Betty has told us some disturbing war stories, some on specific events, others on things that tend to happen.
In the tends-to category, the day she showed us how to clean and care for dentures, she told us to be really conscientious about them (she actually said to "be ever-so-careful"), because they are expensive, warp easily, and along with hearing aids, are the number one item to fall into the bed and be sent out with the laundry. Eek.
There was a point in her career where she worked for an agency that would farm her out to cover staffing shortages at various facilities for 16-18 hour shifts. She said she saw some really unacceptable, unhealthy, unsafe stuff going on at the different places she'd go to about once a month. During one of her shifts it took her _2 hours_ to wash a female resident's hair because of how gnarled it had become from neglect.
She advocates answering call bells quickly. She says she's seen it happen lots, and there's nothing sadder than getting to a room in a longterm care facility to a resident who's broken down in tears, saying "I put the call light on, but no one came, and the doctor just prescribed me this new laxative, and I tried to hold it and just couldn't"--and the person has messed him/herself. It's a first-order health risk, since urine and feces damage the skin, especially the fragile, non-elastic skin of elderly people, and it's also such a blow to a person's self-esteem. How can you have any dignity or sense of self-worth when you're unable to avoid going on yourself?
Several weeks ago a student ask how we should go about finding a job, or deciding where to work. I must confess I'm not currently looking, even though I intend, rather abstractly, to find a job for this summer after I'm certified. Anyway, Betty said what she's done for hospitals is dress normally, go to the cafe, drink a cup of coffee, and pay attention to how long call lights stay on at the nurses' station and listen to how and if people talk about patients. She also said that if anyone stops to see what you're up to, tell them honestly, and if s/he is a nurse or NAC, take the opportunity to ask them what they think about their job, what they like best about their place of work, etc. Clever, and I wouldn't have thought of it. Isn't it great in life that we can learn from others and don't have to reinvent the wheel? I'm not sure, however, how such recon would play out, if it could, at a long-term care facility.
Subscribe to:
Post Comments (Atom)
I can't picture anywhere in a hospital or long-term care facility where one could casually hang out and have a view of the nurses' station. The cafes aren't near the nurses' stations, in my experience. There might be a family waiting area in view of the station, but if you don't have family there, the nursing staff ought to be figuring out who you are in order to protect their patients/residents and their privacy.
ReplyDeleteI'm sure she has seen way more facilities over way more years than I have, but I wonder if that approach is dated?
In principle, it's a good idea.
I think the #1 factor determining the speed with which call-lights are answered, though, is the staff:resident(or patient) ratio. I guess there are cultural and organizational factors that explain some of the variation, but I think if you want to feel you're deliverying high-quality care as a NAC the most important thing is to have fewer patients or residents in your care, period.
Ideally, new NACs who plan to work at it a long time would start in the most coddled environment possible (which would still be hard), gain some efficiency, and then move on to places where they are needed more (less well-staffed, more challenging patients/residents). Of course, that would be moving against one's financial interest, toward lousier jobs as one gains in skill, so it probably wouldn't happen.
With only a summer to spend, you could work at a place with cushy staffing levels, and focus on developing skills, or work at a place with low or marginal staffing levels, and feel good about providing care that is slightly better than the status quo. Unlike actual nursing or medical training, where I think trainees are a risk to their patients, but a necessary one (must train the next generation), new and training NACs (especially priviliged and idealistic ones) probably are a benefit to their patients/residents. If everyone who eventually went to medical or nursing school had to spend a summer as a NAC, and stayed after an extra hour to brush teeth, sneaking out so as not to be labeled a scab for giving free overtime, a lot more poor and middle-class infirmed elderly would get their teeth brushed. Then again, that would take away jobs that people who aren't going on to other professions need, create the appearance that there isn't a staffing problem, etc.
Paying enough people to do this stuff day in and day out for their entire working lives is really the right solution, but that adds to the cost of healthcare. Of course, if we stopped paying for expensive and risky technologies with no demonstrated benefit and hired twice as many NACs to actually do their jobs with adequate time and support, we'd probably spend less, overall.
Sorry to be so negative. I feel sorry for NACs and the people living in long-term care facilities. My experience might be biased, but other than a few expensive facilities, I suspect the whole system is totally f*&%ed. I don't know what I am going to do for my parents, but it will probably be very expensive. I should probably talk to my fiance about that.