Two Episodes in the Life of a Certified Nursing Assistant

by Frederick E. Bernardo

These two episodes (one short narrative and one poem) concern my experiences working as a Certified Nursing Assistant (C.N.A.) and one of the greatest lessons I feel have learned through this job: serving and loving people as people, just as God does. These events described, are certainly true events as are my thoughts and convictions concerning them.

Writing these narratives, or episodes, was quite refreshing in a way because the bioethical issues they address (personhood and the responsibility of healthcare workers) seem to be receiving diminished attention in light of the seemingly more pressing bioethical issues of the day (i.e. stem cell research, genetics, and the cloning debate). More importantly, though, I felt a real sense of fulfillment in writing these narratives because I realized that in the five and a half plus years that I have worked as a C.N.A., I seldom stopped and thought about what lessons I may need to be learning through this work. As King David was blessed with time alone with a flock, I have been blessed with time alone with residents.

"Alone"

"Any mans death diminishes me, because I am involved in Mankinde; And therefore never send to know for whom the bell tolls; It tolls for thee."  --John Donne

By the time I was in high school, I had already accompanied two friends as they mourned the loss of their mothers to cancer. Wakes, I realized, are very ironic situations. Many people who the deceased knew (and didn't know) fill a room in order to pay their respects. Yet the deceased's family will still be dealing with loneliness as the deaths of loved ones leave great voids. Viewing a dead body naturally induces sorrow. Jesus' weeping over Lazarus' death may be as indicative of his humanity as any of the wounds he would later suffer. Mourning is expected of friends and family....

The first time I performed post-mortem care on a resident was rousing because I realized that this encounter with a dead body was going to be far different than any other encounter I had previously experienced. The jarring silence of the corpse made me consider death as never before.
The family of the resident was not present, and I had never met them. Even if they had been present, I knew that, to them, I was "the C.N.A.", not Erik. Because I had a function, not a name, it was implicitly expected that despite the fact that I was dealing with death, that great separator, death itself was somehow supposed to mean less to me. "Don't feel bad, just clean him and change the gown," was a typical expectation from boss and family alike. That expectation made me feel alone...inhuman. I realized the discomfort I was feeling that day was not due to the fact that a corpse was before me. Rather, I was uncomfortable because I was expected to be "lifeless" myself. I was asked to be a corpse; without feeling or emotion. That minimized my humanity in a way that death never will.

"Bea"

Her hair is long,
Comb and braid it if you can.

Her skin is dry,
The moisturizer should be in the drawer.

Her eyes are dirty,
Careful.

Her Attend is wet,
Change it before she gets a rash.

Her bottom is sore,
Apply the A+D.

Her decubiti are getting worse,
Remember...every two hours.

Her contracture has advanced,
Be careful with her knees.

Her N-G tube is long,
Check for kinks.

Her drainage bag is full,
Record her output.

Her ankles are sore,
Check the boots.

Her room gets cold,
Two blankets tonight.

 

Her name is Beatrice,
But she prefers "Bea".

Every once in awhile, a C.N.A. will be assigned "one of those"-a resident whose health has declined so dramatically that it is easy to forget that they are a person. They are bed-ridden, tube-ridden, unable to speak, incontinent, vulnerable to a number of ailments, and so on. Their care is intensive; they simply require a lot of work.

I remember I was once assigned to a resident who was a classic "one of those." Finishing all that I had to do for her (and feeling good of myself for having done what I believed to be a good job), I noticed a little sign on the wall. It was obviously left by her family as I doubted that any one of the workers would have put so much effort into making such a fancy little sign. It read simply, "Mom's name is Beatrice, but she prefers 'Bea'."

Having read that sign, I realized I had neglected doing what, in a greater sense, may have been the most important thing I could have done for the resident: remember her as a human being and not a list of duties.

This was actually a frightening moment for me because this occurred after I had started a masters in bioethics program--a program where I was studying how to uphold the dignity of people in this very context. Being very honest with myself, I knew that through my forgetting that I was caring for a human being, someone of great worth in the eyes of God, no matter how disabled, was a form dehumanization. I was, to a lesser degree, guilty of the same sin as those who would elect to actively end Bea's life before she naturally expired. Attending to the sick and dying is simply not enough; I must take care of Bea. CBHD