TDB&TB Question #9 ~ TV Watching

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TDB&TB Question #9 ~ TV Watching

Unread postby Liz » Tue May 13, 2008 10:41 am

Pg. 100: "Sunday. If the TV is turned on, it is vital to have made the right decision. It is almost a matter of strategy. For three or four hours are likely to go by before the return of the kindly soul who can change channels. Sometimes it is wiser to forgo an interesting program if it is followed by a tearful soap opera, a silly game show, or a raucous talk show. Violent applause hurts my ears. I prefer the peace of documentaries on art, history, or animals. I watch them without the sound, the way you watch flames in a fireplace."

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Unread postby Betty Sue » Tue May 13, 2008 11:16 am

This just reminds me of when I've been sick in bed. Sounds are not too welcome, especially raucous ones on some stupid show you don't like anyway. :freaked: You really need attentive, thoughtful people to monitor this for you if you can't do it yourself, and then you feel such appreciation of them. :heart: It's just too sad that this wasn't often the case with Jean-Do! It must have been torture, and those feelings of anger and resentment must have surfaced. :-/ So helpless.... :bawl:
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Unread postby Endora » Tue May 13, 2008 11:41 am

I can see what he means. For example, I find football on TV very restful, when played quietly. I have no interest in football, absolutely none at all, but the white noise effect of the crowd, and the colours sweeping across the green seem very restful. Watching something you have only a passing interest in can be very calming.

Sometimes if you are alone for a long period it's nice to hear another human voice, though. I suppose most of us have the radio on for company, or the ipod, or even the TV.
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Unread postby nebraska » Tue May 13, 2008 3:07 pm

Even after reading this book and watching the movie, it is hard to comprehend what it would be like to be able to do nothing and be completely at the mercy of the employees in your hospital environment. mr nebraska and I have different tastes. At times, the noise of his TV fare really grates on my nerves. :-/ I can certainly sympathize with Jean-Do having no control over the TV! Watching in silence is an interesting idea - more peaceful, maybe even more interactive since he could write his own script for what he was seeing, and more comfortable with his sensitive hearing. At least when the TV was silent he would be able to close his eye and ignore the obnoxious shows. When there was little else to occupy him, the distraction of television must have been a blessing.

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Unread postby Parlez » Tue May 13, 2008 3:42 pm

This passage offers a very realistic backdrop for Jean-Do's daily existence. :bawl: And doesn't it make you wonder what the so-called attendants in such facilities do on Sundays?? The lack of care is astounding, IMO. It's pathetic, the degree to which a patient has to be his or her own advocate. The person I work with who is paralyzed and mute has notes all over her room, telling people what TV channel to leave on, what radio station to play, and a few other things about what she likes and doesn't like. That would've been helpful for Jean-Do...assuming someone initially took the time to ask him, and others took the time to read. Even then, there's no guarantee is there? Being at the mercy of other peoples' inattention is such a drag! :mad:

Anyway, I'm into silence meself. I never turn the radio or TV on for company; I prefer the quiet. There's too much noise in the world already for moi. Probably the number one conflict issue in the nursing homes I visit is around noise...too much, too loud, too late, or not enough, too quiet. It's hard to please everyone. But that no excuse for the employees not to try.
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Unread postby gemini » Tue May 13, 2008 4:53 pm

I can see where the TV could be a great time passer or a real irritation. He is right making the right choice of channel is important if you are stuck with it. The no sound would limit the aggravating part and on the type of things he liked; art, animals, and history probably wasn't missed.

The part played by the hospital employees bothers me. I know they are spreading their time between a lot of people but the time it takes to ask" is this channel ok?, or "would you like it changed later" seems like just plain good care.

I remember when my father was in the hospital having physical therapy and could not walk or get up or use his fingers. He had a utensil strapped to his wrist so he could dip food but the uncaring staff, some didn't know his condition, left the food on a tray he could not reach, and in containers he could not open. We would arrive later and feed him cold food. We then just started arriving before visiting time to feed him and they let us.
His small impairment makes Jean Do's seem ever so horrible.
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Unread postby Liz » Tue May 13, 2008 5:25 pm

I’m loving all of your answers here.:cool:

Nebraska, I, too, find my DH’s tastes somewhat grating on the nerves. But if I so choose, I can get up and move to a different room, go get my Ipod or put cotton in my ears. That’s because I have a choice. I have freedom of movement. I cannot imagine being at the mercy of a hospital staff that either doesn’t know how or is too lazy to communicate with me.

Parlez, I just think that hospitals and rehab facilities are short staffed on Sundays. But that doesn’t mean that the patients need less care, they just get less than satisfactory care on that day. Plus it is probably a different staff which is not familiar with all of the patients’ needs. I’ve heard many a story about the disconnect after a shift change. It seems like such a no brainer, though—to have notes on a particular patient that the unfamiliar staff person can review before walking into a room.


gemini wrote: I remember when my father was in the hospital having physical therapy and could not walk or get up or use his fingers. He had a utensil strapped to his wrist so he could dip food but the uncaring staff, some didn't know his condition, left the food on a tray he could not reach, and in containers he could not open. We would arrive later and feed him cold food. We then just started arriving before visiting time to feed him and they let us.
His small impairment makes Jean Do's seem ever so horrible.

So does that mean you or someone in your family had to be there for every meal to make sure he got fed because the employees were not doing their jobs? Appalling! Now I know why my step father-in-law isn’t getting any better after numerous visits to rehab facilities.
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Unread postby suec » Tue May 13, 2008 6:35 pm

The sme thing happened when my dad's partner was in hospital. She wasn't eating, and nobody made any effort to see that she was. So my dad went in every mealtime to make sure she ate something - it was a case of coaxing her to. But he got very concerned after seeing so many meals untouched and had to do it.

As for the tv, it seems such a little thing, really, to do to make his life easier. To pop along more frequently and check these things. It makes me wonder how those staff felt after reading his book, or how their bosses viewed it. He does say I think that it was a minority like that but I hope something was done.
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Unread postby gemini » Tue May 13, 2008 7:19 pm

Liz wrote:I’m loving all of your answers here.:cool:

gemini wrote: I remember when my father was in the hospital having physical therapy and could not walk or get up or use his fingers. He had a utensil strapped to his wrist so he could dip food but the uncaring staff, some didn't know his condition, left the food on a tray he could not reach, and in containers he could not open. We would arrive later and feed him cold food. We then just started arriving before visiting time to feed him and they let us.
His small impairment makes Jean Do's seem ever so horrible.

So does that mean you or someone in your family had to be there for every meal to make sure he got fed because the employees were not doing their jobs? Appalling! Now I know why my step father-in-law isn’t getting any better after numerous visits to rehab facilities.

Yes Liz, that is exactly what we did. He was taken to a hospital quite a ways from where we live. Picked up and took there by helicopter and taken for emergency treatment. We should have moved him closer to home for therapy but its hindsight now.
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Unread postby DeppInTheHeartOfTexas » Tue May 13, 2008 8:35 pm

I haven't worked in a hospital setting, only been around family that has been there. I do know that absolutely nothing happens around one on Sunday. It seemed to me there were two kinds of employees, those that truly cared and those that were doing their job but not much else. It occurred to me though, that in order work in that environment day after day, perhaps some people have to look at it as a job so as not to become overwhelmed by the emotion. Those of you that work in health care have a better feel for it.

Parlez, the note ideas is a great one. Is that something the patient came up with on her own or is that a normal practice in a situation like that?

I did like his comment about "flames in a fireplace". I admit to having the tv on most of the time even if I'm not paying attention, unless I'm buried in a book.
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Unread postby Parlez » Tue May 13, 2008 8:42 pm

As you say, Liz, the need in long term care facilities is 24/7, but the staffing tends to run along conventional business lines. All the administrators take the weekends off, and, of course, there are no doctors roaming the halls on the weekends. Staff is cut back on the weekends with the assumption/excuse that families will be visiting the patient. (and so...??) About the only staffing level that remains constant seven days a week is food service. But, as has been pointed out, what good is food if noone's around to make sure it's eaten? :banghead:

We talked about this during one of the tidbits, so I won't rant more on the subject. But, from a economic standpoint alone, when you think of the cost of long term health care, paid either out of pocket by the individual needing care or paid essentially by all of us via Medicare/Medicad, it's a crime (IMO) that budgets are tweaked by cutting back on staff whilst the corporations that own the hospitals, rehabs, and skilled care facilities continue to make huge profits.
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Unread postby Inthezone » Wed May 14, 2008 12:02 am

I am not a TV person, regardless of the show. (unless there is a film in the DVD player) I prefer music for background noise. But sometimes, noise just annoys me. But I get to make my own choices and Liz has an excellent point about choice and freedom of movement.

I was an ER nurse for over 15 years and there wasn't any need for TV in those rooms. I have done research in grad school about the effects of ICU psychosis - where patients lose so much REM sleep they go a bit psychotic from all the noise and different machines etc. Their families note a permanent change in the patient's behavior and especially sleep patterns over the long term, if they survive their ordeal. I was thinking of this when I read this section of the book and wondered how much sleep he actually got!

I had to chuckle when he jokes (?) about the nurse waking him up to ask him if he wants a sleeping pill. The irony of which was not lost on me as I have devoted much effort to updating our hospital's policies and this as a perfect example of such an outmoded yet accepted way of providing care.

I can't add much else for this discussion other than to reiterate something I've already read here. When you have a family member in the hospital, you must be there almost around the clock to be an advocate for their care. Especially when they cannot speak for themselves or are too sick to make demands.

Healthcare organizations around the country are short handed and regardless of the caliber and good intentions of the caregiver, they can't be everywhere at once. They rely on family members to be part of the healthcare team. (spoken like a hospital administrator - but so true!)
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Unread postby nebraska » Wed May 14, 2008 7:10 am

There have been some excellent points made here! I would like to add that in the USA, we need to remember the role insurance coverage has played in all of this. :banghead: Financial difficulties are reality, staff cuts, pay rates, etc.

I believe health care providers need to detach emotionally, otherwise they could not function long without burning out completely. Some may simply not realize the way what they are doing (or not doing) is affecting the patient.

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Unread postby teacher » Wed May 14, 2008 8:16 am

Working in a hospital environment where you meet suffering and death as a part of your job will either numb you or drive you insane, imo. Switching TV channels cannot be a major part of any caregivers job if they have actual medical issues to attend to, which is an explanation, if not an excuse for this situation. It always comes down to different kinds of people.
The helplessness of his situation is devastating, but despite not having the ability to choose, I see the TV as a bit of a help, actually - having Animal Planet or Discovery or whatever on, even without the sound is probably some distraction and maybe even a bit of entertainment. I'm imagining it would be even more monotone and depressive if he had had to be in a hospital, say 60-70 years ago - just him and the walls.
Athough, as someone here said, music is probably a better distraction than TV.
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Unread postby Parlez » Wed May 14, 2008 10:00 am

Sorry, DitHoT, I didn't see your question until just now...the woman's family posted the notes in her room I think, and for the most part the staff pays attention to her written wishes.

I've pondered the issue of what motivates a person to go to work in hospitals and care facitilies, and it sure isn't money (although the money isn't that bad). Most of them (us, since I too work in care facilities) have what I call a Mother Theresa complex - we want to do good and be of service to the helpless and less fortunate; to minister to the sick and injured. Trouble is, like nebraska says, burn out is a problem. Why? Because the need is so great - it yawns in front of you every time you enter the building, threatening to swallow you up. You realized no matter how hard you work or how devoted you are, the need is not going to go away. That can lead to frustration and guilt and fear = stress! Boundaries are definitely called for.

But it's a fine line, boundary-wise, between detaching and desensitizing. To witness, for example, a fully-functioning human being (a nurse or a CNA) walk right past an elder or disabled person who's crying or calling out for help and act like that person doesn't exist is a terrible thing. Even with the pretext that the 'professional' person has more important work to attend to, or more important places to hurry off to, or, heaven forbid, that the needy person might turn out to need more than the care provider can give (time, attention, compassion) it is horribly dehumanizing for everyone.

It's about boundaries, but it's also about focus, IMO. If the hospital attendant would've put his own agenda aside before he entered Jean-Do's room and instead placed his attention where it belonged for the moment, a ton of torment would have been avoided.

Well, I could go on :soapbox: and, of course, my opinions are just that, my opinions. :chill:
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