by Tina Stone
The crazy new lady
|Dillon was a difficult client to work with. Staff, even well-seasoned staff went out of their way not to be assigned to Dillon. He was young, only 19. He was labeled difficult, noncompliant, combative, stubborn. More often than not, it took two people to manage him. No one liked working with Dillion. Except for one crazy lady. Me.
As I've written in past articles, caregivers are prone to be bossy. They have a schedule to keep and many times have a lot to do in a rather short period of time. Many also fail to notice nonverbal communication when they are caring for nonverbal clients.
I had just started working at this particular agency and for the first few weeks, I noticed how frustrated and exasperated my coworkers became after assisting Dillon in his morning routine. This was at a state school, and one thing I picked up on quickly from the staff training me is the abruptness in which they woke up the residents. They would walk into the room, flip on the light and start giving instructions. It went something like this:
Walk-in, flip on the light, "Wake up Dillion, go to the shower." This was said as the caregiver rifled through his things grabbing clothes, shoes, a belt, socks, etc. Dillon would grumble, roll over and ignore staff. "DILLON, GET UP!" This was said with a louder more firm voice. Staff would put his things in the bathroom, return to the room and start pulling the covers off him and usually telling him again, go to the showers. IF this didn't work, they would physically try pulling him up and getting him to respond. At this point, he would begin to try to hit staff. He would refuse to do anything being asked and at this point, a second staff would come and it would take two people to push, prod and get him through a shower, dressed, and ready to go to the line where he would get his morning meds. I observed this routine for nearly two weeks. I was the new girl, so I kept quiet and watched. Personally, I would have done exactly what Dillon did and be totally pissed.
Dillon was not the only difficult client on my floor. There was one other client who was just as difficult. It took two staff to get him up, showered, dressed and ready for the day. It took several attempts to get him up. Several attempts to get him to get dressed and stay dressed. Thomas liked to kick when he got angry and Thomas did not like being rushed. Thomas did not like sharing the bathroom with other clients.
At the end of my two week training period, I talked to my supervisor. I told her I noticed it took two staff to deal with these two particular clients and that it often led to all the clients on the floor being late or disrupted during their morning routines. I asked if I could be the ONLY staff to tend to these two clients in the morning, for the next two weeks. They would be my main priorities along with my regular duties. My supervisor was skeptical but decided to let the crazy new girl try it.
Because Thomas hated having others in the bathroom when he was in there, I decided to wake him first, before any other clients were awakened. The other staff kinda rolled their eyes. They had their routine and here I was not listening. I walked into Thomas' room and did not turn the light on right away. I stood near the door and said, "Hey Thomas, no one is in the bathroom right now, let's get a shower before anyone else wakes up!" I gave him a few minutes to think about it and when I saw he was starting to move around and get up, I turned on the light. I grabbed his underclothes, but then when I got to his pants I ASKED him which did he want...I gave him a choice of two pairs of pants. HE picked what he wanted. Same with the shirt. I gave him two choices and let him pick. In less than ten minutes I had him up and willingly getting into the shower. No-fuss. No badgering. No poking and prodding. He was fully able to dress independently, all he needed help with was shaving and brushing his teeth. By the time the other staff was waking up other clients at their regular time, Thomas was sitting in his room happily watching TV and waiting for time to get in line for meds.
Next, I had to go wake up Dillon. But there were two other clients ahead of him before he could take his shower, but I planned that on purpose. Other staff warned me waking him then would be disastrous. They'd always left him until the last because he was the hardest to deal with. I smiled, said I understood and went into his room anyway. I did not turn on the light. I walked into his room, called his name, and when he grumbled i told him "Dillon, you have fifteen more minutes before you need to get up and shower." And I left his room. I assisted staff with other duties and waited. Ten minutes later I returned to Dillon's room. I walked over to him. "Dillon, you have five minutes. I'm going to turn on your light now so you can see. Its time to sit up." Again I turned and walked out, but flipped the light as I left. Five minutes later I returned. He was sitting up with the blanket over his head! But. He was sitting up.
I greeted him. I told him good morning and that it was sunny and time to get rolling. He glared at me. But he made eye contact so I counted that as progress. He watched me open drawers and get socks and underwear. I picked out two shirts and carried them over to him. I said, pick the shirt you want. He looked at me. I held up one and said "Ohh this makes your eyes look pretty" and I held up the other and said "this makes you look cute...I bet the girls will like it!" Again I asked, which shirt did he want. He just looked at me. I chatted with him as I put the shirts down and went to his closet for pants, his belt, and shoes. When I turned around, he was holding the "pretty eyes" shirt. I smiled and praised him for his good choice! I held out my hand and said, "ready to go get clean?" He did not respond right away. I told him to take his time. I mentioned eggs and sausage were on the menu for breakfast. After a few minutes of chatting, I again held out my hand and asked if he was ready to go shower. He slid off the bed and started to follow me. I didn't have to touch him or anything. He walked straight to the shower all by himself. He allowed me to help him undress and I chattered with him the whole time. From start to finish I had him up, showered, dressed and ready for the med line almost twenty minutes ahead of schedule.
Not every morning went as smoothly. However, it never took two staff to get either one of them ready for their day. I had two other clients to get ready beside these two. In the time it took me to get my four ready, it took the other staff working together to get their five ready. There were nine residents on our floor total. There were some days when my "impossible" clients hit a glitch but those impossible residents quickly became my favorite.