In December 1988 I naively began a career in health care. I knew that I needed a career that would allow me to raise and support my daughters then four and five years old in an atmosphere that allowed their potential to grow and keep their dreams attainable no matter how many times these dreams changed. I also knew that my purpose in society was to serve. I'd served burgers and cocktails so how big of a stretch could it be? I was not at all sure that health care would fit the bill but this is the degree I finally earned at the University of Missouri - Columbia. Prior to my first internship I had never been inside a skilled nursing facility. I had rarely been inside a hospital. I basically had avoided these smelly germ ridden places up until now. As part of my training I worked in each department to prepare to accept the "top dog" position of administrator. I was working at a facility in the home town of John Ashcroft. I remember that some of the nurses had attended school with him and were big fans. I was a young inexperienced person who, fair or not, had the potential to be their boss. Plus I was a "northern" Missourian. These nurses were aces at breaking in the new kid. I was assigned to care for a long term care resident for a shift. This was part of my education on understanding the certified nurse assistant role. Each C.N.A. cares for up to ten residents on the day shift so I made the assumption that my day would be easy or at least doable with only one resident.
Have I mentioned that I have sensitivity to smells? Great perk when drinking wine or tasting chocolate, not so great for most health care settings. I also had an aversion to vomiting. So much so that by the age of two my darling daughters knew not to vomit anywhere but in a toilet as well as to know that Mommy is there for them at least in spirit when this particular illness occurs. So basically I am this little health care rookie with a health care degree and no real life experience or fortitude.
Nurse Ratchet shows me the room that I am assigned to and I practically skip in because I am all goodness and caring with this one patient that I will shower with love for the next eight hours. Perhaps the nurse gave me some instructions but I recall none. The first thing I notice is that the room really smells - at least to me. It is a smell that I had never been exposed to previously. I look at the resident anticipating an elderly person since I was on the long term care unit. The young lady was only a few years older than I. I inhale sharply and try to not look sad or acknowledge my prissy sense of smell.
I start talking to the young lady - probably too much and too fast. Immediately I knew that I was in over my head. I started to give her a bed bath which had looked so straightforward on the video. Her hands were contracted with positioning devices in place to prevent her nails from entering the skin and breaking through the palms of each hand. A gastric tube was placed in her stomach to provide her nutrition. This area of skin required particular care in order to not become infected which could cause a serious problem. To my untrained eyes it looked dangerously infected. Not able to take nutrition or drink by mouth left her mouth dry and crusted most of the time and required special mouth care throughout her day. She lay on her side in a fetal position. Her hair fell across her face and she could not simply reach up and sweep it back. You get the picture.
I made it through the day. I don't recall breaking down in tears until I reached my car at the end of the shift. I do recall crying most of the way home. I cried for young people stuck in fetal positions in nursing home beds, for all nursing home patients everywhere, I cried for the CNA's who did this job each and every assigned shift. But honestly I mostly cried for myself that this was the industry that I would spend my life working in. I was frightened and very much outside my comfort level. Looking back over the years since 1988 I must admit that this industry can still make me cry and I while I dearly love my career - I have yet to develop a complete comfort level that everything is OK in this industry. Perhaps it is the fact that I am always working a bit out of my comfort level that keeps me engaged. Keeps me searching for better practices and solutions. Or perhaps it is the amazing patients, residents, health care workers and people that I work with and meet. Like most health care workers I can now eat a bloody roast beef sandwich while watching a wound debridement without missing a bite. But this is not the comfort level I am referring to that we need in health care. Smells.....that's still another issue.
What was your introduction to health care like? - I'd love to hear about from you.
