Paul's Passing Thoughts

“At least in some cases, the way long term care facility lockdowns are being practiced is causing more deaths than the virus, and proliferating the spread of the virus in other facilities. I wonder if this isn’t true of the national lockdown as well.” 

I am a STNA/MA-C and I don’t talk politics at work. Even if someone agrees with my political opinions, I would never discuss it with them at work. I know a lot of nurses and respect them, and I don’t know what their politics are, and I don’t want to know. I was texting back and forth with a nurse the other night that I used to work with at a facility. She was my charge nurse for several months. I have no idea what her worldview is about anything other than resident care. When we talk, our politics are resident care; our religion is resident care, and so it is.

My reality on the facility unit floor is a world I keep separate from my normal life with a single focus: resident care. I work with gay people, I work with straight people, I work with transgender people, I work with those who like me, and I work with those who don’t like me, and I could give a rat’s behind (sanctified version) about any of that. However, if an aide or a nurse is just a clock-puncher, I do care about that, but to tell you the truth from my perspective, that’s pretty rare. And from my perspective, most aides and nurses share this same obsessive focus that separates our lives into two realities.

With that said, most aides like and respect nurses, but really don’t care for other aides that much. You would think, given how tough the job is, one of the toughest jobs in the world hands down, that there would be a brotherhood/sisterhood thing going on. Um, not so much. As far as eating their own, lions have nothing on them. If you are a decent aide in their book, they will allow you to live. Aides are fiercely competitive and want to believe they love the residents more than any other aide. Think about four mothers having the same children and ponder how that works out, and then toss male aides into the dynamic who have no nurturing instincts. But it’s ok, if  they think they are a better than you, and you become a better aide, that forces them to become better as well. And in many cases, that works well in a lot of facilities.

Then, there is my other world made possible by technology. On my Twitter account, I follow nurses who are Trump supporters. That’s a whole bunch of fun. Would I follow them if they were local and I worked with them? No. Facebook is much trickier. Its got the “friend” thing going on. While Twitter is primarily religious/political/philosophical, Facebook is a mixed bag. Facebook crosses many boundaries between personal life, family life, work life, religion, philosophy, worldview, and politics. And, as the director of a philosophical/religious think tank involving three authors and an educator, my views are often posted on my Facebook account where nurses I have worked with see what I post. For me, that’s a metaphysical minefield.

One thing I have noticed, for reasons I cannot explain, I find aides somewhat apolitical. Nurses, not so much. And regarding the COVID pandemic, nurses have joined the political fray. The most vocal nurses are in favor of continuing the national lockdown. In fact, I saw a meme posted by some the other day. It showed a mob of people celebrating a nurse with a number of scissors sticking out of her back. It said something like: “Don’t praise us and then stab us in the back by protesting the lockdown.”

I saw it, and I thought: “Holy cow Lord, bring the mountains down on me to hide me from this fray!” Those who know me will tell you I have never backed down from a fight, except for this one. This one I will run from every time. Dear God, find me a refuge.

I have also seen a meme that pictures a shell-shocked nurse with PPE lacerations all over her face with the caption, “We go to the frontlines for you; please stay home for us.”

Yikes!

This is hard for me, because regarding nurses, I am respect-driven. It is my honor to serve them. In all honesty, my mentality on the unit hallways is, “The nurse is always right.” I was recently certified by the Ohio Board of Nurses to pass medications in long term care facilities, and on any multiple choice question for the schooling or state test, if “The nurse” is one of the choices, that’s the right answer in every case. Laugh if you will, but the second you see a question that says, “What do you do if…” your eyes immediately look for “The nurse” among the answer choices. Aides make it a point to argue with each other, but they will rarely argue with a nurse.

How hard is the rock between me and the hard place here? Very. As one who does other things aside from healthcare, I have studied religion and philosophy, and their relationship to politics, for more than 11 years as the director of the aforementioned think tank. Before the Enlightenment Era gave birth to America, the world was not a very nice place to live in. If this pandemic unseats America from being the leader of the free world, as far as death, you ain’t seen nothing yet.

And this virus is the perfect agent for Russian misinformation meant to divides us. It poses itself, to a large degree, as a common cold and asymptomatic nuisance, while on the other hand, it bludgeons ICU nurses with watching people die slowly and inevitably despite efforts that leave them physically and emotionally exhausted. How much of that is the COVID gruesome reality? Enough to make nurses political. Enough to make me want to hide and say, “No, I can’t watch this.”

This seems to be their argument; granted, a handy argument presented by politicians. If the lockdown isn’t done properly, the healthcare system will be overwhelmed and there will be no economic recovery and you shouldn’t put lives before money anyway. That’s immoral. Meanwhile, no one has figured out what the balance is, and the last thing you want to do is throw gasoline on the fire by arguing with these nurses about statistics; that’s just going to piss them off and understandably so. The second you start talking about statistics, they are going to see the patient that defies all of the statistics that they did three full codes on, and failed.

Here is what I see, even from great thinkers like Tucker Carlson on statistics, and the argument is both ignorant and annoying. There is a healthcare norm, which is a statistical curve, and then pandemics, which are healthcare spikes that get underneath the normal statistical curves (which healthcare systems are based on) and drive them up. This causes the whole system to implode. Such and such pandemic is not that bad because even this that or the other kills many more people. Really?

I am going to suggest what the problem is before I move on to the main point of the post. Government is way, way overrated. There has been pandemics coming out of Asia every twenty years since Eve ate the bad apple. Yet, this country has no adequate pandemic protocol. Here in Ohio, everyone waits with bated breath for the Governor and Director of Health to give daily briefings at 2pm.

But here is the problem: their all-wise government lockdown is not an intelligent lockdown and it certainly is not based on any science. For example, and for the most part, healthcare workers are coming up with their own protocols. The Director of Health for Ohio didn’t tell frontline workers to quarantine from their families when they go home to their home lockdowns, they are doing that on their own. Who thought it a good idea for correction facility workers and long term care workers to go home to an isolated locked down household?

So, the government dropped the ball on stocking N95 masks? Well, with all these people out of work, the federal and state governments could not have rounded up a bunch of sewing machines, material, sweeper bags, people who can sew, or train people to sew, and crank out a ton of N-95 masks? That’s what we did during WWII for what we needed. We found a way to put the unemployed on the frontlines. While government brainiacs have called COVID a war, they have doled out cash for people to stay hidden in their homes. We even flew to China, where the freaking pandemic came from, to pick up equipment to fight the war. Folks, these people are not the sharpest knives in the drawer. What is becoming more and more clear follows: we needed a science based intelligent lockdown, not the lockdown that occurred.

This brings us closer to the primary point of the post. Long term care facilities (nursing homes) are in lockdown. And, the kind of lockdown in place is indicative of the national lockdown which is loco grande stupid. At least in some cases, the way long term care facility lockdowns are being practiced is causing more deaths than the virus, and proliferating the spread of the virus in other facilities. I wonder if this isn’t true of the national lockdown as well. Let me be clear: I am not saying a lockdown should not have occurred; rather, I question the kind of lockdown that we got.

Let me explain. My information comes from frontline experience and information from nurses that work in long term care facilities. At least in some facilities, mortality is up, not from the virus, but residents being cut off from their families. At any rate, aides talk often about the one’s who have “given up.” It’s usually a death sentence. When you have had everything taken from you; ie., your health, the home you raised children in, etc., and the only thing you have left is family, and you are cut off from that, the results are not good. In fact, per our training, the family is part of the care team for that very reason. Family as part of the care team is LTC official protocol. So, who was the brainiac who came up with that lockdown idea? I was working in facilities that had their own proactive protocols that limited family visits to one family member at a time. There were other precautions taken as well; the family member’s temperature was taken and they had to wear gloves, and were given a short lesson on standard precautions. Then came the total lockdown ordered by the government. All of a sudden, the family is no longer part of the care team. That’s a really bad idea for many reasons.

But the brilliance doesn’t stop there. I am an agency nurse aide. I get a list of facilities that have open shifts. And here is where I will break some news to you. Nurses worry about our healthcare system because though it is the best in the world, it is fragile due to understaffing and lack of training. Nurses I talk to worry about the system being overwhelmed. Well, in the case of long term care facilities, that has already happened.

Let me further the point this way with conversation I have with other agency workers: “Yes, I saw the list of openings at that facility and that’s why I won’t go there, they must have next to no staff and I can’t do two or three halls by myself.” Not only that, being overwhelmed invariably leads to taking shortcuts on standard precautions.

So, you have hundreds of agency aides moving in and out of several different facilities. Anyone see a problem with that? The aides do. Many only take open shifts three days on, and four days off to see if they develop any symptoms because we can’t get tested unless we get sick. Others stick with a single facility so they know where they got infected if they get sick. But again, this isn’t a government protocol, or even an agency protocol, or even a facility protocol, these are individual protocols. I work for two agencies, neither has had a COVID in-service training except for, “Remember to be careful out there!” And like everyone else, they can’t get their hands on the right PPE equipment.

Here is the paragraph I have been wanting to get to. While it is true that the long term care system has collapsed, it is still floating, because of the unsung heroes, that is, the nurse aides. Yes, I am one, but I mostly hangout with them and help out. It is true that a lot of them fled the facilities out of fear; it is true that many quit because they will make more money with the stimulus package for not working at all (more government brilliance).

But, those who are left are taking care of business because of who they are. So to speak, the men have been separated from the boys. They are enough. I got my start in healthcare by starting with a small home healthcare agency in Dayton, Ohio. The RN who was supposed to orientate me after being beckoned off the street was a Muslim women who spoke broken English. It was a short “orientation.” She turned the pages one at a time saying, “Sign here on bottom that you agree.” I signed, and to what I don’t know. I was not very impressed as a retired business owner that ran a pretty tight ship, and I think she knew that. At the end of the “orientation,” she took her hand and started touching  her chest saying, “If you have heart you make it; if you don’t have heart, no. We will see.”

That isn’t lame, she was right. Even though long term care facilities are woefully short staffed right now, the one’s left have the heart. Long term care is much different than acute care, sometimes the aides and nurses are the only family a resident has. I used to think that was a sentimental cliché. I remember when I used to hear aides tell residents they loved them, I used to think, “Oh please, just shut the hell up and do your job.” Since then, I have become a lot less construction worker and more aide.

As a Christian, I know every human being will have to do business with God at some point. But in heaven, there will only be love and no judgment. There won’t be any politics, there won’t be any religion, and everyone’s identity will be without controversy.

I find that most aides in long term care facilities do have a single focus. And that single focus is love. Aides don’t ask how someone ended up in long term care and it doesn’t matter. With the opioid epidemic the way it is, we care for many that are there by their own doings. They get the same care everyone else does. I have never heard an aide judge a resident. Judging other aides? Well, ok, that’s another matter. But, the judgement is always about your ability to deliver care.

Clearly, when acute care nurses say, “I hope the lockdown protestors get the virus and stay home and die,” such nurses have lost their focus. Perhaps the one’s that are furloughed should relieve the shortages in LTC to regain the right healthcare perspective.

Where, for at least the time being, heaven is a place on earth.

paul