Archive for Health

No man, no nation..

Posted in Political Commentary, The Flow and Rhythm of Life, Uncategorized with tags , , , , , , , , , , , , , on 06/26/2017 by Angel D. Vargas

So much in our world has changed since the purported “election” of Donald Trump as the President of the United States. The hard-earned civil rights gains for women, homosexuals, black Americans and other marginalized people all appear to be on the verge of destruction. Our understanding of global warming and the impact of humanity on the planet is muddied by the interests of corporate fat cats who sacrifice the fate of the lower classes for increased profit margins. World War 3 may be close at hand, as those with a Christian bent are becoming edgier and edgier regarding the fate of an increasingly bombed-out Damascus. People lose faith in our government as our now limited news media coverage bombards us with headlines regarding the latest gaff, appalling remark, or tweet made by the leader of the free world. Mere months of this man’s presidency have felt like years to many weary Americans.

 

And life was hard before this farce of American government began eating the last crumbs left to us of the American dream. Full time work for the average adult living in the United States is needed for most of us to survive. Yet the promise of higher education is met with a shrinking job market and staggering student loans for many college graduates, more and more of whom are forced to compete for part time jobs that offer no insurance benefits. Some college graduates turn to the armed forces or civil service work to try to make up the difference, but for various reasons, that is not an option for most. Those of us lucky enough to attain full time work struggle for the time and energy to do anything else on the side, and we are met with stoic advice from the older generations who tell us “this is life,” and who welcome us to adulthood with sardonic smiles and knowing head nods. Baby Boomers get older, and they expect us generation X kids to take on the immense burden of their care with such limited resources that we can barely support ourselves. Yeah, thanks but no thanks.

 

I am often forced to make tough choices regarding my dream to become a fiction writer. And because of the nature of my own full time employment, less and less of these decisions ever seem to lead to my sitting down and enjoying the process of writing a manuscript, let alone having the time to research potential publishers for the manuscript I’ve already completed. Real life problems, depression and a sense of loss further complicate things, and I am left wondering if there is a light at the end of this increasingly long and dark tunnel.

 

But the thing that seems to help the least is technology. The Internet has all but destroyed real communication; It allows bullies to employ the cloak of anonymity to troll and abuse other users. Political discourse becomes little more than obsessive fact checking and online name calling, and people would rather “unfriend” one another on Facebook rather than meet face to face to come up with real life solutions to the growing problems in inequity in Western Culture. Finally, the Internet allows users to accept accolades for which they never worked, to claim false kinship to others with whom they’ve never spoken, or to attain misleading or false information about important subject matters that lead to more questions than there will ever be answers. In this increasingly relativist culture, we’ve allowed technology to take away our ability to even look one another in the eye rather than at our mobile phone screens.

 

We’ve allowed quickness of our fingers to outshine the profundity of rational thought. Want proof? Why don’t you look up Donald Trump’s latest tweet. I’ll wait.

 

Where do we go from here, kiddies? I’m typing this now both as an exercise in catharsis, and as a chance to let certain people know both where I stand on some of the issues of modern living, and why I’ve been so out of touch with my Internet “chums.” We’ve seen history being made with this latest president and his impulsive, often reckless decisions. As Americans, we’ve also had a chance to put things right. But we don’t understand the laws that govern this nation. We’ve lost track of what our government officials do to us behind closed doors because we let this buffoon shut most of the media out of his very public office. We’ve forgotten who we are as a nation, and as human beings. Because I love this country, I am terrified that the United States of America will no longer be the great nation that it once was. I’m already not the man I thought I’d be. It would be a shame to see this nation follow suit.

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Rules of Engagement

Posted in Political Commentary, Uncategorized with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on 01/30/2017 by Angel D. Vargas

-Friday, January 27th, 2017

“President” Donald Trump signs an executive order re: immigration at 4:42 pm Eastern Standard time. This order “indefinitely barrs” Syrian immigrants from entering our borders. The order also suspends all refugee admission for 120 days, and blocks citizens from seven Majority Muslim countries from entering the US for approximately three months.

The order takes effect. Almost immediately, chaos ensues. At airports around the country, hundreds are detained and questioned. Thousands more are left wondering about friends and family, stranded or turned away before they could reunite with loved ones who were simply traveling abroad. Across the world, millions are outraged.

I am outraged. Aside from the Anti-Muslim bigotry inherent in such a ridiculous order, there is more to be concerned about here. This is in direct violation of the US Constitution’s first amendment. For those who’ve forgotten it, here it is in bold print.

Amendment I. Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances.

Federal judge Anne M. Donnelly, who used to serve in New York as a Manhattan Supreme Court Judge, challenges Trump’s executive order, granting a temporary stay for refugees and others. In her words “irreparable harm” would be caused by sending the travelers home.

Irreparable harm. Those are tough words. But we are living in tough times. As such, I’ve had to look at those two words and wonder if Judge Donnelly’s countermand was too late not to have caused irreparable harm to the way American citizens must now view their own country. Trust issues, anyone?

If I want proof about how bad things have gotten within Trump’s first ten days in public office, I only need to remember how recent conversations with friends, coworkers, and strangers have gone. Walking down the streets of Harlem these days, it seems that the tension is thick enough to cut with a chainsaw. People don’t look me in the eye here, which isn’t surprising given that it’s New York City, but many of the ones who do look wary or fearful. Many more appear angry.

Words are also a problem. Now it seems, everyone must be careful what they say. The media is being slowly silenced by a man so hell-bent in preserving his fragile little ego, that nothing bad can be said about him without consequence. Kellyannne Conway promises that journalists who say anything pejorative regarding Trump “will be fired.” Trump continues to malign CNN and other networks that express concern over his heavy handedness or his apparent inability to comprehend the consequences of his own actions.

And now, it seems, citizens don’t know how to talk to one another. I know I’m having trouble. I square my shoulders now when I engage in political discussions at work, for there is a good chance that emotions will erupt like Mount Etna. My home life has been invaded by tense discussions regarding Trump’s latest gaff or executive order. My personal life has ceased to be about the pursuit of happiness. Once again, I am pressed into making the choice between taking in the news of the day, or ignoring it for the sake of my sanity.

As a Hispanic American, I know it won’t be long before I am asked to produce “proof of citizenship.” I won’t deny the temptation to smash the face of the person who will inevitably do so, but there is no doubt that person will be an officer of the law. My father was one of those. I will never besmirch the honor of his service. Yet despite my father’s exemplary career, he has already come under scrutiny for being “the other” since Trump’s election. Now, it seems, the closet bigot is free to come out and play among us all, like a demonic bully child on a playground primed to be “great again” as it gets whitewashed with hatred and ignorance.

I cannot allow that.

But there is something else I cannot permit. I will not permit the others who oppose Trump to judge me for the confidence (or lack thereof) with which I pursue resistance. I’m still unsure what form this sort of resistance is supposed to take in the face of such tyranny. I say tyranny because I am sure that this is the monster with which we are faced. An emboldened idiot has taken office, blindly signing away the liberty and happiness of American citizens and immigrants, appointing self-serving bigots with seemingly corrupt agendas to surround him and shower him with inane praise. “Good job, Putin Puppet. Now, let’s release the hounds on these peasants.”

But what will happen when Trump goes so far that there is no turning back? Has he already gone that far? It’s not even been two weeks, and I am already terrified at the prospect of what’s to come. Will there be a KKK rally here in my home city? How many more hate crimes will be committed around the world that mimic senseless Mosque attack in Quebec?

When will I have to consider obtaining a conceal and carry permit?

That’s right. I’m considering it. Some of you same idiots that fight tooth and nail to defend the second amendment while threatening to shoot yourself some beaners are forgetting one simple truth. Not all liberals and Trump opponents are pacifists.

Think on that.

I’m not into marching or rallies. I never was. But mark my words. The true patriots of America have often been the dissenters. Without dissent, people will not have reason to rethink their potential ignorance of gravely important matters.

I wonder if those who voted for Trump are starting to understand how bad this might get. When will they scream to the stars in penance for what they’ve done? I’d invite these fools to wait for the inevitable “I told you so,”but that would be my own hypocrisy shining through. I am deeply sorrowful for the sharp decline of our Nation’s values. International friends and acquaintances are asking me “what happened?” to my own country. I can’t even give an honest answer. The truth is more horrible than any horror fiction I can concoct. Yet I know I mustn’t give into the sorrow. And neither must anyone else. The moment we the people give up our desire to do the right thing, I’ll know to look for the mushroom cloud on the horizon..

State Certification Exams, and the End of Certified Nursing Assistant Training.

Posted in Uncategorized with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on 03/05/2014 by Angel D. Vargas

3/5/14

My Nursing Assistant training is put to the test during a four day externship to a long term care facility. The adventure begins with the scheduling and organization of the entire affair, but by the time the dust settles, I’m decidedly chagrined with the end result. I somehow have it in my head that we are supposed to get our choice between two facilities. Furthermore, I’ve deduced that those of us who get the required medical forms filled out the earliest are supposed to have first choice in where we want to go, as in a “first come, first serve” basis. I seem to be the only member of the class that got this taken care of early. Since home for me is at my girlfriend’s apartment in Harlem, I am hoping to be placed in what appears to be the only Manhattan location affiliated with my particular training program. Given the living situations of my classmates, they are all more or less hoping for the same placement. I am silently confident that I am going to go exactly where I wish.

Before I even set foot in a Program Administrator’s office for what feels like an official debriefing, my hopes are dashed. Our professor has come back to the classroom and dispersed our assignments to us. Not only has everyone been sent to the same facility, but its “way-the-fuck-out-in- Brooklyn” location staggers us all, as though, like some distant star, its light would take billions of years to reach our planet. Our one student who hails from New Jersey looks at me as though she wants to throw something. Another female pupil lowers her eyes to the ground, a defiant “Hell no” escaping pursed lips.  I cross my arms over my chest and turn my head, disgusted. Once again, I feel as though I’m being backed into a corner and forced to accept yet another arbitrary set of rule changes. Moments of frustration comprise my patchwork quilt of experiences with this school’s administrative communication. This nasty realization comes in the middle of my preparations for state certification tests which suddenly seem to loom like Servants of Darkness on the periphery of my life, waiting. Now I find myself wondering if those rules will change too, or if I will be handed the wrong exam without my knowledge. I vow to be extra vigilant on the first of two scheduled exam dates.

Sure enough, exam day creeps up on me like a stalking burglar. Contrary to the other two of my classmates who will be with me this day, I no longer feel as though I need to do any last minute studying, or partake in any hurried, whispered discussions of what it might be like. Our maternal professor wishes us all luck, marches her “children” into the CNA state exam room for one hour of focused study, and closes the door. The three of us sit at a large table and go over a practice exam, but I just can’t bring myself to care during “the Zero hour.”

It takes no time at all for any of the three of us to complete the Patient Care Technician exam. Sure enough, one of us is handed the wrong test, I am handed the wrong identification number for my test, and the last of my classmates has her name spelled wrong on the official roster. Despite all this, panic blossoms in the middle of my chest, and I forget to be indignant. Once the test begins, however, I feel as though I am in my element, dispatching each question with brutal efficiency. My fabulous progression sends a thrill through my body. Post test, my confidence begins to manifest in a warrior’s swagger. As I calmly stride over to the proctor to take my Phlebotomy exam on little more than a whim, I might as well have the flat of Masamune’s legendary blade resting against my shoulder. My classmates look at me as though I’ve grown an extra head, but then they nod. One of them pats me on the back as I begin the second exam.

“I know you got this,” she whispers before exiting the exam room for the day.

The externship is set to begin shortly after the test on a Monday, the 24th of February. As the day looms closer, tensions rise in the classroom. Some students begin to express doubt about travel time and cost. Others seem to lose their focus, chatting with each other or texting on their phones when they are supposed to be practicing skills for the yet unscheduled C.N.A. practical exam. One exhausted student who also works retail becomes so testy that others begin to express concern.

I become a knot of anxiety and resentment. I will have to wake up at the ass-crack of Dawn and be on a D train headed toward Coney Island for more than a hour each morning. I need to buy new white scrub pants and new white sneakers in order to follow the official facility attire standard. Meanwhile, I get the grim news that I am being laid off “until further notice” thanks to the cold calculations of a regional manager with whom I’ve only exchanged two words in almost as many years. I am still grading the test papers of nearly all my classmates, and our teacher has not stopped handing us paper after paper for our folders, all of which seem to be bursting at the seams like the bellies of expectant mothers.

None of this adds up to anything with which I would want to deal. In fact, the discussion I have with my girlfriend less than a week before the externship’s inception includes both the news of my lay off and the news about my new “wake-up” time.

I won’t bore you all with how awkward the words were as they came tumbling out of my mouth, but I will say that there is a reason to celebrate the love, understanding, and companionship of someone special. Without fail, she arranges for a couple’s massage treatment at a midtown Manhattan spa, a late one-year anniversary gift that comes just at the heels of my surprise dinner reservations for two at the Thai restaurant where we first met. There could be no better time for something like this. The treatment is so lovely and enjoyable that I almost cry when my girlfriend dashes off to a stage management assignment while I go home to melt into a puddle on our futon.

I settle in for the weekend. The fact that I’ve had my last official class in school settles on me like a spring dew. I smile, albeit wearily. It doesn’t take long to map out the walk I need to take once I get off the D train somewhere near Coney Island. I am forced to buy a pair of pants one size too large for me, and without any pockets. It’s all I can afford, and after an exhaustive search in the city, I am lucky to have found that much. My sneakers are cleaned and ready to go. I am as prepared as I am going to be, and I try to take the time to rest.

Monday

It seems, however, that the weekend passes within the blink of my burning, wearied eye. Church bells cut through the night,  and I sit up in a panic until I remember that this is the phone alarm that we’d agreed upon since my schooling began. My girlfriend jokes about wedding bells, but she can’t bring herself to climb out of bed before the sun begins its game of “peek-a-boo” with the clouds. I don’t blame her, and I don’t ask her to go through any more trouble than she already has. Until now, she’s made my breakfast at close to 6 in the morning for almost two months. It would be madness for her to wake up even earlier without a damned good reason. Love and emotional support can only go so far for those of us who are not Mother Theresa.

Without sufficient cause to travel on the D train, I might avoid the aggressive aura from the 125th street stop in Harlem. Still, the train arrives at about ten minutes to seven in the morning. I trundle on, aware that I’m already feeling stand offish. Fellow straphangers can make me feel as though I’m about to enter an arena rather than a public transit vehicle. Getting from point A to point B can be tiresome on such mornings. I don’t manage to attain a seat until about 34th street, but that is still at the very beginning of my journey. I’ve not traveled toward Coney Island for more than a decade, and I forget how long a ride it can be.

I also forget the cold. And this isn’t just any kind of cold. It’s the frigid, carve-a-hole-in-your bones-and-leave-a-wet-mildew-on-your-soul kind of arctic blast you can only  find near the water in the middle of the winter. A coastal city like New York will make you pay for any gaps in winter attire. I chose to wear my white uniform pants without a thought to long underwear. I also chose to don my winter coat without a sweatshirt beneath. The wind howls, and my teeth rattle as though I am a baby being shaken by a mother in the throw of alcoholic rage.

I still manage to get to my assigned Long Term Care facility in once piece. Many of my classmates are already there, dressed from head to toe in white. I find myself torn, wanting to either turn around and walk away, or look for the hospital identification band around my wrist. Everyone except our instructor for the day sports the raised eyebrows and hunched shoulders of apprehension. I forget to be hungry for a few minutes while we settle ourselves in, and our instructor for the week explains the importance of following the facility’s rules for attire, for conduct, and for the treatment of patient information. HIPPA is a big deal, and yet there seem to be so many different ways to violate it. By the time speeches are made and questions are answered, I’d rather like to become a deaf mute.

Receiving our assignments is fraught with nervous tension. We go to our assigned floor, and we receive a warm welcome from the charge nurse. However, the C.N.A.’s under her command are already busy. They arrive an hour earlier than we did, and it appears as though a good portion of their morning duties have been accomplished. Just when I begin to feel like a fifth, white-walled wheel, I, along with the only other man in the class, am assigned to a Nursing Assistant. She takes us to the male patients on the floor, and we set to work right away.

Our first assignment is breakfast. We get to feed a male resident who cannot even hold a spoon in his hand. Nerves mount once more as my partner steps in, meal-tray in hand, to begin. The first few spoons of hot cereal dribble down the man’s chin in embarrassing rivulets. After some nervous titters, we clean the detritus from his face and attempt to find a rhythm to the rest of the meal. I’ve hung back, surprised that my partner feels more comfort with this than I do. Our instructor finds us, nods in approval at our progress, watches my classmate feed the older gentleman, and then tells us to switch places. I don’t know why, but this takes me by surprise. In the end, I remember the classroom training, and I begin by offering the resident his apple juice. “Three sips, three spoons, three sips, three spoons.” This becomes a silent mantra in my head as I calm the shaking of my spoon-hand and proceed to offer encouragement.

The meal is soon taken from my hands by a smiling Nursing Assistant. My confused expression prompts the N.A. to tell us that the man’s wife will be visiting later in order to feed him a lunch. I am almost mollified by this explanation until I hear the bedbound man’s teeth grind against each other so hard, I’m afraid he’ll tear one of them from his gums.

“Does he do that often?” I ask.

I find out, of course, that this is regular behavior for him. It makes me curious, but something in the N.A.’s light, but insistent tone tells me we’d better get going with the rest of our morning duties. Sure enough, there is plenty to do. By the time all is said and done for the morning, my partner and I have made no less than six beds, participated in three bed baths, and learned why bedsores are not something to be taken lightly.

After a lunch and a debriefing with our instructor, our afternoon looks to be more or less the same. The morning’s activities make three hours fly by in a cosmic blur, yet the afternoon seems to drag as though someone pressed the “slow motion” button on my life. Still, things seem to be going rather smoothly. We’ve learned the scope of a Nursing Assistant’s hands on duties, and we are soon taken back to the employee break room. It’s only one o’clock in the afternoon, and our assignment keeps us here until four p.m. for each of our four days.

Our class doesn’t return to the floor. Nor are we released early. Our instructor, a registered nurse, has to go over so much paperwork and administrative procedure with us that I, along with all my other fellow pupils, become slack-jawed and bleary-eyed. Once the end of the first day arrives and we are released to our respective destinations, I find myself hoping that the next three days are just as easy. Yet I am also certain that they won’t be.

Tuesday

When I arrive the following morning, the only apparent difference between Monday and Tuesday for me is that I am now following a male Nursing Assistant instead of a woman. I am sure there will be differences in the male assistant’s approach to the male residents. I am right of course, but that doesn’t stop the work from getting done. He moves quickly, allocating duties for me and my fellow male classmate without missing a beat. Things appear to be the same as the day before, right down to our first task of feeding the same man his breakfast.

Just as we begin to find the rhythm to how to week might progress, another C.N.A passes by the room door and utters something to the effect of “the state is here,” and my stomach almost drops. Just to clarify, our class was taught that the State will often do inspections of long term care facilities in order to document procedure, look out for resident safety, and “ensure the quality of all the employees.” Facilities can be fined for evidence of resident neglect or abuse, and some have even been closed down and the staff arrested and charged with various crimes against the elderly and otherwise vulnerable. In theory, we should all be thankful that State regulators have arrived to oversee our stay at this facility.

The staff’s reaction to a state visit could not be further from one of gratitude. A frantic energy begins to build in the facility. It affects the way we handle the rest of breakfast. It alters the speed with which we attend to the other residents. The sheer volume of cleaning seems to climb exponentially. Even the charge nurse seems apprehensive, and I don’t know why until I recall our visual lesson regarding bedsores. Now I wonder what the State will observe in its tour, and why it seems that we as students are doing three times the work that we were doing just the day before.

Then I think back to my work at a major metropolitan hospital in Minnesota, and I sigh. I’ve dealt with important inspectors before in a healthcare setting. JCAHO (Joint Commission for Accreditation of Healthcare Organizations) sends their own investigative officials to hospitals and clinics. I’ve met with and spoken to these people during my time as a nightshift Psychiatric Associate at a major Midwest Metropolitan hospital. The entire affair ceased to intimidate me the moment I realized I always did what I was supposed to do and did right by the psych patients with whom I was in contact. There was never a real need for me to worry.

Wednesday

Still, the state inspectors give off an aura of self importance. During our Wednesday afternoon repose in the employee lounge, our guiding instructor leaves to run an errand, and no less than three state officials open the double doors and stand there, their roaming eyes calculating, their postures tall and aloof. I glance around, quickly noting the varied expressions on my classmates’ faces. Undaunted, I turn my attention back to the interlopers and nod. After another long day, the smile on my face is small, and I can feel my facial muscles tighten. The self-appointed State Official leader and I exchange pleasant remarks, and I exhale as my fellow pupils chime in with their own greetings. I am well aware that we can’t forget the function of State Inspectors, but I refuse to think of them as above me in any way. It does help my case that I recognize the leader of the group, a tall man wearing what appears to be an ornate yamaka. I only recognize him because we bumped into one another in the men’s restroom just that morning. A chance meeting of that nature has a way of humbling both participants.

After a tense few seconds, the double doors close, and I feel like a gunfighter that just bluffed his way out of a Spaghetti Western Standoff. I want a piece of tumbleweed to roll across the floor. Our instructor returns from her apparent disappearance, and we regale her with the sordid details of what feels like a clandestine waltz with fate.

Thursday

We finally come to the last day of our externship. All of us are tired. At this point, we’ve been told so many things to do and NOT to do because of the State visitors, I’m growing increasingly paranoid. I’ve washed my hands so many times using “state mandated technique,” that my fingers are beginning to dry, and a painful crack has erupted like a tiny fault line along the outside of my pinkie’s knuckle joint. Staring into the faces of my classmates doesn’t provide much consolation. Many appear to have grown sick of the commute, the bags beneath their eyes telling more stories than I can ever truly record. Our instructor reminds us to remain grateful for the opportunity, but I’m sure we’re all more glad that our time here is up in less than eight hours.

My final day at this facility proves to be the most challenging. As adept as my partner and I have become at feeding a particular male resident, we are denied this opportunity because we refuse to allow ourselves to be left alone as students without another employee’s supervision. This continues to be a frustration for us all, as the Nursing assistants all appear to be anxious to get things moving, yet none of the residents seem to be having an easy time of it. At our instructor’s behest, students are forced to stick like glue to their assigned C.N.A.’s. Our C.N.A. is not annoyed with us, but he does appear a bit more distant, as though his morning coffee hasn’t quite kicked in. I don’t blame him. I feel much worse for wear just having contended with this added stress for four straight mornings. I try to remind myself that my C.N.A. has chosen to do this for a living, yet this is when the existential questions begin to manifest like apparitions at the foggy cemetery of my mind.

Did I ever tell you I think too much?

In the middle of handling a struggling male resident who refuses to allow us to clean him, another male resident who can’t seem to eat his hot cereal without coughing up a lung, and a final male whose condition appears to have deteriorated so badly this week that he proceeds to vomit and defecate in the same moment, I ask myself the one question I thought I would save for a lonely walk in the park.

“Why would anyone do this for a living?”

Much to the credit of the staff, they answer me without my having to ask. One female Nursing Assistant reminds me that she chose this occupation because she feels for the elderly and vulnerable of our world, and wants do as much as she can to provide care and comfort. Another employee tells me her grandmother was in such a place, and was treated well by her caregivers, which inspired the Nursing Assistant to pursue this line of work. My C.N.A. doesn’t offer us a tale of woe or of courage, but he simply does his thing. A sparkle does seem to come to his eye as he assigns me and my partner certain rooms where multiple beds need to be made, confident that we will both do a good job. At this point, my partner and I each make our own beds, and I am encouraged by our individual progress.

We also learn to chart on resident cares on the computer. I am surprised at how little one actually gets to comment on their individual impressions of resident progress, and I don’t like being left out of the equation, so to speak. Visual icons represent the various items on a patient’s care plan itinerary. A bedpan, a toilet, or a commode icon speak for themselves. Just point with a mouse, click, and a patient’s abilities with toileting have been recorded for the day. After watching a Nursing Assistant do this with a series of activities for one resident, I realize that this can become rather mundane. I wonder if we’ve made a mistake depersonalizing patient charting, ultimately removing ourselves from the empathy needed for such undertakings. For me, the act of writing something down elicits emotion, for good or for ill. I suppose that’s why I am pursuing professional level fiction writing. Being able to talk with others about what has transpired also matters. As a former mental health worker, I am all too aware of how subtleties in body language and tonal voice changes can comfort, alarm, or galvanize an individual. This new way of charting comes off as cold and impersonal, and leaves me feeling as though my accomplishments were just not that important. Nobody should feel this way about such an important job.

This proves to be the longest feeling day this week. By the time I sit my aching body down on the most comfortable chair in the employee lounge, I find myself unable to process much of anything. My thoughts shift uncomfortably, as though they are a series of songs on a malfunctioning ipod that won’t do anything but shuffle. To make matters worse, during our lunch break, we spy snow falling outside our window, as though we are sitting inside a gigantic snow-globe. As we eat our way through our three dollar meal tickets, the wind outside intensifies until I’m sure I’m looking at the beginnings of a blizzard. This year’s winter has worn New Yorkers down, and I groan as though I’ve been asked trek through the tundra and procure snacks for everyone in the cafeteria.

The afternoon seems to fly by us like a flock of snowy owls. The storm passes quickly, and my mood lifts almost as fast. My partner and I rush around at the beck and call of our Nursing Assistant/mentor, fully aware that this will be the last time we make a bed or dispose of unpleasant human biological deposits in such a setting for a time. Finally, when the last piece of electric assistive equipment has been put away, the last bed has been made and the last resident have waved a frail but warm goodbye to us both, my partner and I head back to the employee lounge for the last of our debriefings. More paperwork followed by words of encouragement and pride seems to hover just in front of me. I think back on my experience, and I can’t help but note one ultimate truth.

This is not the work I will pursue once I graduate the program.

My conclusion has less to do with the residents than I thought it would. But, as always, one is forced to think of the big picture when undergoing such things as internships or externships. And why shouldn’t this be the case? As shaky as the economy still feels, I didn’t go back to school just to feel as though I have to take yet another job I don’t want. School is a risky investment of time as well as money. For this to feel like a success, there must be a true reward for the work I’ve put in. Gainful and meaningful employment was the goal here. Even when the idea of volunteering here is presented as an option to our group, I shudder. The location is just too far for it to be worth an unpaid opportunity.

I am the brave soul who volunteers his reluctance to pursue this line of work. I am also forced to accept another reality for which I was not prepared. The elderly and infirmed force me to face my own mortality in the simplest of terms, in the most direct line of sight. There is no escaping the ravages of time. The human body ages and dies. I may not have been alone in my awareness of this phenomenon, but I admitted it to my class. It depresses me almost unutterably.

The externship is ultimately a humbling experience for me and for so many others. Our goodbyes are short, and the Nursing Assistants can’t seem to let us go without words of advice or encouragement. I don’t give away my true feelings about the work they do, but I understand the meaning of caring for another person in the twilight of their lives. I can’t begin to imagine where I will be at that age, or what society will become in regard to its elders. I can only hope that I am surrounded by warmth and compassion, even when I forget the spelling and meaning of such words.

 

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