in a heartbeat: c.n.a. sonnet
In a heartbeat worlds collide/ I’ve been told if wishes were horses/ In a heartbeat beggars would ride … — Laura Love, "In a Heartbeat" from the CD Pangaea
I commute an hour each way to Grand Rapids, MI, nowadays. I pass by the same things each time: the dozen or so carcasses of deer, raccoons, cats and opossums; the billboards; the stench of the farmlands coated with manure. Grand Rapids has Spectrum Health, a mammoth hospital system I might end up working for one day. Perhaps. Today I noticed a billboard for Spectrum I hadn't noticed earlier. It shows a team of nurses rushing a gurney into an emergency room with the caption: "a lot can happen in a heartbeat."
I didn't think much of that until later this morning I was writing another certified nurse aide sonnet and I began to think about all the disasters that happen in my geriatric ward (and all the averted disasters as well) that literally occur in the space of a glance. I respond to an alarm going off and find one of my residents trying to walk from his bed because he has forgotten he can't walk and is in the process of falling. These disasters are mundane ones, no one is yelling "code blue, go! go! go!" no one is racing across town trying to save someone's life. My job calls for long periods of sanity mixed with intense moments of insanity while disasters pop up all around you.
I understand why the craziness happens. Acts of defiance make sense in contents. Regardless of the orders the family or head nurses give, regardless of what is "safe" and what isn't, the people in my dementia unit are at the end of their lives. They are going to die soon. For the most part, even with dementia (maybe especially because of dementia) there is a rebelliousness against it. Dylan Thomas urging his old father to: rage, rage, against the coming night. Of course we fight it tooth and nail, this butterfly machismo, and in the case of many of my residents that takes the form of trying to stand up for one last time, trying for some simple action of independence.
Of course, my resident's acts of independence can be deadly. Few residents are able to recover from broken hips, falling while trying to be defiant in the face of death and any incident, regardless of the nobility or purpose of those actions, is then reflected upon my skills and future as a nurse aide. I can lose my license for those little acts; which is ironic because we put a lot of energy in the nursing world claiming we respect the idea of the resident's dignity. We do, provided they do not try to act on their own. That is why they are rigged up with alarms. Dignity only goes so far against lawsuits.
We were feeding forty-five residents
all in wheelchairs when an alarm wet off.
A last act, like defiance. Incidents
of dull rebellion, disaster. A cough
turns to aspiration. An epitaph
in the making. Forty-five alarms, each
the same. Fury while eating; does she scoff
and sneer at each spoonful now that her speech,
her skill at this grace, is gone? Sudden screech;
alarm as someone pushes herself up
from her chair, sways, teeters. If I could reach
across the void, spoon in hand, I would. Cup
her back down. All in the hint of a chance.
Time for a last act. Time for defiance.