Friday, May 13, 2011

Have you hugged a nurse lately?

In case you don't stay abreast of these types of things, this week is both National Nursing Home Week (May 8-14th) and National Nurses' Week (May 6-12th... I'm a little late). I work in a nursing home and I also happen to be married to the BEST nurse on the planet... who I met at that very nursing home. So, maybe that's not a very objective statement, but truly of all the nurses I have worked with over the last 8 years, R ranks at the very top. He has replaced me as our family's doctor... thank goodness for everyone I am no longer the most medical-savy.
For someone who at home and socially is extremely non-chalant and at times, oblivious to what's going on around him, R has impressed me from day one in his ability to assess a nursing type situation, identify the problem(s) and formulate and execute a plan. He is not only extremely knowledgeable about medical conditions and medications, he also has excellent bedside manner with patients and families. He is respected by physicians, his supervisors, his co-workers, and the people he supervises... plus all of us ancillary people. He's calm, he's cool, and he means business. He finds a way to create rapport with the most difficult patients and families.
There is an 95 year old woman who has lived at VW for several years and I have always greeted her by name when I see her around the building, but she has never acknowledged me, except one time to tell me not to touch her when I patted her on the shoulder. I thought maybe she was too hard of hearing or demented to have a conversation with me (why else wouldn't she talk to me? I am very lovable!)... until R told me she had given him hugs AND a kiss! He is the only one besides her son who can get her to take her meds when she goes on a streak of refusing.
My 11 year old cousin tried to tease me a while back saying "Your husband is a nurse!" Of course, R wasn't around, because he would be way too scared to actually attempt to make fun of him in person. I told him proudly "yes, and he's the best one I know". It's funny how many people told me they were just sure I'd meet and marry a doctor... yeah, not so much! Thank you Jesus for giving me a nurse instead with a less demanding schedule and much smaller ego. (Sorry for the stereotype! That is certainly not true of all doctors.) Men are rare in healthcare, and even more rare in nursing although the percentage seems to be increasing all the time. Almost all of the male nurses I have worked with have been well above average... I don't know if going into nursing was more of a deliberate choice for men than women, who may choose it by default, so they enjoy it more or what... (NOT to say men are better nurses than women, I am not sexist against my own gender! I know, love and respect many excellent female nurses as well!)
Since it is nursing home week, I want to touch on that topic too. I never thought I'd end up working in and loving nursing homes. Granted, VW is not typical, but it is a nursing home nonetheless. When we used to go visit my great great grandmother and then great grandmother in nursing homes in East Texas, I would hold my nose the whole time because I couldn't handle the smells. When we used to go with church or Girl Scout groups to sing and talk to the residents at local nursing homes, I was scared and tried to stay at the back of the pack.
Things have changed! I hated working in the acute hospital where I'd do a one-time nutrition assessment and have no opportunity to follow up with the patients or see that my recommendations were implemented. In the nursing home/long term care setting, I've gotten to know darling (and not-so-darling) patients and families and see my work pay off!
At the same time, there are many challenges of working in that setting, which is largely seen in a negative light. People don't want to be "put away", nor do families (usually) want to leave their loved ones in a "home". Nursing homes are one of the most regulated industries, if not the most, in the United States, largely due to a sad history of neglect and abuse. Nursing homes are primarily funded by the government (Medicare - short term skilled nursing and Medicaid - long term care) and often take very sick patients who no longer meet criteria to be in the acute hospitals. Payment from medicare or private insurance companies obviously decreases as the level of care decreases (acute hospital is more than long term acute care which is more than skilled nursing/nursing home). As a result, the number of patients per nurse and nurse aide increase to contain costs. And while I'd like to say "it shouldn't matter how expensive it is, we should have as many nurses as it takes that no one ever feels that their needs aren't met", realistically... facilities have to stay in the black to keep their doors open. VW is cutting-edge to have one full-time dietitian for 115 patients, where an acute hospital would have at least 4 full-time RDs. Per Medicare guidelines, a facility ony has to have a dietitian in a facility 8 hours a month per 100 residents.
Like schools and churches, the majority of press nursing homes receive is when something negative happens, despite how disproportionate the bad is to the good. Although I think 85%+ of our patients leave happy, and many return for repeat short term stays, the majority of comments you would see posted on the internet is the bad stuff (that is often exaggerated or misrepresented) because people who are mad are the ones who speak up. So, on that note... look for the good, and when you see it, say THANK YOU! Give a hug, write a positive review, tell someone's supervisor how great they are.
I have cooking and exercise updates to write but this is long enough for now :) Have a happy weekend!
Love, B