Underneath our Scrubs

By Alice, Certified Nursing Assistant

Underneath our scrubs beat hearts that celebrate each success and bleed for each loss of those within our care. We know that our time with them is limited and we can not cure them. We can’t turn back the hands of time and we can’t change the situation that led them to our care. But we walk with them. We do what we can to improve their quality of life. We tell them they are not alone. We try to coax smiles from weathered faces worn down by time and experience. We listen. We translate. And when they pass, we grieve.

Underneath our scrubs are muscles that ache from running up and down halls or up and down stairs as we do the work of three people because of short staffing. Sweat runs down our face as we prioritize needs on the spot in order to provide the best care we can in an imperfect situation. Carefully compartmentalizing the very real frustration that comes from being overworked and underpaid; constantly facing impossible situations and feeling unappreciated, as if what we do is of little value. As if we are disposable. And isn’t that how those in our care feel? Invisible? Overlooked? So we run harder. Try harder. Uphill battles become our bread and butter.

Underneath our scrubs are souls of true grit. Whatever we look like, whether we wear it on the inside or out, we do not give up. Caregiving does not stop for holidays or inclement weather. It is not nice and neat. The most important and necessary tasks fall between the lists of activities of daily living. We face our own mortality every single shift. We face worst case scenarios and see the people beneath; see the strength and courage of those living through them and their strength fuels our own.

Underneath our scrubs, we are tired. We are weary. We are disgusted with the poor pay and misunderstanding of what we do and why we do it. We are tired of being dismissed. Tired of those in our care being misunderstood and dismissed. Tired of “it looks good on paper” mentalities and tired of people with little experience on the floor and no real world knowledge of those in our care deciding what is best for them without our input. We deserve better. Our residents certainly deserve better. And until we get better, we will be relentless and consistent in speaking our truths.

Reprinted with permission from CNA Edge.

Pediatric Trauma: Pedro and His Mets Baseball Cap

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By Jo Cerrudo, ER Nurse

August 1997…

“This is EMS. You’re getting a 9-year old boy in traumatic arrest after a direct blow to the chest with a baseball. He’s intubated; we’ll be there in 2 minutes. ” My hands shook when I replaced the EMS notification phone.

After years of dealing with gunshot wounds and stab wounds in our Level 1 Trauma Center, I was not easily fazed, but taking care of pediatric patients scared me. I worked at the Adult Emergency Room but hospital policy dictated that pediatric traumas come to the Adult side for the initial rescue interventions. Many of the ED staff have young children at home, and cases involving kids always evoked strong responses among the parents in our group. I could almost imagine some of the parents in my staff calling on the phone for their family.

The baseball stunned our patient’s heart, and it was being squeezed to life by the frantic efforts of the paramedics who initiated cardiopulmonary resuscitation at the field. Commotio cordis describes a sudden cardiac arrest from a blow to the chest. The baseball had caused a disruption on the heart rhythm at a critical point during the cycle of a heartbeat resulting in ventricular fibrillation. The quivering heart did not produce a heartbeat. There’s a 65% mortality rate. A nightmare coming to our doorsteps.

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The Effects of Nursing on Nurses

By Grimalkin, RN

This morning, while I was giving report to the day shift nurse taking over my patients, she burst into tears.

She’s going to miss her children’s hockey play offs due to our strictly enforced every other weekend schedules. You work every other weekend, no more, no less, unless you are going to college (I work every weekend because I’m in college). She’s their hockey coach, and inevitably, each year, their last game falls on a day their mother has to work. I’ve come in early for her before.

So I offered to come in on my night off for an hour and a half so she could get to the game. I’m coming in that early because I know she won’t be done charting.

She turned me down until another day RN got involved. I reminded my coworker I only live a mile from the hospital, and it really wasn’t a big sacrifice for me. She finally agreed, and calmed down. We got permission from the charge nurse.

Nursing is one of the largest professions in the world. If you don’t know a nurse, I’m really surprised. Nurses talk a lot about the rewards of nursing. Catching that vital sign, saving lives, providing comfort, but nurses, by nature, are taught to martyr themselves on the altar of nursing.

When I was a new grad, I hated coming to work so much that I would wish I’d get hit by a car on my way to work just to get out of work. One night, while checking medication sheets, I confessed this to some experienced nurses and found out some of them still felt the same way.

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The Worst Float Ever

By Gina, Hospice Nurse

Sometimes when a unit is over-staffed, nurses that are “extra” either get to stay home, or they have to float to another unit to help out there. At a hospital I used to work at, ICU RN’s were allowed to float everywhere but the maternity/OB ward.

Once I was floated to the adult psych ward. That really wasn’t so bad; at worst it was very very boring. I, not being a psych nurse, was not allowed to pass meds or attend psychotherapy sessions. I helped out a little bit with the elderly patients, helping to feed them, etc, but the rest of the time I was playing solitaire on the computer. I kept asking other RN’s if there was anything else I could do, but they said no. I finally asked why I was even there, and someone told me that they needed to have a certain number of RN’s there in case of a riot! HA!! If that occured, I’d be hiding under the nearest table, not jumping into the thick of it!

(Please take a moment here to imagine going to work at 7am only to be told that you are to spend the day helping out in a psych ward. God love all the psych nurses, because I simply could not do it every day!)

But this is supposed to be about my worst float experience. On another slow day in the ICU, I was sent at 7am to work on the ortho floor for 8 of my 12 hour shift. Did that, it went fine. I went back to ICU to find out what I’d be doing for the remainder of my shift and was told that I’d be going up to Child Psych.

Oh please God, no.

That’s what I should have been thinking, but instead I was thinking, “Oh, piece of cake. I can brush up on my solitaire game!”

What a sucker.

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Congratulations! Your Patient Survived

By Binder Smiff, Paramedic

I opened my work tray the other day to find an envelope.  Inside was a letter.  A standard letter suggesting with all integrity that I (amongst others) had managed NOT to kill someone.

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Now, these letters don’t come often, but they do come.  In fact, I have a few now.  And I wager that anyone working in the job long enough will end up receiving at least one at some point.

I remember the job too . . . well, by process of elimination it’d be hard not to.  Of the five cardiac arrests I’ve done this year so far, only one of them wasn’t called on scene!

I would normally prefer to write about jobs that are either farcical in nature or tend to have some form of Frank Spencer-esque feeling about them.  So, it’s a bit weird (and rare) to write about something that . . . without trying to sound arrogant . . . went, um, so smooth.  Well, sort of.

Job simply came down as 70 year old male, unresponsive – red 2.  And, upon arrival I was presented with a venue that appeared perfect for the presentation of a cardiac arrest.  It was a large, empty, well lit room with a couple of chairs.  Near enough in the middle of the room lay my patient, on his back.  Quite possibly the best 360 degree access you could wish for.  Most people had left the room or were in the process of leaving and the only remaining folk were a couple of witnesses and friends of the patient.

As I was dumping my kit onto the floor I got the history . . .

“He said he felt a bit sick then just slumped to the floor”

Ah, short and sweet.  The way I like it!  Looking down at my patient I could see his fingers twitching and thought I could see some facial movement.  Therefore, thinking this was initially fake I leant down and went through the motions of DRABC.

D – Well, unless I’d missed a huge piano about to fall on my head or was about to be presented with an opening chest with teeth – like that scene in the film The Thing, where the chest opens and bites off the Dr’s hands when he performs CPR – I’m pretty sure I was free from danger.
R – I attempted the LAS’s preferred method of approach, calling out the patient’s name loudly and squeezing hard on the shoulder/neck region.  Nothing.  Oh, I thought, playing games are we?  I then flicked the eyelashes for a reaction.  Nothing.  Ah, I thought, that’s odd . . . in fact, is – is he breathing?
A – I quickly opened the patient’s airway for a quick check.  No resistance and clear.
B & C – Leaning down I watched his chest and instinctively went for both the patient’s carotid and radial pulses.  Nothing. Nothing and Nothing.

Well, what do you know.  I thought. You AREN’T faking it.

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Stories by Home Health Workers

 

 

See video at https://www.youtube.com/watch?v=ky1e_sv3byE 

 

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As Executive Director of the 1199 NE Training Fund, I’ve had the privilege of hearing the members tell their stories for many years. I’ve heard uplifting stories and tragic stories. Many stories bring smiles to my face; others leave me sad and shaking my head.
Mercy Osei-Sarbeng, a writer published here, said, “Besides being healthcare workers, we all have personal stories to share, which indeed is for the common good for everyone to hear.” How right she is. I hope that reading this beautiful collection will give you some insight into the world that these committed nursing home workers live in every day. — Steve Bender, Executive Director, 1199 NE Training & Upgrading Fund, Hartford, CT

Publishing With Our Loving Hands fulfills a longtime dream: to mentor worker writers who contribute so much to the social good and to bring their stories to the public. In writing workshops I have listened to many stories about labor. Now they are in print. When workers are given the time to write, read aloud and discuss their stories, the value of their work is reaffirmed. Publishing those stories builds union solidarity and union power, because they show the community the value, honor and heroism of their members. I am proud to help 1199 NE nourish the
creativity and pride of the nursing home workers they represent.

— Timothy Sheard, Hard Ball Press

harrdballpress.com/hgp-authors

Delay in Wage Hike for Home Health Workers

  10/07/2014 
 WASHINGTON — The Labor Department announced Tuesday that it plans to delay its enforcement of new minimum wage and overtime protections for the country’s home care workers, though the protections will go into effect as planned.

Workers who tend to the elderly and people with disabilities in their homes had been carved out of the labor protections that cover other hourly workers in the U.S. After a years-long campaign by worker advocates, the White House announced last year that it would extend those rights to roughly 2 million home care workers as part of the president’s economic agenda for low- and middle-income earners.

But pushback against the new rules came from home care companies as well as several state Medicaid programs, which pay the salaries of many home care workers. The National Association of Medicaid Directors recently asked the White House to wait an extra year and a half before rolling out the rule, which was slated to go into effect Jan. 1, 2015, saying its members weren’t yet ready to comply with the new rules.

In a filing with the Federal Register on Tuesday, the Labor Department wrote that the new rules would still go into effect on Jan. 1 as scheduled, but that the agency would not enforce them for the first six months. For the six months following that, the agency would enforce the rules at its discretion.

The decision appears to be a compromise. By delaying enforcement, the Labor Department gives states and companies more time to adjust to the new rules, while also placating groups that were concerned the rules themselves might be in jeopardy.

Labor Department officials explained the decision in a blog post on the agency’s website Tuesday:

We have consistently emphasized the importance of implementing the rule in a manner that both protects consumers and expands wage protections for direct care workers. We believe this non-enforcement policy will help achieve both of those goals.

PHI, an advocacy group for home care workers, said in a statement that the decision means workers “will have to wait as long as another 12 months to receive even the most basic labor protections, guarantees that most other American workers take for granted.”

The Service Employees International Union, which represents an increasing number of home care workers around the country, said that despite the enforcement delay, it was pleased the rules were moving forward. Mary Kay Henry, the union’s president, said SEIU plans to work with state leaders on implementing the rules during the months the Labor Department declines to enforce them.

Sen. Tom Harkin (D-Iowa), said in a statement that he “applaud[ed] the Department of Labor’s efforts to move forward with this critical rule. Both caregivers and the consumers they care for will benefit” from the policy.

The reforms will bring home care workers under the umbrella of the Fair Labor Standards Act, the Depression-era law that created a minimum wage and time-and-a-half pay for overtime. Home care workers, who generally earn low wages, have been excluded from those regulations under the so-called “companionship exemption” created by Congress in the 1970’s. Advocates argue that the original exemption was meant to cover casual babysitters but not health care workers.

Some disability rights groups have raised concerns that the reforms raise the cost of home care without increasing funding for it. The advocacy group Adapt criticized the delay in enforcement on Tuesday as insufficient.

“The basic problem with the [overtime] changes is that without funding in place to pay for them, states and provider agencies will simply cap the hours attendants can work to avoid any overtime costs and liability,” the group said in a statement. “This will undercut the ability of people with disabilities and seniors to live in the community.”

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