I work the midnight shift (11:30pm-9:30am)in a home for developmentally disabled adults. This means that they are retarded, and also have at least one other severe problem. These other problems range from Down's Syndrome and Cerebral Palsy to heart ailments. Most of our residents have moderate retardation, although some are severely retarded. None of them are capable of living on their own, although most are capable of meeting their basic needs (showering, dressing, eating) with reminders and occasional assistance. Our home has room for 16 people, with 4 bedrooms and 2 bathrooms on each wing. As the home was set up, women have one wing, and men the other, although if we were ever to have married residents, they would be allowed to share a room.
Every weekday, the residents leave between 8:30 and 9:30am to go to a day program, where they receive occupational training and therapy, and for the more able ones, reading and writing classes. They return home between 3 and 4pm. They have weekends and holidays off.
Those little plastic bags of screws and bolts that come with furniture and appliances are very often bagged by people in day programs like these. The government, and some private businesses take bids for their work. While visiting the day program, I was able to watch some of the people while they were working. Some of them have a specific task, such as putting two pieces together, and are paid by how many they assemble. The ones in charge of bagging screws have a picture in front of them, with each and every piece they need to put in each bag. The person covers each picture with the screw or bolt that fits, and when their picture is finished, they know they are ready to bag that lot. They are paid by how many lots they finish.
I say paid by the lot or the item, although that is not completely true. Each resident receives a set amount by the state welfare department, although most of the money is taken out for shelter, medical care, and the like. Each resident receives 30 dollars a month as their take-home pay, although if they exceed their assembly quotas, they are paid extra for their quota. On this 30 dollars a month, our residents are expected to pay for all their entertainment not provided by our home (cable is provided, going to the movies comes out of their own money). They are expected to buy all their clothing (most of the time, families will help with this, although yard sales and auctions are great places to get decent clothing cheaply). Our home provides basic bathing supplies (soap, washcloths and towels, shampoo, straight razors), but anything else comes out of their 30 dollars a month.
Our residents wake up between 5 and 7am. Morning med pass is between 6 and 8. Breakfast on the weekdays is a sit-down affair, held at 7. On weekends, it's a buffet, between 7 and 9. After breakfast, they take their medications (if they haven't already done so), straighten up their rooms, get ready for work. On Saturdays, they have room care, which means dustings, straightening up their things, vacuuming, and the like. Sundays, those who wish to go to church are provided transportation and supervision, and otherwise, it's a free day. Most evenings (and weekend days) there are scheduled activities, in which they are allowed to participate-- going out to eat, going to the movies or a ball game, miniature golf, all sorts of different things. They eat a packed lunch at their day program on the weekdays, and on weekends, they have a hot lunch at 11. Supper is between 5 and 5:30, and that is their big meal of the day. Snack is at 8, and the last med pass ends at 9. Most of the residents are in bed and asleep by 10, and although a few choose to stay up later, it's rare for anyone to still be awake by the time I've arrived at 11:30.
There are 2 day workers (called team leaders), one full-time (Tues. through Sat.) and one part-time (Sun. and Mon.). In the mornings, there is also a cook (one full-time, one part-time), and the midnight person (2 full-time people, who alternate 2 and 3 day shifts). One of the team leaders passes out pills, the other helps wake everyone up, applies creams, does basic first aid if anyone needs, and helps with hair, and otherwise getting them presentable for their day program. While the residents are gone, the day team leader does basic housekeeping, takes residents to appointments, and does paperwork. The cook cleans the kitchen, shops, and does any food preparation needed for supper or for the next day's lunch. At 2:30, the first of the evening people arrives. We have a 2:30-10:30 shift, a 3:30-11:30 shift, and a 4-9 shift. The cook is there until 7, giving her (or him) enough time to wash the supper dishes, straighten up the kitchen, and finish any preparations necessary for lunch the next day.
In the afternoons, most of our people shower, and change into what they intend to wear the next morning. This is allowed, as long as they don't get the clothing dirty, and as long as they change undergarments and socks. After dinner, they have therapy sessions, in which they are taught basic skills: counting money, self-care (proper teethbrushing, showering, and the like), and exercise programs. The evening team leaders help with all of these things, and also help the 2 to 3 residents a day who have personal laundry. After the residents are in bed, the last evening team leader finishes any paperwork, straightens the kitchen, and starts the home's laundry (kitchen towels, bath towels, cleaning rags, and occasionally bed linens).
The midnight person does an hourly bedcheck, finishes the laundry, does basic housecleaning, and actually puts the lunches together for the morning (assembling the sandwiches, putting their macaroni salad into individual cups, etc.). At 5am, the team leader wakes up those who prefer to shower in the morning, straightens up the living room area, and sets the dining room tables for breakfast. At 5:30, it's time to put the lunches in the lunchboxes, and start waking up those who shower in the afternoon or evening. At 6, the day team leader and the cook arrive, and the day starts over again.
The only time that one person may be on shift alone is when the residents are sleeping. The morning crew consists of 3 people, and the evening crew consists of 4 people. Other than the positions I've already described, there are 3 full-time evening and 2 part-time evening positions. We also have a maintenance person and a secretary, who both come 3 times a week (or more, if something breaks), although they are not allowed to do personal care. This makes a total staff (for personal care) of 11 people, including the 2 cooks. Cooks are fully trained as team-leaders, and are allowed (and expected) to help with personal care when necessary.
As of this writing, however, we have a total of 6 team leaders (5 full time-- 1 day, 3 evening, 1 midnight-- and 1 part time evening), and 1 full time cook. Overtime is NOT allowed, and anyone who gets overtime will be written up, and quite possibly fired. I, as the only midnight person, am working Mon.-Fri. nights from 11:30 to 7:30 (as opposed to 9:30). Since that leaves the day team leader alone, the cook is working every morning (other than her days off), leaving the evening people on shift alone. As there are only 4 evening people, and one of them has to work Sun. and Mon. days (for the day person's days off), and another has to work Sat. and Sun. nights (for my days off), there are generally 2 evening people on a shift (as opposed to 3, plus a cook).
We have a staff meeting this Friday, which means everyone has to take off an extra 2 hours (no overtime, remember) to cover the meeting. Yesterday and today, I had to leave at 6:30 instead of 7:30. Today is the cook's day off. That left the day person alone after 6:30.
Last night, while I was putting the lunches together, I made breakfast, and refrigerated everything. I also prepared the coffee and tea pots. This besides my normal work, so that the day person would only have to heat the food up in the microwave just before serving. Between 6 and 6:30, I applied creams to the 9 residents who have them (for psoriosus, rashes, and the like). This is an operation that generally takes an hour or more. To finish in half the time, I had to be "clinical", and depose completely any bedside manner I might have. I went in each room, did my job, and left. I was basically having to treat these human beings like they were factory parts being processed. This is WRONG. They are people, and deserve to be treated as such.
The administration has chosen to support their extremely basic staff by berating us over what we, running at half the staff or less each shift, are unable to accomplish. If one man goes to day program unshaved, or one resident misses her bath because there was no one available to wash her back for her, we are written up.
One of our residents fell last week on my shift. She needs a walker, but generally refuses to use it. She fell against the sink in the laundry room (an large, industrial sink), and sliced her chin open but good. If you are squeamish, skip to the next paragraph. The cut was open over an inch wide, and went to the woman's bone. It ran from her chin to her larynx. Luckily, I heard her cry out, and was able to get an ambulance there right away. She was taken in for stitches, and sent home. She is fine now, and her stitches will be removed Fri. morning, although she hasn't started using her walker any more often.
I was in no way berated or held accountable for the accident (which I fully expected, knowing the current administration). It was just that, an accident, and I did what was necessary to get the woman aid. Luckily, both the day person and the cook were scheduled for that morning. As one team leader is supposed to go with any residents to the hospital, the administrator asked that I call the day person in early. The accident happened a little before 4, and I was able to get the day person around 4:30. She showed up at 5, and went to the hospital immediately, as she had been requested to do. A little while later, she returned, to get the woman some clothing and other necessities, and returned to the hospital. At 7, the injured woman's sister called, saying that no one had arrived yet. The van is old and clunky, and the cook and I were worried it had broken down on the way. The cook left to find the day person, and help her if necessary, while I took care of the 14 residents still home. Knowing the overtime policy, I called the administrator back, to tell her the day person had disappeared, and I needed to stay on the clock until either she or the cook returned.
The day person had had a minor accident on the way to the hospital, which was what had kept her. She, the cook, and the injured woman returned to the home about 8:15. The day person was written up for a) having an accident, and b) not being at the hospital when she was needed. The cook was written up for deserting her post. I was written up for receiving 45 minutes of overtime. We all three presented the same defense: we did what we could, to the best of our ability.
The reason I told you about the accident, and everything that followed it was to point out that had the accident occurred on any other shift, we would have been shut down for failure to properly supervise our residents. And we would have deserved to be shut down.
