I have been a certified nursing assistant since 2017 where I was just a junior in high school. Expanding off of this chapter, it was interesting to see how things I have experienced in five years was provided into statistics right on the page. I was lucky enough to go to a vocational high school to be able to obtain this at such a young age. In most facilities, CNAs really are the backbone of providing care to residents. I have seen first hand, especially with working in the field, but also specializing in memory care how much those individuals need us. In the podcast provided by Marketplace talking about how home healthcare workers have long hours and the wages are low.
Short staffing is an issue that doesn’t just affect those trying to get in home care. We are seeing it in hospitals, nursing homes, and assisted livings. COVID-19 also impacted the staffing shortage. I personally had to leave my job to keep my own family safe during that time. Tim Ortiz in the Marketplace podcast is a CNA that is in North Carolina where he talks about how it is difficult and challenging, but also creative. He states, “I learn every day.” This is truly the case. I can speak first hand from experiences that no day is like the one before and what our seniors have to provide in knowledge is extraordinary. They also just want someone to talk to and be present with them.
Ortiz also talks about how that his investment into his profession is “not appreciated by the system”. He has a point, in most cases it is not. I had to step away from the field entirely due to the fact that I was working closed to 60 hours a week each week working doubles between second (3p-11p) and third (11p-7a) constantly with little incentive for the dedication and loyalty I brought forward. I even willingly worked a double during a blizzard that occurred last year that even we only had one chef show up besides our department. The incentive that was given for working that period was a shirt. Yes, I am grateful, but the fact that I stepped forward as well as others for that time being and that was the appreciation given just doesn’t add up. I now work in Human Resources and the appreciation gift that they gave us for such a wonderful year was that I got to go to a Boston Bruins game last night, sit in a box with food and drinks while also having a night in a hotel, breakfast, AND valet paid for.
Part of the reason for the short staffing that is occurring is do to the fact that we are facing burnout. CNAs, Home Health Aides, RNs, LPNs, etc. are contributing these hours and making sacrifices elsewhere with little in return especially pay wise, people in these professions are starting to look elsewhere. I make more money per hour as an administrative assistant than I was working as an aide. Since 2003, the percentage of workers in nursing care facilities has decreased from 13.8% to 9.3% in 2018.
There is a vast difference between working in home healthcare to working in an assisted living to working in a nursing home. When providing home health could be simply going in as a companion or to provide assistance in activities of daily living (ADLs). Usually it can vary between just a couple of hours to through the night. Assisted livings are a 24/7/365 with nursing staff, this is to provide more independence while also having care when needed. This is still assisting with ADLs like medication, bathing, and dressing. It varies from resident to resident on their care plan, some residents need more assistance whereas other residents you may just see when they’re on their way to meals or an activity. Assisted livings are at a different standard than a nursing home, where people that need help with feeding or need more than two people to assist with ambulating are not able to be admitted. Now nursing homes are a different story, they are able to use more equipment than other facilities like hoyers to assist residents and legally allowed to assist with feeding. In a perfect world as a person would “decline” in health or progress they would move from home health care to assisted living to nursing home.
Now, another outlook to why there is a shortage is what each worker is put through. We are asked to stay later and provide more responsibility when there is a shortage. In certain facilities, you can get mandated to stay if someone doesn’t show to relieve you. In facilities, like assisted livings and nursing homes, there has to be two people at all times. Even until a couple of months ago, I would willingly come in early or stay late due to the fact that I was usually one of the younger workers and I didn’t have children. We put strain on our bodies when there isn’t adequate staffing whether it is physically, mentally, and emotionally. Even though we experience this, we are barely making enough to live comfortably. Now, I was lucky in the sense that I was a high school/college student through this will not as many expenses, but I have seen other coworkers struggle to provide for their families. HHAs/CNAs sacrifice as well as others that work in system between putting our residents/patients first, stepping up when there is a shortage, and we give up weekends and holidays to be there for them.
I could honestly provide more information and detail from not only personal experience as this has been a heated topic especially for myself for years. I am willing to have a conversation with anyone about this topic on a further extent.
Goldsteen, R. L., Goldsteen, K., & Goldsteen, B. (2021). “The People Who Provide Health Care” . In Jonas’ introduction to the U.S. health care system (pp. 84–84). essay, Springer Publishing Company, LLC.
Weekend, M. (2017). 5/5/2017: Hours are long and wages are low. Marketplace. Retrieved January 23, 2023, from https://www.marketplace.org/shows/marketplace-weekend/05052017-hours-are-long-and-wages-are-low/
Hi Ceili,
I enjoyed reading your personal take after having read chapter 3. CNAs are so under appreciated, and I want to commend and thank you for the care you have provided! I also took a CNA class in high school, and completed my clinical at a nursing home. Many of the residents, like you stated, simply wanted someone to talk to and some who cares. I do believe that there has to continue to be a conversation about paying on site healthcare workers (CNAs, ADNs, RNs, etc.) more, as well as other benefits due to the mandates, understaffing, and emotional burnout you all have to experience. Providing care for someone is not only knowledge/technical based, but to provide with a high level of empathy and compassion can take a lot out of someone and there is definitely an under appreciation. I also liked how you mention the knowledge that seniors can pass on. Often times people forget the wisdom our older folks have incurred over their lifetime. I could sit all day with my Granda and soak up her wisdom and listen to her stories. It is so important that people in this field are respectful and compassionate. Because COVID has especially put on strain on jobs, and safety measures, it is important that healthcare workers are celebrated for the sacrifices they make daily.
Hey Ceili,
Your personal insight in the field gives a great view of what help care workers are experiencing with their clients and the health care staff storage. Short staffing through COVID 19 is still on going in health care. It is hard to get a hold of nurses at doctor offices for infant formula prescriptions due to them being so short staff and multiple county WIC offices have zero nutrition working due to no one applying for open positions. The decrease in staff that you discussed is also negatively impacting on those that still work in health care because they have to make up for the work that the facility is not able to hire to fill the positions. Also due to staff shortages the quality of care is declining to having to overwork employees or not being able to give clients the attention they need or the help they need. It sad to see how the treatment of health care workers has declined over the last few years the lack of incentive to given to work long hours or even hire more staff to fill the gaps to relieve the physical and mental toll that health care workers are experiencing. The health care system needs to reevaluate their treatment, compensation and incentive of health care employees to help increase their staff and provide quality care without over working their employees until they quit.
Hi Celli – your post is spot on. Taking care of our patients is so rewarding but also difficult due to the amount of hours and really emotional strain. I have continued to use the term moral injury. We keep showing up for those double shifts, long hours because we know our patients need us and we have so few others on staff to do this. I completely agree that in return we do not get as much appreciation as we should. We see massive bonuses and pay increases to starting salaries for new hires but very little for those who have been doing these roles for years in the same facility. It has led to a good bit of turnover within our teams. I do not the right answer and not sure if we are even close to one. I totally understand why you and others leave bedside care. I too am backing away more towards an administration type role with the hopes of making changes to improve retention and reduce moral injury. Thank you for your service to healthcare. I see YOU and I appreciate YOU!
I agree with your comment, Ms. Threatt. Another profession where moral injury occurs is in education…specifically K-12 public schools. Teachers are not supported by administration, parents, or society and have been leaving in droves . Most school districts right now are running classes with substitute or permanent substitutes; not a good long term formula for building strong learners!
And as a result, the long term health (physical as well as mental) of our children is being adversely challenged by this situation.
I completely agree Dr. Bell! My oldest daughter started just last week as a 7th grade Exceptional Children teacher last week. She is completing her Masters in Education at UNC-CH in May. She comes home every day sharing stories of the substitute teachers who often struggle with children with disabilities like Autism and/or ADHD. One of them told the kids that they were destined to be homeless! This same substitute essentially walked off of the job which probably was a good thing. The schools are bringing in substitutes who do not have education training and the children are absolutely going to be affected. One of my 5 year old twins is Autistic and I cannot share enough appreciation of his teacher. She calls us infrequently to share when he is having a rough day because she fears coming across as being a complainer! We want to hear about when he is having meltdowns and the triggers so we can learn together. I tell her every day that she is truly a saint just like my daughter. Teachers deserve so much more than they are getting and it really is very sad. Teachers play a big part in the molding of our youth and really the future of our civilization. I cannot agree more with your sentiments… I will step off of my soapbox that I do love to stand on!
Hi Ceili. I really appreciate your post and for providing insight into the current situations for many front-line healthcare workers across the country. I believe our healthcare system is still feeling effects of the pandemic and it ultimately exposed how fragile it is. You did a strong job at highlighting the staff shortages of medical personnel among healthcare facilities across the country. Just last week I read an article that detailed the immense shortage of nurses and how it is causing healthcare facilities to turn to unorthodox measures to try and cover the shortage. Most departments within healthcare certainly felt or are still feeling burnout from the pandemic. However, the physical toll that is placed on nurses, CNAs, etc is a different type of burn out that only they can relate to. I also want to applaud you for making the necessary change in your career as I think it brings attention to something that I don’t think gets enough attention. The reality of the situation for front line health care workers, no matter how much you have a passion for patient care and providing the best healthcare experience possible, it gets really difficult to sustain that when your organization does not appreciate you properly. Within healthcare, even though we perform our roles because we love patient care, we are still employees who want to feel valued for going above and beyond in our duties. I think more and more employees (not just healthcare workers) are beginning to realize this and at a much younger age. In the end, it just doesn’t seem as though the work being done is not worth it, especially when we have families at home to provide. I am happy to see you in a position where you are appreciated properly and thank you for your contribution to healthcare.