11.12.2008

The bid'ness

I visited the nursing home this morning to attend a corporate orientation. There were three food servers, two CNAs and another RN in attendance. Most of the speakers were familiar faces, the Executive Director, Associate Director, Director of Nursing, Director of HR, and Director of Accounting. I had met all of these people except Accounting already.

I walked into the room late because I thought I was supposed to be in the HR director's office. Once I settled in I recognized the familiar corporate orientation routine, discussions about safety, abuse/neglect, parking, paychecks, etc.

The Director of Nursing (my immediate supervisor) only got two sentences into her presentation when the Unit Coordinator (Imagine a super-secretary with the ability to move mountains) stuck her head in the room and told the Director of Nursing that she needed her -now-.

Those of us attending the meeting looked around uncertainly, a couple of us made jokes, and then the Director of Nursing's head poked into the room.

"PM, you better come along for this, this will be a good one for you to see."

I lept out of my seat and followed the DoN through the Executive Director's office and into the hallways of the residences. Questions and answers were breathlessly exchanged as we hurried down the hall. Was this an emergency call? No, not exactly. Do we need the emergency bag? No, that won't be necessary. The DoN's voice lowered and our pace quickened, I wasn't able to understand her more detailed explanation because she was speaking in that "confidentiality voice" we're all familiar with.

As we rounded a corner we saw the Executive Director running full-speed-ahead to catch up with us, and we started running too. Elderly residents smiled and waved at us as we flew past them, and we waved back and made jokes about a fictitious employee exercise program.

We finally arrived at one of the residences, where security and the facilities manager were waiting for us. A resident had recently died, they were discovered during some kind of routine check that they do. There was nothing left to do but call the police. I didn't even get to see the body. Apparently since the residents are not our patients until they check into the skilled nursing facility on-site, we don't pronounce death or provide post-mortem care.

The Executive Director delegated the responsibility of notifying the family members to the DoN, and we walked back to the health center at a more leisurely pace, while she explained to me the procedures involved and what would come next.

I returned to the conference room where the other employees were listening to the Director of Accounting talk about shift differentials. The other RN in the room looked at me quizzically from across the table. I grabbed a pen from one of the CNAs and drew a big down-arrow on the back of my orientation packet and showed it to her. She nodded, recognizing the nursing shorthand for "dead".

In addition to attending the scene of a Resident Demise, tonight I will be "In Charge", for reals. I'll have the keys to both LPNs med and treatment carts, and a large circular desk filled with trees worth of paperwork to preside over. The DoN and HUC (Health Unit Coordinator) leave an hour or two into the shift. Thankfully, the Minimum-Data-Set Nurse will be there if I get too overwhelmed.

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