by Cindy Hasz
American Reporter Correspondent
San Diego, Calif.
March 24, 2002
THE LAST BEST HOPE OF THE ELDERLY
SAN DIEGO -- When people ask me how what I do differs from being a "regular nurse," I always think of many answers, so I usually respond by saying, "A nurse care manager is first and foremost a patient advocate." But the picture is hardly drawn by those pale words. How do you I explain that I stand beside elderly people who have no one close enough to help? Unfortunately, even when there is family they are sometimes irrelevant. How do you explain to others that "family" means people who care, and that many times blood is just not thick enough? How do you explain that the simple presence of love, mixed with skill and persistence, can change someone's world?
What we do for the elderly is rock the boat; that's not the old-school version of Florence Nightingale. While the more traditional nurse's job is simply to implement a doctor's orders and perform clinical jobs as a part of caring that has well-defined boundaries, our job is to actively change things for the better. We don't just follow well-used templates; we create new ones as needed for quality care that fits each unique situation we find.
That often means challenging a doctor's orders and angering staff by asking for more care than they are willing to give. That often means protecting a patient from family members who may not have their best interest at heart. Sometime it means supporting a patient or family member the health-care providers don't like -- a job not for the timid or the risk-averse.
We took Jesse out of the board-and-care where the owners were manipulating her bank accounts and drove her to the refuge of a safe house.
We hid Phyllis from the rages of an abusive, alcoholic son.
We helped a daughter say no to a psychiatrist who wanted to "hospitalize" her depressed 80-something mother for ECT (electro-shock therapy).
We helped Barbara get her new leg when others thought her too old to bother with and watched her giggle as she walked on it for the first time.
We insist that hospital staff treat our patients in facilities with the respect they deserve and we move them to other facilites if they don't.
We dismiss doctors who treat the elderly like the lepers of Molokaiand refuse to listen to their patients or anyone else.
We won't shrink from a fight with other health-care providers to make sure our patients get the pain medication they need when suffering and dying.
We will make sure our patients get chicken matzoh ball soup and Chicken Liver sandwiches from the deli if that's what they need to make life worth living that day. Or fresh flowers or Chopin or Nestle's Crunch bars.
We give full-body massages and sing "Moon River" while doing it.
We have pianists come and play the baby grand their arthritic fingers no longer can.
We let them drink gin if they need to, eat steak when they're sick to death of nursing home fare and refuse to force feed them when they say they are not hungry.
We will not patronize them, dismiss their fears or shame their weaknesses.
We will not only give them pills and perform clinical duties, but we will honor them, love them and serve them to the best of our abilities as long as their are in our care.
We will not let them fall through the cracks in the health-care system.
We will not let them be neglected.
We will never let them die alone.
Funny, I've never thought of myself as a particularly strong personality or a leader. I am at heart a contemplative soul, a peacemaker and an accommodating instead of abrasive personality. At the same time there is within me a braveheart in Highland kilts, wielding a sword on behalf of those who cannot wield it for themselves.
The elderly many times cannot even raise their frail little arms on their own behalf, let alone a sword or pen. Senior care managers, patient advocates and all their merry men and women count it their privilege to do it for them.
And if doing things a little differently makes some people uncomfortable, well, that's just fine with us.
Cindy Hasz is a nurse and writer living in San Diego. She can be reached at firstname.lastname@example.org.