1.07.2009

'Till death

I'm all through covering the first shift supervisor shifts for now, and I'm on my way back for some 3-9 shifts for the rest of the week.

I really enjoyed first shift. It was nice to work with the "A" team, and having the therapy director and social worker around was a great experience. When I come up with questions I can just ask! We got a lot of things done, they asked a lot of me and I asked them for a lot in return. Very productive.

Another fun thing about supervising on the day shift is that when I need to get orders from our house MD, he's actually in his office at his family practice. No more asking to see who's on call for him, no pensively waiting for a page to be returned. There he is!

It's a busy shift and there's a lot to be done. I found myself helping the CNAs with toileting and hygene just as often as I was being pulled in a dozen different directions by therapists and aides to perform RN assessments for changes in condition and new findings.

The wandering engineer failed his voiding trial. I was told not to hold out too much hope that it would succeed, since when his condition was initially discovered he had 3000 cubic centimeters of urine in his bladder. I tried every trick in the book. Crede's maneuver, peppermint spirits, the works. His bladder seemed distended with only half a liter of urine in it, so I had hoped his bladder regained some of the tone it had lost. Next time I'm in I guess I'll just see what the urologist wants us to do next.

While spending a lot of time with him encouraging him to void, I spent a lot of time talking to his wife. Some people at our facility have labeled her "histrionic", but she's dealing with an extremely difficult situation, and I took plenty of time to council her about how to prompt him and how to deal with him without getting frustrated. They're such a sweet couple, and when things are difficult for her I encourage her to give her husband a hug and come back to visit again later. I've overheard some of the nurses saying that she wish she wouldn't come to visit him because it gets him "riled up", a point of view that nauseates me when I hear it expressed. Maybe they won't live together again in an independent living situation, but at least they're close by.

When he married her, I imagine, he was betting that she was the one that gave him the best hope of being loved and cared for throughout his lifespan. 'Till death separates them. Now, his needs are too complex for one person to handle themselves. This is where we come in. We're an extension of her love for him, not a replacement for it. Death will separate us eventually, but until then, there's work to do. The work of living, loving, laughing, and taking the good days with the bad. It comes to us all, and if I can help her with this maybe someday someone will help me.

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