Nurse Mates Shoes: Women's Low Profile Nursing Shoes 204214 - 12EW

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Nurse Mates Shoes: Women's Low Profile Nursing Shoes 204214 - 12EW Overview

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During my active bedside nursing years, I was employed by a long term care facility in an administrative role. In a nutshell, my position as the MDS, or Minimal Data Set Coordinator charged me with doing regular comprehensive assessments on all of the residents. These assessments very basically were transmitted to the government or more specifically to CMS, the Centers for Medicare and Medicaid Services. This information translated into payment to the facility for care provided. It also provided a method for quality improvement and determinants for areas of improvement facility wide as well as for each individual resident. This particular facility had a capacity for 93 residents and each was viewed as a member of our "family".

Providing a structured environment for our family to socialize with their respective families, friends and each other was imperative. Our marvelous Activities Director was tireless as she and her staff organized theme nights, parties, dinner dances, musicals and socials, all representing an era with which our family could resonate. Socialization occurred spontaneously as well, during meal time, at therapy and every possible place in between. As human nature would dictate however, especially in light of diagnoses such as dementia, and side effects like irritability or confusion as a result of various disease processes, often times their discussions were heated, their differences in opinion on matters ranging from politics to religion to the best way to pluck a chicken shown through, brightly.

Nurse Mates

This family was colorful and diverse, without exaggeration. According to family sources, one of our family members used to create beautiful and luxurious clothing for workers of "the oldest profession". She also ran the brothel which housed the women whom she dressed. Naturally, she made complete sense to us when we learned of her younger years as she continuously primped herself, wore lovely and festive hats and carefully applied her lipstick, before going to bed. A husband and wife couple, both professional singers in their hay day, often led a rambunctious rendering of familiar songs after dinner, accompanied on the piano by one of the original founders of the Harlem Renaissance. Another woman was a school teacher, and despite the fact that she had dementia, persistently scolded the others for not paying attention, for not listening. She often verbally punished the others, using colorful expletives.

The Quilt

Another family member was an amazing painter according to her spouse and in her state of confusion at the facility would be found utilizing her own excrement to express herself on her bed sheets. There were World War I and II veterans, who shared stories and cried as they reminisced, as well as inventors, homemakers, philanthropists and physicians. Attorneys, welders, grocery clerks and even nurses who remember using glass IV bottles were a part of the mix. Drug abusers whose habits induced debilitating strokes as well as wealthy individuals who could afford to pay for a private room, preachers, secretaries and homeless people with schizophrenia all created an illuminating tapestry. Every single one of them knew the other and as a group, they all created a chemistry which permeated this charming and well appointed structure. While there was much clinical and medical activity behind the scenes, this was their home.

Because of the level of detail involved in the assessment process, I was aware of the condition of their skin, medical diagnoses, mental and hydration status, appetite and prescribed diet, familial support and if they were safe in their immediate surroundings. It was within my scope to know if they were incontinent and what their medication regime entailed. I had to know if they could swallow their medication whole and take it with water, if the staff nurse had to crush it and mix it with applesauce for safe swallowing, what their pain level was, if their cardiovascular status was within normal limits for their admitting diagnosis and if they had any allergies. I was aware of what their "code" status was, if they or their conservator requested that they be resuscitated in the event that they cease respirations or if their heart stopped beating, and if they even had a representative in the event they were deemed unable to make their own decisions on such matters. The ultimate physical examination was performed as scheduled on each and every member of our family, as mandated by the powers that be. As detailed as these evaluations were, the results in black and white crunched into statistics were a poor representation of what truly mattered, what truly defined them. Hindsight, it appears has crystalline vision.

Our family quickly trusted our ambience, our philosophy and our staff. They and their loved ones knew they could count on appropriate and thorough care. Everyone counted on us to understand and embrace this stage of their loved one's life, their golden years. Each department functioned as a finely oiled machine, a cohesive system all for the sake of coordinating the excellent care which we provided.

It is important for the geriatric population to have a sense of structure, yet equally important is the sense of independence which is fostered. Often, family members dropped by my office by self propelling in a wheel chair or if able, ambulated to say hello or to pass some idle time. Daily, I stifled the giggles as these wonderful individuals ineffectively pretended that the butterscotch candies I had in a bowl on my desk were of no interest to them.

On a day which was not unlike countless others prior, I was in the process of completing my assessments, and was in my office entering all of my data into the facility's system, ready to be transmitted for processing. Meanwhile, "The Painter" had propelled herself into my office, rummaging through the butterscotch bowl of crinkly cellophane yumminess as she sang "Amazing Grace" while intermittently mentioning that her favorite color was ecru and that she dreamt her husband had perished in a fire. In cautiously walked Marie, an alert, oriented, pleasant and cooperative family member who was admitted to our facility on a short term basis, status post hip replacement surgery. We all chit-chatted, Marie, myself and our painter friend. Marie admitted to The Painter that she was moved by her gospel voice, and that's precisely when the Painter began to weep. In an effort to comfort our resident artist, it was stated by Marie, "life is what it is, it is as beautiful as the tapestry of your heart, and your heart will live on forever. You will never be forgotten".

Marie was a marvelous sewer, a seamstress by vocation. She had come to visit me at my request to show me the patch work quilt that she was making for her first great granddaughter's impending birth. My face must have exemplified my feelings which depicted deadlines and hunger. Marie winked at me and suggested to The Painter that they go enjoy lunch together. As Marie and the wheelchair she pushed which contained a robust woman humming gospel tunes had rounded the corner, far beyond the physical limitations which were indicated for which her 2 week old hip procedure, I became grounded.

The familiar rumbling sounds and smells of food carts passed me by which served as two jolting reminders. Firstly, it was my turn on the rotation to assist in the passing of trays and the feeding of the family in the dining room and secondly, all I had ingested since my head raised from her pillow of slumber was remnants of toothpaste and 3 cups of coffee. Frustrated, I entered the last bit of data to complete one assessment, took a deep breath to replenish myself and was about to lock my office when I sensed an emergency. The names of physicians returning calls to staff members echoed over the loud speaker system and more than one nurse, along with the Director of Nursing as well as the charge nurse ran by. Something was happening, something was shifting.

I ran down the carpeted hallway and followed the rest of the staff into room 104. One of our family members, a retired and revered police chief from the very town in which we were, was found unresponsive and well, cold by one of the nursing assistants who went into his room to assist him to lunch. As the cardiac arrest cart was whirled to Chief's bedside, his primary nurse skirted to the nurse's station to get his chart. There it was, in black and white and signed by him not even 6 months prior. His legal and witnessed check mark and signature indicated the following: "In the event that I have been found to have no pulse or respirations, I request that there be no chest compressions and no intubation". "I request no comfort measures or palliative care" also received his acknowledgement. Adjacent to the option which questioned who to notify in case of emergency, in his hand was written, "None". Chief was pronounced dead at 12:12 PM by his nurse. His physician was notified at 12:14 PM.

While the Nursing Director was supporting Chief's primary nurse with his post mortem care, notifying the morgue and monitoring the others assigned to her, I went to the dining room to fulfill my responsibilities and tend to the living. Already, the questions began because the energy was palpably altered. One of Chief's table mates for meals, the Piano Player, began asking questions. "Hey, where is Chief? Is he still at therapy? He is gonna be one sorry sap, he is missing Meatloaf Monday", his chuckle hardly convincing. Due to privacy acts, we were unable to explain what had happened to his friend. Usually however, the truth has a way of making itself known in the most raw of ways.

It was clear that Piano Player was concerned, as evidenced by his lack of appetite. He chose to navigate himself down the hallway in search of his companion. As he rounded the corner, he simply knew. It was Chief in that lousy blue bin, secured shut with an industrial zipper, a receptacle which was probably used 3 hours earlier for the same reason, just containing a different life time. Chief was being wheeled to the back door, about to take a ride with no lights or sirens, which would eventually lead to his final resting place.

Rumors spread. Family members were inquiring about The Chief. The Piano Player was sitting parked in his wheelchair outside of Chief's room and appeared pensive and calm. As I approached him, I sensed such confusion. Not his, but my own. The man who was prolific on the ivory keys was angry and sad, quite aware of his emotions. He had nothing to say to me, nothing to say to any of us. We respected his privacy and at the same time, we made ourselves available to him. Evening arrived. Shifts changed, reports on the events of the day shared. We only physically left to tend to our personal lives, and 92 family members remained.

Most long term care facilities have resident counsels. This means that one or several family members are chosen by their peers to represent them in meetings with administration about concerns, events and such. Chief had been chosen and it was unanimously decided that The Piano Player would take his friend's place. He did so with reverence and would be sure that Chief's presence here would never be forgotten.

Ms. Darla, the daughter in law of the new representative of the resident counsel stopped by to visit on Thursday, which she has done regularly for the last 3 years. When she walked into her father in law's room and noticed he was not there, his nurse smiled and waved and gestured to the community room, where The Piano Player was doing what soothed him most. When he saw Darla a smile warmed his face, and he continued playing. Darla sat with the man who was the only father figure she ever had, and silence was always comfortable between them. The Piano Player and his "Dar Dar" shared a peck on each cheek and a warm embrace when he began to explain to his lovely daughter in law what had recently occurred.

"Dar, death is lingering heavy, baby. We are all empty here, one day a friend's beating heart is sitting with you having a laugh and eating a meal, next day he's in a bin and out the door. I have this piano to connect the dots of my feelings and make peace. These other folks don't. The ones who can't speak or feed themselves, the ones who don't even know their own damned name, they all know something's different, they all know one of the family is gone, Darla. You can see it in their eyes. We are all so close here, as if it were in the stars that we are all supposed to live and die together. All of us, from different places and different worlds, crazy lives and heated opinions, all different textures and colors, it's cruel for us remaining to not have a way to grieve. Blue bins with heavy zippers, carrying out the heart and soul and remains of us". The Piano Player's voice broke, tears streaming down his face which glimmered with sadness, anger and purpose. He stood from the piano bench, executed a perfect stand-pivot into his wheelchair, and off he went to the Activity Director's office. All Dar Dar could see was the back of this wonderful man's chair as he waved goodbye to her on the fly. She smiled through her own tears and knew that nothing but good would come of this.

Small groups were organized. It took a month to put it all together, and it would never be finished in totality. It would always be a perfect reflection of the continuum. As new residents were admitted to the facility, they were also invited to be included. The donated supplies poured in from the community and staff, loved ones and friends. If a family member was bed bound, the project was taken to them. If they had no arms, they directed us as to what they wanted theirs to look and feel like. There were embroidered doves and holy crosses, moons, Stars of David and Orthodox symbology. Painted names done by twisted and excruciating arthritic hands, messages of the fragility of life, suns, hand stitched police badges, and a Piano.

Marie had since been discharged to home, yet returned almost daily to bring it all to fruition. She assembled and blocked and steamed and stitched, usually while listening to The Piano Player doing his marvelous thing, creating beautiful music sparkling with harmony and whimsy and wonder, melodies which were the audible representation of the energies of this place, a way to celebrate, a method to encourage one to feel and express.

When she passed, it was quick. She always gave you the sense that this is the way it would be for her. Her body was bathed and mouth care was provided. Her dentures were put in place to maintain proper facial and jaw alignment. Despite what policy dictated, for the ride to her final resting place we placed her favorite hat atop her head, over the body bag. She had applied her own lipstick meticulously that day, even though it was not bed time.

Over the loud speaker, it was announced that it was "Time to Serenade". Soft and beautiful classical music was piped in. If you tuned in to your senses in the truest way, you would smell the roses. The Quilt was delicately draped over The Blue Monster, as everyone stood in silent reverie. Death was less harsh for the dead and the living it seemed, when you take pieces of family with you.

The Quilt

Nurse Your Spirit, LLC is a counseling practice devoted to nursing professionals. Based in Tucson, AZ., where face to face counseling sessions are provided, the founder, Lori Daniell, R.N., M.Div., Ph.D is also proud to offer telephonic and Skype sessions nationally. Nurse Your Spirit LLC offers affordable, professional and responsible counseling in a nurturing, non-judgmental and caring manner. http://www.nurseyourspirit.com