My gosh, she's going fashionista!  Take me home!

Take me back to Blogspot!

Guess what I'm wearing?

Guess. 

Hint:  I am clothed.

Okay, extra hint:  I am wearing extra clothes.

Give up?

I AM WEARING A SWEATSHIRT BECAUSE I'M COLD!

Yes, September weather is finally here and living up to its billing.  Thank goodness, my air conditioning woes are over!  Sorry if you were wanting an explanation of my undergarments (hint:  They need replaced).

Tiger's Eye is already trying to figure out how to get out of his ulnar gutter splint.  He knows it can be done because, dummy that I am, had the same splint on the opposite hand when I was 13.  I got tired of it, too, and took it off for a while each day, especially to shower, and learned to put it back on and nobody knew because I was so good at it.  I told him this.  Why?  Because I'm stupid.  Now, he's thinking I'll let him do the same.  I said I'd let him to shower.  Since that probably won't happen, he's stuck.  Stuck, I say.

I have a vision in my mind this morning and it won't leave.  I'm not sure what the point of it is, but I can see her face so clearly:

Nursing clinicals, 1994, local hospital.  Our task?  Evaluate a lady and form a care plan for this patient needing surgical debridement of decubitus ulcers, bilateral heels.  Nursing home transfer; nothing unusual about bedsores there. 

I walked past the curtain toward Bed B.  That couldn't be a person, right?  Draped under the pink covers, a boxy, horribly angulated frame appeared.  Lying supine, she still sat.  I mean, her hips angled 90 degrees from the bed, as if still seated, leaving her knees straight up in the air, and then bent at the knees to where her calves nearly touched her nearly nonexistent, atrophied thighs.  Contractures of any kind indicate lack of patient care; contractures of that kind indicated abusive neglect.

Carefully peeling back the covers revealed more and more.  Her skin, so dark, bore patches of pink tissue in so many different places.  The smell of infected, decaying flesh turned another student's stomach, but, as a previous aide, the scent told me one thing, and her skin-and-bones body confirmed it.  The nursing home claimed she forgot how to eat.  Sure she did. 

Her heels needed surgery, maybe even partial leg amputation, and even with surgery, her nutritional status left her in limbo as to if she would even recover.  A few hours later, I came back to check on her.  Now with a PEG tube inserted (gastric tube by percutaneous biopsy), her hand moved toward her lips as if she were eating.  Four fingers, crooked and stuck together, and thumb to the first finger, reached down to scoop up her perceived food and raise the deformed hand to her mouth.

"Mmm.  Cornbread."  Her hand kept a constant motion, eating her imaginary food.  "Chicken.  This chicken is good.  Did you get some, baby?"

I'm sure her eyes were a beautiful brown long ago, but thick, cloudy, sickly, pale green cataracts left her without her sight in addition to all the horrors age brings. 

She "ate" a full-course meal in our presence, oblivious to our attention to her heels.  Her beautiful personality obvious, she made sure she offered us the pie and cake, always, always, with her hands moving from her mouth to the imaginary plate and back again.

Hungry.  She was hungry.  Her mind played with her, but she felt the soothing bliss of a filling stomach.  A full stomach made her more active, and, hence, more accessible to her mental status and orientation.  Her cloudy eyes, forbidden to sparkle by cataracts, looked around.  She "saw" us at her kitchen table as she cooked and served.  Those lines on her face became laugh lines and crinkles of a happy face.  I especially loved the crow's feet in animation when we told her the pie was great, and I asked her if she had any gooseberry.  "You done ate all that, baby?"

I'm not sure what happened to her; we rotated out of that hospital and went onto the next cycle of school.  It's such a strong image, though, that hand moving back and forth to her lips, her "eating" food while the tube fed her.  So pleasant.  So forgotten.  Maybe that's what keeps her so strong in my mind is the "forgotten" part.  She affected me, offering me food when she had gone so long without nourishment, her body bent and stuck in sharp angles from remaining in one body position for so long.

Who else have we forgotten?  My big beef with the nursing home industry is that our work involves people, human beings, not packaged meat products on an assembly line, but that's the mentality it takes to provide our people at least basic care.  One moves from room to room, assessing, cleaning, turning, adjusting, dressing, moving them around to different parts of the facility, going back to toilet someone in between, and so on.  CNAs are so overworked, and so many nurses won't help, but they'll sure complain about the deterioration of their patients.  Nurses are busy, too, but I think that my most valuable asset as a nurse was the inability to pass up a call light.  I handled a bedpan expertly, and toileted patients frequently. 

I left the field after having a CNA beating my patients, frustrated because I couldn't prove it, and because she was hired by friendship.  In fact, being short on help, we often worked together on the night shift, because I didn't mind getting my hands dirty.  In my presence, she spoke softly and encouragingly; when I left the room to do nursing things, who knows?  I worked with her one night and left the patient's room after we cleaned him so I could take blood sugar readings at about 6:30 a.m. for our diabetics, leaving her to dress him and get him up for the day.  The next night, I discovered he had his arm set for a through-and-through fracture, and we had to be the last people in that room before he told the day shift he hurt.  Not only that, the screams and yells from down the hall when I did my nursing duties on other nights haunt me.  I could do nothing; her friends at the nursing facility hired her, knowing she had a pending charge of elder abuse with a trial date set.  Online people complain about "cliques."  You have no clue.  Try living with the guilt of not being able to infiltrate a nursing clique, where people tend to cover everyone's butt but the patient's. 

Fortunately, during that time, I had an RN coworker who, too, got her hands dirty.  If we worked together, we sent the CNA elsewhere, and did total patient care.  We tended to our own halls.  We felt less guilty that way.

The thought of returning to nursing scares me.  Nurses are the patient advocates.  When we can't advocate, we fail.  I failed, so I bailed.  Transcription keeps me current with the medical field, especially with the awesome treatment modalities available to patients.  If I go back, I go armed with the medical knowledge of patient care, but can I be proactive for the safety of my patients?  How do you do it?  How do you get past the clique and to the meat of the problem?  Do I need to figure out how to mount cameras for my proof?  Is direct confrontation needed?  Will I lose my job in a she-said/she-said manipulation match? 

I love medical transcription.  Right now, it's more conducive to raising children, but our transcription industry, like many other industries before it, becomes threatened by modernization, i.e., voice recognition and electronic records.  I need something to fall back on, so that's nursing, and I shouldn't waste a perfectly good degree, but...

Lord, help me...

It scares me.

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