Phase V, ACT III: The Warehousing of the Elderly

ACT III: The Warehousing of the Elderly

The screams coming from the room were deafening. As I walked down the hallway toward the sound, I could feel my pulse quicken, my breath coming in short gasps, my palms sweating.

The male nurse must have seen the panicked expression on my face as he tried to catch up… “What’s the matter,” he asked me as if oblivious to the screeches and moans coming from down the hallway.

“What is going on in there?” I asked him.

“Oh, that is just Helen,” he said rather flatly, “She is old and believes that everyone is hurting her.” He turned abruptly on his heels and scampered away as if to nullify my concerns.

I couldn’t believe the callousness in his voice. Regardless of his lack of regard, and dismissing attitude, I rounded the open door and entered the room.

There she was…. slightly propped up on on her right side supported from behind by a long pillow, facing away from the door. She had a bony, tiny frame whose thin, frail skin bore red abrasions over her exposed protruding left scapula that had escaped the confines of the hospital gown carelessly thrown over her. She startled at the sound of my entrance and retracted, her already curled up appendages seemed to pull up closer, as she let out a horrifying scream..

“Mrs. Medlar,” I said to her as soothingly as I could, “My name is Nanaymie and I am the new charge nurse here on the 3rd floor”.

Her neck, as frozen as her bent appendages, strained to move and her eyes looked up at me in terror.

“Honey, I don’t want to hurt you.” I touched her lightly and felt her flinch. I removed the gown to expose the large bed sore over the end of her spine.

The nurse manager entered the room, “Just do the dressing change,” she told me loudly above the wails coming from the frail and writhing frame lying in front of us, “you can’t get involved with her issues. You just don’t have the time.”

“What happened to her?” I asked imploringly, in a vain effort to understand the foundation of the fear being evidenced.

“Helen was the wife of a man who spent most of his time beating her. Now that she is old, she can’t understand the physical pain that she is in and everything we do to help is torture”.

While that might have explained the mental status, it did not even begin to illuminate how this woman’s physical needs had been severely neglected as evidenced by immobile, bent limbs and bed sores that eviscerated healthy skin and tissue to reach the bony prominences over which they lay. Mrs. Medlar was in a perpetual fetal position, a metaphor for her imprisonment in a body that had been ignored, a mind haunted by a lifetime of trauma, warehoused in a nursing home where her caregivers “frankly don’t give a damn”.

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Phase V, Act II: Nursing Training at the Expense of Those who cannot Object

ACT II: Nursing Training at the Expense of Those who cannot Object

I had reentered the Nursing program at Rutgers University after a 7 year hiatus, being traumatized by being placed in a position to protect the life of a young mother in my Maternity rotation. Since that time, I had moved to Vermont , owned a restaurant and had my first of three children that I chose to birth at home. Abandoned by the father of my child, I returned to South Jersey to finish my training….

“I want you all to come into this room here,” the instructor called to the nursing students from the door of a room down the hall where an elderly man lay whose breathing was raspy and audible from the location of the central desk.

All 8 of us filed in the brightly lit room to find an old man propped up on pillows to facilitate his visibly difficult breathing…

“We are going to sink a nasogastric tube. We have been given the go ahead to do so,” she triumphantly blurted out.

The old man barely moved, seemed in and out of consciousness, and completely unaware of what was going to happen.

“Who wants to try?” the instructor asked us.

I was barely aware of the student who volunteered and proceeded to wash up and don her gloves. The instructor’s voice faded as I focused in on the raspy breathing body lying in front of us. He was a portly man sitting at a 45 degree angle just barely aware of his surroundings, though he seemed mildly distressed at the accumulation of bodies standing around his bed. His eyes opened and flickered briefly and then closed again.

“This is Mr. Salinas,” Dr. Romeo told us, and without a moment hesitation cranking the bed to almost a full seated position,” Mr Salinas, we are going to be inserting a nasogastric tube so that you get some nutrients that you need.”

She turned and addressed the nursing student by her side, “Now lubricate the tip of the tubing and insert it into his nose.”

Everyone leaned forward to get a better view as the man seemed to jump at the sensation of the foreign object entering his left nostril. As soon as the tube past into his throat, the gagging began. His face quickly turned red with the added strain to breathe.

“Swallow” the instructor yelled to the gagging, frightened, semi-conscious man in front of her, “swallow!”

I could feel the fear well up in me as I watched the scene in horror. Everyone else around me seemed oblivious to the sheer terror being felt by the struggling form in front of them. It felt like an eternity…

“Well done,” the instructor said to the student as she beamed with pride at the successful placement of the nasogastric tube.

At what cost, I wondered to myself as I followed the entourage as they left the room. I looked back to see the color return to the man’s face and wondered how many more procedures he would be forced to endure “for his own good.”

Phase V: The Professional Nature of victimizing others

In effort to avoid the traumas that we have faced within our own lives, we turn off to the suffering of those in our care. We are taught that “turning off” ensures us that we “don’t burn-out”.  The fact of the matter is that the loss of our ability to empathize removes a critical safeguard in the treatment of human beings. We, the people of the world, actively choose  to emphasize the differences between us, intensifying the dissociation that allows crimes against humanity to take place. It is time to expose the cost of human neglect and ignorance in the care and treatment of our brethren.

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ACT I: Western Childbirth: the Butchering of Women

I was in the midst of my first Nursing rotation. The topic of our placement was: The Care of Healthy Clients. I was placed on the Maternity Unit of a local hospital where I was told to follow a woman who had begun labor some time earlier. The only way that I knew that she was having contractions was by watching the fetal monitor. She showed no connection with the experience that had taken hold of her body. Numbed from the epidural, the contractions took place without her participation or knowledge.

As she shifted her body, the fetal monitor lost the fetal heart beat… A nearby nurse sprang into action. After a quick call to the FEMALE obstetrician, they decided to rush the mother to the operating room for a caesarian section.

I accompanied her to the operating room where they pulled out the perfectly healthy baby boy who exhibited NO SIGN of FETAL DISTRESS!!!

I followed her to the recovery room and began monitoring her vital signs every 15 minutes. She shifted uncomfortably.

“My shoulder hurts,” she told me.

I took another couple of blood pressures and watched as her b/p began to drop. At the same time, her pulse was becoming faint and thready. I decided to go get some help…

“Can someone come in the recovery room? I think we have a problem!”

It took 3 attempts to get anyone to take me seriously. By that time she was unconscious. I continued what I had done when she was losing consciousness, stroking her hair and talking to her soothingly. When they finally determined that there was something wrong, several brusque men pushed me aside and transferred her to a gurney to go back to the operating room.

I gowned up and entered the operating room just in time to watch the obstetrician pull out an 8 inch hematoma from below her uterus. In the haste to perform an UNNECESSARY caesarian section, the obstetrician had nicked the artery under the broad ligament. If the hematoma had burst, she would have died.

A week later I went back to see her.

“You know,” she said looking at me with emotional and grateful eyes, “I didn’t know if the baby was there or my husband. All I knew was that you were there.”

MY RESPONSE: I had seen enough… Armed with the knowledge of what constitutes bad practice, I left to find myself in Vermont. I read as much as I could about being self-sufficient; spent time making my own bread, tofu, past and bought books on root cellaring and building earth homes. I saw myself living more simply, closer and in harmony with the earth and myself. After becoming pregnant I began researching natural childbirth by following the work of Ina May Gaskin and the Farm Midwives. I gave birth to my son Tristan Joshua at home January 5, 1991. I had begun to take back my life!