Stoppelmann
Member
- Location
- Germany
Tired eyes looked at me from the woman at the desk, her lack of enthusiasm understandable after working 12 days straight in a residential ward with numerous bedridden residents, some in the palliative phase preparing for the end of life, others with various stages of dementia requiring a high level of attention. I had asked her to take on another shift because of an acute lack of alternatives. The staff had just been overwhelmed by another wave of sickness that was, unfortunately, a regular occurrence, and because I was working weekends myself. The situation seemed even worse this time as no help was available from other wards or houses. I wanted to spare all my staff the burden of extra shifts but failed and had to face reality.
Angelika was a particularly dutiful ward supervisor and had worked as a care manager for a short time, but now, at almost 60, she was striving towards her retirement and trying to get through the day. She didn't want to cry, but I sensed that it would have helped her if she could. She delayed her answer as if she hoped I would disappear like an apparition, that the weekend would come, and that she could relax. Slowly, she said, "Okay," and although I would have liked to hug her, I knew it would seem contrived. Instead, I touched her shoulder and said, "Thank you" and "I wish I could have prevented this!"
She stood up, took a deep breath, and said, "It's not your fault. I know you're trying ..." but excusing me made the situation worse. I left the ward and was inwardly relieved to have found a solution to another problem. I had not been a care manager in this house for long. However, when I started work, I found that many staff members had four hundred hours of unpaid overtime. I had no way of paying them out if they wanted it. I immediately approached the managing director and protested that he had not informed me about the situation.
It was no wonder that staff no longer wanted to cover for others who were sick unless I could guarantee them a day off. The staff acknowledged my attempts to find solutions, but some were resigned and said, "You can't change it. It's always been like this."
The staffing situation was not the only problem I faced. There was an increase in quality controls and a focus on care planning, which reduced available staff at the beds to enable nurses to produce the necessary documentation. Many of them were not used to this level of regulation and had problems with word choice and clarity. Some were hopelessly overwhelmed with the task. This was, of course, in addition to the stressful task of caring for bedridden people with numerous cognitive impairments, as well as medical emergencies. Above all, the many incontinent elderly people who regularly needed to go to the toilet and very often also needed personal hygiene afterwards made the shifts very exhausting.
The day went on, and one task after another was done, but each day seemed too short, and most of us went home tired but convinced we had forgotten something. The following two days went like this. On Saturday, just before going home, I was sitting at my desk sorting out the tasks for Monday. The phone rang, and I silently said to myself, "Oh no!" expecting the next person to call in sick, but when I picked up the receiver, I heard nothing at first until suddenly a loud female voice called out, "Is this the care manager?"
I replied, "Yes, speaking."
The voice came back, "She's dead, you know!"
I was completely confused because I thought she was talking about a resident who had been transferred to the hospital, "Who do you mean?" I asked.
"Angelika! She's dead. She just fell over and died. An aneurysm, they said!"
I was stunned! I began to stammer, unable to formulate a sensible sentence. "I, I ... don't know what to say ..."
"I can imagine you don't! Our mother has given everything. 'I can't let my boss down,' she said! Now she's dead, what do you say?"
"There is nothing I can say except that I am very, very sorry," I replied.
"But that doesn't help, does it?"
Suddenly, she was gone, and I sat there in absolute panic, a chaos of emotions overtaking me, and I was shaking. A huge wave of guilt washed over me, threatening to drown me, and I struggled for breath. I got up, walked around the office, and sat down again. I picked up the phone and put it down again. I had no answer, no solution. It was too late, an ultimate defeat had left me helpless.
I thought I couldn't tell anyone in the building because the existing emergency crew wouldn't be able to look after the residents, but what if they already knew? I had to check, even though I was afraid to. Hesitantly, I climbed the stairs and entered the ward where everyone was preparing for shift change. There was no sign of emotion, no tears, just people working.
One of the ladies looked up and said, "Oh, hello. You're still here. I thought you'd gone home."
"Yes," I said, "I just wanted to see if everything was all right." I felt guilty about that, too.
"Don't worry about us. We'll be fine now that the crisis is over," she said. "Have a nice afternoon—or what's left of it!"
With that, I went and rummaged my mind about what to do next. Downstairs, I called my manager at home, but he was not there. Then I called the pastor, who was on call for emergencies. She picked up the phone and listened patiently as I told her what had happened, whereupon she let out a deep sigh. "You are probably completely devastated by the news," she said.
"I feel so guilty," I said, "I asked her to do an extra shift on top of the many she has already done ..."
"Yes, but you can't be blamed for an aneurysm," she said calmly. Go home. I'll contact the people at the top, and we'll arrange something for Monday. Will you be there on Sunday?"
"No," I said, "I'm working from home."
"It won't be easy, but use the day to recover from your feelings. I will discuss the matter with all concerned, and we will talk about it on Monday morning."
"We need to get the staff together; she was so popular ..."
"Of course, but let that be my problem. Go home and remember, it's not your fault!"
"Thank you," I said, and after hanging up the phone, I took my things and went home.
The next day and a half were agonising, and although my wife said the same thing as the pastor, the thoughts kept running through my head. I half expected to hear the phone ring and find half the staff overwhelmed by the news, but that didn't happen until Monday.
As I entered the residential areas one by one, I was greeted by teary eyes and staff asking me if I had heard what had happened, to which I replied that I knew. I admired that they continued to work anyway, wiping away the tears in front of the residents who sensed something was wrong, but few asked what had happened. I am so very grateful that the staff reacted the way they did. When I got the message from the chaplain, I told everyone that we would be holding a staff meeting at lunchtime and leaving a skeleton staff on the wards.
My managing director came to me with a concern that seemed faked, but I was not to doubt his sincerity. He offered me all the support he could and promised to be present at the meeting.
The meeting was a tearful affair, and when I spoke to the staff, I stuttered again. I invited everyone to say what was on their mind and was amazed that no one reproached me but only spoke highly of Angelika. It wasn't about me; it was about her and their struggle to get to work, especially when they knew we had staff shortages. The pastor said a few words and a prayer at the end. Everyone hugged each other, including me, and some said, "Thank you!" The pastor said she thought I had spoken well despite my nervousness, and the manager agreed with her, thanking me for how I had coped.
I didn't feel that I had coped, but that everyone else had done much better. I sat in my office in silence with the door closed for a while until my colleague who did counselling sessions with residents and relatives came in with the office lady and said, "We think you should go home now. That's enough stress for one day!"
I thanked her and took her advice, but I couldn't understand why so many people were worried about me and that they registered my worries about them, but then life went on at a slightly different pace than before. My staff were amazing, especially Angelika, who had given her last, and the loss I felt afterwards lasted a long time. The guilt, too.
Angelika was a particularly dutiful ward supervisor and had worked as a care manager for a short time, but now, at almost 60, she was striving towards her retirement and trying to get through the day. She didn't want to cry, but I sensed that it would have helped her if she could. She delayed her answer as if she hoped I would disappear like an apparition, that the weekend would come, and that she could relax. Slowly, she said, "Okay," and although I would have liked to hug her, I knew it would seem contrived. Instead, I touched her shoulder and said, "Thank you" and "I wish I could have prevented this!"
She stood up, took a deep breath, and said, "It's not your fault. I know you're trying ..." but excusing me made the situation worse. I left the ward and was inwardly relieved to have found a solution to another problem. I had not been a care manager in this house for long. However, when I started work, I found that many staff members had four hundred hours of unpaid overtime. I had no way of paying them out if they wanted it. I immediately approached the managing director and protested that he had not informed me about the situation.
It was no wonder that staff no longer wanted to cover for others who were sick unless I could guarantee them a day off. The staff acknowledged my attempts to find solutions, but some were resigned and said, "You can't change it. It's always been like this."
The staffing situation was not the only problem I faced. There was an increase in quality controls and a focus on care planning, which reduced available staff at the beds to enable nurses to produce the necessary documentation. Many of them were not used to this level of regulation and had problems with word choice and clarity. Some were hopelessly overwhelmed with the task. This was, of course, in addition to the stressful task of caring for bedridden people with numerous cognitive impairments, as well as medical emergencies. Above all, the many incontinent elderly people who regularly needed to go to the toilet and very often also needed personal hygiene afterwards made the shifts very exhausting.
The day went on, and one task after another was done, but each day seemed too short, and most of us went home tired but convinced we had forgotten something. The following two days went like this. On Saturday, just before going home, I was sitting at my desk sorting out the tasks for Monday. The phone rang, and I silently said to myself, "Oh no!" expecting the next person to call in sick, but when I picked up the receiver, I heard nothing at first until suddenly a loud female voice called out, "Is this the care manager?"
I replied, "Yes, speaking."
The voice came back, "She's dead, you know!"
I was completely confused because I thought she was talking about a resident who had been transferred to the hospital, "Who do you mean?" I asked.
"Angelika! She's dead. She just fell over and died. An aneurysm, they said!"
I was stunned! I began to stammer, unable to formulate a sensible sentence. "I, I ... don't know what to say ..."
"I can imagine you don't! Our mother has given everything. 'I can't let my boss down,' she said! Now she's dead, what do you say?"
"There is nothing I can say except that I am very, very sorry," I replied.
"But that doesn't help, does it?"
Suddenly, she was gone, and I sat there in absolute panic, a chaos of emotions overtaking me, and I was shaking. A huge wave of guilt washed over me, threatening to drown me, and I struggled for breath. I got up, walked around the office, and sat down again. I picked up the phone and put it down again. I had no answer, no solution. It was too late, an ultimate defeat had left me helpless.
I thought I couldn't tell anyone in the building because the existing emergency crew wouldn't be able to look after the residents, but what if they already knew? I had to check, even though I was afraid to. Hesitantly, I climbed the stairs and entered the ward where everyone was preparing for shift change. There was no sign of emotion, no tears, just people working.
One of the ladies looked up and said, "Oh, hello. You're still here. I thought you'd gone home."
"Yes," I said, "I just wanted to see if everything was all right." I felt guilty about that, too.
"Don't worry about us. We'll be fine now that the crisis is over," she said. "Have a nice afternoon—or what's left of it!"
With that, I went and rummaged my mind about what to do next. Downstairs, I called my manager at home, but he was not there. Then I called the pastor, who was on call for emergencies. She picked up the phone and listened patiently as I told her what had happened, whereupon she let out a deep sigh. "You are probably completely devastated by the news," she said.
"I feel so guilty," I said, "I asked her to do an extra shift on top of the many she has already done ..."
"Yes, but you can't be blamed for an aneurysm," she said calmly. Go home. I'll contact the people at the top, and we'll arrange something for Monday. Will you be there on Sunday?"
"No," I said, "I'm working from home."
"It won't be easy, but use the day to recover from your feelings. I will discuss the matter with all concerned, and we will talk about it on Monday morning."
"We need to get the staff together; she was so popular ..."
"Of course, but let that be my problem. Go home and remember, it's not your fault!"
"Thank you," I said, and after hanging up the phone, I took my things and went home.
The next day and a half were agonising, and although my wife said the same thing as the pastor, the thoughts kept running through my head. I half expected to hear the phone ring and find half the staff overwhelmed by the news, but that didn't happen until Monday.
As I entered the residential areas one by one, I was greeted by teary eyes and staff asking me if I had heard what had happened, to which I replied that I knew. I admired that they continued to work anyway, wiping away the tears in front of the residents who sensed something was wrong, but few asked what had happened. I am so very grateful that the staff reacted the way they did. When I got the message from the chaplain, I told everyone that we would be holding a staff meeting at lunchtime and leaving a skeleton staff on the wards.
My managing director came to me with a concern that seemed faked, but I was not to doubt his sincerity. He offered me all the support he could and promised to be present at the meeting.
The meeting was a tearful affair, and when I spoke to the staff, I stuttered again. I invited everyone to say what was on their mind and was amazed that no one reproached me but only spoke highly of Angelika. It wasn't about me; it was about her and their struggle to get to work, especially when they knew we had staff shortages. The pastor said a few words and a prayer at the end. Everyone hugged each other, including me, and some said, "Thank you!" The pastor said she thought I had spoken well despite my nervousness, and the manager agreed with her, thanking me for how I had coped.
I didn't feel that I had coped, but that everyone else had done much better. I sat in my office in silence with the door closed for a while until my colleague who did counselling sessions with residents and relatives came in with the office lady and said, "We think you should go home now. That's enough stress for one day!"
I thanked her and took her advice, but I couldn't understand why so many people were worried about me and that they registered my worries about them, but then life went on at a slightly different pace than before. My staff were amazing, especially Angelika, who had given her last, and the loss I felt afterwards lasted a long time. The guilt, too.