One recent workday sent me home exhausted. I’d started with eight patients and gotten a glowing report from the offgoing CNA. “Oh, they’re so easy to care for!” she bubbled. “You’re going to have such a great day!”

She was right about one thing. Most of them had few needs. But – there’s always a but, isn’t there? – on day shift, “few needs” doesn’t usually translate to “easy shift.” What it really means is “discharge orders.” Five of those eight left, most of them before lunchtime. The wheelchair’s seat didn’t have a chance to cool off before I was loading the next patient into it. To replace the ones who left, I had five or six other new ones show up. That happens, for sure. It just makes for some chaos!

Unfortunately, my cheerful predecessor did leave out a piece or two of pertinent information. I had one patient whose needs were definitely not insignificant. Thanks to a stroke, he had some mentation, communication, and continence issues. He also needed help with meals. I’d walk into his room to perform a routine task, discover that he had some urgent need, help resolve that, and leave to go do something else. I wasn’t terribly successful in getting other stuff done, because no sooner than I’d start elsewhere, I’d get summoned back to his room.

It was aggravating, all the constant interruptions and the sheer amount of time required. When working with patients, it’s really important to encourage and let them do as much for themselves as possible. This poor guy – nothing was fast for him! Mealtimes required at least 30 minutes to get him to eat maybe half of his food. Since everything else was on a similar scale, I spent at least 3 hours of my 12 hour shift focused on meeting his needs. It may have actually been more than 4 hours, considering that meals alone took an hour and a half. Anyway, at the minimum, I spent ¼ of my shift working with just one fellow.

That’s crazy! In a regular assignment, I don’t spend that much time with one person. I usually can’t, because I’ve got 7 – 14 other people who also need things. This particular day, it was okay. It just worked out. Actually, I made sure it worked. The RN, who typically would have taken care of some what I ended up doing, had an unusually busy assignment and did not have the time to spend in there, so up and down the hall I ran, always rushing back to be in time to help my busy guy.

I went home so tired, tired and yet curiously satisfied. Doing a good job is normal. I expect that of myself. That particular day, though, I felt like I did an exceptional job, and I know the care I gave made a significant difference in that patient’s day.