On being an aid: a look back at my very first day of bedside care.

[TheBlackDogWaits]

I worked my first day by myself as a CNA two Fridays ago, in a local LTAC saturated with totals.

I don't even know where to begin.... I showed up to work at 0545, ready to take on the day. My plan was to start with ice and vitals at 0600, but then I thought 0600 was too early for ice, because surely it would be melted before lunch. So, I skipped the ice. I went straight for vitals, and by 1000 (probably even before that), the ICU nurse, Lincoln*, was rounding the hall asking if we were giving ice this morning because he's had four patients asking for ice already. I had to apologize, and continue with my tail between my legs.

Not long after that I was headed for the ice machine, but not for a lack of other things that needed to be done. Honestly, I didn't have a lick of time; between 107 needing the bed pan, my 109 who lost consciousness and needed to be upgraded to a high-obs room, and the code that happened in 101B, I barely had time to breathe. Obviously, the code was addressed, and Ms. Raquel* from 109 was brought to a more appropriate room, so I attended to 107, choosing the only bedpan available in the restroom, as it was a private patient room. Then there were breakfast trays to be handed out (don't know why the nutrition department can't hand those out), and the subsequent "feeders" (this is what they call patients who are 'total care' and are not able to feed themselves, thus we have to feed them), and the collection of said trays. After my fourth visit to 107 before lunchtime, the patient went on and on about how I was "on it" today, and "are you sure this is your first CNA job?," because, as she flattered, it was clear to her that I would be the boss one day...

Oh, boy! My first day, and I am getting compliments on my performance. A woman after my own soul. It went on like that for the majority of the day. A constant buzz of ups and downs. 101A gets maggot therapy, and suddenly every nurse and aid in the facility turned into Yang from "Grey's Anatomy," all over the treatment like white on rice (couldn't resist the pun). 102A is a new admit, 109P has a very low BP (that's Ms. Raquel, who was later moved to high observation for having a change in LOC - and let's be honest: she hasn't been responsive in the whole three weeks I've been orienting, so shame on the nurses who've let her even get that far without once contacting her physician, who was livid with the development), and 105B has disappeared entirely, and 105A needs to move to a different room, so that 109 can move into his space for high-obs, since it is so close to the ICU nurses station..... madness all day.

I didn't even get lunch until 1430. Then, 1430 turned into 1445 when the other CNAs on the floor were MIA, so I had to take one of their patients out of his bed and place him in his bedside chair (no small feat in and of itself). The nightmare was, the guy needed a hoyer lift for transport. Well, he didn't decide he needed the bedpan until he was firmly placed in the chair, so back into the hoyer he went.....

Then there was the nurse who never wants anything to do with me, and this changed things.

Before I'd even approached her, she knew I was coming for her. I rounded the hall, looking at her with my warm eyes, trying to break through. She appeared burdened by the heaviness of the dying and the consequence of caring, only she doesn't really care. She saw me coming, and I just looked like another distraction; another tasking priority that could just as well be handled independent of her, so why does she have to bother with talking to me?; another what could you possibly need from me now?; another can't you just keep them clean and be on your merry way?; another eye roll. Yes, another eye roll.

Instead of asking anything of her, instead of wasting her precious time, I simply smiled at her, gently placed the single sheet of paper on her desk and said, "Your vitals." Walking away from her, I thought about her obnoxious eye roll, satisfied that I hadn't needed her yet, relieved even. Eventually, down the hall, I succumbed to the fear that I might need her one day.

My foundation shifted, my perspective began to evolve. In my nascent idealism of nursing, I now know for sure that what I never want to be is her.

* Real names have been changed to protect identities.

[Esme12, ASN, BSN, RN]

Whhew! That made me tired.....beautifully said!

Thanks for sharing!

[Atl-Murse]

Be careful with dropping names, room numbers etc "HIPAA"

[TheBlackDogWaits]

Wannabe,

I can't decide if you're trolling, but I did actually change personal information of the pts I saw nearly two years ago, in a location I did not disclose. I do hope you enjoyed my short, harmless narrative. Thank you for taking the time...

[OnlinePersona, LPN]

Girl if you write a book lemme know. You write like a true author :-)