First of all, it only took me 20 minutes to get there! Plenty of time! Off to a great start. My group was all very excited to start hands-on experience. Properly armed with stethoscopes, pens, pen lights, power bars, and hand sanitizer, we marched into the nursing home (name will be withheld) and onto a locked down floor that only treats patients with Alzheimer's and dementia. The floor needs to be locked down so they don't wander away, but they have plenty of areas to socialize, and even a nice little courtyard to hang out in when the weather is nice. Since the place I went to today is one of the nicest nursing homes in Richmond, I was impressed with the care most of these patients got, but it still made me cringe at the thought that I might be as confused and dependent as these residents someday.
So we got divvied up into groups of 2 or 3. I was with my two best friends in the program, Brandy and April, and we were assigned to a care partner, who takes care of the basic needs for a number of residents. My first assignment, take a tray of breakfast food into a patient's room and wake her up so she can eat it herself. In this very first room, I walked in and she was sitting on the toilet. At least that boundary got crossed right off the bat, which made it easier to interact normally with people while doing such a private thing. If you're wondering how I reacted, I smiled politely, said good morning and introduced myself, and told her I would leave her breakfast on the table for her.
My next duty was just a tad more complicated than the first. I was directed to take a tray of breakfast to a patient's room and feed her. This lady was extremely doped up on medicine and never once opened her eyes, but she was with it enough to tell me when she was full and when she wanted a bite of cereal instead of peaches. As I was finishing with this patient, the care partner I was working with told me that she would be in the "tent room," whatever that was, which was supposed to be to the left of the room I was currently in. Well after wandering the halls for 5 minutes looking for a sign, I asked someone. Well turns out I misunderstood and she said "tub room," which is where residents are given showers. This led me to my next task.
I open the door to the tub room to find a naked geriatric woman sitting on this contraption being hosed down by my care partner. Now I could struggle to try and describe this interesting chair, or I can just show you the picture below.
See, it's like a wheelchair with a hole in the middle. That hole is to be able to wash what needs to be washed with the patient seated so he/she doesn't fall. At first I thought it looked kind of barbaric to see someone hosing down a lady, but I realized the woman was really enjoying herself. You see, they only get this treatment twice a week. The other days of the week, they get a sort of spongebath (don't worry, I'll get into that more later). Anyway, so my care partner tells me to observe her wash and rinse the resident (who was pretty able to do most of the washing herself), and then I would be drying her off and dressing her (by myself! Eek!). So I gave the resident (we'll call her Mrs. Tops) a towel to dry herself where she could (as nurses, we're taught to encourage patients to do as much as they can by themselves before we assist them) and I had another towel to dry her off in harder to reach areas. Keep in mind, she's still in this chair contraption, which has now been wheeled to a different area of the room that can be curtained off for privacy while she gets dressed. I did a pretty good job of drying and dressing, I should say. I figured out that I needed to get her underwear and pants around her ankles and her shoes and socks on before asking her to stand up, which is when I dried the REALLY hard to reach areas, and then finished getting her dressed. Mrs. Tops seemed pretty with it the entire time too, but pretty quiet, like she was afraid to say anything because it might not make sense.
So at this point I was feeling pretty cocky. So I ran into April and Brandy and bragged about my latest accomplishment. That's when our care partner asked the three of us to give a bath to another resident we'll call Melissa. This lady was a complete hoot. All she did was laugh and joke about us washing her "boompa" or something like that, which I assume was some word for one of her private areas. She was a little bit more difficult to clean, dry, and dress because she was bigger and also unable to wash or dry herself at all, but the 3 of us made a good team, and Melissa was happy to be clean after just a few minutes. Then we took her into the TV room to socialize, sleep, and watch Sister Act, as the case was.
Since we made such a great team, the 3 of us were asked to give a bed bath to a resident I'll call Mrs. Durrette. She was a sweetheart. Completely easygoing and patient with us. Unfortunately, she was at a stage in her dementia where she knew she was losing it, but couldn't help it. It's almost better when they get past that point and just don't even realize they've completely lost their memory. But I digress... this "bed bath" is not actually a bed bath at all. We just asked her to sit on the toilet and used a basin with warm water and wash cloths to wet her body, then wash, then rinse. When we asked if she was getting too cold or if the water was too hot, she never complained and always said everything was fine. I told her we were nursing students and that we appreciated her letting us learn on her. She jumped into a story about how she took care of mentally challenged children, but she did get confused and thought she was still working. After we finished up washing, drying, and dressing her, we took her into the TV room like we did with Melissa.
Then we made up some beds, changed some linens. Luckily, we didn't come across any soiled linens, but we changed some because there was food from breakfast and other gross looking stuff in the sheets that I figured they wouldn't want to sleep in. Then, the three of us (and another classmate, Yue Ming) refreshed their ice waters. You see, everyone (except for those who have a risk of choking on liquids) gets one of those big plastic mugs to keep ice water in, and we refresh it at 11:00am. So we went into every room and refreshed the water. That certainly took some time. When I was refreshing Mrs. Tops' water, she said she needed to give it to her children first before she could drink it.
We had some spare time after that before we were going on our lunch break, and I started talking to a man I'll call JB. I have absolutely no idea why he's on this unit because he has a really sharp mind. He does word searches all day, and he talked to me about his extremely interesting life. From how he met his wife, to his college alma mater which happens to be very close in distance to my alma mater. He told me about his service in WWII and a very honorable position he took after his service and then where he went to get his doctorate. I had such a good time talking to him that I promised we would continue talking after lunch, but he didn't look like he believed me.
So then I went to lunch. Boring.
When I came back, it was lunch time for the residents, so I was assigned one I'll call Carla. I was supposed to feed her, but she didn't seem to really like me feeding her. She also spoke 90% spanish, which didn't help me much. It took her forever to eat her meal, but after struggling with feeding her a few brussel sprouts, about 5 bites of half-pureed steak, and some baked beans, I let her eat her brownie, and for whatever reason, the bumped up her appetite and she ate almost everything on her plate. Yay!
Well after lunch is a quiet time where residents usually nap or watch TV (Sister Act came on again). Also, someone passed away on the unit while we were feeding for lunch, which was kind of eerie since I went into every room that morning to re-fill ice water. Anyway, since no one was really doing much of anything, I sat back down with JB and talked more about his interesting life, including how he personally knew a very famous General and his family. Now you may think this is his dementia talking, but he had a cap with the organization's name on it that he proudly wears all day. I excused myself after chatting with him for about 30 minutes to make sure that nothing needed to be done, but I promised to say goodbye before I left. As I walked away he grabbed my hand, looked me square in the eye, and sincerely said "thank you." When I asked him why he was thanking me he said "just for talking to me." Yes. Nursing is definitely for me.
I basically didn't do anything else except watch bits and pieces of Sister Act before my instructor said it was time for a quick meeting with my classmates and then we would be free. So I said my goodbye to JB like I promised. He squeezed my hand and told me he would see me Wednesday, and I told him he better have a lot of word searches finished that he can show me then. He doesn't know that I'm going to make him a word search online with a general theme of all the things we talked about throughout the day. I think he'll appreciate that.
All in all, I was very pleased with everything I did. I didn't deal with any poop (success!) and I wasn't even close to as grossed out about the other stuff as I thought I was going to be. The care partners and residents at this facility made it very easy on us. While I won't be doing most of this stuff as a nurse, I wouldn't really mind it if I had to. These people are well taken care of, and it's nice to know that I'm contributing to their comfort during the final stages of their lives. All of the residents were wonderful to us, my care partner was more than helpful (she's been working there for 32 years!), and I can't wait to go back Wednesday.
Also, I'm thinking of starting a brand new blog with just posts of my clinical experiences. We'll see. Until then, I'll just post everything on here.
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