The Impact She Left on Me

Towards the end of this visit, I thought I had a huge impact on my client. I know I did. But I wasn't expecting the huge impact she would leave on me...

Currently, I am working as a home care personal support worker (PSW). This means that I travel from home to home, providing personal care and assistance to clients.

What type of care do I provide?

As a home care PSW, I assist clients with housekeeping, bathing, toileting, hygiene/personal care, changing clothes, etc. Care also includes reminding clients to take their medication, or to assist with laundry. Take the garbage and recycling out. Essentially, I assist clients to complete their activities of daily living.

What type of clients do I provide care to?

I work for clients who are unable to complete the aforementioned activities of daily living by themselves. I mostly provide care for the older adult population, but I also provide care for middle-aged adults and even teenagers too. Completing tasks such as doing the dishes, or even getting out of bed becomes as you get older. Completing such tasks are also difficult for people with disabilities of any age.

To clarify, when I say "home care", it does not mean that I work in a retirement home. I travel from house to house, apartment to apartment, residence to residence, providing care to clients that I am booked with. The position I am in requires me to travel (via bus) across downtown Hamilton. I do not stay in one spot. I could, but there are no shifts at my company that would have me stay in one spot. My visits can range from 15 minutes, to up to 4 hours long. Most of the time, my visits are 1 hour long.

What has it been like working as a home care PSW?

My workdays are composed 50% of me on the bus, and the remaining 50% being my actual visits.

To be honest, it is pretty demanding. Using public transit makes working a bit harder too. I have to consider transit time when I leave one client and move onto the next. Especially on the weekends. The buses come every half an hour, instead of every 10-15 minutes. So I CANNOT miss a bus on the weekend. Or I would have to walk and call my client, saying that I will be late. The company I work for says that my home visits are not "time specific". This means I could arrive an hour early or late. I am not a big fan of this. Just because my client did not book me to be half an hour or 45 minutes late. Basically, being late to the point where there are only 15 minutes of the visit left. If I am late, then I would have to push my next visits back too.

There are times that I do finish early though. If I finish all that needs to be done for my client, I can leave half an hour early. Or even an hour early. I can call my client and ask if I could see them early. If they would like to, of course. Not all clients like being visited early because of an appointment, family visits, or they have a routine. I still get paid for the time I am booked though. So if I finish half an hour early, I still get paid for the 1-hour visit.

The physical work is draining though. I notice that my feet are throbbing the moment I get home. My neck, shoulders, and especially my back, are sore from the lifting, pushing, pulling, and bending associated with my job. I have to be careful. I cannot injure my back, or I would be done as a nurse before I even graduate. It is a lot of work, and I do not think PSWs get enough credit for what they do. We can deal with angry clients and their families. Knowing that some of our clients live in poor living conditions (so bad that it is practically illegal) on a daily, is harder than working in those environments. I go home, grateful for the life that I have because I cannot imagine living life the way some of my clients do. Some clients prefer to have their laundry hand washed. That requires a lot of sitting and bending for a long period of time. I cannot deny a client who has bed bugs. I can go on about the work I do as a PSW, but I think you guys have the idea. All of this, plus busing and walking throughout downtown.

How much do I get paid?

I get paid $19 per hour. A lot of companies only pay their PSWs $15 per hour. That is the minimum wage. PSWs deserve so much freaking more than that. The work that PSWs put in is NOT worth $15 per hour. It honestly frustrates me that an individual is willing to work as PSW for such low paying companies when they can work at a fast-food restaurant or other jobs less strenuous jobs (compared to PSW work).

Is there anything I like working as a home care PSW?

For sure. First off, my company is pretty flexible with scheduling. I get every other weekend off, and they accommodate that I am taking a summer course. When I told my client service coordinator that I need more travel time between clients, she accommodated that. Not everything goes smoothly all the time, but I get the support I need. I had a really shitty, as in real toxic, experience working as a PSW at a retirement home in my hometown. The fact that I feel supported here, especially being a nursing student, is one of the biggest positives I have with my company.

Let me know if you have had a negative experience working as a PSW while being a nursing student. I know not everyone has a terrible experience, so share your positive experiences too!

I think my favorite part of the job is meeting the people. I am a very outgoing and sociable individual. However, I am quite shy and reserved when meeting people for the first time. Being a PSW has forced me to skip that shy phase. Communicating with my clients is extremely important, and I want my clients to feel like they can rely on me. I joke with them. I try to make my clients smile. I try to warm up to my patients. I establish a therapeutic relationship. One of the biggest things my clients appreciate is someone who listens. I have met so many people and learned their life stories. I have learned so many life lessons from getting to know my clients.

There is one belief that I strongly hold on to as a nursing student and PSW. My client/patient is also a person, an individual. My client/patient is not just someone who needs their meds or housekeeping done. My client/patient is a human with thoughts, feelings, and a voice. I always had this belief since the start of nursing school. It has hit me once during a clinical placement, but it hit me really hard this past weekend.

What happened last weekend?

Please note: I am not going to release specific/personal information to maintain privacy and confidentiality for my client

I always call my clients the night before to confirm their visits; unless I have them in the evening, then I would call them the morning of. Sometimes clients have doctor appointments, family visits, or trips, and they forget to cancel their home care visits. I called this one client and asked to confirm if I was seeing her tomorrow afternoon. The client was surprised and sounded upset that I was visiting in the afternoon. She explained to me that she has visits to help her with a shower in the morning. The client expressed her frustration that the company never listens to her because she has told them multiple times that she needs someone in the morning. She said that old people do not have rights anymore and are always forced to be pushed around for other people's convenience. But, she did not state that she wanted to cancel the visit, so I called the office.

We were able to squeeze her in between some of my morning visits, but I was left with little travel time. I called her to let her know of the time change, and she sounded so happy. I heard a complete change in her voice and she thanked me. It felt good, but I was stressed about traveling from my first client to her.

Next morning arrived. I was able to finish early and arrive on time! I knocked on my client's door. There was a little wait. I leaned my ear close to the door and heard little shuffling sounds. As they got closer, I moved my ear away. The door opened, and this tiny old lady appeared. I introduced myself as the PSW who called, but the first thing she asked one question right away, "How old are you?"

"I am 21 years old."

"Oh my. You are so young."

"Yes. *chuckles* I am a baby, I know."

"I know you are a baby, but you are too young for me."

In my head, I was like "Oh no." I asked her what was wrong with my age. She told me because of her old age, that she feels embarrassed and degraded when young PSWs help her shower. My client was self-conscious about her body. I reassured my client that I would do anything to make her feel comfortable during a shower. My client insisted that she work with an older client. I told her that is alright and I can help with other things, but her apartment was already clean. No dishes in the kitchen. Laundry put away. The bathroom is clean. Her bed was made.

There wasn't anything for me to do. Even my client said that there was not more I could do. I told that is alright and I can leave if she is okay with it. My client was alright with me leaving, but she apologized for the inconvenience. She apologized multiple times and expressed how bad she felt. She asked if I was upset. I felt a slight pang of pain in my heart. This lady was feeling bad for me when she shouldn't be. I told her that everything is alright, I was not mad at her. I told her she has the right to refuse and the right to choose.

She replied, "Oh no, old people don't have rights anymore."

I didn't blame her. Studies have shown that the older adult population state they feel a loss of control in their life as they get older, especially in terms of their health and working with younger people. I didn't want her to feel that way with me. I don't want anyone to feel that way with me.

I told her, "Well with me, I will respect your rights. I respect you and your decision to not have a shower because you feel uncomfortable. Please, do not feel bad for me. I am not mad. I understand."

She looked up at me, her small eyes peering through her glasses. There was a change in her eyes from when I first saw her at the door. Her facial expression changed too. It was more relaxed, she didn't seem as tense as before. Her voice became softer too. My client thanked me for respecting her decision and for understanding where she came from. She explained that the afternoon was the only time she could speak to her ill son on the phone. I could tell that she really loves her son and that her son was not doing so well because she sounded like she was about to cry.

I offered her to take a seat and if I could grab her a drink. As I brought her to the couch and sat her down, she apologized for taking up my time. I was flabbergasted, astonished. I was only 10 minutes into this appointment. She is booked with me for an hour and she thought she was taking up my time.

I said, "You know, I am booked with you for an hour. I have lots of time. I don't have to leave."

"You can stay for a bit?" She looks down on me, I was sitting on my one knee after I sat her down on the couch.

"Of course. Let me grab your drink first."

I walk to the fridge and I see a glass of apple juice that she told me about. I brought to the coffee table in front of the couch, grabbed my water bottle, and sat down beside her. I asked her what she would like to talk about, see if there were any topics to cheer her up because of her son. She said she doesn't really know what to say. Lucky for her, I won't shut up. And she was okay with that. I talked about my brothers, nursing school, what I aspire my nursing career to be like. I explained that is why I understood and empathized when she explained why she did not want to shower. By opening up to her, she opened up to me.

My client is alone, all alone. Due to life circumstances, she is unable to see her ill son. She can only call him. She tells me that his prognosis isn't so good. I was heartbroken. This lady is all alone, no other family except her son. And she can't even see him. She was crying. I brought her a napkin so she could wipe her tears, and put a hand on her shoulder. I reassured her in saying that she must feel lonely and that I understand how painful it must be for her.

"You have a good heart. You will make a great nurse", she tells me. Out of nowhere. "You understand people."

"Thank you.", that was all I could say. I had to keep it together and stay professional. I felt like crying. This lady has no idea how much the words she just said means to me. I have struggled so much in nursing school, and hearing that from her gave me the support I never thought I needed. I never thought I needed to hear those words from her. Someone I do not know at all. I was supposed to be the one providing her with support, but she was the one supporting me.

Then it was time for me to leave. I had a bus to catch for my next client. As I walked towards the door and turned around to say goodbye, I see this tiny old lady try to get up from the couch as fast as she can. She took a few small steps towards the door, looked up at me and asked me one question, "Can I have a hug?". I was devastated. When was the last time my client received a hug? My client looked up at me, she was a lot shorter than me. She looked so vulnerable.

"Of course."

I gave her a firm hug and thanked her for trusting me. I thanked her for saying I have a good heart and that I will become a good nurse. I told her to call her son in the afternoon, like usual, and that it was lovely to meet her.

She said, "It was a good thing you came." My client appeared a bit sad that I was leaving, but I can tell that she was happy that I came. And you know what? I was happy too.

I know, the busy life of health care makes it hard to take time to provide that emotional support. We have buses to catch, medications to give, baths to do, assessments to complete, etc. We wish we could have more time, but we don't. Therefore, we rush and try to manage our time to the best of our abilities. But, our clients and patients end up feeling rushed. They feel pushed around just so it is more convenient for us. We may not have the intent of making them feel that way, but that is how they feel as a result of our actions. This visit also reminded me to take a breath, and slow down. I reflected on how life never goes as planned, so why should I rush my client to make it convenient ONLY for me? I need to work with my clients and patients and make it convenient for the BOTH of us.

Recalling that visit the first few times makes me want to cry. It did make me tear up a bit, but I know I made a difference in that lady's life. It is for certain that she made a big difference in mine too. My job, specifically this visit, reaffirmed my belief. My clients and patients are people too. Being in the health care field, we tend to forget that we are taking care of unique individuals. Sometimes, these individuals may have no one to confide in. Developing that therapeutic relationship and personal sense of knowing is essential when providing any type of care to someone. MAKING the time to listen to someone, can mean the world to the person.

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