Miss Trust: Tales from the Bedpan
Shift #3: Once upon a shift go dreary...
Preparing myself for another day at my Long Term Care (LTC) placement, I feel a familiar mix of emotions. A part of me feels dread, not knowing what my day will look like, or whether or not I will be able to perform as a nurse should for my residents. But above all, I feel excited. I look forward to connecting with the staff and residents today, learning new experiences, and enhancing my clinical skills. I know I’ll be exhausted by the end of the day; by the time my shift is over, I’ll rush home to shower and collapse into bed. But I also know that once I step into the LTC center, the day always flies by. Curiosity sparks my mind yet again. What will today bring? Will I face any new challenges? Will I learn something new? I’m eager to find out.
My day started the same way it always does—with the nurse giving report to the personal support workers (PSWs). After the report, my preceptor mentioned she had to bathe one of the residents. Maybe I’m overthinking it. Maybe I’m just a bit paranoid or self-conscious, but the last time she bathed this resident, she asked me to change the bed sheets instead. She didn’t ask me to change the bedsheets today. Why didn’t she ask me? Did I do something wrong last time? Doesn’t she want my help? I suck. I think I suck.
I must be going crazy. Get these thoughts out of my head, now!
Despite my mental demons rising to my conscious surface, I remain eager to help and learn in any way I can. Stay back, demons, just for now, please. I try to encourage myself: You’re feeling more comfortable and confident. You’re working at the LTC. You’re working with your preceptor. You are not alone. You are learning. Everyone knows you’re a student. You are learning.
But one of the mental demons, the smaller one—the one that usually yells profanities at people who try to cut in line at the grocery store—decided to take action. It seized control of my mouth and vocal cords, involuntarily speaking on my behalf.
“I want to help bathe the resident today!”
Once the words were out, the demon disappeared back into the depths of my brain—probably hiding near the one that convinced me to stay out with friends until 3am when I had an 8:30 am lecture the next day. Coward! Now you leave me? I yelled inside my head.
My preceptor looked at me. She probably thought I was nuts. She probably knew I had demons! But then again, maybe she had her own experience with mental demons. She looked surprised, but she was cool about it. She smiled and said, “Okay, dear! Sure, you can help.” To myself, I sighed in relief, whispering, whew, thanks, demon, but next time, remember this isn’t the superstore.
I smiled softly back at my preceptor, and my day began.
We approached the resident’s room, and the next 20 minutes were nothing like I had expected. As per the ‘routine,’ we explained to the resident that we would be bathing her. Everything, check. All is well. She seemed okay with it. We proceeded to place her on the trolley to take her to the shower room, when, like a light switch turning on, all Hell broke loose. She burst into screams. Clearly distressed, clearly frightened. She continued to yell and tell us she didn’t want to be bathed. I froze. I didn’t know how to act or what to do, but I tried my best to ‘unthaw’ and keep focused…stay calm…don’t let her see your fear.
It felt like forever. F-O-R-E-V-E-R! We finished washing her. It was difficult, but we did it as a team. I’m not sure why, but afterwards, my preceptor apologized for the resident’s behavior. I thought it was unnecessary. But then again, maybe, I can’t help but wonder, perhaps this is why my preceptor hesitated to let me assist with this particular bath? Is this resident usually like this? Was she trying to protect me from the reality of this work? Maybe. Maybe that is good, but maybe it is a disservice. Am I seeing everything that I need to see? After all, this is the profession I chose to do. Should I see it all, right away, or is a step-by-step process better? A slow exposure of the ‘nursing care model’ and the sites and experiences that come with it?
Later in the day, we needed to ‘clean up’ a resident. We knocked on the door before entering and then explained why we were there. The resident immediately screamed at my preceptor, shouting, “NO! I DON’T WANT IT!” Oh, again. No one prepares you for days like this. No one tells you to be specifically prepared, other than to mention to be prepared for anything…get it? I’m still figuring this one out.
Well, my preceptor remained calm, again, and told the resident that we needed to clean her because she was wet. The resident continued to yell, saying, “If you don’t leave my room, I’m going to hit you and her.” Whoa that, “her” is ME! Once again, I froze, unsure of how to act, my eyes darting around the room, fight or flight…fight or flight! Meanwhile, unlike me, my preceptor maintained her composure and told the resident we’d come back later. How does she stay so calm? How is she so good at this? Why am I like a wild rabbit?
Throughout the day, I couldn’t help but wonder: Why were the residents so angry today? They were fine during my other shifts. In fact, everything felt calm during my first few shifts. How did everything turn into chaos? Spoiler – I never found out!
While helping put some residents to bed, I encountered yet another outburst. We entered a room to assist another PSW, and without us doing anything, the resident began screaming at my preceptor: “YOU! OH NO! YOU, GET OUT OF HERE! GET OUT OF MY ROOM!” As expected, my preceptor remained calm and told her we were there to help her go to bed. The resident continued to scream and curse, demanding that my preceptor leave the room. Eventually, my preceptor left. I stayed, thinking I could help the other PSW put her to bed. Then, the resident turned her anger on me, shouting, “WHAT ARE YOU STILL DOING HERE? I DIDN’T WANT HER HERE, AND I DON’T WANT YOU HERE!” I never met this resident before. This was my first time helping this resident, but I had been judged and sentenced.
I didn’t know what to do, but I had a feeling if I pushed any further it wouldn’t help. I looked at the other PSW, and she gave me a look, signalling she could handle it from here. I left the room feeling guilty. I wanted to show that I could help. Yet, I did understand, sometimes helping was being available when needed, but also stepping back if this is what the situation called for – a test in judgement.
Throughout the remainder of the day, my preceptor apologized to me. She expressed regret for the residents’ behavior, while I assured her there was nothing to apologize for. She couldn’t possibly think I expected everything to be calm all the time in this environment, could she?
Needless to say, in between the apologies were pep talks and I won’t lie, this was better than a scolding. My mental demons would take care of that later! My take-away was, “Every patient is different.” I got it. Some are more independent, some more complex, and some are cognitively present, while others are not. People come in many different forms – even in a senior’s home or hospital or wherever.
She shared the unfortunate truth that not all healthcare workers possess the same level of patience, and maintaining consistency in the care they provide can be challenging. Long hours test you. Long hours can lead to burnout, causing some to lose their composure, their patience, their smile.
In extreme cases, burnout may lead to the mistreatment or exploitation of patients. It shouldn’t come to this, but it does. And we are all responsible. This possibility exists because we have created the environment ourselves.
My preceptor went on to say that she loves her job, and despite the exhaustion, her biggest fear is mistreating her patients. I reassured her that in the few shifts I’ve spent shadowing her, she has shown the residents nothing but care and compassion. She treats them like family. She genuinely cares for them.
Observing her, listening, so many thoughts begin to surface. She cares. I hope I can care as much as she does. Nurses care. They care for their patients… They care about their people. Yet, they are exhausted. Burning out. What importance do we place on this “care,” on nurses, on the many others involved?
I have some ideas on how to make things better. I’m not an expert, and I can’t guarantee success, but saying or doing something is better than nothing. Better than what isn’t happening now. As a society, we have a twisted way of measuring value, especially when it comes to those who care for us, particularly in our most fragile state. For example, we’ll pay an accountant or a lawyer high fees for their work, yet for those who physically and mentally care for us, we offer 12-hour shifts with minimal breaks. We expect nurses to meet all our basic needs, and some of our most advanced needs immediately. We burn them out, leaving nothing behind, expecting a new nurse to be there for the next shift. We fail to see that behind this attentiveness is a person, a person behind the mask. A real-life superhero.
And what do nurses get for their commitment? Not what you would expect. According to U.S. figures, nurses earn the same salary as a hotel housekeeping manager, a dental hygienist, or a web developer. In Canada, they say a pastry chef makes more than a nurse—it isn’t a joke!
The compensation packages for nurses are exceptionally low, considering the vast range of skills, education, and complexity of tasks they handle—all while ensuring that empathy, compassion, and care remain at the forefront. This is a job surrounded by very tangible life-and-death moments. Few jobs require such an array of education and skills – I can only think of parents.
I don’t mean to say that accountants and lawyers don’t deserve the money they earn, but why doesn’t society place equal—or even greater—importance on a profession that holds such significant value for all of us and everyone we love?
Maybe next semester, I should start putting my thoughts together and ask my instructors and preceptor what they think. My shift is over. I am exhausted. I am going to eat and then sleep. No time for solving this—or staying out until 3am tonight.