Usually sweat begins to form on my forehead by the first 15 minutes of my shift. Certified Nurses Aids (CNAs) are notoriously considered to be underpaid, overworked, and not in high enough numbers to be anything other than short staffed. My facility, which is both long-term and sub-acute care, in the middle of a pandemic, certainly does not break the stereotype.
For the first 10 minutes after arriving I figure out which set of residents I will have and if any have assigned showers for the evening. At this point, I know if I will be able to take my required 30 minute lunch break or if dinner will be at 11pm again.
As soon as I get my assignments straightened out I start answering the call lights that have accumulated during the 30 minutes between shift changes when few people are answering them. When a resident puts on their call light, a light goes off above their door as well as a ringing sound at the nurses station until someone answers it. The ringing is on the majority of the time no matter how fast we answer them so people will often ask why we never answer the phone at the desk. I always explain politely that it’s not the phone but in my head I’m thinking about how I know I have control over how often that phone rings. With my N95 and face shield in place I head down the hall to answer the first light I see. I knock, put on a gown and some gloves to see what this room’s occupant needs.
All the new people coming into the facility are on a strict 14 day isolation, meaning they are alone in their room and their door must be closed all the time. Additionally, the employees must be wearing our N95 mask with face shield and we must follow a strict entrance and exit protocol by wearing a washable gown and gloves. In theory outside these rooms I could wear just my surgical mask but that would require me to change my mask between every room which is something I certainly don’t have time to do. Not to mention my ever pressing fear of unintentionally spreading Covid to any of the residents. I am as careful as I can be, but who knows if I accidentally picked it up at the grocery store and my weekly test did not pick up on it.
I enter and the resident annoyingly informs me that she has been waiting 20 minutes for someone to take her to the bathroom. I apologize and quickly move her chair over to her bed to help her up. By the time I finish helping her, I’ve gotten her to smile and shake off her initial annoyance with me. I ask if she needs anything else and basically hold my breath waiting for her response. She says no and I sigh internally in relief. I always ask because I know I should but I never have time to help with much more. I remove my gloves, then my gown, wipe down my face shield and wash my hands with handsanitizer.
Okay, who’s next.
I repeat this process with all the rooms with those relentless lights on until I get them all answered. Someone needed water, someone was complaining about the lunch they didn’t eat from 3 hours ago, and someone needed the nurse. I take a moment to calculate my next move. I need to take vital signs on every patient before 7:00 but I also should get some showers done to decrease the chance of someone being angry that I am asking them too late in the day. I take a deep breath, adjust the strap on my mask to prevent my developing headache, and go grab a vitals cart.
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After two hours and many interruptions I am only half way done with talking vitals and dinner is in 15 minutes. Shit. At the same time I realize I haven’t even looked at the charting yet either. Touch the patient, touch the chart. That is what we are taught in our training. I laugh at the impossibility of the idea. I do my best but the idea of making someone wait for something they really need because I have to tell the computer every move I make seems wrong. Or at least it should be. Down the hall, another light turns on demanding my attention. Shit.
I answer the light and when leaving the room I wonder if I remembered to wash my hands before going in. At this point, my hands are red from the constant washing, hand sanitizer, and gloves. I wonder about the rules before Covid as today’s world has always been the reality of my job here. It seems like such a foreign idea that I would ever help someone get dressed without a mask on. Right?
Just when I am ready to start working on the vitals again the kitchen staff drops off the cart with all the trays. And so begins my next flurry of trying to pass the trays as quickly as possible without seeming rude and running out of every room in a hurry. While passing the trays I always get requests like “Can I get a different salad dressing?” or “Can I get vanilla ice cream instead?” I try to let these requests accumulate before I complete them. The residents have to wait a bit longer but for me it’s much more efficient as running to the kitchen across the building feels about a mile away and not something I would prefer to do multiple times in a row.
I drop off a tray and I get a 5 minute lecture about how terrible the food is and how it’s my fault that tonight was chicken instead of fish. I struggle to not take the attack personally. Maybe there is something I should have done better.
I have a patient who needs one-on-one assistance with meals so I head in there last after all my other trays are passed. I smile when I head to the room because I like this lady. She is very sweet, but also happens to be very confused and gets too distracted to eat by herself. I get her and her food set up and begin to help her eat. She slowly takes a bit of the mashed potatoes and gravy. I glance at the clock, it’s already getting close to when I need to be picking up the trays from the rooms before the kitchen staff comes back for the cart.
She takes another bite.
I begin trying to plan the rest of my shift, bargaining my time in my mind. If I finish taking vitals next, maybe I’ll have to get some showers done and still get to take my lunch break around 9:00pm.
Another slow bite.
A feeling of irritation sweeps over me. I am willing this sweet lady to eat faster so much to the point that if she said she was finished after only a few bites I would be relieved about saving time. Just as fast as the irritation came, a feeling of guilt takes over instead. She is entirely unaware of how much work I have to do and all she is trying to do is get something to eat and talk to someone for longer than a 2 sentence request when someone answers her call light. Nobody, not even the non-isolation rooms, have been allowed visitors since before the pandemic.
I help her finish eating and check at least twice to make sure she doesn’t want any more.
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Around 7:00 I get my first chance to sneak into the break room to drink as much of my water bottle as possible. My feet are starting to ache from constant walking and standing. I think about the overwhelming amount of tasks I still have to complete before my shift is done. If I can just help a few people with their showers and help a few people get changed maybe I can get some dinner soon. I notice my mask has left a deep red groove all around my face and my hands are a little shaky.
After essentially finishing my water bottle and putting my battle gear on I head to the supply closet to gather some shower supplies. Right before going into the closet another damn call light comes on.
I sigh and redirect my attention to walking towards her room. Once I get there I put on my gown and gloves and knock lightly on the door before opening it.
As I enter I see a frail woman probably in her 70s who had slid down her bed and was now much closer to the foot rather than the head of the bed. Her face is somber but her eyes seem to be calling out in fear. A long moment passes before she begins to talk. She’s speaking softly at first about nothing in particular. She continues on with a shaky voice saying “My kids… they usually call..”. I see her eyes start to fill with tears as she struggles to articulate what she’s feeling.
I let her speak while moving slowly towards her bed so I can hear better.
She erupts talking about all the events that led up to her being here and the problems and fears she is experiencing. I realize that there isn’t actually anything she is really going to ask me to do. At least, there isn’t anything that is really going to help her. After that thought I am tempted to politely apologize and move on to my next task.
I pause, looking at the scared and concerned women in front of me. She is someone’s mother, someone’s grandmother, or maybe someone’s sister. But more that she could be my mother, my grandmother, my sister, or even me.
I take a breath and I sit.
I sit right on the edge of her bed and place my gloved hand on her arm. Every infection control nurse would lose a year off their life if they knew that I chose to allow my “dirty” scrubs to come in contact with my patient’s belongings.
I mostly just listened as she tells about everything she wants to. She tells me how she’s scared and doesn’t know what’s gonna happen. I attempt to reassure her but really I know just as little as she does. By the time she’s done talking her voice is steadier and we even talked about her newest granddaughter which instantly brought a smile to both our faces. She took my hand and thanked me in a way that I am not sure anyone has done since I have had this job. For all the necessary and life-sustaining support I offered people at this job this is perhaps the most gratitude I have felt.
I retrieve a new blanket for her and toss the one I had sat on in the laundry. I step out of her room and it takes a moment for me to remember what I was about to do.
Instead of immediately going to get my supplies I go into the person’s room who was complaining about the dinner being chicken. I ask him if he was able to eat enough and he replies saying it actually turned out to be pretty good. He goes on to explain that it reminds him of something his wife used to make. I talk to him for a minute about his wife and family and he says he hasn’t seen anyone since he got here 3 months ago. By the time I left he was not even the same person who I had talked to earlier.
I step out and see a call light turn on. But this time, I smile then laugh while shaking my head while making my way down the hall.
Brianna Regan | January 2021 | Healthcare facility during a Pandemic