Tag Archives: workplace stress

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 Tough Talk


Alice

I had to have the big hard conversation. It is handsdown the most difficult part of being a caregiver for me. Long hours, short staffing, poor management, bodily fluids…even dealing with death itself is easier than telling someone that I am leaving them in order to embrace a better opportunity. I’ve done it before. You would think that having previous experience with such conversations would make it easier. You would think.
All of my reasons for making the change are valid ones. I gave notice. I’m even doing my best to find someone to fill my position, knowing full well that is not my responsibility. I have all the emotional support in the world from loved ones who know
how hard it is for me to change jobs. I know this is about taking the next step forward and not abandoning a client…but it still hurts. I still feel guilt and I don’t get to minimize the hurt my client is feeling in order to make myself feel better. As always, the woman who was once a client is now a friend and it is never easy to disapoint a friend.
Work boundaries have never been my strong suit. In caregiving, this is a double edge sword. On the one hand,it keeps me flexible and this is a field that demands flexibility. On the other hand, it takes a good kick in the ass and a shitstorm of chaotic emotions for me to move forward. And it’s not just my overblown sense of responsibility or protectiveness; it’s not just the underlying feeling that I am abandoning someone in need. It’s not just about them missing me…I will miss them. I always do. Letting go is also not my strong suit.
Tomorrow, I will go in for my usual twleve hour shift. I will not wallow in my fear or sadness. I will not be morose. I will let them be wherever they need to be emotionally. This may feel like walking on knives but no one can love every aspect of what they do. I will allow this to teach me. Maybe I will set better work boundaries in the future. Maybe I’ll learn how to let go of outcomes outside of my control. The one thing that I refuse to learn is how to not be so close to those in my care. This is hard. This SHOULD be hard. Just because this move is the right one for me does not mean it doesn’t negatively affect others. Just because it’s the right choice does not mean it should be easy. I take care of people for a living. Taking proactive steps forward does not mean minimizing the emotions that are derived from those actions. It means walking through them and using the experience to grow.

Try Again Tomorrow

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Alice

I can’t make her smile. I can’t lift her spirits. She is lost in her thoughts; memories of what was and dreams of what might have been. I can’t reach her there. I don’t have the map or know the road.
The days that she allows herself to travel in that mindscape are few and for that I am grateful. It’s not a happy place and it seems to rob the present moment of all joy and the future of all potential. She doesn’t see the Christmas tree. She doesn’t see the joy she brings to others. She doesn’t see the courage she inspires in me…on those days she only sees her disability.
I can’t make her smile. And I know that I have to be okay with that. I know that we are all entitled to a tough day. It’s my job to meet people where they are at, not to force them to where I want them to be. So I bite back the questions with no answers that I instinctively want to ask. Are you ok? What’s wrong? Can I fix it? I bite back the assurances that I can solve a problem of which I have no real understanding. I do not know what it’s like for her. Not really. I can walk in her shoes only to the extent that my imagination will let me. To pretend that I have any idea of the pain she walks through every day is to dishonor the strength and courage she has within her to face it. I bite back the shallow but well intentioned platitudes that do little but make a person feel guilty for feeling bad. Let’s look at the bright side is a frothy emotional appeal that lacks the depth to be of any real help. It is condescending and dismissive. I will not rob her of her need to genuinely feel whatever she may be feeling.
I can’t lift her spirits. Today, my high energy and enthusiasm are not assets. So I do my best to tone it down as I walk her through the activities of daily living. I let it be known that I am here if she wishes to talk and it’s perfectly alright if she doesn’t. I try to focus on the tasks at hand. Check her blood sugar. Apply lotion to her legs. Separate her laundry. Defrost some chicken for dinner. I do my best to not take her husband’s occasional criticisms to heart. No, I didn’t water the Christmas tree yet. I will get to it when I get to it. No, I do not want to discuss the president-elect. I don’t say any of this out loud. On most days, such things roll off my back with an inward chuckle, but not today. My emotions, held tightly in check while on the clock, are often entwined with those in my care. If she has a tough day, I have a tough day. It’s my biggest challenge in this field. It’s also my greatest motivation. I am attached. Most days, I’m very good at compartmentalizing. Sometimes, though, the feelings alter my perspective enough to turn the day grey.
I can’t lift her spirits. Days like this make me long for my days in a facility. In facilities, if I couldn’t cheer up one resident, I always knew that the odds were I’d be able to cheer another. There was no shortage of people to help or ways to help them. In private care, there is nowhere to go. No one else to help. The powerlessness really takes an emotional toll. I work very long shifts and after several hours, I begin to feel owned by my shortcomings. Without co-workers or other residents with whom to interact, my thoughts go into a self-serving shame spiral as I revisit every decision I’ve ever made since age six, because clearly, my inability to improve this ONE day for this ONE person means that I am an utter and complete failure at life, should just crawl into a vat of Ben and Jerry’s Cherry Garcia and hang it up. But then that still small voice within my heart cuts through the chaotic noise in my head. Alice, get a grip. This is not about you. And in that moment, I recognized that truth. Everything that I value about this gig goes beyond the physical assisting with the ADL’s. It’s my ability to be a companion. It’s the way I see and value the friendship of those in my care. I would gladly share their pain if it would make it easier for them and when I am unable to ease their burden, I feel that I’m falling short. Private care allows enough downtime for my mind to grab ahold of that self doubt and run with it. Especially when my client needs a day to quietly contemplate her situation.
I can’t make her smile. I do not feel great about it and that’s okay. How I feel is nowhere near as important as what I do. Today, my job is not to lift her spirits. It is to walk with her and be supportive through her sad day, just as those closest to me walk with me and are supportive of mine. A very wise person once told me that courage is not always a shout. Sometimes it’s the small voice whispering
“We will try again tomorrow.”…that much I can do.

Behind the Scenes

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Alice
My eyes scanned the unfamiliar environment, quickly assessing potential pitfalls and hidden dangers. Carpet, possible fall risk. No hand rail in the bathroom. Air conditioning vent directly over the only place at the table my client’s wheel chair can fit. No other chair in which she can safely sit. Ok. A manageable if not ideal environment. I had prepared for those obstacles. Thankfully, I thought to put the commode chair in the trunk just in case. All the bases were covered and though I left exhausted at the end of the shift, my client was able to enjoy Thanksgiving at her daughter’s house surrounded by love and family.
When I was told that her daughter wanted to host Thanksgiving dinner at their house this year, I balked inside. It was a twenty mile drive into completely unknown territory and I had no idea what would be needed to keep my client as safe and comfortable as possible. People who aren’t living with or caring for those with disabilities tend to take for granted the amount of effort and time that goes on behind the scenes. This is a truth that transcends all avenues in this field. Get it done. Handle it. Make it happen.
And we do, don’t we? How often have I thought about the impossibility of a problem as I was in the middle of doing my best to solve it. Be it in homes or in facilities, uphill battles are what we do. It’s part of our job description and we don’t falter. Personal life in shambles? Worried about bills? Car troubles? We have to leave it at the door. We don’t get the luxury of falling apart. We have people who count on us.
Today, I was strongly reminded of how much that inability to fall apart has taught me. My dad had to have emergency surgery this afternoon. He is going to be okay, but he has quite the road to recovery ahead of him. I was blind-sided by this news. We all were. My dad, who is the picture of health and stands taller and stronger than most men, both physically and mentally, hit a bump and there is absolutely nothing that I can do about it. After a night of wrestling with powerlessness and fear, I woke up this morning, put on my scrubs and went to work. I don’t have the luxury to fall apart and because of that, by the simple effort of putting one foot in front of the other, I was able to regain perspective.
It isn’t a good situation but it could have been so much worse. I am powerless over his pain, but I am capable of being supportive to both him and those around him. I can offer information about self-care and I have insight that will benefit my family. All of this comes from lessons I’ve learned from the field and the unseen efforts that go on behind the scenes of what we do. Our job teaches us courage. At times, it outright demands it.
Management, regulatory agencies, even the families of those in our care are only interested in the end results; the appearance. If everything looks ok it is ok. If everything looks easy, it is easy. We caregivers know better. We are behind the scenes people, the muscle behind the movement and the heart behind the smile. What I have learned in the simple act of trying to do my best in this field has enriched my life in ways that defy reason. I didn’t want to go to work today. I wanted to hide from the world, but I went anyway. I didn’t want to write this post. I didn’t want to express my fear and vulnerability, but I wrote it anyway. That’s what we do. We tackle the task at hand and keep moving. We do not shrink from adversity and that is what makes all the difference in life.

A Bad Case of the “Feels”

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Alice

Sometimes I have to dig deep within to find the strength to carry on. I don’t get to give up. It’s a luxury that as a caregiver…as a PERSON, I simply can not afford. It’s really a mixed blessing.
On the one hand, I have my days that I WANT to just fall apart. The tough days, when my personal life is in chaos and my client’s husband is feeling a strong need to express his political views loudly and my client is in pain that no medication can touch…those days bring a feeling of powerlessness that makes it hard for me to breathe. I feel trapped by circumstance and very very small. Emotions that I do not have the time to deal with begin to distort my perception. Those are the lonely days. The grey days that make me want to curl up into a ball of self pity and resent the world for not bending itself to my personal whims and preferences.
On the other hand, I am blessed to work with a demographic of the population who’s very existence is an education in courage. They are the definition of perseverance. My love for these people has defined and honed who I am on a deeply fundamental level. How can I feel anything but grateful when so much of my life is engaged with people who overcome obstacles and live through challenges that I can only imagine? I have a daily reminder not to mistake convenience for necessity.
I used to just brush my emotions aside. Once I got through the tough shifts and started to feel better, I didn’t see the need to think about it. It’s easy for me to focus on what I love about this gig and my own life. I would minimize my negative feelings. I’m known as “Little Miss Sunshine” for God sake! I don’t get to be sad or angry or frustrated or hurt. Those emotions are for mere mortals!
The truth of the matter is that never works. Ignoring a fact does not mean the fact does not exist. And I’ve learned slowly, through much experience that my feelings are no less valid than anyone else’s and that I matter too. If I find myself feeling like I don’t, it’s time to reflect on the reasoning behind it and make some changes.
I depend on the people who depend on me. That leads to one of two roads; co-dependency or growth. Today I choose the latter. In order to grow from others, I have to be honest with myself. I have to acknowledge my emotions, good or bad, see them for what they are and then let them go.

Take Two

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Alice

This is not the piece I had intended to post this week. I wrote another one comparing a job description for a CNA that I saw online to the reality of all our job entails. I spent the afternoon on it and put quite a bit of energy and heart into it. I was proud of that piece. So you can imagine my horror when I somehow accidentally deleted it.
It is GONE! Nowhere to be found. As are the hours I spent writing it. It was more than the effort though. I write as I go. No rough drafts. Just an idea, a notion that I flesh out by putting pen to paper or,in this case, fingers to keyboard. I can’t go back and recapture the flow or directions of the words. It wouldn’t come out the same. And I was so upset.
Truth be told, it had been an emotional day anyway, but this was the proverbial straw that broke the overly sensitive-mildly-neurotic-camel-who-is-walking-through-some-challenging-life-circumstances back. And OH! The self indulgent weep fest that followed the moment I was alone was a sight to behold! For fifteen solid minutes I cried and felt sorry for myself; that deep cry that kids do, when the air escapes from the lungs in gasps and fluid flows freely from every orifice on your face and your nose gets all stuffy. I was not a pretty sight.
After I managed to pull myself together, the absurdity of my reaction sunk in. I deleted a blog post. I wasn’t diagnosed with cancer. For that matter, I have seen more than one person cope with such a diagnosis with more grace and dignity than I handled the loss of a bit of writing. My imaginary dog didn’t die…the fact that I have an imaginary dog is a topic for another post. My point is, it was an overreaction and caused me to pause and reflect.
I have found private care to be intensely personal. I work with one family and the shifts are long. A lot of the time in order to give care and enhance the quality of life for my client in the best possible way, I do what I can for the family unit as a whole. This can be overwhelming and often requires long periods of time in which my own emotions are compartmentalized. The pace and tone of my day is very much dependent on the mood of not only my client but also her husband. If there is conflict or frustration or anger, as there is bound to be in any relationship, I just have to work as if I don’t notice. There is nowhere to go and nothing I can say to alleviate it because it is not my place, though they treat me as one of the family. Some days, twelve hours feels like an eternity. Add to that the twenty-four hour news cycle that is constantly playing at work, a lack of sleep, a year full of major life changes and a fair amount of self doubt, its no wonder that I had my meltdown.
I am a woman who pushes through my feelings. I keep it moving and try not to let ’em see me sweat. There is work to be done in this life and I was lucky enough to get a second chance when so many do not. I don’t take that for granted. Not for a second. The flip side to that coin is that I often don’t pay attention to my own emotions. Being a caregiver feeds into the habit of putting myself on the back burner. There is a thin line between caring enough to be effective in this field and not practicing self care. After pondering this for a little while, I decided to cut myself some slack, take a deep breath and begin my post anew.
As caregivers, we work for people living with serious conditions. Every person for whom I’ve cared has taught me countless lessons in gratitude and courage and hope in the face of fear. My own petty problems seem so small and silly in comparison that I don’t even like to acknowledge them but the fact of the matter is that is unhealthy thinking. My feelings and thoughts are no less valid than anyone else’s.
Regardless of whether or not I admit it, those feelings and stresses exist and by stuffing them down, they only build up to the point where accidentally deleting a post is a disaster of cataclysmic proportions. By addressing these moments as they arise, I can better understand their underlying cause and take the appropriate actions to maintain a healthy perspective. I may never do that perfectly, but being aware of it is a good step in the right direction.

I Get By With a Little Help from My Friends

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Alice

I miss my co-workers. I miss sharing rueful smiles over our resident’s antics and commiserating over management’s ineptness. There is a bond between caregivers forged from shared experiences. Everyone may not get along but we all speak the same language. I didn’t realize how much that comradery added to my whole caregiving experience until it was gone.

The joy of working together as a team can get lost amidst the gossip, frustrations and general bitchiness that is often a by-product of short-staffing, poor communication, low wages and mismanagement. I am as guilty as anyone of bemoaning the poor work ethic of others when I was working in a facility. Laziness of others takes its toll on those who are not lazy in our field. On the best of days, it’s hard work and when I felt “saddled” with a caregiver who was not invested, I adopted an attitude of either help me or get out of my way. I took for granted the peace of mind that comes from working with someone else who GETS it, even in the most basic ways.

This jaunt into private care has taught me that caregiving can be lonely business. Or, to put a more positive spin on it, I know now not to take for granted my co-workers in whatever future facility I may find myself employed. I’ve written in previous posts about some of the more positive aspects of working one on one with a client. There is much that I am enjoying about this aspect of caregiving but I do find it lonely. If my client is tired, or cranky or has a day when she just doesn’t want to be bothered with me, I have to take a deep breath and make it work. There is no other option. Like it or not, I’m what you’ve got for the next twelve hours. I have been lucky on that front. There have been very few bad days with either of the clients that I’ve worked with so far but I do know that it is an inevitability. Working so closely with people in a vulnerable state is a dance and sometimes we accidentally step on each other’s toes. In a facility, if a resident doesn’t want to work with you, there are other caregivers who can step up to the plate and vice versa. It was often a flawed team but it was a team nonetheless and one way or another, the work would be completed before the end of shift.

No one can fully understand what it is like to walk with someone through their most difficult days unless they have done it themselves. We see the humor in body fluids. We see the end results of a broken system. We see the people in our care fight their way forward despite that. We see death, but more importantly we see LIFE. Sometimes I wonder if our most important job is to remind those in our care that although they think they are headed towards death, they are not there yet; to remind them that as long as they are breathing, they have value in this world. The family members usually can’t see this because they are too close to the situation. Until I started in private care, I thought it was selfishness. It’s not. It’s an inability to detach from the mental image of how it “used to be”. It’s thoughtless maybe, but it’s human. I do miss working with others who get that; who understand the heart of caregiving even if they don’t express it in words. This shared core of experience between caregivers has been an incredibly valuable tool for me in the battle against cynicism that often muddies my vision of what I believe caregiving can and should be. It took being away from my co-workers to realize how big a part they played in helping me develop as a caregiver and on the occasions when I would fall, it was they who helped me back on my feet. On the tough days, it’s good to know that there is power in numbers and we are not alone.

 

The Power of Caregivers

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Yang

In her December 2 post on CNA Edge “Quality of Life is a Precious Gift, Alice distilled the true meaning of a caregiver’s work into one fundamental principle: “Improving the quality of life for those around us.” While the idea may seem obvious, how we go about living up to it is anything but easy, given the typical long term care work environment.

We all know the list. It’s an environment where caregivers are overworked and underpaid, overwhelmed and undersupported. It’s an environment that features disconnected management and rules that make little sense at the caregiver’s level. It’s an environment where mistrust and dissension among staff is common.  It’s an environment that breeds cynicism and futility.

While we can’t ignore the negative aspects our work environment, how we respond to them is entirely up to us. Even in the worst of circumstances, we can always do something to improve how our elders experience their time with us. In fact, doing so is a kind of moral imperative – something that we know by reason is the right thing to do and a far more powerful and consistent motivator for ethical behavior than the directives and admonishments issued by those above us in the LTC hierarchy.

Alice’s “simple idea” is more than just about doing the right thing. It provides us with a standard of behavior that we can cling to amidst the chaos. Or as Alice put it:

“For me, realizing that truth has brought me great peace. It simplifies it. I don’t have to fix, save, diagnose, manipulate, or perpetuate any negativity. My job is to make life as positive as possible and to preserve the dignity as much as possible for those in my care.”

By persistently returning to that simple idea, we make a conscious choice to liberate ourselves from the drift into despair.

May makes a similar point in her post “Soap and Thought”:

“Sometimes it’s too much, being a CNA. There’s too much stress, too much everything until I think I just can’t take it anymore. Days when I want to tear out my hair; shifts when I want to leave and not come back. The problem, I’ve come to realize, is that the bad things are the big things; the skyscraper problems that draw our eyes and threaten our strength. The good things, well, they’re quiet, understated. Things like washing my hands with a resident that is special to me.”

We need these “quiet, understated” moments. And do so our residents. These moments are as significant as the bigger issues that plague us. In some sense, they are more real. 

The common thread between these two posts is that despite the difficulties, we are not powerless. For Alice, it’s a simple idea. For May, it’s a simple act. As we proceed through our daily routines, we may not be able to directly address the larger problems, but we do have the ability to alter our immediate environment. And our immediate work environment is a big part of our residents’ living environment. In that we find our true source of power.

None of this is to suggest that direct care workers will never play a major role in making fundamental change in the Long Term Care system. In fact, it really can’t be done without us. But to play that role effectively, we must never stray too far from what really gives us our strength.  I’ll explore that idea in my next post.

The Long Goodbye

      photo   ALICE
       I’m calling in sick. I can’t have “the talk” anymore. I just can’t. It’s ripping my heart out. After all, what are they going to do? Fire me?…These were my thoughts as I was lacing up my sneakers and getting ready for work. Even as they floated through my head, I knew the words were a hollow threat. I would not call off. I would not ruin nearly eight years of perfect attendance at work while finishing out my notice. As gut wrenchingly painful as it may be, to cave in because facing this is difficult would be like throwing the game in the last inning. THEY would win. I would lose. And far more importantly, my folks would suffer.
       You can do this, Alice. It’s the right move. After all these years, three owners and five administrators, you know that this facility is never going to change. They will never invest in competent management and because of this, you will always be stuck. Now is the time. Opportunities like this don’t fall on your lap everyday. Take it and run and start moving forward with your life. This has been my mantra, played on repeat, for the week. And it’s true. I know it is. I know that I have to get out of this particular facility. I know that I’m no longer comfortable working under questionable conditions and bosses with very questionable ethics. So, I’m moving on. My resignation letter, worded carefully to not offend so that I may visit my folks without interference from the office, is in.
       I’ve explained the situation to my residents. And explained. And explained. I’m not leaving YOU. I’m just leaving the JOB. I’ll be here to visit at least once a week. It will be different but it will be good! I’ll have time to sit and visit instead of running here and there. You will be fine…over and over again. They are scared and feel like I’m abandoning them. I know this because they tell me and that just shatters me. The average length of employment for a caregiver in this facility is six-eight months and that is being generous. The turnover is ridiculous because the wages are insultingly low and the work conditions are terrible. Because I have been there so long, this is traumatic for them and for me.
       I am letting them down. There is no getting around that. I’m making a choice that is both right and necessary but to deny that it will impact those around me would be dishonest. It is a truth that I can accept and live with, but for the moment it is incredibly difficult and painful. I really can’t discuss it without crying. This decision has turned me into a blubbering mess. I love what I do. I love many of my co-workers and I have been deeply committed to my residents. I resent having to make this choice. I am furious at the administration for not investing and paying a living wage for quality caregivers. I resent the dishonest, inept, incompetent and unethical woman in charge of coordinating care. She has not eased my residents’ stress or discussed with them the upcoming transition. She has not comforted them. She is quite honestly only concerned with how events affect her. Such apathy in this field never fails to boggle my mind.
       A few more days. That’s all I have left there. I will continue to reassure my folks that they will always be a part of my life. After so many years, they are more friends than residents and it will be nice to explore that dynamic. I know that nothing I can say will prove that to them. I will have to show them with action. And I will. Until they see me visit them, I have to accept that emotionally, they are not in a trusting place. Often, the best decisions are the most difficult to make. I know that underneath all of these deeply felt emotions that I am walking through, there is excitement at what’s to come. New opportunities will open up from this very difficult decision. For now, I have to trust the process. After all, life is change and transitions.

Role Reversal

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Alice

“Stop it.” she said, as I adjusted her enormous purple pillow beside her in her wheelchair, making sure she could maneuver her unaffected hand enough to play Word Whomp on her tablet.

“Stop what?” I asked without looking up.

“WORRYING. You’re going to give yourself an ulcer.”  I have cared for this particular resident for more than three years now. I was the first caregiver she met when she arrived at our facility and we became fast friends. Funny, incredibly intelligent, stubborn, and sometimes impatient, she is one of the most remarkable people I have ever had the pleasure to know…she could also read me like a book.

“I’m not worrying,” I said with more certainty than I felt.

“You are so. You always get a wrinkle between your eyebrows and chew on your bottom lip. Spill it,” she said without looking up from her game. Sigh. No time. I had seven more showers to finish, call bells were going off and it was almost time for breakfast. Besides, it wasn’t her job to cheer me up. It was my job to care for her.

“I’ve got to go. I’ll be back to check on you in a little while,” I said as I headed out the door.       “Fine. But you’ll be spending your lunch break with me. You either come back in here or I will find you and ‘accidentally’ run over your foot with my wheelchair.”…she’d done that once before in a fit of anger. I’d always suspected that it wasn’t exactly by mistake, little devil that she could be sometimes.

The morning melted into the early afternoon, blurring by as showers melded into beds that needed to be changed. Between snack time, intervening a feud between residents, and redirecting another one of my folks with a propensity for thievery, I didn’t catch a breath until nearly one o’clock. I decided to take my lunch while the sea was calm.

As I headed down the hall after I clocked out, I felt a nudge on the heel of my left sneaker. I turned around in surprise to see my friend in her power wheelchair. She really is hell on wheels in that thing. I’m lucky I only got nudged.

“Let’s go,” she demanded. There was no room for argument. This was my own fault. About a year ago, I made the mistake of telling her that I consider her and the other residents my boss. In my book, everyone else, including administration, was secondary. It went straight to her head.

“Fine. It’s peaceful in your room and I can still hear the hallway if there’s an emergency.” I perched on the end of her bed as she raised her chair up, elevated her feet and looked at me with a raised eyebrow.

“It’s NOTHING! Honestly. It’s no big deal.” She said nothing. Damn it. She KNEW I was uncomfortable with long awkward silences. Before I knew it, almost as if my mouth had a mind of its own, I found myself pouring my heart out to her; openly discussing my fear that my poor choices in my past would always define me, my frustration that I would never be able to move beyond my current level of effectiveness. I expressed my deep longing to do more to make life better for them and my sincere gratitude that life brought me to this place. My feelings of loneliness and the feeling that I’m always just a little off. A little weird. To my horror, I felt tears on my face. This was no good! I was breaking my own professional boundaries! This was a BIG no-no in the books!

After a moment, she cocked her head in my direction and said, “Well…you ARE a little weird. You are one of the few people I’ve ever met who didn’t see my wheelchair first. From the first day we met, you never assumed I was mentally slow because of how I talk. THAT’S WEIRD! That’s gloriously, wonderfully weird. So yes. You are a weirdo. It’s one of my favorite things about you. Look. I’m a college graduate. I’m an artist. I used to paint before my hand got too bad. Even sold a painting or two. I’ve been to Hawaii before. I am sure as hell bigger than Cerebral Palsy. And YOU are bigger than your mistakes. Hell, we all have a story.”

I took a deep breath and realized, right or wrong, I felt much better after our conversation.

Before I left to clock back in, I gave her a hug and apologized for unloading on her. She looked at me thoughtfully. “No apology necessary. Maybe a thank you for offering such profound wisdom free of charge…Besides, it’s nice to be reminded that I can still be useful,” she said wistfully.

I thought about that for a moment; how I would feel in her shoes. Smart as a whip and capable of much more than most people realized, but minimized to someone who constantly needs care despite the fact that she has so much to offer others. I would go crazy. It’s such a vital part of life to feel useful and of service. I realized then that while setting boundaries is a necessary part of our job, it is just as important to know when to lower our guard and let our residents in. Take away the roles and the walls and we are all just people. She reminded me that life isn’t about the hand we are dealt. It’s about how we play the cards. I gave her a hug before I left her room.

“Thank you for talking me out of my meltdown… And stop running over people with your wheelchair. There are better, albeit less effective, ways to get your points across.”

I sometimes wonder who is taking care of whom.