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Medical Ethics, Part I

On Monday, I started clincials. To become a Certified Nurses' Aide, you're required to spend seventy hours working in a nursing home, so Job Corps students spend three weeks pulling six hour shifts daily. Clinicals. This is when most students who wash out quit.

So I've been working at a West Virginia nursing home for several days now. And there is no element of the job I can't handle. Yeah, it's a shitty job——literally. But I can handle changing a couple of pairs of appends a day. Most of the work is far more boring. A lot of residents require assistance eating, and that's a very time-consuming duty. But I can handle it. Then there's charting intake and output. Trying to figure out how many CCs of coffee a given resident drank during breakfast. That part's easy.

The most difficult part is not the charting, or the heavy lifting, or even the diaper-changing. Simply trying to communicate with someone who can no longer function on their own is incredibly emotionally taxing. Call it Alzheimer's, Parkinsons, senility, whatever. The residents are no longer in sync with reality. Several of them bear striking resemblance to my parents, aunts, teachers; a similarity that seems to grow the more I realize how far gone they are.

But I can handle that, too.

Individually, each element of the job is something I can handle, most of them with relative ease. The problem comes as the stresses accumulate. I work a short six hour shift, and we generally spend only four and a half of that working. There's five of us working two or three patients a day. It's an incredibly light workload, especially considering that at this low-end facility the resident/CNA ratio is often 12 to one or higher. Yet I still return to the center exhausted and worn. I have no idea how I'll be able to survive twelve hour shifts with four or five times the number of residents I have now and little support.

My most charming resident is an 87-year-old woman still in near-perfect cognitive condition. She's up when I arrive and ready to talk my socks off. She loves to tell me tales of her twenty-odd years as a medical aide. She spent much of her time in a maternity ward of a now-closed Charleston hospital, and probably delivered some of my classmates. She still cares about other people the way everyone in the medical field should. She helps keep an eye on her roommate, an extremely deteriorated woman with a tube feed who requires a mechanical lift to move her from bed to wheelchair.

Physically, the former medical aide isn't as unscarred as she is mentally. She's had multiple back surgeries, a direct result of chronic deterioration caused by her work. (Apparently medicine is horrible for your back. My father has back problems for the same reasons.)

This job takes so much out of my I find it hard to string together coherent thoughts, now. I jump back and forth from one thing to another, and can't really see an overall point as I reread what I've been working on. Was Kerouac a medical aide?

I cut my finger pretty badly the day before yesterday. A small cut, not even an inch across, but an avulsion, which means I tore some of the tissue, partially detatching it. The cut took over thirty-six hours to heal, and because of the nature of CNA work, I had to wear a bulky dressing and gloves for even routine tasks.

Things outside the nursing home seem less important now. I got signed up to volunteer at a multicultural festival this weekend. (For Utahns, think the Living Traditions festival, only not as good.) Normally I'd be excited as hell about it. But it's not really grabbing me.

I had a significant quantity of cash stolen out of my dresser yesterday. It's a huge problem, financially. I mean, huge——I'm screwed. Normally I wouldn't let money problems ruin my life, but I can barely muster the concern to try and get things fixed.

My greatest fear is that I'll let this take over my artistic ambitions. The whole point of being here was to earn enough money to put myself through film school. I'm still working on two screenplays, but as I've mentioned, my writing is suffering because of this. I just got several rolls of film printed (and will eventually be getting more from relatives in Boston who are operating on Riley time) but can't muster up the enthusiasm to get prints made of the better shots. Of course, with my cash gone, I can't afford it either, but still...

I try to call a few of the people I rely on for emotionally support (you know who you are) but can't get through to anyone this week (hint, hint, you bastards). That's why I'm trying to work through this stuff here, online. I do normally despise angst-y blogging, but in this case it's probably justified.

All things in moderation, though, and this entry is too long by half. I will bid you adeiu...