So, I want to cover a few points before I actually get started. For those who don’t understand the title, there was a movie that first came out in 1972 and then quite a while later was remade and the name of it was: Stepford Wives. The point I got from the movie was that a man created the ideal wife (in his eyes) and then made or cloaned many more just like her. As I write the description I realize that the fact that I have to explain the title means that I am really freaking old.I’ve always thought that men have man theories. I’ve noticed if you ask a man a question of any depth they always have an answer that they believe with all their heart which in turn sells the story to us! Well, in this blog post I’m going to give you Sunshine theories…..I’m going to state it so passionately you will be tempted to take it as fact……I’m telling you upfront this is only what I think and/or feel and I’ve come up with it through a combination of personal experience and information online…..you know, like: “Dr. Google” and such. I take being a nurse very seriously and 2 things that every nurse should have directly following compassion is professionalism and common sense. My point being: I tend to wear my heart on my sleeve so please know that I don’t say anything about nursing lightly. I have the up most respect for my residents, their families and the facility that I work for but I do it with a great deal of heart which often looks like stress to everyone else. As I’ve mentioned before , I have worked at my current facility for 4 years. I have worked the same “hall” or “pod” the entire time. The first year I worked 12 hour shifts overnight. We then changed to 8 hours shifts. I started working 2nd shift a shift myself and many others have avoided at any cost. For those of you who aren’t aware of the dynamics of nurses and cna’s in LTC, every shift is it’s own animal/adventure and for some reason there is always animosity between the shifts. At any rate it can be hard to keep staffing on 2nd shift because it takes up the majority of your day. I’ve grown to love the shift except for Sundowners. Sundowning is a symptom of Alzheimer’s disease and other forms of dementia. It’s also known as “late-day confusion.” If someone you care for has dementia, their confusion and agitation may get worse in the late afternoon and evening. In comparison, their symptoms may be less pronounced earlier in the day.
As I pointed out earlier every shift is different and each shift: Day, Evening, Night or 1st, 2nd & 3rd shift have their own special difficulties. I’ve worked all 3 shifts over the last 12 years so I understand that 1st shift is super busy but you also have more staff, 2nd shift is hectic because there is less staff and often or always (it seems) has more behaviors. 3rd shift has the least amount of staff (often the bare bones minimum) which wouldn’t be too bad except for the residents who not only refuse to sleep (because that in itself isn’t bad) but inevitably the residents that can’t sleep at night are also either the loudest residents and so they holler out all night or they are the residents who are not safe to transfer by themselves and like to pop up out of their seats or beds every 5 seconds.
This year has been increasingly difficult on my hall. No other nurses want to work it on my days off and all the CNA’s are getting overwhelmed. I know it is because I have a heavy hall when it comes to behaviors. I’ve always helped the CNA’s which of course puts me behind but as of recent it has been impossible for the residents to get the level of care I expect without me micromanaging the hall/shift. So the powers that be have decided that I should “take a break” from my hall.
In my mind that means I am throwing my residents and CNA’s to the wolves! This is very obvious proof that things should change in LTC. There are the very task oriented nurses (that I am not) that can get everything done but often lack compassion. I attempted for a week or so to be that nurse (stepford nurse) my supervisors said: “We have noticied you staying on task lately” and I responded: “I know how to be the kind of nurse you want me to be, that just isn’t me”. I think it was in that moment that it became clear that in order for me to give the individualized attention I desperately attempt to give each day something would have to change.
Everyone on the outside blames the facilities but the fact of the matter is they should also be blaming insurance and the state the facility is in as well.
Although we are caring for human beings that pay a lot (or the insurance/state pays) and these folks have worked their butts off their entire lives and deserve to live out the remainder of their years with the best of care, in the end it still comes down to money and if the state isn’t paying (along with other money issues) then things will always remain the same. I am not completely naive, I realize facilities could come out of pocket for some things…..but out all the facilities I have worked at, my current facility, tries the hardest to provide appropriate staff and a very family friendly space. We have the best family involvement (at times they are very very involved, God Love Them!) that I’ve seen at any facility. Our facility holds activities that encourage family involvement and families, no matter how large can come eat with their family member at anytime for no cost!!
So here I am faced with a choice that really isn’t mine…. I have to take a hall with less residents if I want to provide nursing care in a way that allows me to sleep at night.