I was 16 when I landed my first job as an aide at the nursing home across the street from where my family lived. Reporting to work in my brand new white, polyester dress uniform, I had no idea what I was getting myself into until the nurse in charge led me to a linen closet and told me to fold a stack of adult-size diapers.
It was a tough job, yet I’ve never regretted it. I learned a lot, including compassion for people as they became older and frail, and respect for the people who took care of them, who were mostly women of color. Unlike me, they worked full time. I left the job after less than a year, when I decided it would be more fun to work with my friends at the local movie theatre, but those women stayed. It was their living.
The job has changed a lot since I was a teenager decades ago—you have to get training and be certified. But a lot has remained the same too. These are still low-paying jobs, and the work is still hard. Certified nursing assistants (CNAs), as they are now called, are still mostly women of color, and they don’t get much recognition for what they do.
This past year has been hell for them. COVID-19 has taken the lives of more than 182,000 nursing home residents and workers. Although cases have plunged as vaccination rates have increased, these workers are still coping with grief, trauma, exhaustion and anxiety. Who knows what the long-term effects will be?
Mother’s Day marked the kick-off to National Nursing Home Week. Recently, I had the privilege of speaking with Cheryl Picard, executive director of Apple Rehab Clipper, a 60-bed skilled nursing facility in Westerly, Rhode Island. She and her staff planned to make Mother’s Day a day of commemoration—a way of honoring those they lost over the year and of bringing together those who loved them, including workers at the facility.
Like other nursing homes and long-term care facilities across the country, Apple Rehab has planned a series of activities this week for residents and staff to enjoy. “This is a reminder of why we do what we do,” Ms. Picard says. “We’ve been through a lot together and we’ve gotten through it. Having to deal with COVID has brought everyone closer together.”
I interviewed Ms. Picard and other nursing home administrators as part of the work I’ve been doing with the AHRQ ECHO National Nursing Home COVID-19 Action Network, a virtual community of practice to equip nursing homes with best practices, expert guidance and support for stopping the spread of COVID-19. More than 8,500 nursing homes around the country have joined this learning community.
Working on this project has brought back memories and faces of people I knew as an aide at Briar Crest: Esperanza, a spirited young Puerto Rican woman who managed the kitchen; Dorcas, a wise-cracking mother from Jamaica who worked full time caring for residents; and her frequent partner, Camille, a towering Black woman who brought common-sense wisdom and dignity to her job every day.
I remember how hard these women worked, without complaint, and how much they cared for the residents. I remember losing residents, too—it happens at nursing homes even in the best of times—and I can’t imagine what this past year has been like for today’s workers.
They deserve recognition—and much more. They deserve better pay, help with child care and transportation and paid time off to get vaccinated against COVID-19 and recover from short-term side effects, if needed.
If anything good is to come out of this pandemic, I hope it includes better working conditions and increased professional respect for our nation’s nursing home and long-term care workers.