Authors: Jan Christensen
Laughter broke out, and a subdued cheer.
“Are there any questions?” No one said anything. “Okay, back to work, then.”
The loudspeaker blared, “Aerobics in the dining room in fifteen minutes.” Wanda repeated the announcement as Alice went toward the 300 hall, Joyce rushing ahead to answer a call light.
An old man in a plaid robe leaned heavily on the handrail as he shuffled past. A gray-haired woman in a wheelchair blocked Alice’s path until the old man got by. A short woman in heels and a blue suit said, “Good morning,” as she passed Alice, going the opposite direction. Alice returned her greeting shyly, remembering Joyce had pointed out the woman yesterday as Katherine, the administrator.
She heard a woman cry, “Help me! Help me!”
“Just shut up,” a hushed voice hissed. Alice stopped and peeked inside the resident’s room. “You have to stop that yelling, I tell you. We’ll have to tie you to the chair again if you don’t.”
Nancy’s back was to Alice, her hands on hips. An old woman cowered in her wheelchair, her mouth slack, her brown eyes darting around the room, not meeting Nancy’s eyes.
“Please,” she pleaded.
Nancy grabbed the chair and whipped it around toward the bathroom. “I’ll take you now. But next time you wait and don’t do all that yelling.”
The woman bowed her head, her shoulders shaking. Alice guessed she was crying. Alice’s stomach muscles clenched. A sick feeling overcame her as she went quickly down the hall. She felt betrayed. Nancy had seemed pretty nice the first day of work, as if she really cared.
“Hey,” Joyce said. “I was looking for you. You all right?” Her soft brown eyes searched at Alice’s face with concern.
“I’m fine,” Alice said. “What do I do now?” She remembered the video she’d seen her first day about resident rights. It had mentioned verbal abuse. Wasn’t that what Nancy had been doing? She should report it to Betty, but she didn’t want to see the director of nurses for a while, especially privately.
Alice made herself listen to Joyce. “We need to refresh all the water pitchers and offer juice.”
Lettie came around a corner. “Do you know me?”
Alice couldn’t help smiling. “Yes, Lettie,” she said at the same time Joyce did.
“I like you,” Lettie said.
Oh
, she thought,
what if Nancy was mean to Lettie?
She said, “I like you, too, Lettie. Very much.”
Lettie smiled and nodded, then hurried off down the hall as if she had something important to do.
Alice and Joyce exchanged grins, then went to hand out water and juice.
Brenda was conferring with a family and resident in room 326 when Alice entered. The social services director stood ramrod straight in her high heels at the foot of the bed while a young woman slouched in the visitor’s chair and a man perched on the foot of the bed. Surely they were too young to be the woman’s children.
While Alice repositioned the other resident, she listened to Brenda.
“I have a list of home health agencies here and what they can do to help you. This yellow sheet outlines the care Mrs. Baggett will need and the medicines she should be taking, and when. The doctor wants to see her weekly for a while. I’ve set up tentative appointments. You can change them if necessary, but you did say Thursday afternoons were good, right?”
The woman in the chair nodded. She had an utterly defeated expression on her face, and Alice wondered if she’d be able to cope.
“You understand the diet?” Brenda asked. “It’s very important. There are lots of books about diabetes, and recipe books, too. I’ve made a list here for you to take home. You can give the insulin shots and do the testing?” She raised her eyebrows. They both nodded.
“I’ve included my card in your packet. Please call me if you have any questions or concerns. Merry Hills and I will be here if you need us again. Do you have any questions now?”
“No.” The man stood up and shook Brenda’s hand. “Thank you for everything.” Slowly, the young woman rose from the chair, shook hands, and murmured thanks.
“Let’s get you dressed now, Nana,” the woman said. Alice jerked with surprise. Something stirred in her memory. She shook her head—she couldn’t remember.
At break, she asked Joyce to describe exactly what Brenda’s job was.
“Gee, I’m not completely sure. Something called discharge planning. You know the ultimate goal is to get everyone to go home. And lots of residents are here short-term. Brenda counsels them and their families. She also has contacts with lots of agencies and organizations for, like, the blind, or the deaf. Diabetes, Heart Association, things like that. She gets special adaptive equipment and info for residents from different groups. She meets with the other department heads for care planning.”
“What’s care planning?”
“Each resident has a plan of care so they can get better, or at least stay at the highest level possible for them. Let’s see. Nursing, Dietary, Activities, and Social Services meet, I think every ninety days, and discuss each resident. They talk about what should be done to help. You’ve seen those big folded cardboard things in the charts?”
“Yeah,” Alice said. “It has goals listed at the top, and I remember seeing the signatures of Betty and Margaret, Brenda and Yolanda.”
“That’s it. And I think Brenda has to make notes in each chart every so often about the resident’s social service needs. Yolanda does the same for activities, and Margaret for dietary. Hey,” Joyce said, “I know more than I thought I did!”
“Yes.” Alice smiled. “I didn’t realize how much there was to caring for each resident. So Brenda does nonmedical stuff?” She thought about Nancy yelling at that resident. If she could tell Brenda instead of Betty, she’d feel better about it. Brenda should be sensitive to resident abuse.
As Joyce and Alice went back toward their hall after lunch, Rita met them at the rotunda.
“Alice, there’s a fire-safety class you need to attend this afternoon. Joyce, can you manage by yourself for about an hour?”
“Of course,” Joyce said.
Rita told Alice to go to the conference room. “Be sure to sign the attendance sheet. Sally, the staff development coordinator, will conduct the class. You’ve probably seen her around.”
Alice shrugged. She didn’t remember if she had or not.
“Anyway,” Rita said, “when it’s over, come back and help Joyce.”
Alice nodded and went to the front of the building.
About ten other people were in the room when Alice arrived. Sally bustled in and began the class by showing a film. It explained the procedure to follow when someone first noticed a fire, how to close off sections of the building, and how to evacuate residents.
When the film ended, Sally took them outside and showed them how to use the fire extinguisher and told them about the Dr. Redd code. “When you hear ‘Call for Dr. Redd, Call for Dr. Redd,’ you know there’s a fire somewhere in the building. Immediately start closing off your section of the building. Follow the other procedures in the film.”
Alice was glad when the class was over. She didn’t even want to think about a fire. Skirting a group of people who had gathered in the hall outside the conference room, Alice went back to the 300 wing.
Joyce pushed the cart with extra pitchers, glasses, ice, and juice. “I’m glad you’re back! Can you finish this while I give some bed baths?”
“Sure,” Alice said.
It was three o’clock before she knew it. Not until she walked in the front door at Hannah’s house did she remember she’d meant to speak to Brenda. She hesitated in the hall, debating whether she should go back. She felt so tired.
Surely, it could wait another day.
After the staff meeting, Betty went to Katherine’s office. The administrator was on the phone, but she waved Betty to the visitor’s chair. Betty got comfortable and watched Katherine play with her pen as she talked to a resident’s daughter.
“Yes, Mrs. Adams, we’ll take care of it. … I’ll investigate, I promise. … Yes, I know. Sometimes this is what happens, you understand. … No, no, I’ll check into it.” She rolled her eyes at Betty and grimaced. “Yes, please come see me the next time you’re here. … Right. … Okay. … Yes. … Good-bye, Mrs. Adams.”
Katherine put the phone down with obvious relief.
“Family member sees deterioration in mother, thinks it’s our fault. Says her skin appears gray, and she’s gotten two new small bedsores in the last month. Lost four pounds, too. Quite an observant woman.”
“She sure is. That’s Mrs. Reynolds’s daughter, isn’t it?” When Katherine nodded, Betty continued, “I’ll check on it for you. Have to start somewhere about the decubiti. Might as well start with Mrs. Reynolds. Lost weight, huh? Think I’ll do a correlation chart with decubs and weight loss. Although four pounds isn’t much,” she mused. “So tell me, how’d the rest of the place do on the inspection?”
Katherine went over all the scores with her. Betty winced when she found out Brenda had a better score in Social Services than Nursing had received.
“What are you going to do about Activities?” Betty asked when Katherine finished.
“Ah, Yolanda,” Katherine said, leaning back in her chair. “Her heart’s in the right place, but she isn’t very organized or good with resident records. I think with this resident load she needs an assistant.”
“Good idea,” Betty said. “She can’t get enough volunteers in this small town. I know just the person, too. Let me hire another aide, then Alice Strong can be Yolanda’s assistant. She appears to be a little too sensitive to do direct resident care. But she’s young, and I bet she’d like doing activities with them.”
“All right,” Katherine said, tapping her pen on the desk. “I’ll check with Maxwell to see if we can get it worked into the budget. I’m sure we can.” Katherine smiled her cat’s-got-the-cream smile.
Betty thought,
I’ll bet you’ll work it out. It helps when you go to bed with the regional director. Will you and Maxwell discuss it there or over cocktails and dinner? Be nice
, she told herself.
It’s none of your business
.
“How’s Huey?” Betty couldn’t resist asking.
“He’s fine. Out of town this week. Sometimes it’s difficult having a husband who’s hardly ever home.”
“I imagine,” Betty said dryly and changed the subject. “You heard Mrs. Lacy died yesterday?”
Katherine looked somber. She stopped playing with her pen. “Yes. A shame.”
“Dr. Henderson put it down as a heart attack. Two in two days is a little much. Especially during the inspection.”
“Both were handled discretely.”
“Thanks mainly to Rita. I was too busy.”
“Well…”
Betty stood. “On that gloomy note, I’ll leave you now.”
Katherine got up and walked her to the door.
“Jenny out today?” Betty asked when she saw the uncluttered assistant’s desk.
“Yes. A migraine.”
“You give those to her?” Betty asked, smiling.
“Oh, yes, I’m sooo difficult to work for. No, I think the inspection put a strain on her. She’s such a perfectionist and takes everything to heart.”
“You’re probably right. A good diagnosis for a nonmedical type.”
“Been hanging around you too long,” Katherine said. They both laughed. Betty waved her fingers at Katherine and went toward the rotunda.
“Rita,” she greeted her assistant, “I want some of the charts of folks who’ve gotten decubs in-house in the last six weeks. Can you pull me about eight? Make one of them Mrs. Reynolds’s. I’m going to walk around, then I’ll search through those records.
“Sure thing,” Rita replied.
It was lunchtime for the residents, and Betty watched the aides distribute trays to their rooms, then went to the dining room to see how things were going there. She watched from the archway as dietary aides distributed food to the tables and helped some of the residents eat.
Margaret stood next to the swinging door, blue hairnet in place, arms folded across her chest.
Suddenly a large crash sounded from the kitchen, then expressive swearing. Margaret whipped around and rushed through the swinging door. Betty hurried to follow her to see if anyone was hurt. Most everyone in the dining room stared, but a few residents, oblivious, continued to eat as if nothing had happened.
A stainless steel cart full of dirty dishes lay on its side, broken crockery everywhere.
“What happened?” Margaret screeched as Betty stepped into the room. Margaret didn’t see her and began cursing. Betty stood, appalled, as Margaret shouted, “You stupid idiot! Can’t you do anything right? How can you be so clumsy? Get this cleaned up right now. All of it!” She cursed some more.
The aide, in tears, pointed to a broken wheel. “I didn’t do it,” she blubbered. “The wheel broke.” As she dashed from the room, Margaret turned and saw Betty. The food service director’s face turned bright red. She said to another aide, “Get this mess cleaned up, pronto,” then headed toward her office, Betty on her heels.
“Margaret,” Betty said.
Margaret wheeled around. “Get out.”
Betty stopped, stunned. “What?”
“Get out of here. It’s none of your business. This is my department. Out.” Margaret slammed her office door in Betty’s face.
“Well,” Betty said. She turned around. No one moved. One aide had stopped in the middle of spooning desserts into a bowl. Another held a broom, ready to sweep up the mess. Two more were starting to upend the cart. The aide at the sink held a cup in one hand, a cloth in another. Betty stared at them a moment, then left the kitchen rapidly, striding around and over the mess on the floor.
Betty decided she needed lunch. She used the intercom at the rotunda to let Rita know she was going out for a while.
When Betty came back from the deli, full from a club sandwich, she went to her office and called Rita again. “Can you have someone bring me those records you pulled? Then pull about eight more.”
“Sure thing,” Rita replied.
Betty went through her mail until the charts were delivered, then she made up a form and carefully went through each record.
When she had finished the first eight charts, Betty got up, stretched, and gathered them up to take back to the nurse’s station. As she left her office, she met Katherine coming in the front door. Her color was high, eyes bright, and she smiled happily at Betty. Betty glanced at her watch. Two forty-five.