girl in greenwood

This was the first week where we actually went to clinical at the hospital. Last Thursday we had clinical orientation but that was just a tour - this week we actually got assigned a patient and had to assess them, come up with care plan, etc. I was terrified of the whole thing since I don't have any hospital experience at all - I hate doing new stuff, even though it's good for me blah blah blah. But it went pretty well and I at least know where to find a couple of things on this unit at the hospital... if nothing else I can get a patient a clean gown and measure their oxygen saturation or blood sugar! By the end of the week I started to think that I might actually have fun by the end of the quarter.

However, I also started to think that I need to quit my job. I was supposed to work this morning but called in. I'm just too tired and stressed out, and R* says it's more important to him that I do well in school and that we have some semblence of a home life than that I bring home a few hundred dollars a month. Also, an unexpected variable is that my classes run a lot longer than they are scheduled - for example, I chose to work Wednesdays 2-10 PM because I was supposed to get out of skills lab at 12:30. In reality, I don't get out of skills lab until 1:30 or later, which makes it impossible to even get to work on time. I've already been in touch with the mom of the little boy I babysit occasionally, and I'm going to pick up some babysitting hours a few afternoons a week. While I don't have tons of free time, I think I can make that work, and it will be way less stressful than trying to cram in an 8 hour shift at work! Now I need to call my boss and explain that I'm leaving. I feel guilty about it - but I know I've gotta do what's right for me and R*.

Labels: CNA, nursing school

Most of my coworkers at the Old People Hotel are not white, and are not originally from the United States. The largest group are Ethiopian or Eritrean, with a few Kenyans and a handful of Filipinos. I was chatting last week with one of the Ethiopian women, in fact, I was thanking her for helping me with Bedridden Lady. She waved off my thanks and said she was glad to help. Then she blurted out that "we have been talking about it [and by we I'm guessing she meant the Ethiopian crew] and we agreed you are the only white girl who really works."

Heh. You never know when that Midwestern work ethic will be noticed.

Labels: CNA

I have a huge backlog of books that I've already read but haven't written up, and it occurs to me that I'm starting 9 months of school in a few weeks and I don't really see myself doing a lot of book reporting in that time... so prepare yourselves for a great deal of literary rambling. If book reports bore you, come back next month when I'll have interesting nursing stuff to talk about.

But before I turn back into my former lit major identity, I want to write some more about working with hospice patients. I know it's too early in my nursing student experience to declare what I want to do - but I really think I like working with people near the end of their lives. Putting that down in black & white sounds kind of morbid, but my most satisfying caregiving experiences have been with patients who are on hospice or about to die.

I've already written about Hospice Lady, who I think is just holding on because her children are going to come visit her soon. There was also Tired Lady, who went rapidly downhill and passed away peacefully in her sleep (my name for her refers to the fact that over the last week of her life, every time I asked her how she was feeling, she said "I'm just so tired." I think she was just done, you know?). I was one of her caregivers during that week and while it seemed obvious to me that she was going to die, her family and her doctor didn't seem to notice. Interestingly, her children called me every time she needed anything at all - help to the toilet, changing a soiled nightgown, eating some food (although they were successful in getting Tired Lady to come up with something that sounded good to eat), getting dressed, whatever. Of course I was glad to do all of it - but it was neat to have this moment of "aha! that's why I'm here! Her family is dealing with emotional stuff and baggage and can't just take care of her, so I will!"

And finally, the last couple days I took care of Bedridden Lady who was given less than a month to live... six months ago. She is basically unable to bear weight on her limbs and can barely speak, and spends most of her time in bed. I didn't do anything heroic while caring for her - I fed her and changed her and put lotion on her face and cleaned her mouth and put some moisture goo on her lips and opened the blinds when she gestured toward the window. And all I got in return was some smiles and a couple of "thank yous" - but that was more than enough.

I know a lot of people are creeped out by caring for patients who are near death - and even my husband has asked me if I'm setting myself up emotionally by getting attached to terminal patients. But I'm not. When Tired Lady passed away I felt relieved for her - she was just so tired, and now she can rest. And when Bedridden Lady and Hospice Lady pass on, I will be relieved for them, too. I will miss Hospice Lady but I know she's ready to die, and that death will not be a sad thing for her. And spending time with her near the end of her life has been a joy for me, and for her - I know because she tells me! It is really, really rewarding for me to be present with these people.

Who knows, I may end up feeling this excited about other areas of nursing as well. Which is why I won't make up my mind until I've been through all my clinical rotations... but I have to say, I'm really drawn toward hospice work.

Labels: CNA, nursing, nursing school

Today is the second day of two days off from work. Yesterday I cleaned house and ran an errand or two. Today I got my hair cut and had lunch with my friend L* downtown, and am going grocery shopping this evening. Boy, is my life exciting. Oh wait, we did go out for dinner last night with three friends - that was fun.

In other news, the less-than-competent Boss Lady at the Old People Hotel got canned this week, and one of my fellow CNAs got promoted into her job. So I think my work schedule will get more tolerable and consistent soon. In fact, she called me today to let me know that I'm scheduled to work Thursday through Sunday, and that she was putting me on my favorite section all four days. So I'll be able to work with my favorite residents, including my hospice patient. Consistency is good.

I met briefly with a couple of my nursing school classmates on Sunday - we allegedly were going to start studying pharmacology, but we mostly ended up talking. We did pages through our pharm text and the drug guide, but decided that it would be much more useful to actually have a syllabus in hand before we tried to figure out where to begin. It was really nice to see my friends - it's actually been kind of difficult emotionally to be away from them after being so close for 10 weeks. It's nice to feel like I belong - I'm not much of a "joiner" so that's kind of an unusual feeling for me!

Labels: CNA

One of my residents who is on hospice told me she was ready to die.

She is very weak and mostly incontinent, but is still able to get around a little in her wheelchair. She takes pleasure in spending time with people, passing out hugs and kisses in the dining room like a politician running for office. She has very little appetite but still eats a bit at each meal. She has some memory loss but is perfectly capable of holding a conversation and expressing herself appropriately.

Last weekend I worked the evening shift on the floor where this resident lives. And when I was getting her ready for bed, she told me she wanted to die. I took a deep breath and said, "you feel like you're ready?" and she said yes. I sat down and took her hand, and said "It sounds like you're tired of the way things are now." And she exclaimed, "Yes! I'm exhausted!" I told her I could understand why she might feel that way. She got very quiet for a few minutes and patted my arm and petted my hair (I have long hair and was wearing it in pigtails) - she seemed to find the touch reassuring. Then she said, "Maybe I just won't wake up tomorrow." And I agreed, "Maybe you won't. Or maybe you will, and either way, whatever happens will happen." She smiled. I asked her what I could do for her before she went to sleep - she wanted a drink of water, and a hug and a kiss, and then she smiled again and said, "And hit me over the head with a baseball bat!" I couldn't help but laugh... but pointed out that I wasn't going to do that. She said, "Well, I don't have a baseball bat anyway."

I sat with her for a little while longer just holding her hand. She told me after a few minutes that she would be able to sleep. So I kissed her goodnight again and went on my way.

How did I do handling this situation? I wanted to make it clear that it was okay for her to talk with me about dying, that I wasn't uncomfortable or creeped out. She seemed comfortable with my response.

Labels: CNA, nursing, nursing school

I have been working my butt off at the Old People Hotel! And my back is a wee bit achey. I intended this to be a part-time job, but I made the possible mistake of telling my manager that I was willing to work whatever shifts were available. So. Last weekend I worked a double on Friday, Saturday PM, and another double on Sunday. I was wiped out. This week I'm not scheduled for any doubles but I am working six days in a row. It's crazy.

The one good thing about working the morning shift is that I get off work at 2:00, and can stop by the gym on my way home and still be home by 4:00. And the best thing about the gym isn't the workout - it's soaking my aching muscles and feet in the hot tub!

The job is harder that my previous job at The Home, I think. I occasionally work on an assisted living floor, which is more like my job at The Home. But a lot of the time I work on the Alzheimer's ward, which I find much more challenging. Not only are the residents impaired mentally, they tend to be much more physically impaired, requiring assistance with transferring from bed to wheelchair, toileting, bathing, and feeding. I have never worked in such a physically demanding environment before - but I can do it. The part I'm finding more challenging is that the Alzheimer's residents are really, you know, demented, and it's hard to make a connection with them. Some of them are so advanced in their dementia that they hit and scream and resist any attempts at caregiving. Some do bizarre things like go into a random room and poo on the floor. I think the reason I'm having a harder time working with these residents is that I want to make a connection with my patients, and I can't help but take it a little bit personally when I get hit or screamed at, even though I know the hitter or screamer is not "all there". It's emotionally exhausting.

On the other hand, the CNAs that I described in my last entry don't seem bothered at all by the dementia patients. They like working on the dementia ward because they are not at the beck & call of assisted living residents - they just do their caregiving routines and call it good. Although, I don't want to make it sounds like they're all robots - yesterday, for example, a CNA who has been there a long time insisted that we call the nurse on duty right away for a resident who "wasn't acting right". She couldn't quite explain was wasn't "right" about the resident, but when the nurse arrived, she assessed the resident and agreed that there was a problem.

I just feel happier working with slightly more cognizant people, I guess. I have been working on a floor where one of my patients is a sweet little old lady on hospice - she is very weak and needs lots of care, but is just so good-humored. She pages me constantly when I'm working, which would drive me nuts from some people, but with her I can't get upset because I think she just wants some company and some affection. Last weekend I cared for her for two days straight and when I put her to bed one night, she announced, "I love you!" and gave me a big kiss. So sweet. It's going to be tough when she dies.

Another resident on that floor has serious short-term memory loss and a chronic pain condition. She is fixated on her pain medication and with the memory loss, can't remember when she last had it. So she pages often to tell me that she's in pain and she wants some medication. I tried rubbing her back where she said it hurt, and it was like a miracle - her breathing slowed, she relaxed, and said she could rest and wait until dinnertime for her medication. I felt like a freaking genius. :) It's not like I did anything major, but it felt really good to make a small positive change for this lady. I felt like a nurse and not a caregiving robot.

Labels: CNA

Do you have Britney Spears in your head now? No? Then go back and read the title of this entry again.

Today was my first day training at the Old People Hotel. I've been away from the CNA role since April 1st, which really isn't that long. And I've had 10 weeks of nursing school, which really isn't that much. And yet I found today that I feel completely differently about the CNA job than I did in April.

The girl who trained me is actually one of my classmates from my CNA training class last fall, which was a nice surprise - it was nice to see a familiar face in a new setting. But I was very much struck by the attitude of "getting my work done" that all the CNAs showed - not that they are uncaring or abusive to the residents in any way. But instead of putting the residents' well-being first in their minds, they are more concentrated on finishing their tasks on time. That is such a contrast to the conditioning we've gotten in nursing school, where we are taught to be primarily concerned with the client's needs and preferences even if that makes our job harder. (Up to a point, obviously.)

I think I was probably somewhat this way before starting nursing school, although I'd like to think that I was more attuned to what my residents wanted and needed. I guess it was easier at The Home because the residents were for the most part more "with it." So it was easier for me to remember to respect their individuality, because they would remind me.

In any event, I'm pretty sure that what my nursing instructors would tell me to do is to model the behaviors that I believe to be correct. So I will model good teamwork, respectful treatment of residents, and personal responsibility. And I will earn my stardust ('cause you sure can't call a CNA's wage "money") and keep my head down until it's time to go back to school.

Also, I went to the gym and worked out after work - and then soaked in the hot tub for my aching feet. I am not used to be on my feet 8 hours a day anymore.

Labels: CNA, nursing, nursing school

I took my last final yesterday and am officially done with my first quarter of nursing school. I know I should feel elated, but mostly I just feel tired. Part of that is probably exhaustion from the whole whirlwind experience. Part of it has to do with some psychological issues I'm dealing with myself (don't worry, Mom, I'm not hugely depressed - I'm just struggling with the ongoing anxiety). Part of it has to do with some stuff R* and I have been dealing with together (again, don't worry Mom, we're just dealing with finances and they're tight and money makes me anxious!).

But now summer is here! And I'm starting my new job on Monday morning, at the assisted living place. I never heard back from the mom of the little girl - I guess that means she wasn't interested. Well, whatever. I'll work as much as I can at... hmm... I need a new work alias. Let's go with Old People Hotel. So yeah, I'll work as much as I can at the Old People Hotel and that will help our financial situation, and I'll work on all the home projects I want to do, and go to the gym a lot. The gym is more or less between the Old People Hotel and home, so I can probably trick myself into working out by going there after I work a morning shift, because I'll get off at 2:00. Then in August/September I already have some babysitting work lined up, so I'll be able to earn a little extra on top of my job. It's even possible that I could keep 2 shifts a week or so during the next quarter of school, which would ease the financial burden on R*. That would be good for both of us, I think.

We got email today telling us what our clinical assignments will be. I am in the least-desirable clinical group - at a big hospital downtown with clinical on Thursdays and Fridays. Parking at this place is $5/day, and if I were to take the bus, it would cost me $2.75/day and take more than 2 hours of commute time. I may carpool with one of my classmates instead - she lives fairly close and we discussed it today. And she would probably pay for parking in gratitude for not having to drive downtown. We are in clinical with one of the Problem Children from our class and we are both dreading the experience. We've agreed to remind each other to stay calm and professional, even when Problem Child makes us want to scream.

Another part of the email was the textbook list for fall quarter. It looks like I'm going to be able to spend less than half of what I'd budgeted on textbooks because I have the opportunity to shop around and order them early. The campus bookstore is such a ripoff! But first quarter I had no choice because I had to buy books the day classes started.

Out of the 30 students who started this quarter, we ultimately lost 7. One dropped out voluntarily and the rest failed one or more parts of the program. That seems like a frighteningly high attrition rate... I hope it's not like this every quarter. There is a core group of people who I really like and want to stick with - I should write them an email proposing that we get together and join forces to get through the program! Maybe we need a secret handshake or something...

Labels: CNA, nursing school

Rosebuttons, your comment made me laugh... I am definitely not in love with every one of my classmates! But there is a smallish group of us who are very tight and I appreciate them so much.

So this summer is nearly upon me. I've got a couple of things pending, and lots of plans. The pending things: I interviewed for a CNA job at an assisted living & Alzheimer's care facility that is SO NICE. I actually really hope that they hire me - I was extremely impressed with the dementia care practices I saw and would like to get a closer look at that. I may change my mind in the future but right now I'm still quite interested in working with the elderly after graduation. The other pending thing is a possible babysitting job for a 9-month-old girl a few afternoons a week. Her mom is a freelance graphic designer and wants to have someone watch her daughter while she gets some work done. I should hear back about both of these opportunities in the next few days.

I have other plans, too - I really really really want to get in shape. My intention is to go to the gym or work out hard at home every day (granted, I won't achieve it every single day), and I'm still trying to figure out how to fit it in, but I really want to do yoga every day too. And I want to keep our house spotless. And I want to finish a bunch of projects that have been up in the air for a long time. And I want to clean up my garden. And I want to cook healthy meals and use up stuff in the pantry. And I want to go through all our closets and cupboards and other hiding places and get rid of the stuff we don't actually use.

Where can I get another 12 hours a day to fit all this in?

Labels: CNA, nursing school