Forever Changed

I know that I have not written in at least 3 weeks. I have been so busy with CNA classes and then clinicals, but I am now off for a few weeks until I go back to review and then state test at the end of the month. I may have a flair for the dramatic, but I need to say that this experience has left me forever changed. The last two weeks have opened my eyes to what nursing is about. I have experienced all conditions of the human soul, from anger to joy, defeat to untiring victory, and heart-brokenness to unyielding, never wavering love. I have cared for patients that have suffered from strokes, GI bleeds, heart surgeries, and cancer among other things. I wish everyone could have this experience. I swear that it has made me a kinder, calmer, and more patient person. 

There are of course awkward things, things you never imagined yourself doing. I still giggle as I remember the first shower I had to give to a man at the nursing home with my instructor watching, and how mortified I was as she instructed me to "Just pick up his penis and wash it." Wow. :) It's funny, because 2 weeks later, I don't even inwardly blanche at toileting and bathing complete strangers! 

Long Term Care
I found the nursing home to be both depressing at times, and lively at others. Seriously. While my heart ached for the residents that clearly did not want to be there or were so far gone they never attempted to communicate with you at all, my heart also swelled for the residents that took pleasure in visiting with one another and sharing activities, like a bowling tournament and a visiting musician. It takes a very special person to work at a nursing home facility and to be able to do it right. I met some of these people in my clinical experience. Young women and men that cared for their residents in calm, compassionate and dignified manners while never complaining of the myriad of obstacles they had to deal with daily (and sometimes hourly). It is hard work...harder in many ways than the job of the CNA at a hospital. There are residents that need everything done for them. They need to be got up in the morning (with the use of a mechanical lift which takes 2 assistants to man), have their briefs changed, new clothing put on, their faces washed, teeth and hair brushed and taken to have breakfast. Many residents have limited mobility, and every single simple action that we take for granted, and are able to do on a daily basis has to be done for them. Often they lack control of their bowel and bladder, and will have to be cleaned up each time they have what to us is a normal bodily function. While some of these people do not speak to anyone at the home, others do. Others are completely alive in their minds while their bodies are failing them. These people apologize each time they need help. 

I came home from the first day exhausted. This is back-breaking work, literally. Hoisting people this way and that, bending, stooping, and walking (all day long walking and being on your feet) is physically taxing. And poop. There was a lot of poop. I know that is not eloquent, but I am not sure how else to say it-you are cleaning up a lot of poop.

Emotionally I was exhausted as well, and on that first night after that first day I lay in Barrett's arms and cried. I cried for the residents that I already cared about, and the ones that were cheerful despite everything else. I cried for those that just wanted someone to listen, someone to care about  their day, and I cried for those that hit, pinched, and fought us every step of the day as well, because we, not them, had control of their entire existence. Some had visitors often, and some had none the entire week. I have to guiltily admit that my faith was shaken that week at the nursing home. I told Barrett this, likening the lives of some of the residents to that of Tom Hanks in the Green Mile (when he is living forever and everyone he loves has already passed). He says, "I have begun to think that God has forgotten me." I told Barrett that I felt angry at times, while assisting there, like some of these people had also been forgotten about. 

Hospital Work
Stepping foot into the hospital was a dramatic change from the nursing home, and was refreshing in many ways. Most of the patients were much more active, and could do many things for themselves. Instead of giving a full shower, you were assisting them to take a shower, and instead of wiping for them after toileting, you were simply helping them from the bed to the toilet and back. Of course there are variations on this, and there were/are patients that are on complete bed rest and they will need many more things done for them. I enjoyed the hospital much more. My patients were there a few days, and got to heal, recover, and go home for the most part. Many of them were extremely nice. They were embarrassed to need assistance with anything, and would chat with you as you came and went, most welcoming of conversation and distraction. At the hospital I got to learn things from watching the RNs as well, and assist with them a few times as they started IVs and catheters. They were receptive to questions, and truly encouraging of someone like me, wanting to be in their shoes in a few years. One day my assigned CNA got to leave early, so I was assigned to an RN to shadow and help the rest of the afternoon, and she showed me how to look at labs for liver functioning, and how all her charting is done. We spoke of diabetic patients and their special needs with skin care. I also spoke with a respiratory therapist who told me all about his job and what he liked about it.

I changed a lot of beds, took out trashes, brushed dentures, showered and shaved people, washed hair, provided catheter care, recorded everything a person ate and drank (as well as what they voided. This is Intake and Output). I gave bed baths and mouth care, walked with people that needed to exercise before getting discharged, fed people that needed to be fed, and of course, assisted with bathroom needs. There was pee, poop and blood (no puke thankfully!), but I was not grossed out.  I assisted with catheter removal and bladder scanning. I loved the team at the hospital and felt at home there after the first day. 

At the hospital though (and in long term care as well) sometimes patients do not get to go home. Sometimes they do not get better. I was touched by a dying patient and their family in the hospital. The grief-stricken family was so thankful to me for the simple acts of tracking them down some crackers, tea and soda-not wanting to leave the floor to go to the cafeteria. They were thankful for the care that their loved one had been receiving-the same care that my CNA and I had performed just hours earlier as we cleaned the entire room, linens and very gently the patient (who had gone from talkative to non-responsive in just a few days). Death was coming soon, the RN predicted within the next day. I was not scared or grossed out by anything that I experienced. Skin changes, breathing changes too had been explained to me by my CNA who I had questioned plenty. I was honored to give the patient dignity, respect and most of all compassion during this time. I cried deeply that night. I know I will experience many deaths as I continue my journey through healthcare, and I was unsure when exactly this one would happen, but it touched me. The care I was taught to provide touched me in ways that words could simply never convey. I will remember this patient always, not because I knew them well, and not because the situation was dramatic or even unique, but I will remember. I will remember because this was the accumulation of my defining moments. The finale of my learning that firmly cemented in me that I will journey on with purpose. Perhaps these patients have not been forgotten as I previously thought, but through their suffering others like me learn how best to care for those yet to come.