A Clinical Lesson – Part II

One year of my nursing journey has somehow already passed, and unsurprisingly, the last three weeks have been the most significant thus far. My first clinical placement experience was an important milestone – I needed to test my strengths and weaknesses and bring all of the knowledge taken in throughout the year into the real world. Just how real is where the experience became a critical one.

There were many moments over the three weeks that will remain in my mind as I reflect on my interactions, but three moments in particular had what I feel will be a lasting impact. As in all accounts of a medical and personal nature, no real names are used in these stories that follow.

PART II

The second week of placement had a new challenge – feeding residents with varying levels of care requirements. This offered many insights, one of which was a gentle reminder to not take the simple things in life for granted.

There were three residents that I had to assist with their meals and each one presented a very different set of challenges. The first, a gentleman who had speech issues and also struggled to lift a spoon to his mouth, took me a couple of feeds to learn his quirks. One thing I kept reminding myself of was that this was a person deserving of the exact same treatment that any of us would expect – just because he had issues feeding himself did not render him useless or not worthy of my time or respect.

He was hard to read – at times, he would reply to my questions of what he wanted to eat next with a nod or a little smile, at other times he would just stare off into the distance. I didn’t just want to assume that he would eat whatever I put to his mouth. He really seemed to enjoy his beans and carrots, but his breakfast, not so much. Breakfast never really looked that appealing, so I could understand his lack of excitement for it. He would raise his empty fingers to his mouth, as if he thought he was feeding himself, so sometimes, I’d let him pick up his food with his fingers and eat that way. Sometimes though, I’d just raise the fork to his mouth and he would eat without hesitation.

After a few feeds, I was feeling more comfortable with him. So I was shocked when one of the carers (a loose term to use for this particular person) decided to walk up and take the spoon from me and force it to his mouth. “You have to feed him! You have to tell him what he wants. He doesn’t know”. I was so taken aback at their utter lack of care for this man that I didn’t know what to say. It seemed that my way of feeding was working just fine, but this was clearly a very bad habit of this carer. I did notice this person also doing some other things that did not please me, and I know they are under time pressure to get tasks done, but when you lose sight of the fact that each person under your care deserves respect and dignity, it’s time you find another job. Sadly, I did see and hear of other events that trouble me in relation to a lack of care from some staff – one morning while walking past a resident’s room, I saw a carer eating the resident’s toast. When they noticed that I had seen this, they offered an excuse: “she wasn’t going to eat it anyway”. I didn’t think it was my place as a student to say anything, so I just gave a disapproving look and kept walking.

The next resident I was assigned to feed was a dementia sufferer, and this presented much different challenges. She was so sweet, yet so frail. She would regularly fall asleep at the table, either before or during the meal. I’d ask which food she wanted and she would reply that she didn’t know. Everything appeared to be so tiring for her, even just trying to answer a question. Within the space of a few seconds, she would say she didn’t like chicken, but then proceed to eat it the very next time I asked. The only constant for her was ice cream – there was never any confusion about whether she liked ice cream! She would gaze at me with her troubled eyes and sometimes attempt a smile, but at other times, I could sense she was so confused about everything that was happening, and it was quite confronting to see.

Dementia is a cruel way to spend your final years – just imagine not knowing if you like a particular food or not, or what it is you’re actually sitting at the table for. It was heartbreaking. We all did our best to make her smile and took our time with her. She even said to me one day, “Hello RMIT”. She could see the logo on my uniform and obviously thought it was my name, and I just smiled and said hello back to her. I understand that she doesn’t know that she’s forgotten some of the basics, but it was still hard to accept that this is the way some people live out their lives. Seeing her sing along at the various events the facility put on made me smile, she was good with the lyrics to plenty of the classics, but it was the simple task of eating that seemed to provide her the most troubling test.

To finish this thought on a positive note (it wasn’t all doom and gloom after all), it just needs to be said: do not, I repeat, do not underestimate how seriously residents take their bingo! I learned very quickly as I was calling out the numbers one day just how serious it is (to the point where one resident was cheating, and one of the other residents discovered this and made quite the scene about it!). One of them even “shooshed” me a couple of times as I was trying to have some fun with it. And if you don’t shuffle the numbers properly after every game, you’ll definitely hear about it too! Also make sure you know what to say with each number, such as “legs eleven” or “two little ducks” for 22 (followed by a “quack quack!”) – thanks to Google for helping out with that part. The daily activity time really was wonderful to see and the staff involved should be congratulated for their efforts to put smiles on the residents’ faces each and every day.

Part III to follow.

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