With my Community Care Placement beginning tomorrow I have been considering the lessons I leant from my Aged Care Placement I completed at the end of 2016. The placement was nothing like I had anticipated, I pictured the stereotypical residence scenario where most of the residents where mobile, ate in a large dining hall, played canasta for a large portion of the morning and slept away the afternoon, before retuning to the dining hall for an early evening meal. But this was not the case.
1. Its their home you are just a visitor
The trap some young, inexperienced not necessarily just age young, Nurses and caring staff fall into is that you are at work, a building in which you arrive to every day, clock on, complete a series of tasks, clock off and go home. What you should remember is you are entering someones home, this is where they spend all their time, it’s not a dining hall it’s their dining room, it’s not a common room it’s their lounge room, and it’s not just the room their bed is in, that’s their bedroom, their sanctuary. To that end, you are not an employee who has the right to barge in and do what needs to be done, you are a guest in their home and need to act as such. Tasks should only be completed when they are fully explained, permission is given and in a manner that the resident/client/patient is comfortable with.
2. Residents are People and not Tasks
This may seem like something obvious but when you get under the pump and time is short, the task that needs to be completed can seem to be the priority. As previously mentioned, you are entering the residents home. Picture for a moment a stranger walking into your home; briefly introducing themselves, making your bed, demanding you get up and have a shower, dressing you hurriedly, giving you a small cup full of unknown colourful pills and demanding that you take them. This is, unfortunately, how some residents are treated. Thankfully the placement I had, I didn’t see anything remotely like this behaviour, but there were times when some tasks where pushed with less than complete consideration given to the resident. So remember you are there to care for the resident/client/patient not complete a series of tasks, take the time to care.
3. Refusal isn’t personal
As Nurses we are taught that residents/clients/patients have the right to refuse treatment, medication or procedures, this also extends to cares, showers, getting dressed and even getting out of bed. How many times have you woken up and just thought “I am not getting out of my pyjamas today, I am sitting on the couch, eating ice cream and watching “Sliding Doors”. This situation is no different for those in your care, they have the right to refuse anything, even having their cares completed by someone who isn’t you. As a Male I had to be prepared for most of my female residents to refuse to have their cares completed by me. Thankfully this didn’t happen too often, but I did have one resident who absolutely refused to even have me in the room at all, it took nearly two weeks for her to get used to the fact that I was there to assist and allow me into the room, she did however always continue to refuse for me to shower her, dress her or in any way see her in a a state of undress, which is completely understandable. Refusal isn’t personal and as such shouldn’t be taken to heart, just discuss alternatives with your supervisor and move on.
4. You can’t disconnect completely
We are all human, and as such we all develop some degree of human attachment. We are taught to be caring, and supportive, but not to be overly involved. Working in an Aged Care facility I had prepared myself for the inevitable reality of the environment. I am normally quite astute at separating myself from emotional attachments unless it’s necessary, like relationships, friendships and the like. I thought I was doing a great job of it too, I was still caring and supportive of the residents, I was compassionate to their needs, but wasn’t attached in a way that left me vulnerable. Until I met ‘Dave’ (not real name), Dave was a palliative patient who had served many years in a volunteer capacity, his children where only able to visit briefly every week, and he constantly questioned why he was still alive. I endeavoured to make him as comfortable as humanly possible, make sure that his every need was met, but inevitably he passed away a couple of weeks later. It hit me harder that I expected. Though I was glad that he now had the release he was so desperate for, I still felt saddened by his passing, I knew this world had lost someone who truly cared about others, and placed them above himself. It is perfectly normal to feel saddened, but don’t let it consume you, often there is still plenty of work to be done, and many other residents/clients/patients who need your care as well.
5. Don’t forget to Care for yourself
Anyone who has flown before has been told to “Ensure you have secure your oxygen before helping others”, this extends to the care environment as well, you need to care for yourself before you care for others. If you have cheap, unsupportive shoes, you will get sore feet after standing on them for 8 hours. If you don’t eat properly during the day, you will get tired, lethargic and unwell. Here are a few things to consider to help you help yourself;
- Buy good supportive shoes, they may cost over $150 but will save your calves by lunchtime,
- Remember to actually stop and eat, we tend to be consumed by tasks and time runs away from us, plan to have a small break twice a day and a longer break for lunch. All this assumes your workplace allows this,
- Eat fruit, nuts, lean proteins and complex carbohydrates. Try and avoid the tendency to grab a quick slice of cake, handful of chocolates or other quick snack,
- Rehydrate, Rehydrate, Rehydrate! Remember to drink plenty of water during the day. It is not unusual to walk over 20,000 steps in a shift, couple that with the dry air conditioning of most facilities and you will quickly realise that your intake will have to be higher than normal, and
- Actually go to the bathroom, it only takes a minute. With all that water, and normal body processes you will need to go to the bathroom. Actually go, there are many health problems that can develop from urine retention over time, take the time to relieve yourself.
This is in no way all of the lessons learnt during my placements, and certainly not an exhaustive list of cares for yourself, but they are some of the most important. I am thoroughly looking forward to the next opportunity to serve the community and those in need. I anticipate there are going to be an inexhaustible list of new lessons learnt from this next placement, but as one of my Commanding Officers once told me “The day you stop learning is the day you become dangerous”, it was true then and remains true today.
Do you have lessons learnt from your nursing experiences? Do you have secret cares that you can’t go a day without? Write them in the comment section below, after all community is key to success.