Tag Archives: stress in direct care work

Keeping the Faith




Some shifts, the world seems against me as if some dark cosmic force with an appreciation for irony is pulling the puppet strings of everyone with whom I come in contact. My residents lash out. My body aches. The weather doesn’t cooperate for my walk to work and I spend eight hours running around in wet shoes and scrubs. Management that cares only that there are bodies on the floor, trained or not. Not enough money to pay my bills, crossing my fingers each month that nothing gets shut off. On those days it just feels…impossible.

         And I have my fair share of them. Days when I question why I stick with this. Days when my patience feels short and my humor is rusty; when I begin to wonder if I genuinely love what I do or if I’ve just convinced myself of that out of this desperate need of mine to see the bright side.

       Some days I’m bitter and angry and frustrated and weary and sad; my insides as covered in “yuck” as my scrubs. Those are the days that make me wish I didn’t give a damn. They make me want to scream YOU WIN, REALITY! YOU WIN, DEFEATISM! This system is beyond hopeless. These people are screwed. I am only one person and I. Can’t. Do. This. Anymore…I give up.

       But then I look at the poster above my front door, the one that says going in one more round when you don’t think you can, THAT’S what makes all the difference in your life, and I lace up my sneakers, grab my stuff and head to work. Because that poster is right. Time and time again it has proven true for me.

       I do not always love my job. Sometimes I resent the unending uphill battles and impossible situations that relentlessly whisper “You will fail in this”. And unless there are major changes from the top down, that is true. We will all fail because the system will eventually collapse upon itself. Still, every day I put on my scrubs and show up. I love my folks and that love has created in me a faith bigger than my resentment at my bosses, bigger than my fears of financial insecurity and bigger than the occasional despair during the rough stretches. From that faith a commitment to change the system and improve the lives of those who live and work within it has taken root. I don’t know where this commitment, this fire that oscillates between burning me and guiding me, will lead. I hope that we reach people. I hope we defy the odds. And I know that it begins with us.

A Different Kind of Career Path




Two glorious days off! IN A ROW! It had been over a month and a half since I’d had that luxury and I was counting down the minutes on Friday. I planned to have a creative, productive, friend filled weekend and intended to enjoy every moment of it. I gave myself a strict “no work talk” rule and actually managed to stick with it. I drew, wrote, went to a movie, rested, caught up with friends and volunteered. As much fun as I had, by Sunday night I knew I was ready to return to the hustle and bustle of the floor.

         The idea of “career people” used to conjure up images of high powered entrepreneurs, doctors, nurses or lawyers rushing to and from important meetings; people very dedicated to their careers, sometimes to their own detriment. It never occurred to me that the term could apply every bit as much to those of us scraping by on an hourly wage in broken down facilities in a broken down system and yet, here I am, just as much of a career woman as those with advanced degrees.

       Let’s look at the facts: I’m single, without children. When I’m not at work I’m writing about work, or attempting ways to improve work. I’m incredibly dedicated to my residents and have the lofty long-term goal of doing whatever I can for as long as I can to greatly improve the system in which they are forced to live from the bottom up. That is the very definition of a career woman.

         The SYSTEM may think we are disposable, our pay, bosses, and the ethic of those who have been so burned out that they can no longer care the way they should may reinforce that idea, but it isn’t true. Ask the residents who they count on, who they trust, who knows them the best, who SEES them, and their answer will be us; the caregivers. We cannot allow anything else to dictate our self-worth or the value in what we do. I wish I could burn into the heart of every caregiver the knowledge that they are uniquely gifted and desperately needed in the lives of those who have so little. Our skills are different, not less. We are not diet nurses. We are not “ass wipers”. We are the frontline.

     I will learn and forget countless bits of knowledge as I go through my life. I don’t know if I will always be a caregiver, but I do know that whatever path I may end up on in the future will be richly informed by the career that I hold right now. As I punched in early Monday morning, I was met with smiles from my residents and fellow workers on the floor. I missed them while I was gone and though I don’t know what my future may bring, in that moment I felt like I was coming home.

Wonder Woman





Taken for granted. THAT’S what I’ve been feeling. I’d been trying to put my finger on what exactly has been causing this nagging malaise for a few days now.

It’s nice to be able to finally put a name to it, though it’s not a feeling that I like admitting. It feels so very self-serving. Poor me. I work so hard for so little. People don’t understand the nature of our work. Blah blah blah blah. That is not who I am. That’s not who I WANT to be.

How can I feel SORRY for myself when I’m surrounded by people living with sometimes unimaginable hardships? Who LIVE in the environment that I can leave at the end of my shifts? How can I feel such exasperation, frustration and occasionally even anger towards my residents who I really do love very much? How can I hate and love what I do in such equal measures? Is such a juxtaposition of emotions normal? Is it the facility? Is it me? What’s going ON here?

It took some time for me to work it out, but I did find my answer. My facility is toxic. It is all excuses and no accountability. It is impossible situations piled on top of undertrained staff. It is equal parts challenging, which I love, and frustrating, which I don’t love. This is not new. This is how it’s always been. I’ve learned to compartmentalize very effectively, but every so often the doors will open and all of a sudden, I’m feeling everything at once. So far, thanks to the hectic pace of first shift, those fall apart moments happen off the clock; they happen in the quiet of my own apartment (or on break in a linen closet) when I’m alone with no one depending on me.

I’ve been in the same facility for seven years. The bonds I’ve formed with my residents have been an incredible gift in my life. It is through working with them that I’ve learned to trust, not only others, but also myself. They have taught me how to value the moment, to not take life for granted, to look beyond the obvious. They have greatly enriched my life, and I will always be grateful for that.

They are WONDERFUL people; that doesn’t mean that they are EASY people.

“alice. Alice. ALICE. ALLLICCEEEE!!!!”…all day every day. The down side to having been in the same facility for so long is that they are used to me. In a world where faces change as fast as underwear, mine is the familiar one. Twenty-eight residents, a brand new trainee and a call out. Alice can handle it. Before I even hit the clock, Ms.___throws up a massive lake of stewed beef and peaches. I got it! Nobody panic! Mr.___ doesn’t like his feet to touch the floor. Ms.___ is claustrophobic. Ms.___ isolates when she’s feeling depressed. Mr.__ lashes out in anger when he’s scared…hundreds of pieces of knowledge that are now like muscle memory for me. What residents need boundaries and what residents need coddling. So I run. All day every day, from resident to resident, task to task determined to do whatever needs doing…but that’s not fair. It’s not fair to my residents, my co-workers or to myself.

I learned all I know by working consistently with my folks. What I NEED to do, instead of running whenever a co-worker says they are calling for me, is to encourage her to try for herself and encourage the residents to allow her to do her work. Otherwise I am enabling all of us, myself included. Make no mistake, there is a part of me that has become as dependent on filling the role of “Wonder Woman” as they are at putting me in it.

The inner need to “fix” impossible situations is an old song and dance for me, as if somehow solving a problem guarantees that I wasn’t the cause of it. It is an issue of mine that I am working through, but MAN does it fit in well within the world of Long Term Care.

The truth of it is this: it is not my job to be the solution to every problem, inside of work or out. It is setting myself up for failure and OF COURSE it leads to feelings of being taken for granted. I have choices. I could leave and find another job. I CHOOSE to stay, at least for now. That means I have to gain a measure of acceptance about the facility as a whole while doing my best to improve my corner of it. I don’t want to be Wonder Woman. Take away the magic lasso and invisible plane and she is just a regular person dealing with issues of co-dependency.

CNAs ARE Smart




In a recent post on one of the CNA Facebook pages, a caregiver complained about some disparaging remarks made by her RN supervisor regarding the intelligence of CNAs. Some commenters – including a few CNAs – echoed the RN’s opinion by saying that an individual doesn’t have to be particularly bright in order to do this kind of work. As you might expect, other commenters voiced some rather strong objections to that notion.

Part of this disagreement stems from the fact that caregiving in an LTC setting is almost always described in terms of the physical and emotional qualities of the work. Things such as compassion, empathy and altruism are highly valued, but are almost exclusively understood in an emotional context. The intellectual side of caregiving is rarely talked about or even thought to exist. Yet the work includes several aspects that require significant mental ability and effort.

The misunderstanding is further complicated by how we define intelligence. The distinction between “book smart” and “street smart” is widely understood and accepted. The first is associated with academic success, while the second is more of a practical intelligence that helps us navigate through life’s many problems. Since employment as a caregiver has comparatively low educational requirements, CNAs are often thought of as lacking “book smarts.” While this is an unfortunate stereotype, it is certainly true that good CNAs exhibit a great deal of practical intelligence.

There is a popular meme on social media that is ostensibly directed toward RN supervisors “Our skills are DIFFERENT. Not LESS. Sincerely: Your Hardworking CNAs.” If we accept that our skills are “different but not less,” then it should be just as easy to accept that how we employ our intellect may also be “different but not less.”

Since most caregivers work in environments that include overwhelming caseloads, they are compelled to organize their time in the most efficient manner possible. Each shift is a unique time puzzle that the caregiver must solve if the residents are going to receive the best care he or she can provide. But the puzzle is dynamic, the “pieces” changing according to the immediate needs and expectations of residents, coworkers and management. The caregiver must continually adapt his or her time organization to ever changing circumstances and priorities. In essence, the caregiver spends the day involved in perpetual problem solving with ethical implications. This requires more than a caring attitude. It requires the ability to think on your feet and make immediate judgements that have positive outcomes. This is practical intelligence in action.

The mental aspect of caregiving is also an important part of the caregiver-resident relationship. In a narrow sense, we can sometimes provide intellectual stimulation for residents (and vice-versa) as part of our larger social relationship with them. In many cases, we are the primary source for this. More importantly, the ability to see past age and disability and look at a resident as an individual with unique qualities who is still capable of personal development is indicative of high interpersonal intelligence. What the Green House Project calls “a deep knowing” goes beyond simple sensitivity and familiarity with the resident. It is a level of awareness that requires abstract thought and imagination. It probably isn’t a coincidence that the part of our brain that develops abstract thought is also responsible for managing the higher emotions such empathy and altruism.

Finally, intrapersonal intelligence can play a critical role in the life of a caregiver. It’s easy to get lost in the emotional milieu and drama of an LTC work environment. We experience such a complex mix of thoughts and emotions on a daily basis, often crisscrossing with the people around us who are also going through something similar. The accumulative effect over the course of weeks, months and years can sometimes be a little overwhelming, even debilitating. The ability to process these thoughts and feelings and gain some perspective is a function of intrapersonal intelligence. Articulating those thoughts and feelings help us make sense of them and provides a coping mechanism. But also, through reflection and introspection we can gain a deeper understanding of ourselves and the true meaning of our work. We learn to accept our weaknesses and employ our strengths. And we grow as caregivers.

CNAs ARE smart. But sometimes, it’s just in a different way.

Two Open Letters






To Potential new hires,

I want you to be responsible for the care, protection and quality of life for a hall full of people with a wide variety of physical and mental illnesses. Make sure they are clean and dry, supervise their gait, and make certain that their oxygen tanks are full and on the appropriate setting. If they have a doctor’s order for TED hose, please make sure they are on in a timely manner.

Because these folks are unwell, they are occasionally combative. We will offer no help to you in these matters, other than suggesting that you get another aid to help, if you can find one. Often, you won’t be able to because we have a bare staff. We are also desperate for help, so many of the people we DO hire are unable to lift and are squeamish about body fluids, so they will not be much help to you. We hope that you are not like that, but if you are, eh. You get what you pay for. Someone will pick up the slack. Someone always does.

We can’t promise that we’ll remember to tell you if your hall partner called out or your shift relief will be late. We are very important and busy people. You can’t expect us to value your time and effort enough to interrupt our own.

You will be covered in any number of body fluids, we will often run short of supplies and expect you to figure it out. As a matter of fact, we pretty much expect you to handle any situation with little or no input from us. Oh! We will make rules and change them without telling you and we will apply them with inconsistency, as we see fit. This applies to both you and the residents. There will be no raises. No benefits and no rewards for doing an excellent job. But there will also be very few consequences for doing terrible job. Life’s a balance. We’ll pay you 9.00 an hour. What do you say?




To Potential new hires,

This job is tough. It is not for everyone. It will break you into a million pieces and teach you how to put yourself back together in ways you never thought possible, if you allow it.

There are facilities with kind, involved supportive management who offer substantial training and ample rewards for good work ethic. There are facilities with relatively calm residents who are not living with severe mental illness. This is not one of them, a fact that over time I have grown to appreciate, oddly enough. When there is no one willing to solve problems, it motivates you to first understand the problem and then figure out how to solve it yourself.

I have learned more about life, love, courage, vulnerability and perseverance than I could have in any other facility. I have explored, hand in hand with my residents, the subculture in which they live. I’ve learned to trust and be trusted. I’ve learned how to speak my truth, and more importantly, to speak theirs.

None of this will pay my bills, and there are times that I am resentful at the lack of pay, and basic lack of respect for what we do; a job that matters deeply to me is dismissed by those who should know better. I don’t wallow in that though, because I believe that WE can change that. If enough of us refuse to allow our pay rate to dictate our level of care, if we use the systems flaws and mismanagement to teach us how to problem solve and lead ourselves rather than embitter us enough to lose our empathy, then we really can make a difference. I believe this in my heart of hearts and truly hope that you will be a part of the solution. It’s easy to be a light in the day. My facility needs lights in the dark.


Your fellow Caregiver

My Plea



        I am tired. I am tired and heartsick, frustrated, disillusioned and losing patience. I know that many of us work in a subpar facilities within a broken system. I understand that we make less money than pretty much any other field. I GET that, in our facility at least, there have been no raises and having worked there for the better part of seven years, I can almost guarantee that there will be none forthcoming. This is the reality of it and nothing I say or do can change it in the short-term. I feel your frustration because it is my own.

       Having acknowledged that, it needs to be said that there is a level of accountability that we, as caregivers, need to meet despite the above mentioned conditions. In this, we are failing and in our collective inability to elevate ourselves above these pitfalls, we inevitably shortchange both our residents and each other.
        Lately, the level of cattiness, finger pointing, laziness bred from apathy, and passive aggressive tendencies have played havoc with my morale and because of that, I find myself becoming impatient with some of my co-workers. I don’t want to spilt my focus between resident care and conflict on the floor; conflict over nothing. I simply do not have the energy to deal with both.
       I know that I can be overzealous, overprotective of my residents, and perhaps I have higher expectations of my co-workers than I should, but don’t we owe them our best? Don’t we owe that to each other? Don’t we owe that to ourselves?
          If I didn’t believe we could do better, I wouldn’t find it so maddening. I expect very little out of the administration because they neither know nor really care about the world on the floor. Oh, they care if it smells, or if it looks neat enough for prospective clients, but other than that, they care only that it’s quiet. They want the residents quiet and the workers quiet. But the residents psychological, physical and emotional well-being? It’s not on the forefront of their minds. Neither is ours, for that matter. 
        That will never change if we continue to feed into their stereotypical view of us. Often enough, we give them the very excuses they use to not offer us decent pay or recognition for the work that we do. Call outs, tardiness, poor work ethic, constant conflict all contribute to their preconceived notion that we are disposable. And where is there room for our residents in the midst of all that chaos?
       The bottom line of it is that our residents, our sick, elderly, vulnerable residents deserve better care than 8-9 dollars an hour can provide. We cannot allow our pathetic excuse for wages to dictate how we work. We have a choice here. We can let the negative toxic work environment dictate our attitude and personal ethics, or we can face each day with a clear, stubborn and consistent determination to do our very best regardless of what goes on around us. We can be strong enough to not be defined by the broken system in which we work and by doing so, we will slowly but surely affect change. Robert Kennedy once said that “Few will have the greatness to bend history itself; but each of us can work to change a small portion of events, and in the total; of all those acts will be written the history of this generation.” …I wholeheartedly believe that. The first step towards being a part of the solution is to not be a part of the problem.

Something Worth Exploring




Yesterday, I had the opportunity to visit a local Green House home as part of a six-hour workshop concerning the Green House Project. I’m still processing everything I saw and heard, so this is going to be a very short post. However, I do want to say a few things about my first impression.

First, from a caregiver’s perspective, this is well worth exploring. It’s pretty amazing in fact. In essence, what the Green House Project does is create places where a high level of skilled nursing is done in not just a “home-like” environment, but in an actual home. The kind that anyone would recognize as a home and not a “home for elderly” or a “home for the disabled” or any other qualification you could add. Just a home. How this is done and why we would want to do it – again from a caregiver’s perspective – is going to be the main subject of my posts on this blog for the next few months.

Second, the Green House Project is truly revolutionary.  This is not just Wouldn’t-It-Be-Nice talk about “culture change” or “new paradigms” by people with lots of letters next to their names. It is, in fact, “culture changed.” It is both a physical and philosophical transformation in how we approach the entire long-term care process.

Third, on CNA Edge we talk a lot about the significance of the caregiver-resident relationship.  In my last post, I said that what caregivers want more than anything is to “reach” all of the people in their care. While my natural skepticism prohibits me from becoming a full-fledged Green House Project advocate without taking a closer look, as I listened and watched yesterday, the voice in the back of my mind kept saying “They finally figured it out – this is what we’ve been wanting for so long…”

We’ll see. One of the things I’ll be doing in the coming months is seeking out caregivers who have had experience working in Green House homes and getting a better feel for it from the direct care perspective.

The Hole in My Sock




    “Breathe, Alice. Just breathe,” I told myself. I could hear my name being shouted. It was Mr.__, waiting not so patiently to be laid down. I knew I had to get back out there, but I had told him ten minutes and I still had five of them left.

         I was in the linen closet. Hiding. Breathing in the subtle scent of cheap detergent and being embraced by the cool comforting darkness.

        It’s safe in the linen closet. The solutions are simple in there. Shadows and worn out towels cannot be disappointed in you. You cannot let a bedspread down. A fitted sheet is in the flat sheet spot? Easy fix. No fear of missing something, no getting sucked into the toxic drama of the wash cloths. Pillow cases don’t die.

        So how did such a ray of freaking sunshine end up cowering under a blanket of her own neurotic fears in a linen closet? Well, it all started with a hole in my sock.

       The first thing I noticed as I was punching the clock was that Mr.___ was already up, dressed and in his wheelchair, a rare and pleasant surprise. As I walked down the hall and greeted my folks, I saw that three of my residents already had their TED hose on. I smiled to myself and made a mental note to say thank you to third shift. It had all the makings for a remarkably smooth day and I gathered my supplies, blissfully unaware of the impending shit storm of inner crazy that was headed my way.

      Because third shift was on top of their game, I was able to knock out two showers before breakfast. It was in the middle of the second shower that I noticed it; the beginning of a hole in the big toe of my left sock. I could barely feel it. A minor inconvenience in an otherwise good start to the shift. I shrugged it off, finished the shower and gathered my folks down to the dining room.

        It was about twenty minutes into breakfast when I noticed it again; my big toe slowly, but with great determination trying to escape the confines of my sock. My sock, which was wet at this point from the showers. They invested all this money on renovations and couldn’t be bothered to find a crew who knew enough to leave a dip in the floor so that gravity pulls the water to the drain. When I mentioned it, they tossed us a squeegee, which did nothing solve the wet sneakers problem. And running around for eight hours in wet sneakers is exactly as gross as it sounds…

  “What is WRONG with you, Alice?! For Godsake, you walk everywhere anyway. You’ve been handling the wet sneaker situation for years. Peppermint oil, hot water soak and lotion. Why are you stressing about it now?” I thought to myself as we finished clearing out the dining room.

      After doing a round and checking the hall, I sat down and adjusted my sock so that I couldn’t feel the hole, willed myself not to wiggle my toes and got back to work. Mrs. __ was a little worried about her friend in the hospital. Mrs.__ is dead set against the idea of using her walker. Mr.__ needs clean sheets. It’s clear they weren’t changed. Honest to God. How hard is it to change a bed?!…all the while, I felt the hole growing; my toe rubbing rebelliously against the top of my still damp sneakers, mocking the other toes for obediently staying in their cotton cage.

       As I went along with my day, I noticed that my thoughts darkened. I didn’t have easy access to my supplies. Every time I get used to one supervisor, they are replaced with another. No benefits. No money. No boyfriend. No 401 K. I found myself worrying about things that ordinarily do not weigh much on my mind. The world’s smallest violin grew louder in my head as the damned hole grew bigger in my sock.

           By the time I found myself in the safe cocoon of the linen closet, I had worked myself into such an inner storm of nerves that my smile wasn’t fooling anyone. I didn’t understand why my emotions spiraled when the day started out with such promise; why I was choking on some weird, undefined panic. Why was I suddenly living in fear of tomorrow, convinced that the world around me would implode because of my endless list of shortcomings? It made NO SENSE!  All over a hole in my sock? It was like drowning in a tea cup.

        So I took a break. I sought refuge and in the safe confines of the linen closet, I quickly began to sort through my shit.  As maddening as they can be, a hole in a sock has never driven someone to the brink of insanity. Clearly, I had some underlying issues going on.  I had five minutes left to get a grip and put it back in perspective.

        I tend to focus on my actions rather than my emotions.  What I do matters more than what I feel. After all, feelings always pass and come what may, the show must go on. I have an incredible amount of gratitude and passion for the life recovery has given me and any sort of self-pity seems like spitting in the face of a second chance that many people don’t get. I do not take this for granted, but there is a thin line between working THROUGH your feelings and STUFFING them down. It took a hole in my sock to realize that I had been doing the latter for quite some time.

      I wrote last week about this job being about perspective more than money. That is true, but it doesn’t mean that I am not affected by financial insecurity. As caregivers, most of us are a paycheck away from homelessness. It’s my normal. The money always seems to work out, but it is a stressful scary reality. I like to minimize that fear, to focus on the positives, but that doesn’t mean it isn’t there.

       I like to write about the beautiful raw, heartbreaking, humorous moments that I share with my folks on the floor and how they bring such depth of meaning to my life. Every bit of that is true. But it is also true that every shift, I face my own mortality. We deal with so much loss.  I love my residents as individuals; as friends and I have days when I’m keenly aware that my very best effort is nowhere near enough to make their quality of life as good as they deserve. Some days, I feel like a failure because of that. Just because I don’t allow myself to sit in that feeling doesn’t mean it doesn’t exist.

       The ability to adapt and persevere, the lessons learned from overcoming challenges, finding meaning in the mundane; all favorite themes of mine. That doesn’t mean that the challenges themselves don’t leave scars.

      Focusing on the positive is a good thing. Focusing on the positive to the point of denying the negative, however, can be dangerous. It’s a tricky balancing act. I forget sometimes to leave room to grieve, to give myself permission to be human, to feel anger or fear, to not be “okay”.

      It’s a subtle, unconscious drive to be superwoman. A need to be the solution because I feel like I was the problem for so very long. Though my intentions are good, the end result is me hiding in a linen closet because my world imploded over a hole in my sock.

       Thankfully, life has a learning curve. Sometimes a mini meltdown in a linen closet just what the doctor (or shrink) ordered to force some much needed reflection. I took one last deep breath and left the safe confines of my “crazy” cave.

       “HEY! What the hell is going ON with you today?” Mr.__ demanded, as I stepped out to the bright fluorescence of the hall.

       “…I have a hole in my sock. It’s been nagging me all day.” I mumbled.

     “You should have said something earlier. You could have borrowed a pair of mine”…Sometimes the toughest challenges we face are those we don’t show and sometimes the simplest solutions are the ones we don’t see.

Defy Gravity




Often, I have heard it said that CNA’s “eat their young.” For some, it stems from burnout due to understaffing and high turnover. For others, it is that all of their patience is saved for the residents. Maybe, it is simply because it’s a tough field. Keep up, or move out of my way. I can understand the reasons, but I do not consider them excuses for poor behavior. There is a difference between being honest and being cruel.

       There is a dark part of the human nature that thrives on kicking people when they’re down.  I see it on the news, on Facebook, on videos of others’ misfortune that go viral and I recognize it for what it is; that ugly pimple on society’s face that is born out of collective fear and insecurity; that need to feel superior to another human being in order to feel ok about oneself. It’s a temporary, false sense of confidence and by its very nature, it is destructive. It also has no basis in reality and holds no truth.

       This cliquish mentality that holds us back, prevents us from compromise and promises to keep us in a futile battle of the egos, has been prevalent in almost every environment in which I’ve worked, but nowhere have I seen it have such a divisive, disruptive and dangerous affect than in the world of long term care.

     Third shifters are lazy. Second shifters all call out. First shift are all whiners.  Medication Aids don’t listen. The office doesn’t care. The administrator is useless. The activity director is lame. Did you hear what she said?! Did you see what she did?!..Where, in all of our self-righteous finger pointing, is the solution? Where is their room for our residents? It’s toxic and contagious; a virus of negativity.

        Make no mistake, I sometimes find myself thinking along those same lines. I GET the inclination. It stems from fear and frustration; a subconscious need to believe that, whatever the issue, it’s another person’s fault. It’s a way to avoid accountability. I feel awful when I allow myself to be dragged into the abyss because I know that with that awareness comes responsibility.

       The truth is, NOBODY is right if EVERYBODY is wrong. The truth is, we are powerless over everyone but ourselves. Our choices. The truth is we are in the business of lifting people up rather than bringing them down. In order to do that, sometimes you have to defy gravity and rise above the chaos. If enough of us consistently try to help our fellow co-worker, whatever their department, rather than rip them to shreds, then maybe we can set an example and create a new, more cohesive, happier environment. Happier workers mean happier residents.

Out of the night


When I punch in the code for the door, it feels as though I am literally punching the keypad. There’s a great deal of feeling being expressed on my exit from the building…none of it very positive.
The sad thing is, it was a good shift. Nobody died. Nobody hit me. I wasn’t overwhelmed and my workload wasn’t excessive.
But there’s a psychological stink these days, like dread and exhaustion have inhabited the walls. Maybe this place is haunted, not by ghosts of residents passed but by the negative emotions of the caregivers.

It’s hard to tell which is causing the other: are we exhausted because we dread coming to work or do we dread coming to work because we’re exhausted.
I don’t know. All I know is that I was content until I came in and now as I’m leaving I am numb. My mind is so full of echoes that I can’t hear my own voice; other people’s opinions and frustrations have filled me to the brim and I can’t find the line between what I feel and what everyone expects me to feel. Herd mentality? Peer pressure? Too many overworked aides with no relief in sight? The door clicks open and I walk out of the building. The outside air is cool, crisp. It stings my cheeks and finally my thoughts stop chasing themselves in circles and start to sort themselves out.
I was fine until shift change…if not fine, then at least coping. Then shift change happened and it seemed as though report had less to do with the residents and more to do with the situation. Did you hear so-and-so put in her notice? Well, this girl just walked out. Damn, you worked another double? How much more can we take? This place is a joke. Let me tell you girl. They don’t care.

I draw in a deep breath of the cold air and suddenly I feel like screaming in frustration…and it’s not the situation driving my agitation. It’s the gossip, the drama, the constant complaining. Isn’t it bad enough the I have to put up with the situation, the exhaustion, the dread without having it all shoved in my face every day? I’m told I am naive and gullible when I try to see “their” point of view. Every time I say “but”, I feel like I’m either going to be shouted down or glared into silence. Am I burying my head in the sand or am I resting my eyes when I don’t join the negativity train. Why, exactly, do I have to have a staring contest with the abyss?
Yes, I know things are bad–but I can’t help feeling like the constant repetition of the unfairness isn’t doing any good. There’s bringing awareness to an issue and then there’s fueling misery. It’s like some of the aides get off on working themselves and others into a state of resentment. And I haven’t got the energy to be both resentful and responsible. My poker face sucks: if I’m unhappy, I am utterly miserable and everyone knows it…everyone including my residents. And my residents deserve better than the worst version of me.
I can’t be flailing or flaccid. I won’t be. I hate reactionary people, so I’m going to have to be active in my own life.
Leave or stay. It’s not inaction or action, a choice or complacency.
I either choose to leave or choose to stay. But it’s an active choice either way. If I choose to leave, it can’t be because I’ve flown off the handle and walked out. If I stay, it can’t be because I’m paralyzed and afraid of change. I owe it to myself and my residents to do this the right way.
Exhaustion can curb many of our mental functions, it can impair judgment…all this is true and yet I do not have to surrender my willpower to it. I might be at the bottom of the ladder, but I am not helpless. I don’t have to be a victim of circumstance, bad though they are–I can still choose my way.
Leave or stay. Action, not a reaction to the grumbling of others. I don’t have to leave because other aides are and I don’t have to stay because other aides are.
My choice. What do I want to do? What is the right choice for me? Maybe the poem “Invictus” wasn’t just written for kings and presidents. Maybe CNAs can also claim a measure of their own destiny–or at least, claim the right to decide for themselves what they think and what they do with the circumstances and crap dealt us.
I arrive at my car and slowly open the door. I’m still bone-weary, but the heaviness of dread has lessened. Exhaustion I can deal with, I think. Maybe even exhaustion and the situation. But not dread. That stays here in the cold night air. It doesn’t come home with me.

I feel several ghosts lighter when I finally drive away.