in such a flawed environment. Not so much in independent home care.
My first encounter with this was my very first family. God bless them, they were lost and desperate for help. Having not expected their family member to suddenly need to live there full time, they weren’t certain how to proceed. They were loving and trusting people with a strong desire to do this right.
That particular job landed at my feet at a time when I desperately needed a change. Now, I had never done home care so at first, I was eager to learn whatever I could from my co-worker. That eagerness faded quickly. Instead of being welcoming, she was…well, bossy. At first, I chalked up the differences in how she expected me to transfer my new client with the maneuvers I had learned in the facility with the change in environment, but I very quickly decided that as much as I wanted my new co-worker to feel comfortable with me, I did not feel safe doing transfers the way she preferred to do them and just like in facilities, within certain parameters, such tasks can vary from caregiver to caregiver. I tried to explain this to her to no avail. That’s how I learned to smile, nod and go about my business working my shift the way I see fit. Unless my client or her family complains, there is no reason to alter how I perform my job and I was told as much by the family who hired me. They explained that the other caregiver was under the mistaken idea that there was a hierarchy.
I’d been in this field long enough that it rankled me to be micromanaged by my peer, especially considering we worked on opposite days and other than showing me the ropes on my first shift, we had never worked together. She communicated with me in long notes that detailed what she wanted me to cook for our client, how she felt I should spend my shifts, what activities she wanted me to avoid and exactly where she wanted each cleaning bottle. Being a rookie at the time, I assumed she had worked for the family for a while. I had no idea that she only started the week before I did.
She was let go for reasons that I won’t go into, other than saying it had absolutely nothing to do with me. For the rest of my time with that family, I was the sole caregiver. The hours were insane. It was too much and I was awful at setting boundaries. I missed my old facility and I had renewed sense of gratitude for my former co-workers.
By the time I left that family for my current job, I had a much deeper appreciation for working with others and had chalked up my first experience with a co-worker in private care as a fluke…until I met my new co-worker.
She had been with the family for two years and is very…involved. At first, it was off-putting. I had to explain to her that I was not going to question my client’s doctor about her medication. That wasn’t my place. As a caregiver, one of my roles is that of an observer. I note changes in behavior, variations in blood sugar, mobility, mood, urine output, blood pressure, etc. but in no way do I attempt to diagnose. That is out of my skill set. I do not question how my client chooses to spend her money or lie to her about appointment times in order to “speed her along”. It is just not how I do things. For me, mutual trust is sacred in this field and I can’t expect my client to trust me if I am not being honest with her.
For quite awhile I resented my co-worker. She was doing this ALL WRONG! The responsibilities, job duties, and boundaries that were so ingrained in me from my years in facilities were being thrown right out the window! Because there are parameters that I was unwilling to cross, I began to feel a little insecure. I started second guessing myself, especially after she said that from now on, she would schedule the doctor appointments on her shifts.
I got myself in a real tizzy over that one. I vented. I wrote about it. I made certain to time it so that my co-worker’s and my path rarely crossed. I ranted to my friends that this lady thinks she OWNS my client and I didn’t feel that was right. I was reveling in all my self-righteous glory. I did everything but actually have an adult conversation with her about it. I was wrong.
One day, in the middle of a shift, my phone rang. It was my co-worker. She was calling to see how our client was feeling. She sounded nervous and apologized for calling in the middle of the busy time, but it was her only spare moment and she was concerned because our client had been sick.
A switched flipped in my head. Yes, I was uncomfortable about the way my co-worker micromanaged everything. Yes, I thought she was overly involved and territorial, but not once had I sat down and had an honest discussion with her about it. Not once had I considered that maybe…just MAYBE her attitude had nothing to do with me and everything to do with the well-being of our client. That had to change.
So I asked her if she would like to see a movie and hang out and she agreed. After biting the bullet and swallowing my pride, I addressed my concerns and admitted my insecurities and asked her what she thought might be a possible solution. It turns out, part of the reason she was so territorial was that there were many caregivers over the years who were not so great. High turnover and missing meds caused her to be cautious and protective. I could understand that. She opened up about her own insecurities like this bring her first and only caregiving experience. We began to learn from each other. I won’t tell you that things are always sunshine and rainbows between us all the time now, but it’s been much much better. True growth in this field stems from an openness to be honest and a willingness to begin from a place of understanding one another. That is how we stop resenting one another and learn where we can best serve the needs of those in our care. There can be no teamwork when there is no interest in understanding the other members of the team. This was a lesson well learned.
There were hair dryers and curling irons hanging from the ceiling. That was my first impression as my client and I entered the front lobby of a high end salon. With her family reunion coming up, she wanted to look her best and after five days of rain, she was more than ready to get out of the house for a bit. She had a week of poor mobility and high levels of pain because of the weather but come hell or high water, she was going to find a new beauty salon and get her hair done.
My client gets like that. Her sheer determination to achieve a goal often overrides what I think is best. Where she saw gorgeously coiffed hair teased to perfection, I saw transfers in the rain, maneuvering a completely unfamiliar environment for both of us and the potential for her feelings to be hurt like they were by her last stylist. One look at her face was all it took. Sigh. Ok. Let’s do this. So off we went! Despite the rain, her pain and the garden variety challenges, we were women on a mission and would not be deterred.
As we entered the salon, carefully maneuvering around subtly placed displays of make-up and hair supplies, I couldn’t help but be impressed by the atmosphere. There was an artsy, creative feel to the place and the front staff was energetic and engaging. It was a world away from my own regular salon, Great Clips (the price is right, so keep your fingers crossed and hope for the best).
After transferring my client into the shampoo chair, I sat down and took it all in. As I sipped on the cucumber infused water that they offered me (which is every bit as gross as it sounds), I noticed how engaged the stylists were. They were genuinely interested in what my client had to say. When her stylist heard that she used to be a cosmetology teacher, she began to ask her questions and discuss the pros and cons of the beauty field.
My client was given the princess treatment. For three hours, she was simply a former stylist who offered valuable insight and a valued customer. They did and said nothing that made her feel awkward or different from anyone else in there and it was all done with authentic enthusiasm. For three hours, my client forgot her pain and embraced being pampered and I found myself moved to tears, which I hastily wiped away lest it ruin my reputation for being a bad ass.
I write a lot about the apathy I see in this world. I write about the challenges and difficulties and need to overcome. I know all about the struggles we as caregivers face on this journey to improve this flawed and broken system and I want badly to help inspire the change in thinking that will enable these lasting improvements. All of that is hard wired in me, but I have to be honest here. It was beautiful to have this moment to write about this week. This simple, pure event that renewed my spirit and reminded me that there are people in all walks of life that are capable of seeing through the diagnosis to the person beneath. Such a simple thing, a trip to a beauty salon full of genuinely kind people, had a profound personal impact on me. In this world where kids are getting shot, the sick and elderly are so often mistreated, refugees are considered terrorist threats, racism is still a thing, people scream online about guns, and he who must not be named may become president, there are more genuinely kind people who look past the obvious than I realized. In my heartfelt zeal to fight apathy in all its forms, I sometimes forget that there are plenty of people who’s small and daily acts of kindness shout volumes about the goodness inherent in all of us. I do those people a disservice by forgetting that everyone isn’t either a hammer or a nail. To all of you quiet heroes out there, I apologize for my shortsightedness and I thank you for the reminder.