I just started as a CNA at a Long Term Care center. Long term care also refers to comfort care for the dying. I don't really have the same patients over and over. Sometimes I will be in one hallway then next shift and I will be on the complete opposite side of the building. I'm starting to adjust to my job as a CNA. I still need to familiarize myself with the building. I will be walking to get something in one room then stop myself and think, "this isn't right. I think I'm supposed to go down this hallway."
We are a comfort care facility so there are people that live out their last days here. Basically with comfort care, if people are going to die, they are given to us and we make their last days, months, or years comfortable. My on the job trainer even told me that even the least spiritual or least religious night shift workers are superstitious. There is a ton of people who've died here. One hallway, has more patient deaths than any other hallway. I'm atheist as can be and I always feel I'm being watched in that hallway. I'm always looking up to see if a coworker came into the hallway and I just didn't hear them come in. White orbs have seen and patients have seen people that the employees can't see.
Every shift my supervising nurse have the CNAs take vital signs from specific patients. My facility uses machines for vital signs so unless I'm having a crazy night, vital signs doesn't take long at all.
A few days ago, when I got to work I was placed in the hallway where I always feel I'm being watched. The day shift CNAs told me of a new patient. For reasons of HIPAA, I will call this patient, Bob. Even though that's not his real name. Bob came to us from a hospital and it was obvious it wasn't going to be a very long time until he passed. He was a DNR so if he stopped breathing or his heart stopped, we would have to let him go. If you attempt to resuscitate a DNR at any facility, you get in serious trouble. Plus this is a nursing home so not everyone is hooked up to a monitor. So when someone is dying, we won't know. Unless they're full code, that's something different.
I'm unfamiliar with his condition but I did ask him if I could check his brief and he barely was able to nod his head. I told the nurse that he had zero bowel movements since his admission and asked her to double check. And she agreed, no bowel movements at all which is a little odd for someone who isn't independent.
The next day, I was placed in the same hallway. The nurse asked me to do vital signs. I did all the easy patients where I just need their blood pressure and O2 levels. With Bob, I needed to get every vital sign. That included respirations, pulse, blood pressure, O2 levels, and temperature. Bob's blood pressure, pulse, and O2 levels weren't anything out of the ordinary for him. However he had a fever and he was breathing deep, rapid, and shallow breaths. I remember getting frustrated and retaking his respirations. But I got the same result. Also, I felt his skin with the outside of my palm and thinking, "wow. He's burning up." Again no bowel movements all night.
I reported his fever and respiration levels to the nurse. She said that since he's dying that it's nothing weird. She continued to say that unfortunately, he'd probably be like that for quite some time as the "Death Process" is typically slow. I remember sitting at the nurses station thinking, "he probably has about 8 hours left. Looks like I won't have my first patient death just yet." I further discussed his vital signs with the nurse and she said nothing was out of the ordinary. She went to go check on the patient and I went to start my last rounds for my shift when I heard the nurse call my name.
She simply told me he was dead and that she needed a witness when she pronounced him. I walked to the patients room with her and she felt for sign of life. She confirmed he was dead. I was the last to see him alive since I took his vital signs an hour before and I had no idea at the time. This time, he was very pale. When I last saw him, his skin was a bright red because of his fever. She assured me that this happens and patients pass with no warning.
If you were looking for a heroic story on how we all tried to pitch in and save him or that I held his hand as he died and it was super emotional like something you would see on Grey's Anatomy, this isn't the story. I never got to know him so it was like the death of a stranger. My only regret is that I wish I was there for my patient. Even if I had no idea that he would pass so soon. My supervising nurse assured that this does happen, sometimes patients pass with no warning, and nobody has any idea.
This job is a learning experience. So even though I don't like long term care, I'm trying to make the best of it because I have a lot to learn. That was also the first time I ever seen a dead body. I've gone to funerals but for every funeral I've gone to, the person was either cremated or it wasn't open casket. When I have my first code on a patient that will be something completely different. Especially if I'm the first on scene.