What Night Shifts Reveal About Connection

 Living in a facility is an emotional toll in itself. Losing all privacy, the comfort of your own home, and the support of your family can push people into a bad place mentally. To add to the pressure, strangers enter your room everyday, and overwhelm you with information you may not understand. They wake you up at 6am to take your vital signs, and they control when and what you get to eat. Oftentimes, residents in long-term care facilities need some sort of other emotional support. In fact, nighttime is when all the emotions come to the surface, because that is the loneliest time of day. Constant overthinking leads to restlessness, so many patients are awake at night simply pondering. Family and friends eventually stop visiting, and the person that residents rely on ends up being the CNA. Let’s take a second to appreciate this privilege. Someone, who doesn’t know anything about you, trusts you enough to confide their deepest emotions in you, and they blindly trust you to respect those secrets and empathize with them. As their caretaker, you now have a responsibility to not abuse that vulnerability that they are showing you. 

When patients used to approach me with emotional topics, like talk to me about their family or financial situation or relationships, it would often be abrupt. It felt like they had been holding those feelings in for a while, and it got to a point where they just needed to get it out. I would be cleaning their room or serving them lunch, and unexpectedly, a patient who has never said a word to me would start talking to me about their life and their experiences. Never planned, but always sincere. That feeling of bottling up your emotions is what scares me. What happens if no one is there to listen to those emotions? What happens when a patient finally snaps and those feelings become too much for them to handle? That is exactly why I advocate for CNAs to be an emotional support for their patients, as well as a physical support. We already help residents with activities of daily living, like walking, changing, and bathing, but coping with your thoughts is another activity of daily living that is not taught in the CNA textbook. 

I used to volunteer as a peer counselor for Teen Lifeline, taking calls on the hotline. The number one golden rule of that job was that we are in a position of power over the caller. For that reason, we can never tell the caller what to do. Even if the caller mentions feelings of suicide, we cannot tell them not to act on it, because we simply cannot make decisions for them. Why? They will likely act on it, because in that moment of crisis, they view us as a higher authority. I applied these teachings to my work as a CNA as well. When a patient opened up to me about their mental state, I would be a good listener. I stopped what I was doing, and gave them my undivided attention. I would ask them clarifying questions, ask about how specific aspects of their situation made them feel, and paraphrase what they told me so that they could hear their emotions out loud. However, if they asked me for advice, I would continue to ask them about their feelings, and what they thought the best outcome could be from the situation, so that they could develop that plan of action on their own. Most importantly, I constantly reminded them that we, as a care team, are there to help them in every facet of their care, and that encompasses mental care. 

They don’t teach you how to deal with these situations in CNA classes or in CTE education, but I truly wish mental health was emphasized more in healthcare. Mental distress can have a direct effect on a resident’s physical state, and if the care team only emphasizes the physical state without recognizing the role a mental state can have on it, they are creating a huge gap in understanding between the caretakers and the resident.