I remember one Christmas, I was probably 7 years old, I wanted a child’s toolbox full of working tools like a kid-sized hand saw, screwdriver, wrench and a hammer. They all came in a metal toolbox that had a latch and a handle so you could carry it around.

I must have seen it in a store and asked for it, like Ralphie did with his Red Ryder BB gun. Lo and behold, on Christmas morning, there it was. I can still feel the elation of that moment. I also remember that in short order I was in the garage sawing up old cardboard boxes and making stuff that I proudly showed my parents. 

I hope you have memories like that. Just a few months before my mom passed away a few years ago, we all got out the photo albums and 8 mm films and reminisced about those days. It was a precious time I’ll never forget. Remember Clark Griswold in the attic. 

2023 has been a difficult year. The regulatory onslaught was brutal. But we are surviving. These challenges have also made me nostalgic. I often think about the day I made what I thought would be a temporary switch from acute care to long-term care. I became an MDS coordinator. A competent ICU step down nurse, I quickly realized I was out of my element in this new role.

In 2001, the MDS nurse was something new. PPS had just been initiated a few years earlier and the industry was still reeling. The MDS became electronic with that change and was required to be submitted to the state, via a modem. Do you remember the sound those things made? 

Quality Indicators, now quality measures, were new as well. No one really knew what was going on. Someone had to oversee it all. And so, the MDS coordinator position was born. 

Today there are a litany of resources available for the MDS nurse to rely on for advice and support. It is a wonderful thing to watch online communities take root and grow into vibrant discussions. Organizations like the American Association of Post-Acute Care Nursing (AAPACN), and others, have become the gold standard for educational opportunities and certifications. 

In those days, however, unless you knew someone who was also an MDS coordinator, there were relatively few resources available to answer questions and offer guidance. My paperback MDS manual was only a few hundred pages long and was scant on coding tips and clarifications. But those were the good old, “less complicated” days, remember? 

I also remember through the years those who helped me grow, many of whom have become career long friends. I remember my first administrator who had confidence that I could do the job. 

I remember several others I respected who came along, offered guidance, helped me gain confidence, and shed light on previously unrealized abilities. My initial nursing career plans did not include long-term care and these incredible people are the reasons I now do what I do. 

I came to understand through their compassion and care for this patient population, that the MDS and all it represents, is a powerful tool for good, that when a community of caregivers surround it and it is properly utilized, our residents are the beneficiary. What a joy!

As I think back, I am grateful for Randy Lewis, Joy Powers, Sandy Deakins, Mary Marshall, Diane Brown, Mendee Rock, Linda Estes, Manning McGraw, Sumit Malhotra and the many others who carried me along like a leaf on the river of this unexpected career.

Thank you also to McKnight’s Kimberly Marselas for reminding us of what it was like to have good friends by sharing this year’s Amazon ad, “Joy is shared,” in a recent article. I have a lump in my throat every time I watch it.

The RAI process is a wonderfully formidable task that cannot be accomplished alone. I hope that you have a circle of friends who help you grow and care about the MDS tasks you accomplish each day. Their support is indispensable. The outcome of those relationships will produce remarkable results, especially for the residents you care for.

Gracing our residents with those outcomes is the reason most of us do what we do in long term care.  Clarence the angel said it best to George Bailey in “It’s a Wonderful Life”: “No man is a failure who has friends.” 

I feel that intensely as I reminisce. How about you? 

Joel VanEaton, BSN, RN, RAC-CT, RAC-CTA, is a master teacher and the executive vice president of PAC Regulatory Affairs and Education at Broad River Rehabilitation.

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.

Have a column idea? See our submission guidelines here.

Residents and their families were treated to tours around the 184-bed Cheektowaga, NY, facility — fully decked out with holiday lights and decorations — courtesy of a horse-and-carriage team brought in from nearby Banner Farm.

“I thought it would be wonderful for the families and the residents to get together during the holidays,” said Rhonda Gorman, activity director at Garden Gate. “A lot of times we do a tree lighting or something like that, but this time we thought it would be nice to do something different.” 

She was inspired to organize a carriage ride activity after the success of festive fall hayrides earlier in the year. 

The event — which Gorman is calling “Country Christmas” — drew quite a crowd. Gorman estimated between 50 and 75 residents, family members and staff came to hang out with the horses.

Residents who were physically able were whisked away on the carriage ride, but even those who weren’t able to access the ride itself got to participate in the highlight of the event.

Even more than the holiday spirit-boosting ride, the horses were clearly the star of the show. The team showed up early and stayed late, Gorman said, ensuring that everyone got to spend time with and even pet the enormous Clydesdales. 

“It really adds a wonderful quality of life for the residents to get outside in the wintertime and see horses and be with their families,” Gorman said. “It’s something that we strive for with our staff.”

The Banner Farm Clydesdales don’t only go out for Christmas events, but the horse breed has become synonymous with Christmas ever since it was featured in an iconic series of holiday Budweiser ads. 

This is the first time that Garden Gate has run the carriage ride event, but it will not be the last.

“This will definitely be an annual tradition,” Gorman stated.

And the holiday season is just getting started for Garden Gate’s residents, as the facility has more Christmas events lined up, including three days of lunch and gifts with Santa later this week.

One I saw was a wool throw blanket that looks like a piece of meat. Now I know my friends in Kansas love their beef, but I cannot imagine any of them wanting to be draped in a flannel steak.

I saw an ad for a Christmas screaming goat toy. Now I find the YouTube video of the fainting goats hysterical, but I am sure I’d go insane if my grandchild was playing nonstop with a screaming goat toy. 

Then I saw an ad for a set of holiday dad joke pencils. While my husband probably would love them, the rest of us would go nuts as he read them to us over and over and over. 

And who wouldn’t want a set of “Jingle Butts” — hand blown glass ornaments that look like a person’s behind but in festive colors. I guess you can combine it with a set of festive beard ornaments. (Yes, that is a real thing.)

One gift that boggles my mind is the padded toilet seat. I mean, how long are you going to be sitting on the toilet? Do you think your legs are going to go to sleep? Hasn’t anyone ever talked to you about bran?

Then there is the assortment of flavored candy canes that seem just so yummy!!! Sour pickle flavored candy canes, ketchup flavored candy canes, sour cream and onion flavored candy canes, hotdog flavored candy canes, Dante’s inferno candy canes and bacon flavor candy canes. (OK, maybe the bacon ones would be worth a try.)

Of course, Hairball Kitty is a great gift because having a fake kitty hacking up hairballs is so much fun. 

I read that an often-given hated gift is a diet book. Like seriously, a diet book when you have all this delicious, delectable holiday food. Who is cruel enough to give this as a gift? Satan? 

The holiday drama emergency ambiance candle might be a good gift when your dinner guests start talking politics. However, the public toilet survival kit may be a gift I get myself. Yes, I suffer from public restroom anxiety disorder. 

But the very best gift is all of you, who dedicate your lives to making this world a better place every day. Thank you for your sacrifices large and small, for your dedication, and for caring. That’s the best holiday gift ever!

Just keeping it real grateful,

Nurse Jackie

The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, Senior Director of Clinical Innovation and Education for Mission Health Communities, LLC and an APEX Award of Excellence winner for Blog Writing. Vance is a real-life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.

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.

Have a column idea? See our submission guidelines here.

But the holidays are here, and that means it’s time for the second-best advertising season of the year. Yes, I know it’s all consumerism designed to make me spend my hard-earned money, but I can’t help it when the sappy music and the family gatherings come together in perfect time.

For my money, Amazon has won the winter advertising blitz two years running by focusing on products that bring joy to seniors — and pulling all the elements together to sucker us younger folks into the feelings fest too.

Many of you will remember last year’s Alexa spot, which featured an elderly couple swaying to the Flamingos’ 1958 version of “I Only Have Eyes for You.” When the music stops and the woman begins to look lost, the husband tells Alexa to play their favorite song again. And just like that, the confusion lifts and she’s remembering a dance from decades ago. 

That look of recognition is one anyone will notice if they’ve had a loved one (or a patient) with dementia. While voice command technology can’t possibly erase memory loss, music has been shown to help sustain connections. Those moments of clarity are worth more than any physical gift Santa might bring on Christmas Eve.

Yep, that one got me everytime.

So I was grateful when Amazon put out a little more uplifting holiday commercial this winter. No, we can’t buy happiness, but as Amazon would have us believe in this ad, you can surely order up a little fun online!

The ad opens on three bored-looking older women, the snow-covered scene behind them dreary and depressing as we hear the opening strains of the Beatles “In My Life.” The ladies are wistfully watching children sledding on a nearby hill, when one decides she’s had enough.

The next thing you know, she’s used the Amazon app to order three orthopedic cushions that they use to make some cheap plastic sleds a little more comfortable. The sun comes out as the helmeted women take to the hill themselves, rushing downward with full-faced smiles as children stare in awe.

There’s a memory sequence here, too, and it’s fitting given that the holidays are all about creating new memories with the ones we love.

If you really want a good cry, though, I suggest you find a quiet room and carve out five minutes to watch a new Chevrolet spot produced in coordination with the Alzheimer’s Association. This may be one of the most emotionally powerful ads of all time, though with its length, it’s not an ad you’ll see on TV often.

Steve Majoros, Chevrolet’s head of marketing, developed the messaging and committed his company’s winter ad spend to the long-format holiday piece. (Chevy is skipping the markedly less emotional Super Bowl extravaganza in 2024.)

The result is a beautiful piece of storytelling in which a quiet grandmother seems to not notice her family arriving for the holiday dinner, even when the youngest kids throw gifts in her lap.

That changes when an unlikely hero, a grumpy looking teenager with a pixie cut, grabs the keys to her grandparents’ vintage Suburban and literally drives down memory lane with grandma. 

“We talked a lot about reminiscence therapy — not that it’s a cure or a solve, but the power of music, the power of memories are things that can enable the person going through it to feel more comfortable,” Majoros was quoted as saying in a USA Today review, “and the people that are the caregivers that are surrounding them, to also feel more comfortable.”

Some folks might not appreciate the ads, thinking they’re exploiting aging and dementia for commercial gain. But for many of us, the holidays may be the one time of year we see some of our older relatives. It’s important to remember what they might be going through, and why it’s worth the extra effort to stay connected in any way we can, for any moments that we can.

For that, I’m willing to keep the tissue box handy this commercial season.

Kimberly Marselas is senior editor of McKnight’s Long-Term Care News.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.

PHCC launched the annual Adopt-a-Resident program in 2019 — going beyond the facility’s usual family gift-giving tradition and asking the local community to pitch in with donations for residents so that all of them could be included.

The results have been beyond expectations.

“This program was started to make sure that everyone gets something for Christmas,” explained Emily Mounts, director of social services at PHCC. “It’s kind of expanded into that they get a lot for Christmas.” 

Since its launch, the Adopt-a-Resident program has picked up steam in the 120-bed facility’s Princeton, West Virginia community. Churches, schools, Boy Scout and Girl Scout groups, and local radio stations have all contributed to make sure Christmas is a big deal at PHCC. 

Gifts rolling in include everything from candy and snacks, to clothes, activity books, room decorations, warm clothes and blankets, magazines, scented lotions and jewelry.

Residents will open their gifts at this year’s Christmas party — always PHCC’s biggest event of the year, according to Mounts. 

“This is a very great time for us. We really love the resident Christmas party — we talk about it all year long. We try to set aside a date well ahead of schedule and put that out in our newsletter to families so they can save the date too,” said Mounts. 

“We put a lot of effort into making sure this is something memorable for them.” 

Residents can expect to have presents delivered by Santa, whose arrival will be announced via loudspeaker. 

Christmas may not come to an end on the 25th, either. The program has grown so much that the community’s generosity spills over into helping residents throughout the coming year.

According to Mounts, any leftover gifts and monetary donations are held onto and used for residents who need help with quality-of-life issues like repairing damaged glasses or for newly admitted residents who might not have all the warm clothes and comfort items they need.

As they gear up for this year’s Christmas party, it’s a special time for staff and residents at PHCC. Mounts is confident that this year’s celebration will be another success.

“This is something that’s very special to [our residents], and that’s our main focus — making sure that they have a great Christmas,” Mounts said. “And with all the support that we’re getting, I’m 100% sure that they will.”

For more stories of nursing homes embracing the holiday spirit, see McKnight’s coverage of a facility’s special Veterans’ Day ceremony.

“National Lampoon’s Christmas Vacation” has so many funny one-liners. Remember when Clark finally gets the house lit up and each family member comments on the spectacle? When it finally gets around to Clark’s father, he is at a loss for words and all he can get out is, “It’s a beaut Clark, it’s a beaut!” Just then, Cousin Eddie shows up, and, well, you know the rest.

It’s been kind of like that this year, hasn’t it? We finally got the new MDS in all its glory and then things started to go downhill — kind of like Cousin Eddie showing up. The challenges we’ve faced with this implementation have been unprecedented and many. 

All of the prep work and long training hours hit a snag when we all began to realize that there were, and still are, issues to get used to and some that still need to be talked about. I’m thinking specifically about the unfolding changes to the quality measures and Five-Star rating now that section G has been officially retired. 

There are five quality measures that will be affected by these changes. The table below crosswalks these five measures to their GG equivalent measures. Note that measures one through four affect the Five-Star rating. 

Recently, the Centers for Medicare & Medicaid Services released QSO-23-21-NH in which it spelled out the effect that removal of section G would have on the four quality measures that will impact the Five-Star rating. 

Specifically, CMS indicated that, “Starting in April 2024, CMS will freeze (hold constant) these four measures on Nursing Home Care Compare. In October 2024, CMS will replace the short-stay functionality QM with the new cross-setting functionality QM, which is used in the SNF Quality Reporting Program (QRP). The remaining three measures will continue to be frozen until January 2025 while the data for the equivalent measures are collected.”

CMS also posted an announcement in November addressing two important impacts that this Section G to GG transition will have on the reporting of all five quality measures on the IQIES MDS 3.0 Facility-Level Quality Measure (QM) Report. 

• “… these five measures were frozen (held constant) in the iQIES MDS 3.0 Facility-Level and Resident-Level QM Reports on 10/1/2023. Starting on the first Monday of November, iQIES will process any qualifying records submitted on or after 10/1/2023 that had a target date prior to 10/1/2023 in order to provide updated measure data based on newer submissions. 
• “… MDS records with a target date on or after 10/1/2023 will not be included in these impacted measures. As a result, if the requested report period (i.e., Begin Date Range and End Date Range) in the MDS 3.0 QM Reports includes dates on or after 10/1/2023, then there would be expected decreases in the numerator and denominator due to the MDS G-GG transition.”

In addition to these notifications, CMS also released MDS 3.0 Quality Measures USER’S MANUAL (v16.0) which contains the technical specification changes to the quality measures noted above. Providers should become familiar with the revised specifications. All five measures contain striking differences that we will need to understand and get used to. 

One example of this is the current measure, “Percent of Residents Whose Ability to Move Independently Worsened,” which measured the change over time of MDS item G0110E Locomotion on unit. This MDS item was defined as, “How a resident moves between locations in his/her room and adjacent corridor on same floor. If in wheelchair, self-sufficiency once in chair.” 

The GG Equivalent Measure, “Percent of Residents Whose Ability to Walk Independently Worsened,” measures only MDS item GG0170I Walk 10 feet defined as, “Once standing, the ability to walk at least 10 feet in a room, or similar space.”  The GG equivalent measure eliminates measuring a large portion of the long-term care community who use wheelchairs for locomotion. This is not an equivalent measure and begs the question, “Is this really a useful measure for the long-term care population?” 

Another example is the current measure, “Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased.” This measure used the four late loss ADLs, Bed Mobility, Transfer, Eating and Toilet Use as proxies for declines in function over time. 

While the measure title and description has not changed for the GG equivalent measure, the MDS items it measures, again, are significantly different from what the section G items measured in the current measure. The revised QM measures the following items out of section GG, Sit to Lying, Sit to Stand, Eating, and Toilet Transfer.

You are probably as surprised as I was when I first saw this new measure. Take toilet use vs. toilet transfer for example. In section G, toilet use was defined, “…as how resident uses the toilet room, commode, bedpan, or urinal; transfers on/off toilet; cleanses self after elimination; changes pad; manages ostomy or catheter; and adjusts clothes. Do not include emptying of bedpan, urinal, bedside commode, catheter bag or ostomy bag.”

The GG equivalent toilet transfer only represents the resident’s, “…ability to get on and off a toilet of commode.” This too is not an equivalent measure and again begs the question, “Is this really a useful measure for the long-term care population?” 

These are huge changes. Keep in mind that all, but the discharge function score measure, are long-stay measures. It is relevant to remember that Section GG was developed as a standardized way to measure functional ability across post-acute care, not long-term care. It seems as if CMS is trying to pound square pegs into round holes here and it’s a bit bewildering as to why, the IMPACT Act notwithstanding. Nonetheless, preparation will be key as these new measures are phased in over the next year.

When Cousin Eddie showed up at the Griswolds to a surprised and befuddled Clark, Eddie askes “Clark, are you surprised?” To which Clark responds, “Surprised, Eddie … if I woke up tomorrow with my head sewn to the carpet, I wouldn’t be more surprised than I am right now.”

These G to GG equivalent measures are no less surprising and puzzling. Perhaps if CMS had engaged the provider community to some degree before they finalized these changes, we may not be having this conversation. But here we are. The innocence of the MDS is that it started out as a standardized way to assess residents, create care plans, and measure quality. The fundamental idea is a “beaut” — it’s the nursing process for goodness’ sake. 

These new complexities, in my opinion, take away some of the original intent. It doesn’t have to be this hard. Like the arrival of Cousin Eddie, we will have to accommodate these measures. Part of that may mean we will need to press CMS to make continued adjustments to these long stay measures affected by the G to GG transition so that they better reflect the long-term population in our communities. I hope there may be opportunities here. 

In the end, despite Cousin Eddie’s unanticipated appearance and Clark’s Christmas bonus debacle, the Griswolds were able to give Christmas to Eddie’s kids. Christmas really does embody the idea of hope. 

Amid all the changes we have had to assimilate this year, let’s encourage each other not to lose sight of the gifts we bring each day to the residents we serve. A little hope goes a long way. 

Joel VanEaton, BSN, RN, RAC-CT, RAC-CTA, is a master teacher and the executive vice president of PAC Regulatory Affairs and Education at Broad River Rehabilitation.

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.

Have a column idea? See our submission guidelines here.

I sing along loudly for all I’m worth while driving to work, thankfully with my windows up so no other driver feels the need to hurt me! (I live in Florida, and lots of people carry guns there.) 

Many of us listen to Christmas music this time of year, but do we really pay attention to the lyrics? I am not positive I ever really paid attention because when I don’t know that second or third verse, I just “la, la, laaa!” But for some reason, I actually listened this year and then was like, “Whoa, did I just hear what I think I heard?” And then, being me, I had to just start researching songs. 

I thought after the year we have all had, we all could use a laugh. As you know, dear readers, I am a bit strange, and sometimes when I hear something, it strikes me as “funny.” So let me share some of these “odd” lyrics or songs and share how my weird mind works. 

Hopefully, this will make those long shifts seem shorter and more sane!

Up on the Housetop

So yup, this is a real stanza from the song “Up on the Housetop” a Christmas song written by Benjamin Hanby in 1864: 

“Look in the stocking of little Bill
Oh, just see what a glorious fill
Here is a hammer and lots of tacks
A whistle and a ball and a whip that cracks”

And everyone wondered why little Billy grew up to be a psychopathic teenager!

Have Yourself a Merry Little Christmas

Songwriter Ralph Blaine wrote the classic song “Have Yourself a Merry Little Christmas” for Judy Garland’s 1944 movie “Meet Me in St. Louis.”

Arguably the most “downer” of a Christmas song. The composer Ralph Blane must have been in a very dark space when he wrote this song. Did you know that the lyrics originally went, “Have yourself a merry little Christmas / It may be your last/ Next year we may all be living in the past.” Talk about depressing!

So, it was rewritten by request of the filmmakers but still remained pessimistic with, “Through the years, we all will be together / If the fates allow.” Great, so maybe we’ll all be dead next Christmas? Thanks Ralph!

Baby, it’s Cold Outside

“Baby, It’s Cold Outside” was written by Frank Loesser in 1944. While the lyrics make no mention of a holiday, it is commonly regarded as a Christmas song owing to its winter theme. The absolutely worst line in this one: “Say what’s in this drink?” Because nothing says Merry Christmas like a roofie, right?

Silent Night

“Silent Night” is about the wonder of a tender and mild newborn child, written in 1816 by Joseph Mohr, a young priest in Austria. But I’m not mad at this one. I mean it is a Christmas miracle if your baby sleeps through the night. Just saying.

Twelve Days of Christmas

“The Twelve Days of Christmas” is an English Christmas carol. The lyrics detail a series of increasingly numerous gifts given on each of the 12 days of Christmas (the 12 days that make up the Christmas season, starting with Christmas Day).

The carol, whose words were first published in England in the late 18th century, are attributed to a few writers. But the lyrics and music we are familiar with were updated in 1909 by Frederic Austin.

If he were still alive today, I’d say, “Fred, it’s in need of another serious update.” If someone gave anyone these gifts (except for the five golden rings, because, come on…) no one would question you breaking up with this extravagant gift-giver. Animal and bird droppings everywhere, people leaping and dancing about, overcrowding your place. Ain’t nobody got time for that.

Winter Wonderland

“Winter Wonderland” is a song written in 1934 by Felix Bernard and lyricist Richard Bernhard Smith. Due to its seasonal theme, it is often regarded as a Christmas song. But … just who the heck is Parson Brown, and why is he going around asking people if they’re married? Seems kind of rude to me. None of your business, Parson! 

I Saw Mommy Kissing Santa Claus

“I Saw Mommy Kissing Santa Claus” is by British songwriter Tommie Connor and was first recorded by Jimmy Boyd in 1952. I say first recorded because, as you all know, it has been re-recorded by many artists. To me, perhaps the most disturbing was the Jackson 5 in 1970. I mean, these kids weren’t exploited enough to then have their hopes and dreams of Santa destroyed? Singing this song, they learned that a child is awakened by the sound of reindeer on the roof. Then there’s a sound in the chimney. Could it be? Jumping out of bed, our little child rushes into the living room, and yes! He’s real! Santa is real. And then whoa, hey, wait just a minute! Get your hands off my mommy, you bearded holly-jolly homewrecker!

Dominick the Donkey

“Dominick the Donkey” is a Christmas song written by Ray Allen, Sam Saltzberg and Wandra Merrell, recorded by Lou Monte in 1960. The song describes Dominick, a donkey who helps Santa Claus bring presents (made in “Brook-a-lin,” huh?) to children in Italy because reindeer can’t climb the hills. Wait, don’t reindeer fly? Whatever. Now, Italians have given us wonderful things, such as designer clothes, Ferraris, pasta, and pizza, but man, oh man, this song. It’s “Hee-Haw, Hee-Haw!” refrain is enough to make you want to jump out of that Ferrari. Just no.  

“Please, Daddy (Don’t Get Drunk This Christmas)”

Originally written and sung by John Denver, and then forgotten, which was good. But nooooo! Alan Jackson had to bring this one back to life. Why, Alan, WHY?? This song just should NOT exist. Period. Enough said.

The last, and absolute worst, on the list is so bad I had to attach the video.

“Leroy The Redneck Reindeer”

This song by Joe Diffie is so bad, that between the mullet, the line dancing and Santa now delivering beer and cans of oil for Christmas, I may never be the same!

May your days be merry and bright, no matter what shift you’re working or what your building census may be!

Just keeping it real (hopeful for happy holidays!),

Nurse Jackie

The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, Senior Director of Clinical Innovation and Education for Mission Health Communities, LLC and an APEX Award of Excellence winner for Blog Writing. Vance is a real-life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates. 

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.

Unlike previous years, there are little or no postings on social media encouraging comments from “friends” on what they want to ask Santa to bring them. It is almost as if making public one’s heart’s desires will some weird way influence the events of 2022 to do the exact opposite. 

It also might be that we do not know how the naughty and nice list is being defined these days. What is nice? Who knows what to say about naughty? We all know that Santa is watching but we hope from a safe distance, wearing a mask and has made plans to not drink from millions of cups of milk. Talk about a super-spreader event.

I must admit I sat down the other day and wrote a letter to the guy in red. I told him that while he hopefully knows who has been naughty or nice, he needs to have a new category. The category of showing up. You see, I want him to know that you showed up.

I am not sure he is aware of what showing up means now. I feel a sense of urgency that he understands that showing up has a new meaning. If you look at the definition in a dictionary, it states, to be clearly visible, to arrive and to be present. I am pretty sure that is what he thinks, to look for people that were visible and present. I even envisioned that he would argue that those people would be on the nice list. I wanted him to know that those who showed up this last year did so much more than that. 

I wrote to him that showing up has meant putting oneself in the line of fire with an invisible enemy that keeps changing the rules of engagement. Showing up has meant exposing oneself to the totality of the loss of life. Experiencing the sheer pain of grief. Showing up has meant to deny oneself acknowledgment of the emotional exhaustion that is continually present. 

Showing up has meant summing up the courageous strength to face each day, meet the demands and say, “I have given my best for what was on today’s menu of challenges and needs.”

Through a 25-slide PowerPoint presentation that I embedded into my letter, I presented to him that “showing up” deserves acknowledgement. Slide 20 exhibited the gifts that those in this new category deserve.  Showing up needs to be given the greatest gifts of humanity. The gifts of gratitude, compassion and love. 

Gratitude for every second that healthcare providers have given to their profession this last year and every year.

Compassion for them for all they have seen and experienced. Acknowledging their humanness. 

Love, well love is the greatest gift they have given us, and we can give back to them.

I wasn’t expecting a return answer as I know this time of the year is busy for him. But answer he did, and he wrote the following:

“Ah, I see what you are saying about those who work in healthcare. They are so much more than either naughty or nice. You are right they need their own category. I see that they are called heroes, that is true. Yet, they are more than heroes. They are truly the best of the best. I will leave the gifts of gratitude, compassion and love for them. “

“Tell them to look for it not under the tree but in the eyes of those they encounter. 

It is there for them to see. It is there.”

Martie L. Moore, MAOM, RN, CPHQ, has been an executive healthcare leader for more than 20 years. She has served on advisory boards for the National Pressure Injury Advisory Panel and the American Nurses Association, and she currently serves on the Dean’s Advisory Board at the University of Central Florida College of Nursing and Sigma. She was honored by Saint Martin’s University with an honorary doctorate degree for her service and accomplishments in advancing healthcare.

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.

‘Twas the morning of Christmas, when all through the building
No staff member was sitting, but everyone scurrying.
The residents were washed and groomed with care,
Knowing that visitors (finally) soon would be there;

No more COVID restrictions would make them feel blessed;
Grandkids would come, dressed in their best.
Mrs. Brown in her sweater, Mr. Schmidt in his cap,
With Boots, the group’s kitty, having a nap.

When out on the lawn there arose such a clatter,
I sprang from my computer to see what was the matter.
Away to the window I flew like a flash,
Tore open the shutters and threw up the sash.

When what to my wondering eyes did appear,
Our usual COVID surveyor in her car, parked so near.
I tried not to panic, tried not to be sick,
Maybe I’m dreaming, maybe it’s St. Nick!

More rapid than eagles this surveyor came,
But she smiled, and grinned, and called me by name.
“Don’t you fret, don’t you worry, no IC survey today.
I’ve come to visit Aunt Bessie, then I’ll be on my way!”

A wink of her eye and a twist of her head
Confirmed that inside I had nothing to dread;
In just a few moments some breath found my lungs,
Then off of the floor, I picked up my tongue.

Up to the units, I rounded, I flew —
With a heart full of joy, my staff felt it too.
Despite being masked, the residents joyful.
My staff, the best — all heroes, so loyal.

As I turned my head, I saw activities abound,
Carol singing, cookie making, what fun was around.

I missed seeing my kids open gifts Christmas morn.
Yes, I missed being home, but I wasn’t forlorn!
Seeing staff and residents jolly and merry,
Reminded me my calling was not ordinary!

My mouth drew up big like a smile in a bow,
You could “feel” my smile under my mask, I know!
Then I ordered some food my staff always favors,
To go with the baked treats, I hoped they would savor.

And when evening came, and I could go home;
I knew there was no better place that I’d roam;
You could hear me cry out, as I drove out of sight—
“Happy Christmas to all, and to all a good night!”

Just keeping it real (and joyful… Happy Holidays!),
Nurse Jackie

The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, Senior Director of Clinical Innovation and Education for Mission Health Communities, LLC and an APEX Award of Excellence winner for Blog Writing. Vance is a real-life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.

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.