Once she made her mind up, Billie Jo Mleko had no doubts. She was going to become a nurse.

Beginning at a young age, Mleko was surrounded by nurses. She was born with aortic stenosis, which eventually called for an aortic valve replacement with a mechanical valve. But during that nerve-inducing time, Mleko found comfort in the staff that helped her through.

“That was a huge event in my life, and it was very scary,” she said. “But the medical staff that was with me, just hearing them say ‘You’ve got this’ … and really explain to me what’s going to happen … it turned something that was so scary and so petrifying —which it was; no matter what you say, it’s always going to be scary — but it lessened that, and it gave me the courage and the hope to be like, ‘Okay, I’ve got this. I can do this.’ And that was huge.

The impact of that medical staff is what influenced Mleko to join one of her own and do the same for others. Now, she is a psychiatric certified nurse who has been impacting lives at Southwell Medical in Adel, Georgia, for seven years.

“(These patients) were very hard-working individuals. They had careers, whether they were farmers or homemakers. …They worked, and they’ve been through a lot in their lifetime. Now that they get to this point in their life where they’re not able to do for themselves as much anymore,they need somebody to be there for them and to help them.” — Billie Jo Mleko

Though she had worked in the medical surgical and emergency units previously, Mleko found herself in the geriatric psychiatric unit about three and a half years ago. Since then, she’s become immersed in the care of people from a generation different from her own.

“(These patients) were very hard-working individuals,” she said. “They had careers, whether they were farmers or homemakers. … They worked, and they’ve been through a lot in their lifetime.Now that they get to this point in their life where they’re not able to do for themselves as much any-more, they need somebody to be there for them and to help them.”

While a lot of the responsibilities of geriatric nurses include typical nursing duties, such as basic care, assessments, planning, and communication with families, much of it also involves caring for patients’ mental health. For Mleko, these type of interactions and therapeutic interventions are the best part of the job, whether they’re coloring or playing Jeopardy.

But it’s not always fun and games, and sometimes patients just don’t want to get involved. They may take a break, but when they do decide to participate, Mleko remains positive and encourages patients to keep going when they need it most.

“They’re calling out answers for Jeopardy or different games that we do with them, and we’re like, ‘Wow! Look at that! She’s getting them all right!” she said. “We tell them, ‘Good job.’”

That day-to-day progress for these patients is what’s most rewarding to Mleko.

“Dementia is a progressive disease,” she said. “So, what I always tell families is that we want to get them to the best that they can be at this point. Now, whatever that is for that patient is going to be different for each one. But when you see the families come to visit them, and they can tell that they’re doing much better or that they are remembering them a little more (or) they’ll have conversations with them, and they’ll feel like they got their family member back.”

Sometimes, however, these patients’ best isn’t ideal, and that’s what makes Mleko’s position difficult. When medication adjustments and interventions have been exhausted, the staff may have to simply conclude that it’s already “as good as it gets.”

“That’s kind of hard to accept sometimes,” she said.

No matter the situation, Mleko carries important advice that has helped her throughout her career: Whether patients with cognitive disabilities and issues respond or not, always speak to them.

“Let them know you’re there, let them know what you’re doing, and always be aware that they can hear you,” she said. “And sometimes they do understand more than you realize, so always be very conscious of that. And that can be true in a lot of different nursing settings, maybe in ICU when patients are unconscious and whatnot. Always talk to them and still give them that respect and dignity to make them aware.”

While Mleko has learned a great deal about caring for others, the biggest thing she has learned is how to care for herself. According to Mleko, patients deserve the best from their nurses, and that can’t come from an empty cup. Proper self-care can help keep the cup full. And when Mleko’s cup is full, there’s much to give.

“Let them know you’re there, let them know what you’re doing, and always be aware that they can hear you. And sometimes they do understand more than you realize, so always be very conscious of that.” — Billie Jo Mleko