An Open and Loving Heart: Susan Tucker's Story

Susan Tucker is a CNA who works in and around Biddeford. Susan sees how essential quality care is from a number of different perspectives. As a PCA, she worked in homecare, and after getting her CNA license, agreed to split her time between nursing home and homecare work. She is very committed to her job and her consumers and so has learned to adapt to both, though they offer their own unique challenges. She has also managed support workers in her own home who come in to work with her ten-year-old son, Keatz. Keatz has benefited greatly from the Habilitation Specialists that have worked with him over the years and Susan is clearly a proud, loving mother. She sees the problems and virtues in the direct care and support workforce and continues her investment in it with quiet dignity and a real commitment to make things better for those working around her.

A Love for Learning

I started doing this work about three years ago. I had taken care of my grandmother and my mother-in-law, but I wasn't getting paid for it. I was just helping them out as they needed it. I would take them to go to the grocery store or do the dishes or take them to the doctor's. Then three years ago I answered an ad in the paper and got an interview with the director of the agency I work for now.

It was something I always wanted to do, to go into nursing, but I took a detour in my life and actually worked for a health insurance company for seven years. Then I stayed home and had my son, Keatz, for seven years. Then I decided to go back to work and answered that ad. I had been working for the agency as a PCA for two years when I took the CNA class. I asked the secretary when the next class was going to be. I had to hurry pretty quickly because the classes were starting in September and I asked her about it in August. The training is 150 hours. It used to be 75 in Maine, but they doubled it. They have six modules in the book; it's a really big, thick nursing book. Basically the class was 4 months long, three times a week.

It was tough because I had to juggle work and family and school at the same time. I wanted to do it, even though I knew it would be hectic. I think I went into it kind of blindfolded, but they were very good at work. They gave me enough hours that I could keep my benefits but were pretty flexible while I was taking the class. There were mostly a lot of young people in the class. There was a mother-daughter team there. Everyone was enthusiastic about learning; there were always questions raised. The instructor showed us the equipment that we'd be using. We had a class on how to make a bed, and we'd practice giving bed baths on each other so we had to wear shorts and tee shirts that day. That was fun. There was only one guy in the class, it was almost all women. And he would say stuff just to be funny and the instructor would just look at him like she wanted to throw something at him. It was a fun class.

The best part of the class was that it was about teamwork. We had study groups. We actually had each others' phone numbers in case we had to get together before class. The book for it was interesting. There was a lot to learn because of the medical terms, but the teacher said, "Don't worry about a lot of that stuff. It is more important to know how to be good with people."

There were some people in the class who hadn't done the job before and they were really nervous. Maybe because they had never seen the work, and were scared; you know, having to know how to deal with a catheter or with someone dying.

There was one particular class where someone came in and did a death and dying seminar. She talked about the stages of death and dying, and she talked about respecting the families and how a CNA can deal with a client's death. It turned out to be really useful because I had done my clinicals at the same nursing home I ended up working at later. I hadn't been there for seven or eight months and when I went back to start working I realized a lot of people were gone. Usually when someone does die at the nursing home, the staff kind of keeps to themselves and is very professional while they are with the family. Then they will go into another room and start crying. It can be hard. Especially if they've cared for the person for so long.

I think the best part of being a CNA is the people. Some residents can be a little crabby, but it's because of the kind of day they had. Sometimes they need a hug, it makes their day. I love going in there and seeing their smiling faces. I just got a hug this morning from one of my clients; she was just glad that I was there. A lot of them feel like they're lonely. At least they have somebody to talk to when I come, so they're glad that I'm there. If you're going to take the time to do this job, you've got to take some responsibility for their feelings.

I love the conversations I can have with them about their past. Sometimes they talk to me about where they've been. One of them will talk about World War II. He was the frontline man, and there were guns everywhere, but he wasn't armed. He was just picking up the guys that were wounded, sort of like a medic. He never thought he would come back because he was on the frontline with shooting everywhere. He was surprised he never got shot. He tells me that story while I'm there, and I always like to hear it. I like to learn about people.

The People Make it Worthwhile

After I got my CNA license, I was just working in home care, but then the agency I work for contacted me and a couple of other CNAs that did home care and said, "Would you like to do some hours in the nursing home?" I had done my clinical there so I was comfortable doing that type of work. I liked the idea of getting the experience of not only home visits but of the nursing home, too.

In the nursing home I'm go-go-go. I have to answer the bells quickly. You can't spend a whole lot of time. When someone rings you've just go to do what they need and that's it. For the girls in the morning it's really tough to get all the residents out of bed and ready for the day. And then when somebody calls out sick, they have to just go as fast as they can with each person. If you give them the face cloth and put soap on it, a lot of the residents can wash their own face and body. Some people can do that, some can't. You have to do it for them. I think the residents feel like they're being rushed because they don't want to do certain things in a certain time. When they were in their own home they had a set routine. Now they are in the nursing home and they probably feel like they're being pushed around to get ready for breakfast.

I know the residents get up pretty early in the morning. They have to be up by 5 o'clock, some of them, or quarter of 6 at the latest because the trays are out by 7. It's a real rush for the nurses' aids because there are one or two out on the floor to do 14 beds sometimes. Sometime they don't even have two nurse's aids; they only have one to do 14 beds. That's not fair to the person working at all.

There are mistakes when that happens; there have been times where people have fallen. Either the nurses' aids have to go too fast or the resident is very nervous and is antsy. That happens, and sometimes they'll even make themselves fall because they're confused or trying to do things on their own when they shouldn't. It can be pretty crazy. It's bad for everyone.

I come into the nursing home later in the day to help them out because I usually have already worked a shift doing home care in the morning. I am just a floater, but I'm busy all the time; helping them toilet people before dinner and helping pass the trays out when they come in, giving out med drinks and stuff. Then after dinner I usually go take a break for a bit, like fifteen minutes and then come back and help toilet and put them to bed.

Doing in-home work is more relaxed. I'm not rushed when I'm doing my work. In the home I'm free to move around more. In the nursing home I just go from one room to the next. You don't get a whole lot of time with people; it's five minutes here, two minutes there. You should spend more time with people, but you just can't.

Right now I have a total of six in-home people. It switches -- sometimes I have five and sometimes I have six. The ones that I have been going to are easy to deal with. There are some limitations they have, they can't do everything for themselves and I might have to do some things for them, but it's not very stressful. They all have something good to say when I come over.

Right now I have one client in Saco that starts at seven in the morning. A couple days a week I go there and give her a shower, and get her dressed and get her ready because she goes to adult daycare. I'm scheduled on Thursdays with her in the afternoon for a couple of hours, so I go over there and feed and shower her. A diversional activity that she likes to do is to watch movies on TV, so we'll watch a movie and I'll do her laundry. She's a really nice lady. She gives me hugs and stuff and she says thank you a lot.

I like the nursing home, but people are easier to get along with when I do home care. I can go at their pace to do things. I think at home they feel happier because they're not in a facility. As long as they can stay in their home for as long as they can they're better off.

I like to be in people's homes. They have more there that makes them happy and comfortable. They can still keep their pets, too, and some people have had the same dog for years and years. The pet actually senses if you should be there or not. Most of the time if you are not compatible, they'll either make it or break it for you. If the pet doesn't want you there, he's going to tell you to go. The client I had this morning has two dogs and a cat. If I go up to the client's desk, the dog will be lying under there and will start growling. He's very protective, thinking I'm going to hurt her. If I tell him, "It's okay, it's just me" he calms down. But when I first walk in he'll bark and then the other one comes running and the cat comes around too. It gets hectic. This morning I had to give both dogs some cookies, and they were okay.

People in the nursing home, it's their home but I think they wish they were back in their regular house. They miss what they used to have and being able to use their own things and have their own schedule. They have very little other than their clothing and personal belongings with them in the nursing home. That must be difficult.

What's Most Important

I have direct support workers that come and help my son Keatz. I had Keatz in 1994 and shortly after his birth my mother and I noticed that there was something wrong. He wasn't responding very well. I had had a normal pregnancy right up until the end, but I had to have a c-section. When Keatz was born, the nurses had drawn blood and taken all the normal tests. That night someone called upstairs to the nurses' station and said, "Put Mrs. Tucker and the baby on antibiotics. They have Group B Strep Meningitis." That's a fatal illness, especially in children. If they don't die, they end up going into a coma or something like that and they have to learn everything all over again; how to dress, how to wash themselves, how to do anything. Not only children get it; adults can get it, too. They caught it in time but he ended up with developmental disabilities because of the damage, because he had seizures to go along with it, and his fever would shoot up past 105. He was fighting the illness, and the doctor told me that if he wasn't as big and strong as he was when he was born we would have lost him.

Keatz had to stay in the hospital for about a month. I got to bring him home the day after Valentine's Day. I still had my work cut out for me because I had to give him medication in his formula. He was on that medication for at least three or four months.

When he was six months old I had to get a therapist from the Department of Human Services. He needed therapy to help get his total motor functions working. He was late with a lot of things, like grabbing stuff and holding his head up. We had to help him, to make his muscles stronger and to teach him fine motor skills. The people from DHS were great, they were very professional. They were just absolutely fantastic for Keatz, and he liked them a lot.

After he was about a year old a local agency started a program for younger children with special needs and other problems and he got to go to that until he could start nursery school. After that, he went into public school and has someone come after school and in the summer to work with him. They are mostly young people, young girls. A lot of them were college age or going to be going to college. Kara, who is taking care of Keatz right now, is an HS -- Habilitation Specialist.

We've gone through five or six people, and we finally settled with one agency. He went to overnight camp with them in the summer, and he has Kara that comes into the house and works with him. She comes in about three or four hours a week and takes him out into the community and does what he wants to do. She's fun, she's energetic, Keatz likes her. Sometimes they'll have battles back and forth but Kara wins anyway. She takes Keatz to the library or plays basketball with him. Sometimes they get together with another person and the child that they take care of and they go places like bowling, or out to dinner, or they go to the movies or they go to the Children's Museum in Portland. He gets very excited. I don't tell him before he goes, because then he'll look forward to it and if he can't go, he gets really upset. I'd rather it be a nice surprise.

I had gone to other agencies and they just weren't consistent. The person would call out again and again and he would be so disappointed about the fact that they didn't show up. So finally I said, "Look, I need somebody who is going to be dependable and work with him. If we get a phone call saying that she's not showing up, there should be somebody else you can put with him." When they'd finally hire somebody, we'd find out that they were leaving in a couple months' time. That's no way to hire somebody. If they needed to go to a job with more money or to do something else because they didn't like it, what about Keatz? He likes the girls and gets attached to them and then they are gone. You know, it should work better than this.