In nursing school, we started out working in nursing homes during clinicals. We were doing the work of CNAs, because we hadn’t learned anything particularly RN-like yet. Each of us students was assigned a resident to care for during that quarter of school. My first resident was an ancient lady named “Betty.” She was notorious throughout the nursing home for being difficult to work with, and I strongly suspect that she had bipolar disorder, though she was never diagnosed. Some days she would be friends with the entire world, and other days the whole world was out to get her and she could be downright nasty; oftentimes her moods could change drastically in the space of an hour or less. When I worked with her she was in her nineties, but some days she would report that it was her 100th birthday.
When I learned that I was assigned to Betty, and I heard the nurses and CNAs describe her, I was a bit wary. I was nervous already, and having a resident as volatile as her just made things seem so much worse. My first interaction with Betty was trying to get her blood pressure early in the morning. We were allowed to use a battery-operated wrist blood pressure cuff, but getting Betty’s wrist out from under her was quite a challenge – she didn’t want to have her blood pressure taken, and so she would curl up under her blankets in a pretty good attempt at hiding from us. The nurses and aides said to just do what you could, and that she did things like this all the time. Eventually I learned the technique of coaxing her to take her meds and let us check on her to make sure she was healthy. When she was in a good mood she would chatter on without taking a breath, mostly telling stories about her childhood. She had a tough life, and after hearing her stories over and over again, I began to respect her more for being such a strong woman.
Toughest time with her (other than when she would curse at me and refuse to cooperate with anything) was one morning when she was so worked up and almost frantic. I asked her what was the matter, and she cried out that all of her chickens and cows were going to drown (it was currently raining very heavily outside, you see). She was so distraught about her animals, and she kept begging me to go get them inside the barn so they would stay safe. In nursing we are taught not to play into delusions (“Your cows and chickens are in the barn already”) nor to shut them down harshly (“You don’t have cows or chickens anymore – you’re in a nursing home”). Instead we are instructed to use redirection and diversions to get them focused on something real. I remarked that she must care about animals very much, and then asked her how long she had owned cows and chickens, and then she launched into several stories about her childhood and young adult years on a farm. She clearly cared for her animals, and within a few minutes she was back to eating her breakfast, her “cows and chickens” all but forgotten.
During my second year of nursing school (over a year ago now) I got to mentor a group of first year students at that same nursing home, where I ran into Betty once again. She didn’t remember me – no surprise there – but thankfully I still remembered her, and I was able to help the first year students learn how to work with her. I have no idea where this woman is now. Perhaps she is still alive – with her personality and stubbornness, it wouldn’t surprise me!