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Medical Ethics, Part II

Someone called in today, leaving the nursing home short staffed. Even with nurses neglecting their charting duties to help the CNA's, and housekeeping staff doing some CNA work, and six students with an extra RN to supervise them, the patient/CNA ratio was even higher than it's abysmal norm of 12:1.

I once had someone argue against universal health care by pointing out that this sort of generally inadequate care is the norm in Canada. I reply by explaining that it's the norm here, too, except America has two distinct minorities who get different treatment: the rich, who hire home health aides; and the poor, who die in homeless shelters.

The cut on my finger has been bleeding for seventy-two hours now. Not badly, but a small drip that won't stop. I may have to get it looked at.

You always check the care chart inside a resident's dresser before doing anything. It will let you know if they have a weak side, require a mechanical lift, and provide other general information. Sometimes you have to check their big 'ol chart in the nurses station before doing something. There's a surprising amount of paperwork on each resident. But to really learn about someone in the home, you ignore all the paperwork and head straight for the bulletin board above their bed. This is where the family pictures are. This is where you really figure someone out.

The more dextrous residents often have little crafts up there, often papier-meche crosses. The total assists have certificates of appreciation from the nursing home that more able residents are able to tear up with impunity. Family pictures can help you guess age. Residents in their sixties and seventies have baby portraits of grandchildren. As they approach their eighties, baby portraits are replaced with high-school yearbook photos. (These are the most fun: does resident A know her grandchild is flamingly gay? does resident B see the way the photographer hid his grand-nephews multiple eyebrow piercings?) Once residents hit their ninetieth or even hundreth birthday, baby pictures of great-grandchildren appear.

A unique picture is one resident's picture of her parents. It's from the late nineteenth century and is an authentic daguerreotype. I once saw several in the archives of the Utah Historical Secioty, doing some community service (for mandatory, not altruistic, reasons). It's really an impressive thing.

Letters from family aren't common, although one 103 year-old resident has some e-mails from her obviously with-it son in his seventies, which the staff have printed out and tacked up. And they say old people can't manage computers. While letters are rare, many residents have cards—happy birthday cards, christmas cards, thinking-of-you cars. There is a sort of rule here: the more cards a resident gets, the less their family visits.