It is a bad bird that shit in its own nest, sounds a Danish saying, and this is how the system has obviously perceived nurse Vigdis J. Reisæter's report from the front line in Norwegian elderly care. In any case, her expertise suddenly still could not be used during the covid19 pandemic, when it came to the attention of the hiring officer that she had written a critical article about the conditions that in the autumn of 2018 made her leave elderly care.
She had had enough
Now she has written an entire book. Because when people end up sailing around in their own shit while waiting to be followed to the toilet – or almost explode in their own piss when no one for several days discovers that urination does not work – because there is not enough staff in the nursing homes , which forms the framework of their last time here on earth, then someone has to sound the alarm.
And nurses generally do not, according to Vigdis J. Reisæter, who herself believes that she has written too few "deviations" – as it is called when nursing staff report something that has gone seriously wrong during a shift – in her time at various Norwegian nursing homes.
When people end up sailing around in their own shit while waiting for that
be followed to the toilet – or near explode in own piss.
Her experience is that many nurses fail to report for various reasons. On the one hand, there is no possibility of this within working hours, on the other hand, it can be perceived as disloyal by the management, and on the other hand, it almost never has any consequences. The times Vigdis J. Reisæter herself wrote deviations, it had absolutely no effect other than that her own frustration grew.
After more than a decade in active service as a nurse in the elderly care – a job that Reisæter found her calling for when she cared for her grandmother, who herself had a long life as a nurse behind her – she had had enough. She could no longer legitimize a system that all too often forces patients and caregivers into degrading and sometimes dangerous situations.
I will help you was instead Reisæter's longest and probably most honest deviate. It is touching and often hair-raising reading to follow through the nurse's flashbacks and reflections on both general conditions, concrete situations and (un) human encounters with the elderly she was put in the world to take good care of, with the relatives, with colleagues , and the parent.
How dignified care often happens in spite
For example, Edle, who at a too young age has been chained to the bed in a nursing home due to multiple sclerosis and for the same reason is not immediately friendly to either the outside world in general or nursing students specifically, becomes the first patient, Reisæter gets the primary responsibility to help through an unreasonable everyday life in every way.
This first attempt to build a relationship with a patient that can enable care to be performed in a meaningful way also serves as a narrative introduction to why it is so crucial that caregivers have the time – the right time – to familiarize themselves. in the patients' life situation, their individual needs, their reaction patterns, their signs of improvement and of deterioration. Reisæter has that time with Edle, but – it turns out – only because she is still in education at that time.
Where all too often it ends not only sad but really wrong.
From there, we are led deeper and deeper into a universe where dignified care often happens in spite. Where patients become malnourished because no one has time to help them have a functioning and comfortable dining experience. Where dementia sufferers receive sedatives with questionable effect instead of care and comfort when they become anxious.
And where all too often it ends not just sad, but really wrong. Because there are too few on duty, and because those on duty are neither sufficiently educated nor have sufficient connections to the specific nursing home to actually know the patients.
With your legs in an awkward position
By reading Reisæter's accounts of why people can only be cared for properly if they are treated as just that – as people, people with stories and personalities that are crucial to how their disease picture emerges and how it can best be treated – I came to to think about my father's last hospitalization before he came to a nursing home, as it is called in Denmark.
He had been found by the home care in the morning with a high fever in a bruised and confused state. I went to his house and packed some things for a few days in the hospital while we waited for him to be picked up. At the hospital, I handed over his things to the staff, who promised to take good care of him.
When I got back in the afternoon, he had been driven to another ward. When I finally found him, the first thing that caught my eye was a large red plastic bag that had been pressed down between the edge of the bed and his unconscious body. There lay his stuff, in the bag there, and there he lay, with his legs in an awkward position because of the big bag. I got so angry and wanted to shout at the staff that he was a real man with experience and lived life and relationships and incorrigible opinions and bad jokes, and that those forces should not treat him like a packet of dead meat. But there was no staff to shout at.
At the nursing home, the experiences for my father and for us relatives were a lot better, and one thing was at least clear: That the staff wanted the patients the best. Even though there were not always resources for everything they wanted to help with.
Reisæter emphasizes that the book is written based on subjective experiences, and that there can be a big difference in how well-functioning one nursing home is over another. But she also makes it probable through both information about the shortage of nurses and the health system in general, and through descriptions of routines and staffing at several different nursing homes, that it is hardly just her who has unrealistic expectations of what a nursing home should be able to offer, or her who just can not deliver what it takes as a geriatric nurse in the 21st century.
Each chapter is equally shocking, and along the way I became increasingly disturbed at the thought of what might turn out to be the drop that caused the cup to overflow. It's an incredibly painful story, but it's a lot of what has gone before as well.
It took a decade for Reisæter to get worn down because the system never let her do her job the way she had been trained to. For some it takes longer, for others shorter. Hopefully, Reisæter's strong testimony will have consequences other than an individual work ban directed at the person protesting.