"How Can You Stand It?"

If I had a nickel for every time I've had to answer that question, I'd be able to retire tomorrow. Nurses General Nursing Article

It is a question I am often asked whenever I meet new people. After the how-do-you-dos are said and the subject inevitably turns to "what do you do?", I almost always get sympathetic looks and comments on how I must be such a saint to work in a nursing home, with "all those senile old people" who are "just going to die anyway".

"How can you stand it?" they want to know. "Don't you ever get depressed/bored/frustrated/angry having to take care of people who can't even go to the BATHROOM by themselves?"

The short answer, naturally, is No. I love what I do! I don't necessarily love everything about it---the sheer volume of paperwork comes to mind immediately---but the long answer is this:

1) I do this work, in part, to honor my parents' generation. I was orphaned relatively young, and some of what I miss about having parents are the stories........of the Depression, of the hardships that shaped their characters, of the war that defined America at its best. At the nursing home, my residents may not remember my name or what they had for breakfast this morning, but they can recount, in vivid detail, every moment of their wedding day or a battle they took part in. There will never again be a generation like theirs; I want to hear as many stories as I can and cherish them in my heart, for once they are gone, no one can take their places.

2) As a Baby Boomer, I'm no youngster anymore, and there are already two generations after mine who remind me of that every day. But hanging out with eighty- and ninety-somethings tends to push away any thoughts of creeping decrepitude and make me feel positively youthful........especially when one of my old gentlemen tells me in all seriousness, "you may not be a spring chicken, but you're still beautiful to me".

3) Caring for the elderly is a ministry as well. Whenever I hold a glass of water to dry lips, spoon food into a hungry mouth, or assist a resident with repositioning to make him comfortable, I am reminded of Jesus' words: "Whenever you have done it to the least of these, you have also done it to me." Knowing that helping the helpless is pleasing in His sight makes the less-glamorous aspects of the work much easier to bear, and I like to think that perhaps I could be helping one of His angels in disguise!

4) The word 'serendipity' has become more than a word; it's a way of life. How can there possibly be anything on earth better than earning a decent living doing work I love?

5) Contrary to popular opinion, LTC isn't boring. I get the opportunity to use whatever creative gifts I possess on a daily basis. What other healthcare setting gives one so many chances to learn how to improvise (wrapping washcloths around the ripped upholstery on an old wheelchair to prevent skin tears when the resident's insurance won't pay for a new one), think critically (hey, wait a minute, let's do a fingerstick before we give that Ativan---Mrs. P. gets agitated only when her blood sugar's too high), and face adversity without panicking ("OK, this resident's toes just fell off in my hand........he's not freaking out, he doesn't even know it's happened, so let's be cool now")?

6) I've discovered that a place that deals in decline and death just happens to be a great laboratory in which we can learn much about life. I am probably never closer to understanding the purpose of my existence on this planet than when I am caring for someone about to leave it. It is an honor and a privilege to be the last voice another human being hears, the last touch he or she feels as life slips away. It's never easy.......but I wouldn't trade my experiences with the dying for anything.

7) Oh, and as if all that weren't enough: I get to have fun at work! And I have an appreciative audience for my funny and dramatic sides---the residents love it when I tell corny jokes and recite silly poems, when I stomp down the hall singing old songs in a loud and off-key voice, and when I dress up in outrageous costumes on the different 'theme' days. I enjoy keeping the mood on the unit light, and even my more curmudgeonly folks tend to respond favorably to my efforts in therapeutic communication. Like the time I was checking a blood sugar and forgot where I was for half a second; I'd just finished a Coke, and when I went to say something to the resident, a horrendous belch issued instead..........which to my surprise resulted NOT in condemnation, but raucous laughter! To this day, she doesn't remember my name, but she knows my face and voice, and she tells everyone who'll listen: "That's the nurse who burped---she's my favorite!"

And that, folks, is how I can "stand" working in LTC. For whenever I touch one of these dear old souls, I realize once again that it's really been the other way around all the time.

Specializes in LTC, assisted living, med-surg, psych.

:imbar

Your post has rendered me speechless (for once), so........Thank you!!

I also work in LTC as a CNA while I attend nursing school. All I have to say is there is no better feeling in the world then to walk into work and see your residents faces light up knowing your the best part of their day!!! What an amazing thing to be apart of!

Specializes in CAMHS, acute psych,.
The way I look at it, SOMEBODY has got to care about these people---the government sees them as numbers, the medical establishment largely ignores and under-treats them, and the corporations that own and operate nursing facilities view them only in terms of dollars and cents. ...

Someone far wiser than I already said this, and I believe it to be true: you have to BE the change you want to see in the world. This is my way of being that change. What is yours?:specs:

It's the same in Australia. In the place I work they have the funds per shift for 1RN (does the documentation and most wound dressings) + 1EEN (hands out the pills) (endorsed enrolled nurse - a 2yr technical college rather than university course) and, if they're lucky on a shift, all the personal care attendants (who do everything else) turn up for their low-paid jobs (less than untrained vet assistants get because in western society we care more for our pets than our parents) at the rate of 1 per 5 residents morning and 1 per ten residents evening shift to look after 60 high-care (i.e. very frail, many comorbidities, mostly incapacitated elders). And this place is a non-profit, run by one of the largest churches in the country.

In fact, this is one of the major reasons I am studying to become a nurse, thence a post grad dip in mental health nursing to care for those with dementia better - and maybe, if all goes well, a research degree - so I have enough seniority to stand up and shout about this injustice and increase my chances of being heard and changing a ROTTEN system.

PS I love all your posts - you are an American me!)

I'm a new BSN gaduate and I have to say that my time spent in LTC as CNA helped me immensley with any skill in the hospital. There were wound vacs and drains that I was more familiar with then some of the experienced RN's on the floor; not to mention the amount of exposure I had to trach's, foleys, and ambulating patients. My instructors, preceptors and classmates always asked how I knew so much and where did I get my confidence (but not too confident:nuke:), and I would tell everyone I learned it from the nursing home.

There's a lot of misconception about what we LTC nurses do, I think the main myth being that we 'lose our skills'. I don't know, it seems to me that when you're working with IVs, wound vacs, central venous catheters, dialysis fistulas, tracheostomies, feeding tubes of all kinds, ostomies, and nephrostomy tubes---to mention just a few---staying current on 'skills' is a no-brainer.

Just the other night, I had one of my dialysis pts come back home after his shunt malfunctioned and he had to get it replaced, this time in the internal jugular vein. He started bleeding out shortly after being settled into bed; I applied pressure, alerted staff to call 9-1-1, and was still standing there applying pressure when the EMTs got there ten minutes later. They actually complimented me on stopping the bleeding! Like they expected me to not know a simple first-aid maneuver, just because I'm a nursing-home nurse.:icon_roll

I'm a new BSN gaduate and I have to say that my time spent in LTC as CNA helped me immensley with any skill in the hospital. There were wound vacs and drains that I was more familiar with then some of the experienced RN's on the floor; not to mention the amount of exposure I had to trach's, foleys, and ambulating patients. My instructors, preceptors and classmates always asked how I knew so much and where did I get my confidence (but not too confident:nuke:), and I would tell everyone I learned it from the nursing home.

Specializes in LTC.

I started my job in a local nursing home as an aide when I was 19. People would give me funny looks and make comments when they found out where I worked. I remember just starting out one lady told me that's too bad you work there, that really is going to age you. I'm 24 now and yes that 19 year old is gone baby gone. I've grown SO much working there. I stand up for myself, for my residents, and I can take a whole lot more that I could back them. Partly from working with the residents and partly with dealing with some nasty staff. I'm starting nursing school in September and I'm REALLY excited! I want to work at the same place as a nurse and I really enjoy my job there. I have a strong bond with the residents and even some of their families. Yes I do cry when they die. I've been told it's bad. But I disagree. I think it ups the level of care that I give them. There are days that place depresses me, but mostly I try to bring happiness in. My mom once said that with me there it seems happier. I try to laugh and tell jokes, and I'm there for residents when mentally and physically they are having a rough time. I really enjoy my job.

Specializes in LPN.

I agree, that you are required to be responsible for so much in a nursing home setting. I didn't realize the difference until I worked in a hospital. I am an LPN, and had experience in things these RN's had no idea of how to do. How sad. When I moved, I gratefully returned to nursing home work, where I again had the responsibility and need to keep my skills sharp. The toteum pole is upside down.

As an aspiring RN, I thank you for sharing the information the way you do Viva. I am one of the fortunate students who has been around health-care in some form since I was about 12 and my Mother became an LPN.

Like you, my Mother devoted her career to LTC, working with Alzheimer patients. I would often asked her the same or similar questions...how do you do it? She would always answer the same way as you have in many of the answers you have given. I am so happy to have a Mother that has taught me to be more like the two of you in appreciating what is left in the tenderness of a patient that is nearing the end of their time.

Thank you so much for what you do, you are an angel trapped in a nurses body...:nurse:

Specializes in LTC, assisted living, med-surg, psych.

It's very sweet of you to say that.

My 18-year-old son just began his journey today as a student nursing assistant, this being his first day of clinicals. I am thrilled that ONE of my kids got bitten by the nursing bug! He's worn out from being on his feet for an unaccustomed 8 hours, but he got checked off on 17 different skills and was given kudos by his instructor for doing a particularly good job with a shower. He also spoke with tender concern of a resident who had sustained a large skin tear, and another whose meal tray was filled with foods that were on her "dislikes" list (he went back to the kitchen FIVE TIMES to get it fixed!).

I think he'll do just fine.:redbeathe

That is awesome. I am happy for you as I am sure you are very proud of him for what he is doing! I know my Mother is over joyed that I am going to be a nurse!!

Congrats again.

Rob:D

Specializes in PICU, NICU, L&D, Public Health, Hospice.

What a treat this topic is! Unfortunately, I have been caught up in the "Ticking Time Bomb" thread which has been combative, argumentative, and divisive. I came home from the university in my second summer and announced to my parents that I was going to go to nursing school. They were relieved that I had actually developed a career path! Given that I was financing my own secondary education, I opted to attend the local community college for their ADN program. Much to my surprise my mother decided that she would fulfill her personal goal of nursing at the same time. There we were, mother and daughter, nursing students. Always in the same classess and often in the same labs and clinicals. School was always easy for me, I was used to classes and papers and studying, and I was young, so I played (alot). My mom was a very smart woman and she was a perfectionist, so she spent hours preparing and studying and reviewing. She was an excellent typist, her hands simply flew on the keys...she had supported herself and her 2 children as a legal secretary after her divorce...so she typically typed all of our papers from the long-hand drafts. We were in a psych class together and she went to Hawaii with my dad...so I prepped both of our papers in her absence. She returned and typed them. Because the papers were (probably obviously) authored by one individual they accused me of riding my mom's coattails. My mom dropped out the very next week. She finished her ADN after I was graduated and off campus. I know my mom was proud of me. She told me in so many little ways over the years, and she came right out and told me much later. But, you know, I am not sure that I ever told her that I was proud of her. All the while I was a hotshot pediatric critical care nurse she was taking care of alot of "old people" first in cardiac care then in oncology. We would have Sunday dinners and, of course, she would ask about my work. I would have some fabulous tale of saving the mva victim, or the tragedy of the accidental shooting of the toddler...and she would listen and smile and then tell a story of sitting with a dying man while his family was travelling to the hospital, a man she knew well from his battle with some cancer or such. I didn't know what to say to her in those days. I didn't get it. Where was the adrenaline in that work, where was the thrill? My nursing evolved over the years. I got married, had children, dealt with the PICU from a parent's perspective, and beat breast cancer...all of these things changed me as a nurse. When I went into hospice nursing 4 years ago my mother confessed that she always wanted to do that. Two years ago this month I sat with my mom as she died in her Florida living room. I told her I loved her, that I would miss her, that I would be okay and she could go. I wish I had told her how proud I was of her...that she was the best nurse I ever knew. I finally got it.

I know you are proud of your son. I bet he is proud of you too!

Specializes in LTC, assisted living, med-surg, psych.

Tewdles, that is a wonderful story about you and your mom!! Thank you so much for sharing it..........you brought tears to my eyes.

And FWIW, I'm pretty sure she knows how proud of her you were, and are.:redbeathe