At the ripe old age of 24 I took on my first job as a nursing home administrator. There I would roam the halls looking for all the things that were wrong. That was how I was trained. To look only for the bad. (With a clipboard, because with a clipboard everything becomes that much more serious.) Looking for Unmade Beds Part of what I’d do was walk around in the morning, around 9:30 searching out who was still in bed and what beds weren’t made up. “Why is that person still in bed?” “Why isn’t that bed made?” I’d inquire when I came across a staff member scurrying around the long stretch of halls struggling to get their endless list of tasks completed. I wasn’t a bad person. In fact, I went into long term care because I had been a nursing assistant in college and hated what I saw.
How then had it come to this?
How was I the one responsible for residents getting ripped out of bed at 5 AM for an institutional breakfast tray that would arrive over two hours later? How did I become the reason that residents were snatched from their warm beds to be placed on display for hours as they sat slumped over in a chair? How could I not understand the incredibly powerful message I was sending to staff? Residents don’t matter. Tasks do. A bed with perfectly tucked in corners is more important than the person who snuggles into it each night.
How Did I . . .
How did I miss the point that I was hardening the staff? The very same staff that I was often disappointed with because they were acting so hardened in their work? You pluck a person out of bed enough times, yelling, crying, scratching or even worse, quietly enduring the barbaric treatment because they surrendered long ago, you can’t afford to show any emotion. Your heart simply cannot bear it. And so the people entrusted in my care suffered. Residents. Staff. The very people that I went into long term care to try to help suffered because of my senseless actions. What was wrong with me? How had I lost my way? I went into the work with a giving heart. I was trained by caring people that were good administrators. When I reflect back on those early years, I think it comes down to the fact that I simply did the best that I knew. I didn’t know there was another way. I didn’t even know to question the status quo. (I find that bewildering now given my rebellious nature!) I did what I was “supposed” to do. It hurts to reflect back on those days and realize I not only allowed all this misery to occur, but I encouraged it. Eventually I found my way and my defiant, teenage-like mindset emerged. I wish I could turn back the hands of time. I can’t. Instead I take my heavy conscious and share my heart-felt lessons with others in the hopes that I can make a difference in the lives of residents now and in the future.
Why on earth do we still think it’s acceptable to wake people up at hours they don’t want to be awakened?
I have often shared in my presentations that I think this practice should be considered a reportable form of abuse. I truly believe it. We kid ourselves and declare things like, “We don’t get them all out of bed; some people we just pull them up to eat and then they go back to sleep.” So if you aren't a “get up” you are a “pull up”. The two wonderful names we bestow upon the poor souls that we torture each morning. (If a resident sleeps to when they want to they are probably another one of my favorite words in long term care, “difficult”.) If you don’t think it’s happening in your organization, I hate to be the one to break it to you, but there’s a really good chance it is. If you serve breakfast at a set time each morning, I’d pretty much guarantee it. Don’t tell me staff can call down to the kitchen for a late breakfast. That’s an extra step for staff and they have no time for extra steps. Don’t tell me you have “late trays”. That’s a Band-Aid that assumes a person has the same waking patterns every day of the year for the rest of their life. Find out what is really happening. Not what your policy is or what the department directors presume is the practice. Ask. Observe. Dig deeper. Do what you know is right. Your residents deserve better. Your staff deserve better. You deserve better. Denise
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