The Arbitrator

Miss Prater enjoyed a long career. Fresh out of nursing school in her twenties, she began her employment at the Sunset Manor, now renamed Sunset Village. She insisted on keeping the moniker “Miss” well beyond when trendy first name references replaced gender titles. Her employees always knew the ropes so they could toe the line. They not only learned their daily duties and mandatory protocols but they knew to always error on the side of service. “These are precious human beings,” Miss Prater emphasized early in her career. “Always treat them with the utmost respect.”

At the unprecedented young age of 34, Miss Prater became the head nurse of the nursing home, now properly referred to as the Assisted Living Wing. She also helped establish a Memory Care Unit for those residents who presented a risk to themselves or others because of their unstable or deteriorating mental capacities. Though technically the doctors’ job to send a resident needing extra care and confinement to the Memory Care Unit, Miss Prater decided who should go and when. Many family members of the residents, some nursing staff, and even doctors occasionally disagreed with her assessment, but she always stood her ground and arbitrated successfully for her selections.

Thus, she became known by her staff (behind her back) as Miss Prater the arbitrator.

Her controversial position garnered plenty of work floor discussions. “She is so bossy. Always has to have the final say.” “It’s about time. Mr. Peterson should have been out of here a year ago.” “I think she pulled the trigger a little early on poor ole Patricia. She wasn’t hurting anyone.” “I feel so sorry for Eddie. He’s going to feel like he’s in prison now.”

But Miss Prater didn’t allow the rumors to dampen her resolve. She knew her role, and she knew her patients. “Patients” is what she called them, even though that term became politically incorrect. These “residents,” as the board of Sunset Village insisted on calling them, were all dying, Miss Prater knew—some in the natural twilight of their lives, some from physical diseases or overused body parts, and some from dementia or other mental disorders. Her responsibility, as she saw it, was to see that the facility that housed these patients ran as smoothly and shrewdly (when necessary) as possible. This involved making tough, sometimes even heart-wrenching, decisions. But she vowed to do this professionally, joyously, and efficiently. Compromising was inevitable. Whether she compromised her patients for her business more, or her business for her patients, who could tell?

Those patients with extreme memory deficiencies presented significant problems for the Assisted Living Wing ecosystem. Though difficult to accept, the need to separate those patients with severely impaired judgment from the others forced the formation of the Memory Care Unit. Once there, these patients conveniently no longer concerned Miss Prater.

But someone had to decide which patients needed to be weeded out from the Assisted Living Wing. Miss Prater realized early on that the person making this decision should be the most prudent, most aware, most gracious arbitrator possible. The task suited her.

To add levity to these formidable assignments, Miss Prater marked each person’s file she sent to the Memory Care Unit with an FF. Humored by her own tagline, none of her employees ever guessed what the silly designation referred to. Though they often questioned her about this strange practice, saying things like, “They must have really flunked to get a double F,” the head of nursing never revealed her secret. They all just knew that “FF” meant the resident so denoted no longer belonged in assisted living. This inside mystery tickled the unmarried, unmatched Miss Prater.

Throughout the years, Miss Prater prided herself on her sound decisions. She never waited too long before sending an at-risk patient to the Memory Care Unit. Her spotless record covered even the most challenging scenarios.

Once, a Mrs. Beverly was the primary caregiver of her stroke-victim husband. She bathed, fed, and changed him around the clock. Her tireless emptying of herself for her partner of 58 years impressed everyone… until the staff noticed her increasing forgetfulness. She misplaced her purse. Then she lost her clothes, which were in the oven. When similar events became her new normal, Miss Prater took notice. Though Miss Beverly still possessed the strength to lift her ailing husband in and out of the bathtub, when she forgot that she had situated him in there one day and the water overflowed, flooding the Gehrig’s unit below, Miss Prater knew she had to send the forgetful caregiver’s file, marked with an FF, to the Memory Care Unit. Mr. Beverly then required around-the-clock care from her staff.

Mr. Pritchard was a kindly soul. He walked the corridors of Sunset Village greeting all with a pleasant “Howdy-do.” When his daily jaunts no longer included his cheery salutations, Miss Prater went on high alert. Oddly, numerous women residents complained that their underwear began disappearing around this time. Upon learning that the laundry personnel found ladies’ panties in Mr. Pritchard’s underwear drawer and brassieres in his sock drawer, his gig was up. Miss Prater confronted the pilfering patient. He told the arbitrator, “They wanted my wife to have them.” His wife had died twelve years prior. Miss Prater knew his memory had left the station.

Calhoun, as he was called, never stole a thing in his life… until he stole one too many peeks in inappropriate places. A helpful gentleman when he first arrived, he used to help ladies to the dining hall, open doors for those needing assistance, and continually asked the staff how he could help them. Such unheard-of, courteous behavior enamored the staff. But then he began asking, “Do you need help?” a little too often in too many indiscrete places. Screams from uninviting hosts began occurring regularly and the nursing staff would need to rescue the screamers by chasing the unsuspecting Calhoun from their premises. Though Miss Prater the arbitrator was convinced he meant no harm, the peeper’s actions nevertheless warranted an FF and a move to memory care.

In such cases, when the patient lost discernment but not their gentle demeanor, Miss Prater told her nurses, “We are caring not just for the patient, but for all of their neighbors. When others’ fears surpass one’s good intentions, it’s time for the troublemaker to go. Safety first.” Loosely translated, her staff recoined this to mean “Don’t let the inmates run the asylum.”

Diedre loved traveling. She often told the other residents about the sights she’d seen and the adventures she’d delighted in in her youth. As her stay at Sunset continued, her restless feet yearned for daring new territories to explore. At first, they found her in the garden alone, smelling the petunias and admiring the rose bushes. Then they found her in the parking lot, noting the American-made cars. But when the local burger joint down the street called the police regarding “a lady crossing the busy street in front of our establishment,” Miss Prater knew the lovable adventurist needed to follow a new path to the Memory Care Unit.

Diedre’s relatives argued that it was Miss Prater’s fault Deidre escaped, insisting that her staff should have been watching the rambler. But Miss Prater the arbitrator held firm because such babysitting demands required greater care.  A locked door in the Memory Care Unit was a start. FF.

Though tempted often, Miss Prater never erased those unsavory patients from the Assisted Living Wing who appeared to exist for the sole sake of annoyance. “I need another drink,” Juanita said after every meal. “Give me another drink.” When the wait staff provided her with another water, or tea, or milk, she’d rail at them. “This isn’t a drink. This is a kid’s drink.” Every meal they’d have to talk her down.

Complainers wore the staff thin. But arguers rubbed many a helper raw. Warren argued about his medicine, his room temperature, the TV channel, and the weather if the listener would bite. But the head nurse refused to mark his file with an FF. “An abrasive personality does not qualify as a memory issue any more than being ugly does,” she reasoned. “Likeability is not a risk factor.”

Haters, however, wore even Miss Prater’s patience thin, tempting her to give in to her baser tendencies. Irma, in particular, liked to get the head nurse’s goat. She would say, “This place smells like a pig sty. Are we a bunch of animals around here? I’ve seen chickens dressed better than these rag dolls working around here. You’re a miserable excuse of a nurse boss.” Miss Prater always responded with kindness to the angry woman’s jibes. “We’re doing our best to serve you, Irma. I hope you find it in your heart to forgive our imperfections and try to bless someone with your words today.” Irma usually growled and said something like, “When hell freezes over.”

To her credit, Miss Prater never sent a patient packing with their FF papers for inappropriate reasons. She was proud of her flawless arbitrating record.

…Until Ronaldo came back from memory care to the assisted living. He passed all the appeals required for such a reversal. And to complete the aberration, the Memory Care Unit staff agreed that this haphazard dresser was closer to brilliant than demented. On more than one occasion, Miss Prater had found Ronaldo wearing two different shoes. When he came to the dining hall without his pants, she marked FF on his file and never second-guessed herself. But she did not know the physicist had a history of similar clothing debacles. She failed to read his entire file—something she had never missed before.

When Ronaldo returned to the Assisted Living Wing, the staff looked to Miss Prater for her reaction. Never, in her thirty years as head nurse, had she ever inappropriately sent a patient to memory care. She initially reddened and turned to leave when she saw him face to face. But then she halted. Her lungs expanded, and she turned back to look the renewed patient in the eyes. “I’m sorry, Ronaldo,” she said. “We’re glad you’re back. Don’t hesitate to ask us if you need anything.”

Ronaldo squinted his dubious eyes. “If you could just let me know when my attire is missing an accessory, I’d appreciate it.”

Miss Prater smiled. “We can do that.”

Life at Sunset Village went on as usual, with some patients finding their way to the Memory Care Unit, and some receiving general assistance as needed.

Then another patient came back from the Memory Care Unit. Then another… and another. The last wrongly accused resident wanted to know why she had been so abused.

Miss Prater swallowed hard. She could not remember. She looked at the chart marked FF before her. “Um… Dorit…” she tried to look her in the eyes but could not. “It appears that we thought you were talking incessantly about arbitrary TV shows.”

“Arbitrary?” Dorit frowned and nodded her head, convinced. “Well, excuse me! I’m sorry I don’t have anything to do but watch my soap operas. I take an interest in something and you send me off to the crazy bin. What, am I supposed to be a wallflower, so I don’t rub anyone the wrong way?”

“No, of course not. You be you. I’m sorry. This should have never happened. I’m not sure how it did happen, frankly. But I’ll be looking into it.”

“Well, make sure you do,” said the agitated old maid. “I think there’s a whole lot of others around here that should go to that place before me.”

Later that day, a board member asked to speak with Miss Prater. “Are you feeling okay, Miss Prater?”

Miss Prater said, “Well, I’m not sure.”

“You’re not sure?”

“I seem to be making some uncharacteristic mistakes.”

The younger gentleman nodded. “We’ve noticed.”

“I’m sorry. I’ll have to… think things through a little better. I…”

“When’s the last time you took some time off, Miss Prater?”

“I don’t remember.”

The man in the suit said, “Maybe it’s time to start thinking about retirement.”

Miss Prater winced. “Retirement? I’m not old enough to retire?”

“How old are you?”

“I’m 52.”

The board member looked at her patiently. He looked down at the file in his hand, then handed it to his favorite employee. “Miss Prater, you’re 64. You’ve worked for us for over 40 years. There’s a great severance package in there to go along with your retirement. You’ve made this place the best nursing facility in the state. We’re beyond grateful. As you have been to us, we are Fully Faithful to you.”

She received her file which said “Fully Faithful” on the front. Speechless, she watched him walk away. Inside the folder, she found a large severance sum to be deposited in her bank account, her retirement papers, and all the accolades from the board members for her years of service.

She sat at her desk and slowly closed the file before her. Fully Faithful. The Fs were exaggerated. She couldn’t help but see the irony. “FF.” She tried to remember what that meant. Why had she earmarked those patients’ files FF? There had been a twist of humor to it, she knew. But what? What was so funny about sending a respectable person to a memory unit? As hard as she had tried to run the elderly care facility smoothly, humanely, and efficiently (and okay, shrewdly when necessary), even she treated the residents as numbers… as diseased… as patients—not fully human.

Now she was designated “FF.” F-F. She couldn’t remember what that stood for. Fully Faithful was not her meaning. But what was it? Failed? Flawed? Forgetful? Forgotten? No.

Then it hit her. And she saw no humor in it. For, her destination was likely the same as all those people she had sent away from her pristinely run facility. She, too, was headed for the Funny Farm.