This past Tuesday, I had a total knee replacement. On Friday, I went to a rehab near our home to learn how to navigate our 34 steps at home. I have been here now for four days. I hope to be able to leave within the next week. We'll see. I am in a semi-private room with a dear 90-year old woman who fell in her home and who struggles with additional medical problems. She has already been here for two weeks and hopes to return to her home by month end. Although this facility I am in is referred to as a "rehab" for me given my current condition...this is also a nursing home. I have been told I am the youngest patient here at this time; that was made clear when I was asked how important it was for me to choose my own clothing to wear each day. Today's blog post is about all that I have observed as a result of my stint so far in this "skilled nursing facility".
Although the facility I am at will remained unnamed throughout this post, it is clearly a five-star facility from the outside looking in. We toured it before I had my surgery and I felt like I was in anything but a rehab/nursing home. Beyond the exquisitely decorated public areas, it didn't smell of urine...people were smiling....and the amenities were on par with what I have seen at "the best of the best" in metro Detroit. I was told that year-round residents pay $10,000 a month to live here; I was not surprised by that figure.
The first afternoon/evening was, in short, a nightmare. It was clear to me that there was no "prep" on the part of nursing staff to be aware of or know who I was, where I came from, or what meds I needed and when since leaving the hospital and being transferred to their facility. The first thing the nurse assigned to me said when we met was "You're so cute." Okay. I guess that was meant to comfort me. It did not. By the end of that first evening, I was texting my husband furiously to bust me out of there asap. He didn't. I endured. Given that I just had a total knee replacement and was on some heavy duty pain meds---it didn't feel too good when my nurse said "maybe" one particular med could be obtained by the next day because there was none on hand at the facility. Okay. By the next morning, the skies opened up and the next shift's nurse arrived---along with the next shift's CNA (certified nursing assistant). Things went MUCH better on day two. Yet the third shift CNA that second evening of my stay asked if I was going to get up at 4:30 the next morning to be dressed for the day. When I said "Uh...no thanks", she began arguing with me. AS IF I was just supposed to do it because...??? Who knows. I don't know if she was cognitively impaired or just assumed I was "supposed" to agree with whatever she suggested because "there are rules here you know". She also told me I was only allowed to have a shower twice a week and maybe I'd get one on Tuesday (four days later). What I realized from that moment on was that I was in charge of my own acceptable level of care whether I wanted to be or not.
I figured that during those first four nights of my stay---I unknowingly blew through about sixteen or twenty "staff" who were assigned to me each shift. I don't know if this is a good idea on the part of any skilled nursing facility because it leaves no room for an authentic "patient/caregiver" relationship to develop. Just as you get to know the name of your nurse or CNA---they disappear with the end of their shift. And you may not see them ever again---or days later when you least expect to. It's kind of like opening a birthday gift and not knowing if you will find a beautiful sweater inside...or a dead rat. Then as would be true for so many of us, the dead rat always manage to stick around longer than the beautiful sweater does. Go figure. That part of my stay truly sucked wind.
Everytime I was assigned an inept, distracted, rude, or just plain lazy CNA or nurse...I practiced what I preach at work by asking "Is there something I have done or said to upset you?" OR "May I ask why you just said that/did that just now?" My questions being designed to elicit the motive behind any given staff member's inappropriate or neglect-based behavior towards me. One CNA in particular waited 40 minutes before coming to my bedside after I rang for her. Then she never returned when I asked for an ice pack for my knee. It happened again over my request for pain medication. After those two incidents, it was clear she was too busy with "whatever"else to deal with me. So I iced her (no pun intended) and asked my nurse for someone else to replace her during that shift. As is true in life, we must know when to hold 'em, fold 'em, walk away, and run. Since I couldn't walk away or run...I just folded that particular CNA up and sent her packing. And it worked for me.
As I write this now, I have been discharged from the facility after being there for exactly one week. Things went pretty well between days two-six; I didn't exactly look forward to the "I have to give you your shower" moments and "that's all there is to it"...but I got used to them. I just imagined myself as Cleopatra, and the "teacher" and her "student" as my maidservants. Actually, that part of my stay was the most relaxing in spite of my initial reservations about being seen naked by anyone other than my husband. I have to add that the physical therapy staff were also top notch. So, as is true in life, every cloud still has its silver lining.
Now that I am home, I am grateful. Very grateful. I wish I knew the solution to the "staffing" issue which does not guarantee consistency or quality of care no matter how "posh" one's surroundings might be. It would be nice if everyone who made it their career to "care" for people on a daily basis really DID care for people on a daily basis. Unfortunately, it's one thing to say it---another to do it.
When all is said and done, I learned a lot by being in rehab...and I hope if I ever have to go back, I will be fortunate enough to have more good than bad experiences with the caregivers assigned to me during each shift---as they come and go.
Thank you in advance to the carers at my facility who do their job right and will be receiving a copy of this blog post.
MD
Although the facility I am at will remained unnamed throughout this post, it is clearly a five-star facility from the outside looking in. We toured it before I had my surgery and I felt like I was in anything but a rehab/nursing home. Beyond the exquisitely decorated public areas, it didn't smell of urine...people were smiling....and the amenities were on par with what I have seen at "the best of the best" in metro Detroit. I was told that year-round residents pay $10,000 a month to live here; I was not surprised by that figure.
The first afternoon/evening was, in short, a nightmare. It was clear to me that there was no "prep" on the part of nursing staff to be aware of or know who I was, where I came from, or what meds I needed and when since leaving the hospital and being transferred to their facility. The first thing the nurse assigned to me said when we met was "You're so cute." Okay. I guess that was meant to comfort me. It did not. By the end of that first evening, I was texting my husband furiously to bust me out of there asap. He didn't. I endured. Given that I just had a total knee replacement and was on some heavy duty pain meds---it didn't feel too good when my nurse said "maybe" one particular med could be obtained by the next day because there was none on hand at the facility. Okay. By the next morning, the skies opened up and the next shift's nurse arrived---along with the next shift's CNA (certified nursing assistant). Things went MUCH better on day two. Yet the third shift CNA that second evening of my stay asked if I was going to get up at 4:30 the next morning to be dressed for the day. When I said "Uh...no thanks", she began arguing with me. AS IF I was just supposed to do it because...??? Who knows. I don't know if she was cognitively impaired or just assumed I was "supposed" to agree with whatever she suggested because "there are rules here you know". She also told me I was only allowed to have a shower twice a week and maybe I'd get one on Tuesday (four days later). What I realized from that moment on was that I was in charge of my own acceptable level of care whether I wanted to be or not.
I figured that during those first four nights of my stay---I unknowingly blew through about sixteen or twenty "staff" who were assigned to me each shift. I don't know if this is a good idea on the part of any skilled nursing facility because it leaves no room for an authentic "patient/caregiver" relationship to develop. Just as you get to know the name of your nurse or CNA---they disappear with the end of their shift. And you may not see them ever again---or days later when you least expect to. It's kind of like opening a birthday gift and not knowing if you will find a beautiful sweater inside...or a dead rat. Then as would be true for so many of us, the dead rat always manage to stick around longer than the beautiful sweater does. Go figure. That part of my stay truly sucked wind.
Everytime I was assigned an inept, distracted, rude, or just plain lazy CNA or nurse...I practiced what I preach at work by asking "Is there something I have done or said to upset you?" OR "May I ask why you just said that/did that just now?" My questions being designed to elicit the motive behind any given staff member's inappropriate or neglect-based behavior towards me. One CNA in particular waited 40 minutes before coming to my bedside after I rang for her. Then she never returned when I asked for an ice pack for my knee. It happened again over my request for pain medication. After those two incidents, it was clear she was too busy with "whatever"else to deal with me. So I iced her (no pun intended) and asked my nurse for someone else to replace her during that shift. As is true in life, we must know when to hold 'em, fold 'em, walk away, and run. Since I couldn't walk away or run...I just folded that particular CNA up and sent her packing. And it worked for me.
As I write this now, I have been discharged from the facility after being there for exactly one week. Things went pretty well between days two-six; I didn't exactly look forward to the "I have to give you your shower" moments and "that's all there is to it"...but I got used to them. I just imagined myself as Cleopatra, and the "teacher" and her "student" as my maidservants. Actually, that part of my stay was the most relaxing in spite of my initial reservations about being seen naked by anyone other than my husband. I have to add that the physical therapy staff were also top notch. So, as is true in life, every cloud still has its silver lining.
Now that I am home, I am grateful. Very grateful. I wish I knew the solution to the "staffing" issue which does not guarantee consistency or quality of care no matter how "posh" one's surroundings might be. It would be nice if everyone who made it their career to "care" for people on a daily basis really DID care for people on a daily basis. Unfortunately, it's one thing to say it---another to do it.
When all is said and done, I learned a lot by being in rehab...and I hope if I ever have to go back, I will be fortunate enough to have more good than bad experiences with the caregivers assigned to me during each shift---as they come and go.
Thank you in advance to the carers at my facility who do their job right and will be receiving a copy of this blog post.
MD