Just Raven

Most skilled nursing facilities have a nursing assistant/resident ratio of about 10:1. Thats a lot of people for one aide to be caring for. But it is reasonable and it can be done without too much sweat. At my work, the ratio is 2:1. The people I serve are profoundly compromised. They require a lot more attention and care. In nursing homes, the residents don’t usually have all the tubes and machines I deal with. And many of the residents can walk, talk, feed themselves; they can help with transfers and push themselves around in a w/c.

On my unit we have 20 beds and the current census is 18. So we have 9 LNA’s scheduled to be at work. This weekend 5 called out sick. That left 4 aides to care for 18 very acutely ill young adults and handicapped children. I don’t complain too much at work; my attitude is JUST DO IT and shut up. I like this quote, and it speaks volumes about my work ethic…So I did it and kept my mouth shut. But my co workers would not do it and did not shut up! They whined and moaned and groaned. The nurse manager kept coming to me, to go do this and that…”Can you do trach care on so & so because his aide is really getting tired…” I smiled and let the other’s workload pile onto my own.

Due to the severity of medical needs we care for, none of the patients can walk, talk, take themselves to the bathroom, feed themselves. Thats my job. So I had 8 patients. The nurse assigned me to all the hard cases because I “do well” with “time management” so she told me. They get taken to the bathroom every 2 hours, in a 16 hour day. Multiply that by 8 and we get 64 lifts. Add in all the showers, transfers into/out of various seating devices for alternative positioning…Consider that the average weight of a patient is about 150 lbs; who knows how many lifts I did all weekend. All I know is by 8pm last night, I was exhausted beyond anything I have experienced in awhile. I hadn’t taken a break all day. The nurse says to me: “Why don’t you go outside. You look hot and tired.” I had just given a patient a shower, and that meant I was soaked from the shower because of the arrangement of shower chairs to the wall in the bathroom. As I walked off the unit, I noticed 2 co workers sitting in front of a TV watching the Super Bowl. I forgot it was even on.

I grabbed my coat and went outdoors. I hadn’t been outside since 6am. I stood for a minute,stretched out and eyed a snowbank. I threw my coat down on the snow. My scrubs were really wet, but I didn’t care about how cold I suddenly got. I just collasped onto the coat and laid flat, looking up at the sky at the stars and a sliver of a moon. It was cold enough for ice to grow around my hair, which was wet with sweat. I lit up a cigarette and relaxed, closed my eyes and felt goose bumps form all over me. Strange as it might sound, I was actually liking being COLD and icy. Steam was rising off of me while I laid there. Kind of surreal and weird. I think I was so tired I just didn’t care. It was feeling good, just laying there in the cold and drifting in and out of reality. Daydreaming maybe? My respite didn’t last long.

A co worker runs out the door, tells me the nurse needs me back on the unit because so & so’s g tube is clogged and she needs MY help. My break lasted a whole 5 minutes. I said to the co worker:
“Can’t you help?” He says: “No, I need a break.”

Knowing that he had been out for a break every hour all day, and still feeling comfortably numb from the cold, I said to him: “You know, this is really rotten. You take breaks all day and I end up doing half your work, and half of everyone else’s work. I’m really going to be done with this shit.” As I walked up 3 flights of stairs to get back to my unit, I thought about learning to say NO. I really need to stop allowing these people to walk all over me like they do at work. Its tough though. And it only happens at work.