Swing for the Heart

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Unknown doors into the ‘known’

Alice was looking forward to the morning when she, too, would head to a real job. Just like she’d once looked forward to getting her driver’s license. Finally, she broke through, and after persistent responding to all job postings, she can now contribute to their family bread-basket. The hardest part was not the constant trips to the job bank, where she printed resume after resume, but the fact that nobody was responding. She took it very personally and thought it a slap in the face. But she got used to it, and accepted David’s theory that nobody would reply if she gave up and stopped sending her resumes – now polished and perfect to the tee.

Now Alice had a response. The gloomy day in February of 1999 had a fairytale-like load of good fortune in store for them. Alice passed the interview and was hired. Even though her English was not flawless and never involved much medical jargon, she managed to convince all three female representatives of the nursing home. And now she was already filling out paperwork, even if some she understood only very little. They hired her. She has a job!

One of the papers confused her; she got a whole brochure along with it.

“It’s an application to be a union member,” explained one of the three women, the youngest one. Alice’s mind flashed to a memory of a bulletin board framed in red. A red flag with three capital letters used to adorn the upper corner in those days.

“Maybe…I will think about the membership. I’d probably need to know more…,” she lacked the vocabulary she needed to explain her trepidation.

“But it’s mandatory. It’s part of the employment contract,” illuminated the young one.

“Even if I didn’t sign it right now?”

“It doesn’t matter. You’re a member.” Alice felt disoriented. She also wasn’t in a position to express her opinions the way she’d learnt to do under David’s influence. She’s found work and everything else is minor and irrelevant.

Her job wasn’t far from home. Sometimes she paid a little more and Mrs. James walked little Kačenka to school; other times, Alice drove her herself. It depended on her shifts.

The first day of spring couldn’t have been more beautiful, which multiplied her happiness and feeling of pride. She has a job. She walked in her colorful, flower-patterned uniform of a personal caregiver, joyfully looking around other people who were also on their way to work. Alice walked through the glass door with her co-workers greeting her and felt even more elated than she was showing. Alice knew them already. She was still confusing their names a little, but already she knew who’s friendly to her and who’s just showing off and pretends to know everything. Naomi, Sandra, Maryla, Tien,…Alice was smiling and felt she belonged in a team. From time to time, she also ran into a man whom she’d guessed to be fifty-five years old or so. He was one of the exceptions, because otherwise the only other men were the maintenance staff. She had to smile to herself. All women! From the bosses to the janitors.

Alice found her spot in the semi-circle of caregivers gathered around the head nurse, trying to understand as much information as she could, as they were being briefed by the night-shift personnel.

“…Mr. Dwight from room number three passed stool three times last night, still bloody, runny. Today he’s taking a bath, and at ten he’s going again for an X-ray. He didn’t have a fever. Mr. Henley from number three was calling out until around midnight, wanting to go to Oregon to be with his son. He got a pill, then fell asleep….” Sandra has been working in the home for three years now, she knew all the procedures and where everything was, and Alice was able to ask her questions. Her reports were always satisfactory and Alice felt she’d like to be able to deliver them too, one day. For now she was still struggling with English. She was listening intently, etching in her memory the proper jargon and expressions.

“…Mrs. Ferguson is breathing very slowly, about four or six breaths per minute, only superficially, pulse is weak, barely discernible. When I tried giving her tea through the straw, she touched it weakly with her lips, but didn’t take a sip. She reacts to questions only by moving her lips.”

“…Mrs. Ferguson is DNR.”

“Yes, I know. We’re expecting it today, probably as early as this morning.”

“Let me know, we’ll need to call her granddaughter. Don’t forget to take her sink to be sterilized and clean out her night-stand. Make sure you keep an eye on it, there are two other residents with her there. You understand.”

“Yes. That’s all from my rooms. Also, in number seven the window is poorly insulated.”

“Write it down, Mr. Weiss will take a look at it. Since we’re on the topic of writing, don’t forget about our internal ‘silent mail’ system, ‘Good Pal’, it’s helpful to all of us.” So much new information, what does DNR mean? She’ll have to ask later. And the internal mail? She didn’t dare asking just yet, because she didn’t want to highlight the fact that she didn’t know something. Tien came to her rescue. She asked.

“Is it the green box?”

“Yes,” answered the head nurse, “underneath is a stack of small forms. I’ll repeat it for those who still don’t know.”Alice was quiet and listened. “…you have the opportunity to write down if you see something that’s not right, or notice something that’s positive. Anything. For example, one of you will forget to lock the door to the smokers’ patio and her colleague will notice it. So she’ll jot it down, so that we don’t forget next time. She’ll write down the name of her co-worker, exact time, and will describe how she’d broken the rules. Or, of course, the other way round, if Naomi sees that Elise…”

“…Alice….”

“Ok, Alice…that Alice is going the extra mile in helping a resident look their best, for example, then she’ll note it down too. Throws it in the mailbox and we have an overall picture and know where and what we need to improve. Just keep your eyes peeled and write. It’s important for maintaining the safety of our residents and the excellence of our work generally. And that’s the point.” It sounded a little strange. Alice wanted to find in the principle of ‘silent mail’ something that would excite her, but she wasn’t able to see beyond what it was. She didn’t want to ask.

The reports ended, Sandra went home with the others from the night-shift, including the older, serious gentleman caregiver from the north wing. Alice knew that her work-partner today would be Tien, and felt glad about it. Tien was quiet, petite, hard-working, and did her work well. She came from Vietnam, where she used to teach elementary school.

“Today we have rooms five, six, seven and eight. But we have to hurry, because in number eight we have three ‘complete lifts’.” Alice already knew what that meant. They’ll have to bring a large crane with straps and a suspended cot made of fabric. Rolling the resident onto the bed first and attaching the straps, they’ll be able to move him using the crane. One of them operated the crane, the other held the patient. Once they transfer him onto the wheelchair, they’ll take him to breakfast. But everything has to be done before eight, so there’s no time for chatting.

When they left the first room, Alice quickly squeezed in a question.

“What does ‘DNR’ stand for?”

“Do not resuscitate. It’s for those who don’t wish to be revived. You need to know that, Alice, because it would be illegal, against the patients’ wishes. You’d be in trouble. Let’s keep going. It seems to me that here in number seven, someone soiled themselves big time….”

With Tien they worked quickly and efficiently. Together they managed to wash, dress, and prepare for breakfast all their residents before eight o’clock, and even make the beds. Alice felt proud when, two minutes before eight, they were leaving room number eight with the last patient ready for their meal. Tien then had to return for one of their resident’s glasses. Alice slowly walked Mrs. Richter through the corridor, Tien already catching up with them with reading glasses in hand, when suddenly they noticed something unusual.

The head nurse was striding towards them in a quick and resolved pace, with Laura – another morning caregiver – rushing a step ahead of her. She was telling something to the head nurse, and then Alice and Tien only saw them disappear in room number two. They slowed down, to be able to see through the open doors what’d happened. Naomi was standing next to the bed, operating the lift crane. The patient was just about to make a soft landing in the wheelchair as Naomi was guiding him. Using her right hand to operate the lift, and navigating the patient with her left, she was about to place him exactly in the right spot.

“Nurse,” shouted caregiver Laura, “I opened the door, and see that Naomi alone is lifting the crane….”

“And where is…?” In that moment, Maryla – who’d run into the bathroom to grab new diapers – appeared in the doorway. Surprised, she watched the drama unfolding in room number two.

“I’m…I was just…” whispered Maryla, already suspecting she was in trouble. In the meantime, Mr. Berger had been safely lowered into the chair. Naomi stared at Laura and the head nurse in shock. It was too late.

The head nurse spoke.

“Maryla and Laura will finish here and you, Naomi, can come with me.” That sounded terrible, like the whistle of a bullet. Naomi! Why Naomi!

The head nurse with Naomi passed Tien and Alice, heading to the office. Mrs. Richter shuffled slowly through the hallway, unaware of what’d happened. Only Tien and Alice, who knew the import of what just transpired, walked towards the dining room in silence and with an unpleasant feeling of premonition. They were just passing the head nurse’s office when the door opened. Naomi had been there for about thirty seconds. She was now leaving the office with tears in her eyes, walking g to the locker room. Before Mrs. Richter and her two caregivers reached the dining room, Naomi walked out of the change-room with her coat in hand, quickly waved to Alice and Tien, and stepped out into the first spring day.

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