On the mainland, the shortage of professional care workers is not a new topic. With the intensification of the aging of the population, the elderly is becoming an important social issue, accompanied by how to find a reliable and good caregiver?
Today, we want to tell the experience and feelings of an ordinary Beijing citizen in contact with various types of nurses in the years of his parents' old age and illness, and also about the complexity and necessity of this group of nurses.
Wen | the original second sister
Caregivers are just needed
Basically, there are elderly people in the family, patients with sudden emergencies or surgery who are hospitalized, and it is just necessary to ask for a nurse.
First of all, everyone counts on nurses, but nurses are too busy. Family members who have seen the phenomenon of nursing staff on social media believe that the work that should have been undertaken by nurses is now passed on to nurses, and families have to pay more.
How to say, in the case of my parents' hospitalization and emergency room, the number of nurses is seriously insufficient. For example, there are only 6 nurses in the entire emergency room, and 24 patients are full. The nurses couldn't keep busy. It's either that medical staff are lazy and don't work, or that there are more people and fewer resources.
Second, it is a reality that most of us have to work, and it is impossible to care for patients all day long.
Third, the work of the nurse is fine, you have to stare at the infusion, stare at the monitoring at any time, remember the amount of in and out (how many milliliters of urine), feed, turn over and pat your back, assist in urinating and urinating, scrub the body, and also need to suck up the phlegm, not to mention the technical threshold, at the end of the day, these things, it seems that there is no heavy physical labor, you yourself stare at the day to know. A moment of a trivial matter, especially there are night infusions, feeding, turning over and patting the back to suck sputum, is unable to sleep, it is not easy to toss in the middle of the night, more than four o'clock in the morning, less than five o'clock in the blood draw, and have to get up and watch.
My mom had a year of minor surgeries, and I accompanied her, and I was able to stand up on the first day after the operation, and on the second night, it was I who slept like a coma at night. My mom was going to go to the bathroom, and I remember it clearly, and she was rather unhappy to call me five times before I woke up. I couldn't rest during the day, I couldn't sleep well at night, it was basically a continuous rotation, and I collapsed in 36 hours.
My biggest change in my thinking in the past ten years is this, I really don't have to be tired of myself to be worthy of my parents.
Fourth, the nurse is still not the same as the nanny, and the nurse has a professional and technical threshold. Many patients with lung problems and need to suck sputum at any time must be suctioned in time, but when the sputum comes up, the nurse is really not necessarily available, so many nurses play a shining role at this time. And most of the patient's family members, without learning you just won't.
There is another one, because we have feelings for our families, and this feeling will consume a lot of physical strength. Nurses are faced with a job, of course, they will have feelings for the patient after a long time, but compared with the family, it is two different psychological states.
In short, various objective reasons are superimposed, and caregivers are really just needed, and in the future, they may become more and more just needed.
Most caregivers are middle-aged women, and like male caregivers, they need to have a certain amount of physical strength or they are not up to the job. Image source Visual China
The caregiver is also a jianghu
In the hospital where my parents lived, the nursing profession consisted of two camps: the "regular army" affiliated with the nursing company and the unorganized, purely individual "temporary caregiver".
When my mother first stayed in the hospital three or four times a year, I didn't have any experience and believed in the company. I always feel that having an institution, an organization, and a management is more credible and more reassuring. They are usually linked to the ward, and the nurse will also recommend, which is more formal. But over the years, there have been more than a dozen or twenty used caregivers, anyway, from the situation in our family, the caregivers of the caregiver company have no obvious advantage over the temporary caregivers.
The nursing company wants to extract a certain management fee from the income of the nursing staff, so the same is 200 yuan a day, the temporary caregiver takes 200, and the regular army only has 170, because the nursing company has to take away the management fee of 30 yuan, for example. Therefore, some regular soldiers will also find ways to make more money, or appropriately reduce some labor -- they all want to earn more money when they come out to work and suffer hardships, which is the common sentiment of people.
Between the temporary caregivers, about the acquaintance society, they are all fellow villagers, helping each other to introduce work. In the past, I was always afraid that I would not find anyone, in fact, it was not the New Year and the busy season of farming, they introduced each other, there was always a way. The person you introduced is not good, and the next time I don't use this person, I won't look for you, so these unorganized temporary caregivers still pay attention to reputation.
Over the years, four of the dozens of caregivers that our family has been in contact with before and after have impressed me, and they are all temporary caregivers.
One of them, Sister Zhang, was a god man. I was both grateful for the help she had given me and full of curiosity about her.
On the day of my dad's first cerebral infarction in 2017, I stayed in the emergency room to watch my dad. Before five o'clock in the morning, the door to the observation room was gently pushed open. Came in a well-dressed middle-aged woman. Long hair, coiled head, not messy at all. She smiled at me first and then asked me in standard Mandarin if I needed a caregiver. I said I'd wait a while to see if there was a hospital bed. She sat down without seeing the field and said, "Then I'll accompany you for a while."
To be honest, my first impression of her was good. I was very impressed by her cleanliness.
There is a pair of small talk. She said her surname was Zhang and was from Henan. He said to me again, "It doesn't matter if you use me or not, but in this case, uncle, you have to buy a triangle pillow, you know, he turns over and you have to pad him up, otherwise it is easy to grow bedsores." Then, she took out her mobile phone, liso and entered the shopping platform, "That's it, you buy it online, it's cheap online." There is a commissary on the second floor, and it sells expensive." He also said, "When the uncle enters the ward, you rent an air cushion with the nurse and make the bed to prevent pressure sores." The elderly are afraid of pressure sores. Eight dollars a day. Also, you have prepared a diaper pad, that's it." Looking at the uneven quilt on my dad's body, she picked it up neatly with three clicks and two clicks, "I just like to be neat." She said.
I said, I don't look for anyone else, then you. She must have seen it, and I was even a little dependent on her.
By eight o'clock we were lucky enough to get a bed. On the way to the ward, she specifically instructed me, "If you get to the ward and the nurse asks, you will say that I was brought from home by you." They don't let themselves find it." I was so sloppy that I should come down.
Sure enough, the nurse asked, where is this nurse? I said, I brought it from home. Within half an hour, the nurse called me to the nurse's station and said to me very seriously, "You can't use this nurse now." I don't know, so I can't use a caregiver, or can't I use a temporary caregiver? The nurse said, "You can use anyone, but this one can't do it."
I was even more confused. What's going on here? The nurse said something in two words: the other nurses resisted this zhang sister, and the nurses in the whole ward came to the nurse and said that they could not let her in this ward, otherwise they would not do it. The rest, the nurse didn't explain, anyway, "Hurry up and let her go." It dawned on me why the nurses in each room came to the door to look at us when they entered the ward, staring at us coldly. It turned out that I had brought the public enemy with me.
When I went back, I told Sister Zhang that the nurse had talked to me and said that she would not let anyone brought by the family be used. Sister Zhang said why it was so unreasonable. I said yes, they asked me to find someone through the caregiver company. Sister Zhang was dying and struggling, and she was disobedient, so I gave her a hundred yuan (at that time, the nursing fee for a whole day was only one hundred and eighteen), and she left the ward.
That was the first time I had met such a concerted collective boycott of one person, a real resistance. It's dead or alive, not wearing the sky together. But I don't understand why.
Later, after my father's nursing sister went home with us, she talked about the elder sister Zhang in small talk, why she was also a fellow in Henan, she was so unpopular. My eldest sister said that she heard that her own patients were not good to look at, and she went out to look for work, and when she found them, she did not do it, and transferred the patient to another nurse, and she earned money from it. After a long time, the people in the ward were unwilling to pay attention to her. Thinking about what happened later, oh, so, the ward couldn't go on, so she simply went to the emergency room?
In the years since, I have entered and exited and passed by the emergency hall of the hospital several times, and I have seen this elder sister Zhang many times. Sometimes, 120 or 999 pushed emergency patients inside, and she also helped push the cart, faster than any family member. When I went to get the medicine, she also asked me, "Do you want a nurse?" Apparently, she didn't remember me.
I also saw several women sitting next to her who were obviously caregivers, who centered on her and tilted their upper bodies towards Sister Zhang when they spoke. It was as if she were Corleone of Sicily, a temporary caregiver-like presence.
In short, she was different from all the other caregivers.
My dad later recurred, and when he was in the emergency room, he saw that Sister Zhang was still there. Our elder sister said that Sister Zhang herself has completely stopped doing the specific work of nursing workers, and she now relies on finding work for others to collect commissions. At that time, the nurse's fee was about 230 yuan a day, less than ten days, she directly drew 300, higher than ten days, she drew 30 per day. Probably that's the proportion.
I don't wonder if it's legal for her to do so. But since it exists, she must have her strengths. For example, whenever you need to rent a bed, she can move it to you immediately. And the nursing company, not all the time when there were people 24 hours a day, you couldn't find anyone at night, even if there were people, they couldn't send what you needed so quickly, but their fees were the same as Sister Zhang. Ten pieces per bed.
Resisted by so many peers, Sister Zhang can survive for a long time, which is enough to show that the nurse is a huge market - yes, there are always two black-eyed family members, just like me back then, meeting her is like meeting a savior.
The hospital's emergency department is sourced from Visual China
Henan and Shaanxi are major provinces of caregivers
There are many nurses in the hospital, but there are not many male nurses. My dad once caught up with a male caregiver.
The eldest brother's surname was Liu, and he was also from Henan. The most nursing workers we met were from Henan. The second is Shaanxi's. Maybe these two places are densely populated, densely populated, and relatively far from Beijing, so nannies and nurses, these two places are large provinces.
Brother Liu belongs to the guerrilla type of short-term care workers. They don't always find work in Beijing. When the field needs manpower, he will go home, harvest wheat and corn, come to Beijing to do odd jobs when he is idle, do work when he has work, and go back if he does not. Relatively loose.
Usually the nurses who take care of my mom and my dad, I let them eat with my mom and my dad, and swipe the card directly. When I don't have any money, I'll charge it. The same is true of Big Brother Liu. However, when I ordered the meal, I found that he almost never ordered meat dishes except for eggs and meat dishes for my father. I told him several times to eat better. He always said that he could eat enough.
When my father's mind was clear, Brother Liu pulled my father to talk and chat, saying how many acres of land their family had planted, what the harvest was, and how much money they could earn. My dad knew a lot more about the crops in the land than I did. When he was young, he was laid off and planted. I didn't expect that my dad, a researcher of nuclear fuel, could talk to Brother Liu about farming. The director said that he wanted my father to talk more. Therefore, it is good to talk about anything and let him open his mouth.
Shortly after that discharge, my father entered the palace. It was summer, and I don't know why, there was a shortage of nurses. I looked for one in the first day or two, but the guy had something to go. I called Brother Liu. At that time, he had already returned to his hometown in Henan. When I answered the phone, it was obvious that he was drinking. But I understand. He asked me how many days I wanted to see my dad. If you only look at it for three or five days, he will not come. I said at least fourteen days for a course of treatment, not fourteen days, and I would check out the bill for fourteen days. Brother Liu said, OK, I'll buy a ticket to go in a moment.
I thought he was on the high-speed train, which was just a few hours away. He arrived the next day nearly noon. This still knows I'm in a hurry and takes the express train. For him, high-speed rail tickets are still too expensive.
When he saw him coming, my dad smiled happily. I'm down to earth.
Brother Liu finished handing over to the man in front of him and took out a large bucket from his luggage. "What am I going to bring you?" You have everything in Beijing. You don't have that. Sesame oil milled at home."
I divided the barrel of oil into six vials and gave it to my friends and my mother. That sesame oil is really incense. Natural incense.
The male nurse in the ward is pictured in Visual China
The complexity of a good caregiver
When my dad was hospitalized for the first time, my grandfather in the same ward had a disease with my dad, but it was more serious than my dad. Look at his nursing elder sister, surnamed Zhang, who is also from Henan. A long black hair, thick and enviable. People are also welcoming.
The first night I stayed with me, and she told me, you go buy a pair of gloves. what? Buy gloves in July? She said that patients with cerebral infarction cannot control themselves and will unconsciously pull out the indwelling needle of the infusion, and if they really pull it down, they will be in trouble. Therefore, there are special gloves that are safe for patients to wear. After the eldest sister finished speaking, she lay down and went to sleep. Whoops.
At that time, the commissaries in the building and downstairs were closed. I can only buy it tomorrow. I lay dry all night. Can't sleep. One moment to see if my dad pulled out the needle, the next to touch my dad if he had a fever. That night, my dad didn't have anything else, that is, you can feel that he always wants to pull out all kinds of needles and tubes on his body.
In the middle of the night, Sister Zhang woke up, sucked the phlegm of her grandfather, patted her back, turned over, saw me come together for a while, and said, "You can't do this, can you watch it 24 hours a day?" How many days can you watch it? Tomorrow you ask your family to take a towel or a handkerchief, just be soft, and tie your uncle's hand to the bed railing when you go to bed at night, otherwise you won't be able to carry it for three days." Not to mention three days, but when the sky was polished, I stood and began to shake.
As soon as I gritted my teeth, I bought gloves and brought handkerchiefs. I also realized that the nurse's tiredness is really tired; the "cruelty" to the patient, wearing gloves, tying the head of the bed, these "anti-human" things, are also unavoidable.
I came and went to be familiar with Sister Zhang. Her caretaker grandfather was a great intellectual, what an expert, and Grandpa's daughter in the United States came back a month a year. Grandpa couldn't say a word. But when Sister Zhang came home to collect the wheat, she walked on the front foot, and Grandpa had a fever on the back foot. He knew in his heart that the person he relied on most was not around for a while.
Sister Zhang originally worked in a nursing home, and one person was optimistic about several elderly people. Because I really earned little money, I came to the hospital as a nurse. She showed me her caregiver's ID. Very formally a small red book. Later, when my dad needed to hire a nanny at home, I had trouble finding a male or female nanny. Nanny, how do you bathe my dad? Sister Zhang, she looked at me like she hated iron and steel, and said, "What's so difficult about this, I used to be in a nursing home, washing several times a day." It's all that time, what kind of man and woman?" After listening to her advice, I found a nanny sister to take care of my father. This is a posthumous story.
At that time, if there was anything to inquire about, I asked her. Asked in vain. Once in the elevator, I forced her to give her money, and she didn't want to live or die. She said, "We're not that thin-hearted." My mom and my dad were hospitalized, and I asked her to help introduce the caregiver and rent her bed. When I was discharged from the hospital, I never gave more than the money to rent a bed. I think she helped me solve a lot of problems, and the meaning is also the right one.
Later, my parents were hospitalized once, and our nanny sister followed to accompany me. Nanny sister is social XX disease, within a few days to sweep out, Zhang sister helped me find a nurse, she is also commissioned from it. I wasn't surprised. After a long time in the hospital, knowing more fellow villagers is equivalent to having more resources in hand. Why not idle is idle.
It's okay to make money from me. In May 2021, the hospital where my dad lived let us get discharged, and I wanted to find a first-level hospital that could take medical insurance and stay for a long time, and if there was a fever or something, there was no need to call an ambulance, and the hospital could deal with it. Sister Zhang introduced one. When I went to see it, I thought it was okay, and specifically proposed that I want to use my own nurse, and the hospital promised that it would be no problem. When we arrived, we changed our words and said that we would not use our own nurses, and we also remembered to include my elder sister as their management system. There was nothing to prepare for the family that day, and my father and the elder sister of the nurse stayed in that hospital for one night. The next morning, the more I thought about it, the more wrong it became, and I quickly took my dad home.
Later, my nursing sister told me that Sister Zhang introduced customers to the hospital and also took money.
I have no problem taking the money, but I don't know if she knows that the hospital has deceived us.
Image source Visual China
How important is a good caregiver?
The process of building trust between a patient's family and a caregiver is slow and concrete, or rather, a small pile of details.
My father's current nurse, Sister Chen, was brought home from the hospital when he was discharged from the hospital in 2019. One detail shows what kind of person she is — she wears gloves whenever she sucks on my dad's sputum. Don't look at such a detail, it is really not every caregiver who can do it.
About Sister Chen, there is another detail, she loves to be clean, since the first day to take care of my dad, I found that she changes clothes every day. Even in the ward, where she could hardly see anyone outside, she insisted on changing her clothes every day.
Her seriousness, doctors and nurses are all recognized. At the hospital where my father stayed for eight months, the head nurse said that when it comes to taking phlegm on the elderly, other people's nurses are looking at it diligently, and no one is watching it, and it's like that, "Your eldest sister is not, you should shoot a few times."
When my eldest sister first started to take care of my dad, my dad could still say a sentence and a half, usually a single sentence. Hungry or not? hungry. At that time, when I went to the ward, sometimes I saw my eldest sister lying on my father's ear and asked, Uncle, are you hungry? Didn't you just finish eating? Observing her expression and tone, she spoke to my dad like a child. She talks to us normally to adults, except that as soon as she turns her head to talk to my dad, she automatically switches to coaxing mode.
Once when I went to the ward, my dad wouldn't talk to me, not even if he was hungry. I said, "Dad, why don't you ignore me, why don't you ignore me every day, you have to ignore me." The more he talked, the more aggrieved he became, and he ran directly into the corridor and collapsed. The eldest sister chased me out, and while accompanying me to shed tears, she said, "Uncle, he doesn't like to talk, it's not that he ignores you, uncle understands it in his heart."
The eldest sister is not a sweet-mouthed person. There are sweet mouths, and the family members come to ask for warmth. The eldest sister wouldn't say that. But she had numbers in mind.
She would tell me which one, "The director likes you, when will you go to her and say maybe we can stay longer." "The family members of the people have given fruit." You can also buy some fruit, just put the nurse's desk. You should also have a little heart and eyes."
The eldest sister did not rub the sand in her eyes, once called 999 to change the stomach tube for my father, it was a little girl, the operation was not very standardized, the eldest sister was not happy, "Aseptic operation you don't know?" The next time a young man came, the eldest sister still remembered this. I don't think it's about the boys, so I started to mud with thin mud. When the elder sister left, she said to me, "You are a person who is afraid of things." I said let's have a red face and a white face, and the next time we will look for someone else, it is not. The eldest sister said what red face and white face, you do not point it out to her, she will bully you, thinking that you do not understand.
From the hospital to the home, the eldest sister has one more job of cooking. Eating in the hospital canteen and returning home, especially after my mother left, my father and eldest sister had to make their own meals. I think it's a troublesome trouble. But the eldest sister said, it's all right.
It is like this bit by bit, slowly getting to know each other, generally knowing who the other person is, and then rest assured to hand over my father to the eldest sister. She also made me understand that good caregivers are too important. Like my father's case, how to say it, if there is no trustworthy nurse, I mention the throat eye every day; there is the elder sister of the nurse, the heart mentions the throat eye three inches down.
The "Perfect Relationship" between Nurses and Patients' Families
According to my eldest sister, in Beijing now, the hospital only has people from nursing companies available, and the market is about 350 a day for emergency nurses, 70 for the company; 300 for wards a day, and 60 for companies.
In fact, I have met so many nurses over the years, but for the qualifications of nurses, I still mutter, do they have professional training? Who trained it? The nursing certificate that Sister Zhang showed me earlier, my eldest sister later said, that kind of certificate, you can have it with some money. Of course, this may also be a one-sided statement, after all, I have not investigated.
But as a family member of a long-term patient, in my opinion, one of the biggest problems in the current caregiver market is whether caregiver companies can have unified standards, access standards, training standards, and regulatory standards.
Over the years, I have also met a lot of nurses from nursing companies, there are very good and responsible, my father had a year when he was hospitalized, next to the bed grandpa's nursing brother, is a nursing company. At that time, I soaked in the ward every day, observed him from the side, and looked at him with dedication. But there are also things that are not so ideal.
Not long ago, a friend who was turning a corner was hospitalized, only the people of the nursing company were available, the big sister was from Jiangsu, the big package mail area, WeChat ID is an English name, the big sister pays attention to the process, what is done every day, what time to get up and wipe the body A few times to wear elastic socks and the like, everything is recorded. But there is a detail that exposes her unprofessionalism - she will discharge the urine in the patient's urine bag in the clinical urinal every day, and then as soon as she raises her hand, she will fall into the washbasin, in fact, not far from the washbasin, is the toilet.
When a caregiver company is dominant, the standard is more important - as an institution, do you have basic job requirements? Is there a unified basic training? Is there a professional code and regulatory system? This is all based on personal experience and doubts, I hope it is really a partial generalization, but as a patient's family, we still hope that the nursing company community can have a clearer and more referenceable standard, rather than the current situation, you come to the hospital, you can only use the people of this nursing company, good or bad you don't know, you don't have to choose, patients and families are more passive.
Of course, these are my personal experiences, not representative of the whole, maybe there are companies that are very complete in all aspects, but I have not encountered them. Looking back at our family over the years, the caregivers we met were generally quite good, probably because of good luck.
Not long ago, I saw several news reports that in Shanghai, several elderly people decided to transfer their personal custody and inheritance to the caregiver, and to be honest, I was not surprised.
During my parents' hospitalization, I also more or less saw some so-called worldly changes. How to say it, the legal recognition of who is the child, it may be a rule of succession in terms of inheritance, but it does not guarantee that the inheritor of the inheritance will certainly be good to the elderly. Once, when I went out to dinner, a few young girls at the next table made small talk, and one of them said of his parents on the outskirts of Beijing, "I told them that if the house has me, I will take care of you, and I will leave you alone without me." My sister-in-law is worried about their room." I remember the girl's calm attitude. Dare to love blood relations is not omnipotent ah?
Taking care of the elderly, especially the disabled elderly, is a meticulous job, trivial and tired, long years to work, the elderly to the nursing staff, to the nanny, I am willing to believe that there is a real feeling between the elderly and the caregiver.
As far as the family is concerned, there are only two things I can do, one is enough money, the market price is how much, eating and brushing my dad's meal card, can save you a little is to let you earn a little more, I pay more money I think of my own way; the second is respect to give enough.
Regarding the relationship between nurses and patients' families, I have never felt that a "family-like" relationship is the best relationship. Family relationships are easy to blur boundaries and dilute responsibilities, and the farther away they are, the more good people are, and the people who really do things are complaining. On the issue of caring for the elderly, I have heard many stories of indistinct family members. Therefore, I feel that my elder sister and I are more like a good team. Is a further relationship than mere employer and employee.
Our relationship, according to the rules of the business society, is a normal, harmonious, efficient employment relationship is already very good, on this basis, plus a little closeness, is a team that can play. Taking care of the elderly, in addition to having soft feelings, there is also a hard responsibility.
Yes, it is a responsibility first and foremost.