I have been working in long term care facilities and health care centers since 1983. I was 17 years old and a junior in high school when I got my first job as a laundry aide in the same nursing home my mother worked at. She had worked there as a nurse’s aide for years while my siblings and I were younger, and when we were old enough to help out around the house, she worked full time nights and put herself through nursing school during the day. I would watch her when we worked together and the love that she had for her patients, the compassion and the empathy that emanated from her was beautiful in so many ways, and I knew that I wanted to be just like her. She was my mentor and she taught me how to take care of people the way that they deserved to be cared for.
My first nursing assistant position was on the dementia unit of a long-term care facility and my training consisted of a 2 hour orientation, a tour of the facility and instructions on appropriate uniform attire. It was mid-July, a particularly hot summer day when I walked off the elevator that first day, and the air conditioners in the entire building were not working. The first thing that I noticed when I walked onto the unit was the strong smell of urine that hung heavily in the hot summer air. I was given an assignment and was told to forget whirlpools for the night because there had been a few call-outs. Whirlpools? I didn’t even know what that meant! I had 20 residents to put to bed that night on a total care unit. There were several Hoyer transfers and 90% of my assignment were sitting in chairs, tied up in some sort of restraint, whether it was a pelvic, waist or vest restraint. Haldol was the physician’s drug of choice that year and every single resident on the unit was snowed, which made transferring extremely difficult, especially since it was only me and one other nurse’s aide, and she was on the other end of the hall.
I remember how terrified I was that day. I had never seen a man naked and suddenly I was changing men that looked my grandfather, I was shaving them, I was feeding them, I was washing their privates!!! I had no idea how to wash a man’s penis, never mind a catheter tube! Not even a smidgen of training and I was responsible for this sort of care?
I remember the first time a patient fell because of my lack of training. I remember her name and I remember the panic as I screamed for help. After several minutes of screaming for help I realized nobody was coming, the adrenaline kicked in and I picked her up off the floor and put her into bed. No small feat for a 116 pound teenage girl who was running on fear alone at that point!
I remember my first skin tear and the amount of blood that was everywhere. I remember the first time I shaved the very wrinkled face of a man and the way my hand shook each time I passed the cheap plastic razor down his cheek. I remember the first time I had to give someone a whirlpool and how I had no idea what to do when the person on the bath chair became increasingly combative. I remember the first time I walked into a room after someone had died and being very afraid to touch him when I was told I had to clean him up before they took him away. Again, no training. I was working on instinct alone.
We used green cloth “diapers” with snaps on each side and elastic leg bands. We restrained everybody when they were sitting in their wheelchairs and then lined them up along the halls and around the Nurse’s station. Nobody was toileted, there were no “activities” and everyone ate pureed food – mashed potatoes, green stuff and brown stuff.
In 1987 it became mandatory to become certified if a person wanted to work in nursing homes thanks to the Omnibus Reconciliation Act, and had it not been for the fact that I was in nursing school at the time, I would have been “grandfathered” and would not have received any training. Despite the changes in policy, funds were not available for training programs. It wasn’t until the early 90’s that CNA training programs began to appear in facilities as part of the hiring process.
Over the years, as my children were born, my experience as a CNA broadened. I worked for an agency that placed me in facilities all across the county so that I would be able to work full time and still be available for my children. I became Rehab Certified and it was then that I learned proper techniques in transferring with gait belts, as well as many other skills that have become vital in the care that I provide for my patients/residents today. I became MAP certified (Medication Administration), Restorative Aide Certified and in recent years have become certified as a CNA II which has given me extensive training on skills including oxygen therapy, urinary catheters, fecal impaction, sterile dressings, and suctions just to name a few.
In 2007 my husband, who was only 40 years old, was diagnosed with end stage melanoma which had spread to his lymph nodes. I used my years of training and education to care for him, and despite the emotional toll that it took on me as a person, I was determined to give him the best quality of life, no matter what. Numerous surgeries that completely and totally disfigured a once vibrant, athletic man resulted in wound care and several dressing changes each day, radiation and chemotherapy left the man I loved even sicker rather than help him, and finally, it was time to accept the fact that he wasn’t going to get well. My Mom and I talked daily on the phone, with her guiding me, supporting me, offering me words of encouragement and advice, and when she felt that I was strong enough, she told me it was time to begin letting go. I learned at that point, what Hospice is, and with great trepidation allowed strangers to come into my home and teach me what it meant to allow the man I loved, the father of my children, to die with dignity and respect. At the age of 41, my husband died at home, with me by his side. A day that I will never forget. A day that changed the way I understood the meaning of what being a caregiver truly meant.
In 2016 my mother, my mentor, my idol, my Rock of Gibraltar, had a massive Myocardial Infarction, followed by a severe stroke. I drove 23 hours (1050 miles) to be by her side and cared for her around the clock for three weeks right up until the day she died. Every ounce of my energy went into taking care of her the way I had seen her care for her residents over the years, and when she died, I know in my heart she was proud of the daughter that she had trained to follow in her footsteps.
At the same time that my mother had gotten sick, I was caring for my late husband’s mother, who had been diagnosed with Alzheimer’s and lung cancer in 2013. Two weeks after my mother passed away, I brought my mother-in-law to live with me. I had made a promise to my husband that I would take care of her, and when the time came, I stood by that promise. I took college courses on Alzheimer’s and Dementia, its epidemiology, and how to best provide customized care for anyone experiencing symptoms of Dementia or Alzheimer’s disease. I became Support Care Certified in order to provide her with the best possible care as her dementia worsened and her health declined. I set up the perfect environment for her, complete with hospital bed with air mattress and any other medical supplies and equipment that may be needed. When the time came, I had the knowledge and understanding that was needed to bring hospice into our home, and I knew how to provide the palliative care she needed. Less than a year after caring for my mother as she gained her angel wings, I sat with my mother in law, holding her hand, as she, too, gained her angel wings.
Mine is not a sad story, nor is it a story to be told with tears of sympathy. Mine is the story of a Certified Nursing Assistant’s journey through time. Over the years, as I have worked in numerous health care settings, cared for people of all ages and ethnic backgrounds, at every level of need varying from rehabilitation from motor vehicle accidents to end stage leukemia, and I have learned that my role as a CNA is tantamount to the quality of life that each person I care for has. I have also learned first-hand how difficult it is to be the “family member” and today I am guided by compassion and empathy whenever I walk onto any unit. I care for each and every person as if that person is a member of my family, I respect the family equally, and I never forget to let them know how important they are. I kiss foreheads good night as I turn the lights out at day’s end, I sing Somewhere Over The Rainbow as I am giving showers, I bake birthday cakes for the ones who have no family to celebrate another wonderful year, I work holidays and weekends, I work doubles when staffing is short, I hold the hands of those who are nearing the end of their life story, I dance, I cry, and I love the fact that I can care for those who need it without a second’s hesitation.
My name is Kim, I am a CNA, and this is my story.