Gary Tetz

Maybe it comes from working in the highly regulated long-term care profession for so many years, or maybe it’s just from being a subservient Canadian, but I’ve become quite a prolific rule follower. If one exists, I will generally obey it, and I expect others to do the same. 

So when groups of rule-breaking miscreants started sneaking over the fence and into the pool at my apartment complex late at night, without regard for the clearly posted 10 p.m. closing time, I started to get a wee bit riled up. Even under ideal circumstances, sleep is elusive for me. Toss in a few noisy teens with their Bluetooth speakers turned up to 11, and I’m doomed.

After sending a frustrated email to property management and making a couple phone calls to an unresponsive security team, I deemed vigilante action to be warranted. But to set the scene, my third-floor dwelling faces the pool and is about 30 feet away from it — roughly double the distance from Lincoln’s box seat to the stage at Ford’s Theater. So unfortunately, unlike John Wilkes Booth, I didn’t have the option to leap from my balcony, shout “Ever thus to pool-crashers! The obedient are avenged!” and flee on horseback.  

This left only one choice — to start shouting at them from my darkened, tree-shrouded window. To protect a carefully tended image as a mindful, patient pacifist, I won’t report my exact words. Let’s just say they were loud, pointed and colorful. One time, at about 2 a.m., my sudden outburst appeared to cause an inebriated, oblivious teen and her loathsome male companion to nearly levitate in fright. They still didn’t leave the pool, but I felt a whole lot better.

Eventually, in a moment of post-dawn introspection, I realized with some degree of shame that I’d basically become the grumpy old guy, sitting in my bathrobe in the darkness, trying vainly to make those infuriating kids follow the rules. But I’m OK with that, because when you’ve tried everything else, a little anonymous shouting can be incredibly cathartic and perfectly harmless. 

I was thinking about this as I read a recent letter from AHCA president and CEO Mark Parkinson to HHS pleading for pandemic rules to be applied fairly and consistently. “Despite the progress we have made, nursing homes still must follow extremely stringent COVID-19 protocols … or face harsh penalties,” he wrote in calm, measured tones. “Meanwhile, there are concerning reports that other healthcare settings are held to different standards with little to no consequences for failing to adhere to COVID protocols.”

I’m glad our leaders and advocates are still setting up cordial meetings and writing polite letters, but it has to be extremely frustrating to represent a rule-following profession in a world where other people aren’t forced to play by them. So I hope they’re also leaving some time in the day to step outside and do some therapeutic shouting into the wind.

This could also be an important strategy at the facility level, where the burden of rule following is most intense and exhausting. A few minutes of shouting time should be scheduled right after standup, where leaders and staff can yell about all the things that make providing great care at this stage of the pandemic so challenging.

Yell about why you’re still in PPE when so much of the world has moved on. Yell on behalf of the residents who have still never seen your faces. Yell about the oppressive protocols that make the staffing crisis worse, and the obvious but apparently impossible changes that could make it better. Yell about the rules you have to follow that other people don’t, and the misguided rule-makers who have never set foot in a long-term care facility.

Trust me, you’ll feel better. Because when you’ve done all you can, it’s shouting time.

Things I Think is written by Gary Tetz, a two-time national Silver Medalist and three-time regional Gold and Silver Medal winner in the Association of Business Press Editors (ASBPE) awards program, as well as an Award of Excellence honoree in the APEX Awards. He’s been amusing, inspiring, informing and sometimes befuddling long-term care readers worldwide since the end of a previous century. He is a writer and video producer for Consonus Healthcare Services in Portland, OR.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.