Father Bart is a thoughtful, kind, and spiritual man who worked not only as a nursing home chaplain, but trained as a Certified Nursing Assistant prior to his four years in long term care. He graciously consented to be interviewed for my blog, despite having moved on to other pursuits. What follows is an intimate and touching discussion of his experience at the Cabrini Center for Nursing and Rehabilitation, a Christian facility in Manhattan, NY serving people of all faiths.
I decided to work in a Nursing Home rather than in a Hospital, because in the Nursing Home population both the patients as well as the Staff are more stable. I knew this factor would give time for people to come to know me as well as for me to come to know the people, and to have a better follow-up, day by day. By nature, I am a slow man. I would feel completely lost working with a constantly changing population.
What did you like about working in nursing homes?
I shall speak only of my experience at Cabrini Nursing Home, because that’s the only place where I have worked and that too only for four years. Therefore, with due respect given and allowance made to all kinds of human limitations, I must say that at Cabrini Nursing Home I came to appreciate the dedication of the CNAs as well as the rest of the Staff.
What didn’t you like?
With a distance of one year I would say that what I did not like there is part of my own inability and lack of skill to embrace the difference, that is, my inability to accept a way of thinking and doing things, which is different from mine. In fact, this is a constant challenge I carry within me.
Why did you decide to train as a CNA? How do you think your training affected your perspective?
I am a member of a Roman Catholic Religious Order, called “The Little Brothers”. We live mixed among common, ordinary people, earning our bread through manual work, sharing their daily life, their joys and sorrows, and participating in their festivals and celebrations, like Jesus in Nazareth. As a Little Brother I learned carpentry and worked as a carpenter in India for eighteen years.
Called by my Religious Order to New York, I was given the work to take care of the showers at the Holy Name Center for Homeless Men on the Bowery. So, for nine years, 5 days a week, every morning I welcomed Homeless Men at the Showers. In the afternoons, when all had left, I would clean the place, the Showers, etc, wash the towels and keep everything ready for the next morning.
After nine years, I felt it was time for a change. I had seen many of my Brothers in the Order working as Nursing Assistants and I had always wanted to learn that skill. Moreover, I had recently followed six months of psychotherapy as part of my personal human growth, mainly to learn how I could handle a deeply seated feeling of dissatisfaction and insecurity I carry within me. During those sessions I became aware that, as a grown up man, the path to manage those feelings, in short, to take care of myself, was to take of others. “To nurture” was the catch word my fellow worker at the Holy Name Center, David Batista, would use to describe this skill. David would say that anything you do with love is “nurturing,” whether it is washing the car or cleaning the windows. From him I learned that “nurturing yourself and nurturing others” is the same skill: It is to be a nurse to yourself as well as to others!
So, it was clear to me that I wanted to train as a CNA. The course itself lasted only a month. I was impressed to see how well done this course was, especially how it touched every aspect of human life, with great importance being given to the spiritual dimension.
During the gap of two months between the academic course and the State Exam we were to learn practice as a CNA. I was glad when Cabrini Nursing Home accepted me as an apprentice/volunteer CNA. I had chosen Cabrini because it was only five minutes walking distance from the place where I lived on the Lower East Side, NY.
After the Exam, when I got my Certificate as a Nursing Assistant, I approached Cabrini Nursing Home to ask to work there as a CNA. The Administrator said they needed me as a Chaplain/Priest. I said “yes” on condition that I may be allowed to use my skills as a CNA. I was thrilled when the Administrator replied: “so much the better.”
That is how I worked at Cabrini NH, without the people, I mean the visitors and the Staff, knowing or distinguishing in me, the Priest and the CNA, especially during the first two years. As to the Residents, I always introduced myself as a Chaplain/Priest. The fact that I combined my skills of a CNA to my work as Chaplain enriched immensely my relations both with the Residents and their families as well as the rest of the Staff. The fact that I was a CNA made me understand the Residents’ suffering better.
One of the things which has touched me the most, and which I would call “the spirituality of a Resident of a NH” is the following: One of the things which those of us who are not in a NH find very difficult to handle in daily life is to know to wait. We find it difficult to wait for the Bus, for the Train, for a Doctor’s appointment. We get upset when something unpleasant happens, when our Flight is cancelled, when we get stranded…, etc. Now, that is precisely what a Resident of a NH is going through all the time from morning to evening. He/she is dependent on others, family, Nurses, CNAs… He/she is waiting for the CNA to come to dress them up, to serve them the food, to help them with the toilet needs, to give them a bath, to take them to go to see the Doctor, etc. It is endless. I have tried to look at the Residents at Cabrini with deep respect and sympathy and I have tried to learn from them, and I’m still trying…
Is there anything you’d like people to know about the CNAs job?
CNA’s job is tough/stressful and a very sensitive one too. The CNAs are in fact the backbone of a Nursing Home. They are those who are the closest to the Residents, day in and day out, attending to their most basic human needs. The Nurses depend almost entirely on them. One of the teachers of the CNA course I took said: “It is the CNAs who make or break the Nurse.”
I would like the family members of the Residents to be more compassionate toward the CNAs. But more than that I hope the CNAs themselves learn to be compassionate toward themselves, by learning to do what they can, and to be happy to do what they can.
What changes would you like to see in the nursing home environment?
According to me, the Residents of a Nursing Home live a particular type of spiritual poverty, which touches their self-esteem and sense of human dignity. Almost all of them have had a professional life in which they were proficient. Being admitted into a Nursing Home it is like having lost almost everything: good health, their home, their family; and not being able to be in charge of their life and money, and the humility of becoming dependent on others. “No one is a happy camper in a Nursing Home” I would say, quoting once again my CNA course teacher.
On one hand one can ask what is the alternative to a Nursing Home. All things and aspects being taken into consideration one concludes that most of the time the family members do not have much choice. That is why all those who are involved in the care must do whatever they can not to make it more painful than it already is to their elderly/infirm family member.
During my four years at Cabrini N. H. I’ve observed that in general those Residents who are the happiest are those who receive frequent and regular family visits, especially from children. So, I’ve been asking myself how family members could become more involved in the care given to the Nursing Home Residents and at the same time how to avoid anything which would make the work of the CNAs and of the Nurses more stressful. I am very much aware that to strike the right balance is not always easy. But the goal would be “how to make a Nursing Home a real home away from home”. Our natural human tendency is to expect the “world and heaven” from others, that is, from those who take care of us. But no one is able to give the “world nor heaven” to oneself, let alone to others. Yet “to do what we can” is and remains the golden rule. Well, I think I’d better stop there, because I’m beginning to talk generalities…
Do you think a nursing home that isn’t run by a religious organization, but has a full-time (or even part-time) religious staff member can achieve some of the results of a religiously run organization?
Yes, I think so. All that is required is an integral human training of the Staff.
What do you mean by that?
Once again I’m going to be personal. It is just as you said of yourself: “I’m not religiously trained in any religion.” I believe we do not need to be trained in any particular religion. Because true religion is genuine love, which is solidarity with others for being human, nay for being part of the Creation. Love is not words, it is “caring,” “nurturing,” “being a nurse to yourself,” and “being a nurse to others,” without expecting anything in return. I think it requires tough discipline and a sustained practice in order to constantly battle with our natural narcissistic tendency which we take for granted as if it were a skill required for our survival. That is why I like your approach seeking to create “a nurturing and a psychologically healthy environment,” and I am entirely with you. I respect the “business aspect” of health care, just like in everything. As long as it is not a license to greed. Obviously we need to pay the rent, buy food, etc.
What I mean by an integral human training is: “a sound training appropriate to the respective task the Staff is required to perform; a sound training to being compassionate to one’s own self and to others; a basic knowledge of our human nature.” I suppose that a religious organization seeks to accomplish the above as part of their mission. But why wouldn’t every NH/Hospital/ School, etc want to conduct themselves in the same way? Since the goal is the same–the means should be similar too — whether such humanitarian institutions are run by a religious organization or not.
In conclusion, I would like to say how much I enjoyed my work at Cabrini Nursing Home. I have learned a lot of things and I’ve improved my skills as a “nurturer,” in everything I did, even when taking care of the plants in the Chapel. Because the goal of the nurturer is to handle all life with care from birth to its natural death. I’ve improved my skills, and acquired new ones, learning from fellow workers like you, Dr Eleanor. Your job was a very sensitive job, helping the Residents to handle their present situation with compassion. Also I remember the session you gave to the Staff in which you reminded each one of the very important task we have in life: “not to wait till we get old and infirm to sort out things we feel uncomfortable with in our life.” You see, I registered that very well.
May God fill you with great peace and joy for the work you are doing in every field.