23 February 2006

Yesterday I met a delightful woman who was to be taken to a skilled nursing facility and she asked a hard question. Specifically, "is the place I'm going nice?" I didn't know how to answer that as she was going to a place I do not find especially nice, but telling her that isn't going to accomplish anything because clearly the decision has already been made, and since she was heading to the county facility it might have been the only option her family could afford. I don't know anything for sure about the place, just the couple of times I've been there with other patients, it gives off a negative impression and the staff aren't especially friendly.

I ended up telling her that I thought they would take good care of her, but it still didn't feel right. Too much like a lie. When we got there, I wanted to sink through the floor. They didn't seem to be expecting her as no one on her unit knew where to put her and nobody wanted to help us. It took us almost 5 minutes to find a nurse. Our patient was somewhat forgetful and occassionally had trouble finding her words, but seemed mostly together, talking about her past and her family, and quite on top of the ADLs (activities of daily living). We may have been seeing her on a good day, I know that not every day is the same for patients like her, but this unit did not seem like a good fit. It was locked down, which is not uncommon and not a big problem, and the day room we had to go through the middle of was full of the other residents sitting mostly in wheelchairs and drooling or talking incoherently. 2 nurse assistants and about 15 residents. When we got around the corner, there was a woman sitting 6" from the TV and moaning/screaming constantly, another trying to go through the closed half of a glass door, and a guy rolling his wheelchair repeatedly into the counter.

Our patient can see as much of this as we can and began to looked panicked, as though she was searching for an exit and I didn't blame her for a minute. We left her with 2 of the only 4 staff I had seen on the unit, so I worry what was happening with all the residents we didn't see. It was the hardest place to walk out of and if she had asked us not to leave her, I probably would've broken down and cried because I didn't want to leave her there. The guy I was working with that day didn't seem to get it; the woman I worked with today didn't seem to get it either when I tried to explain it. Everyone looks at me as though it is because I'm new, and maybe they're right, but I prefer to think it is because I can empathize with feeling a little lost and confused in your own mind and then finding yourself in a place like that, with nowhere to go but down.

1 comment:

Anonymous said...

I don't think it has anything to do with being new, it has to with caring. I work as and EMT in a small town and we have a facility very much like the one you described. We picked a guy up there the other day to tx to the local hospital... I thought about that poor guy all night. He had supposedly had a major seizure and fallen and hit his head, he needed stiches. As soon as we got him out of that place and into the back of the ambulance he was like a totally different person. I wonder still if he didn't hurt himself as an excuse to get out of there.

I feel for you, I too feel guilty taking people to those places. Not all are bad, but it seems like the ones that are bad are REALLY bad.