Saturday, August 16, 2008

Work, etc

I finally have completed my much more than usual work schedule. This has been a busy three weeks--trip to and from Missouri, then working lots of shifts all over the time spectrum. I don't work again for a week, which is great because now I have time to go to the grocery store and cook lovely meals, clean my house well (important to me), engage in centering prayer, go to the Farmer's Market, do yoga, and blog.

I did find time this last week to resign from all of my church offices. Our phone is ringing off the hook but for the most part we have not answered it. This deserves its own post--although due to the public nature of blogging, I cannot be forthright here. Actually, due to the "straw that broke the camel's back" reason (which was not the meeting I spoke about before), I really can't be forthright at all, except to a select few. I'm having lunch with one of those select few next week, someone who already knows a good bit of the story.

Anyway, work yesterday. We had ten guests, six of them with personal alarms, which is what is attached when folks who really shouldn't get up without help try to do just that. That alerts the staff (us) that they are on the move. The staff yesterday consisted of one nurse (moi) and two nursing assistants (known here as patient care techs). One fellow moves really fast but is very weak, and fell once during the night as the staff heard the alarm but couldn't get to him in time. We moved him to a room closer to the nurses' station and asked our volunteer, who normally answers the door (we are a locked facility) to sit with him. Otherwise we ran (almost literally) all day doing what needed to be done, answering the door as well as the phone, turning people and giving baths, giving regularly scheduled medications and also pain medications as needed. By the way, I'm the only one who can give medications or do certain procedures. We were insanely busy.

Other things, too. One of our long term guests was feeling very low. She said something to the effect that only God knows what will happen to her. I spied a copy of the Holy Scriptures on her bed, and told her, "You know, in our church we say a birthday prayer which says, 'O God, our times are in your hand.' I find that quite comforting." (I normally say nothing about God at work unless the occasion arises, as it did then.) She looked at me with a grin and sparkling eyes and said, "I like that. That is a more positive way of looking at it. Thank you for sharing!"

The Book of Common Prayer to the rescue again.

On the more troubling side, the son of one of our guests was upset as when we had given his mother a bath that morning, we had not put clothes on her but put a nightgown back on her. We had done that as it is much more expedient to put a gown on a bed bound patient when one is as frantically busy as we were than to put a blouse and slacks on, which is really difficult but which we do try to do when we can. I totally understand his sentiments, and I knew he was not interested in hearing that we didn't have enough staff to give the care we truly want to give. So two of us went and dressed her, which took 15 minutes to do. That doesn't seem like a lot of time, but do the math.

And then the family of the man who kept crawling out of bed left, the volunteer that came later didn't want to sit in the room (too boring), and so the fellow tried to go over the siderails again. What saved us all (including him) was that we had moved him closer to the nurses' station. We could not spare a person to sit in there. The techs were able to get to him in time to prevent another fall.

Then I went into another guest's room to see that he looked very close to death (this is a hospice so that happens). I had a quick conference with the family about their particular dynamic and what the turn the father took meant for that, and called the chaplain.

Anyway, toward the end of this particularly shift, one of the techs working with me left the floor for a few moments; when she returned, she announced that she had resigned. I don't blame her. The way our scheduling is done, we could have been expected to care for a total of twelve guests with the exact same staffing. We didn't think we were able to give the best care we could with ten. Our night shift only has an RN and a tech on no matter the census.

The nurse that came on in the afternoon to relieve me was really bitter. She said it is too bad that we have to take the flack for staffing decisions that we do not make when we are trying to do our best. Her husband is after her to quit this job. (As is mine, btw.) We know that other hospice houses have different staffing levels--one in MT we heard about has an RN, an LPN, and an aide on at all times. An LPN can flex up to pass medications, or down to do the work of an aide, depending on needs.

We'll see how this continues. When I was in a work situation similar to this many years ago, our bosses really hammered us when we made mistakes. If that starts here, I'll resign. Since I'm moving next year, I'll be resigning anyway, but I'd rather wait until I move so as not to mess up the resume.

Again, the state of health care in this country. Cheers.


FranIAm said...

I do not even know what I could say to that post... You are a strong woman indeed.

What a state of affairs we are in, there are no words are there?

Ruth Hull Chatlien said...

I'm sorry to hear of the inadequate staffing and the difficulties it causes. Sorry too about the tension at your church.

You're in my thoughts.