Paul's Passing Thoughts

Introduction   

    Welcome to a book about one of the greatest, self-fulfilling careers in the world, the nurse aide. Yet, unless you have been on the moon for the past decade, you know the shortage of nurse aides in the healthcare workplace is severe. And, considering that in post COVID nurse aides are finally making respectable wages, how can this be?

    The focus of this book answers those questions with an event witnessed at a healthcare facility somewhere in the state of Ohio. It was a conversation between a facility resident and a STNA (state tested nurse aide). After a hearty greeting, the resident asked the aide, “What are you doing today?” The aide answered this way: “I am a certified butt-wiper, and I am doing a lot of it today.”

    Full stop. The one sentence spoken by the aide encapsulates the core problem with the present-day nurse aide crisis; identity, the problem is an identity crisis. That is the thesis of this book. For the most part, nurse aides have no vision, and have not been given one by the healthcare establishment. To a large degree, nurse aides do not know who they are. An emphasis on what a nurse aide is will solve the problem, as it did with nurses.

    Nursing was not always a reputable profession. It is fair to say that nursing of the early 19th century had no vision. Nursing was an occupation, not a profession. Hospitals were referred to as “pesthouses” and were staffed by untrained personal. Workers loosely referred to as nurses were generally women of ill report, such as prostitutes and prison inmates.[1] Florence Nightingale was the reformer who changed all of that. She gave nursing the identity it needed to fulfill its true calling. She was one of the few in her day that saw nursing for what it really is.

    Technically, the identity of nurse aide is a profession, but it is overwhelmingly seen as an occupation. Ironically, the training and state requirements show that it is a profession, but in the field, it is treated like an occupation. Do not misunderstand, there is virtue in all work, but professions are distinguished by levels of training and demands on the individual. The true identity of nurse aide demands much, but in reality, little is expected from nurse aides themselves and those who need their services. After all, for the most part, they are “butt-wipers.”

    Frankly, there are a lot of people who are dead well before their time because of this aide misidentification, and you might ask yourself the following: What does aide self-image project to those being “cared” for? But these are subjects for later in this book. A nurse aide reformation is needed; nurse aides must find themselves for their own good and the good of those who need them. We can begin there with the true identification; nurse aides are needed by doctors, nurses, patients, and the extended families of patients. In a long-term care setting, hundreds of extended family members are counting on aides to do their jobs. It is a sacred trust before God; it is God’s work.  

    That is only the beginning of the identification. This book will attempt to articulate the identity in depth, and supply the necessary vision. But we will hardly stop there. Included in the vision is a new way to think about the nurse aide profession. What it truly is—is astounding, but the challenges are part of that identity. Part of the nurse aide identity follows: nurse aides are not inclined to search for the easy road. Caring for others is not always easy, and quality care is the ultimate goal. Nurse aides will do things they would have never done before they were an aide because the goal of quality care was not on the other side of the task. You may call that “love” if you want to, that is probably apt nomenclature.

    It is 0:600 somewhere in Dayton, Ohio. A nurse aide pulls up to a drive through window at a local coffee shop about a mile from his assigned facility. The shop manager opens the drive through window and hands the aide an extra-large coffee, black. The manager notices the scrubs, and asks, “Are you a nurse aide?” After the affirmative answer, the manager states, “I saw an aide care for my dad while he was dying, it’s a very hard job.” After the aide agreed, the manager asked, “What do you have to do to become a nurse aide?”

    What was going on there? After all, the manager was already in a career. Apparently, the manager saw something in her father’s aide that she wanted to aspire to, even though she knew it was hard. This is because intuitively, we know that hard tasks bring greater self-fulfillment. And in life, there are some jobs that must be done; someone has to do it. Therefore, self-aware aides know they are the ones who stand in the gap. They know that they go places and do things others will not do, and they like that about themselves. They do what they do because someone has to; that is their contribution to humanity, and that is honorable.

    With all of this said thus far, you are probably assuming there is a type of brotherhood or sisterhood among nurse aides like you see in law enforcement. You would be totally wrong about that. No profession eats their young, so to speak, more than nurse aides. If the profession is so difficult, why is this the case? The answer is easy: no vision. No identity.

    Aides who work for staffing agencies are special aides that cover staff shortages on short notice; they stand in the gap, right? Yet, agency call-offs are commonplace, and are an oxymoron of sorts. The agency aide who was supposed to cover a call-off, called off. How could this possibly be commonplace in our day? Same answer. Aides simply do not know who they are.

    Why are all kinds of abuses against residents and patients by aides commonplace as well? Is it because they don’t know who they are? It’s a rhetorical question. Moreover, if an aide identity was clearer, it would prevent many from obtaining the position who do not belong.

    This book will provide the vision, which includes identity, worldview, and mindset necessary to survive the rigors of the profession, and the ability to excel in it. To a lesser degree, we will discuss execution.

    So, it is the nurse aide state of being; it is who we are, which leads to what we do, and the goals we set for ourselves to realize the full vison. If, we know what all of that is.

    Together, we can overcome the nurse aide identity crisis, and do our part to put this sacred trust on full display.  

Paul M. Dohse, STNA/MA-C

[1] Msn, C. K. R., & Msn, G. K. R. (2018). Foundations and Adult Health Nursing (8th ed.). Mosby. p.2