My First Nursing Instructor

UM Review RN, ASN, RN

I was in my teens when I started work in a local nursing home. This was eons before HIPAA, way before the nursing home industry was regulated. This was when nursing homes were true hellholes, where residents could be restrained for days, where dressings were changed once a week or whenever someone felt like it, where doctors made monthly rounds and refused to treat patients screaming in pain because they were too old.

We didn't wear gloves. Gloves were expensive and only used for sterile procedures by the nurses. I was a nurse's aide. There was no certification course for aids back then. I was taught to change the sheets every few hours and only wash the patient if there was a messy BM or if the urine smelled like ammonia. Only when the urine had turned to ammonia, I was taught, would the skin suffer harm.

I worked with one other aid on two different shifts. When I worked afternoons, we would serve dinner, wash the dishes, give a couple of showers, and put the residents to bed.

I loved taking care of the little German lady. She couldn't walk. She was incontinent. But she was sweet-tempered, ate all of her dinners, suffered through the cold air after the shower each night without complaint. Once in a while, she would point to something she wanted. A glass of water. Another dish of pudding. Always with a big, gentle smile.

On the night shift, there were three rounds made for the 100 residents starting at midnight. It was on one of these rounds through the four open wards that the little German lady and I had our extraordinary communication.

Rounds were late that night. When we threw the covers back on the little German lady's bed, the overpowering ammonia smell literally choked me. There was no disguising my expression and I didn't try to hide my disgust. I can still hear myself trying to hold my breath as we surveyed the poor woman, soaked from her head to her feet.

It's hard to explain what happened next because it was one of those moments in which time suddenly melted away and all I recall is being caught up in her gaze. Her eyes brimmed full of such hurt that it made me gasp with a realization of how my reaction had shamed her. I will never forget that look, never will forget how her eyes filled with tears - not from the odor, but from my betrayal of her dignity.

That is the day that I was so mortified by the behavior that I prayed to God to lose my sense of smell, to learn how to accept my patients without judgment for the things that they could not control.

That day, the day that I began to see all of my patients' humanity in the episode with the little German lady, is the day that I was given the heart of a nurse.

My First Nursing Instructor

About UM Review RN, ASN, RN

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