Why Are Nursing Assistants So Poorly Paid?

By Yang, Certified Nursing Assistant

his week there has been a lot of talk in the media about the movement to raise the minimum wage to $15 an hour.  While most of the attention was focused on fast food workers, advocates for direct care workers took the opportunity to highlight the negative impact that poor wages have upon caregivers and their residents. In an article in McKnight’s, Matt Yarnell, the Executive Vice President of SEIU Healthcare Pennsylvania, pointed out that nearly one in six of the state’s nursing home workers are paid so poorly that they are forced to seek public assistance through the Supplemental Nutritional Assistance Program, Medicaid or both.

Yarnell wrote “If we are serious about providing the highest quality care for our residents, then we have to back our rhetoric with action. It means we have to provide living wages to caregivers to cut down on turnover, to not force caregivers to work excessive overtime and double shifts. It is about not forcing workers to have to look to the state for public assistance to provide for their families.”

Why are direct care workers so poorly paid? A common argument points to the low educational requirements necessary to work as a caregiver. Often this point of view comes from within the Long Term Care community itself.

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Home Care Workers Deserve a Living Wage

By Adelaide Baramburiye Manirakiza, Home Health Aide

My whole working life I have been helping people. When I lived In Burundi I worked for customs and advocated for people with HIV to be strong and to fight against the disease, and helped them learn how to protect themselves and others. When my husband died in the military, I realized that widows and orphans lost everything; we had no shelter, no electricity, and no health insurance. So I organized other widows and orphans in the army to fight for our rights. I was considered a dangerous woman by the government, so my life was in danger and I had to come to U.S. in 2007.

I have been working as a home care worker in Maine for the last 7 years. I started at $8.50 an hour, and now make $10 an hour during the day, but the agency I work for reduces my pay to $7.50 an hour for 8 hours each night because I should be sleeping. My job is to help people, and they need strong, good people who are alert and ready to help them. I don’t feel comfortable sleeping.

I work 48 hours a week, in a job that is hard and stressful, but I still don’t make enough to pay all my bills. I have MaineCare (Medicaid) for my health insurance, AVESTA for affordable housing, and have used TANF to get through hard times because the money I make through my job is not enough to cover all of our basic expenses. All four of my daughters are now in college. Sometimes I have to borrow money or get help from friends to help my daughters. Raising the minimum wage to $12 an hour would mean I could earn more to support my daughters in college and make sure their education positions them to be qualified to get paid more in this country.

Reprinted with permission from Mainers For Fair Wages.

It’s Important, Exhausting Work. And It’s $10.35 an Hour

By Nicole Hodgkiss, Certified Nursing Assistant

I’ve been working as a CNA at a nursing home in Waterville, Maine for 6 years.  I live in Winthrop with my sister, who works as a hair stylist. At my job, I take care of elderly people and residents that live on a psych unit. It’s important, exhausting work – emotionally and physically taxing.  Yet, over 6 years I’ve received a total raise of a dollar. I now make $10.35 per hour.   The wage I make as a CNA doesn’t recognize the skill or commitment that I bring to my work, and it’s obvious that there’s really no opportunity for me to move up the wage scale.  It would be impossible for me to support myself on my own or even dream of raising a family on 10.35/hour.  I’d like to go on in my medical training but I’m not sure how on a low-wage that I would be able to afford it.  I know there are a lot of women in the same situation as me. For me and for my family, a minimum wage increase to $12 (or more) would be a shot at making ends meet.  It would mean that my work, and my mom’s work (she too is a CNA) was recognized and valued.

Reprinted with permission from Mainers For Fair Wages.

Nothing Good Comes After…

By H.P., Pharmacist

Words are wonderful. They are how we communicate. When put in a certain order, words can ask, answer, elate, hurt, calm, soothe, comfort, enrage, or simply terrorize. In today’s case, nothing scares us more than these phrases, alone or, in the scariest situations, in some unholy arrangement that will leave us sleepless for weeks. I believe that a little knowledge can be a good thing. However, a little information can be a bad thing.

“I have this rash…”
“Can you look at this for me?”
“Do you have any questions for the pharmacist…?” (We should ask, “germane to your prescription”.)
“I looked it up on WebMD and they said…”
“Can you identify this?” (asked while holding an apparently clear bag)
“I saw this on Dr. Oz…” or rather anything that starts with or includes “Dr. Oz…”
Same goes for anything that includes “…ObamaCare…”

“I think I might have this rash, and I saw this product on Dr. Oz, and I need you to look at it and identify it, and is it covered under Obamacare, because WebMD tells me it’s cancer.”

Reprinted with permission from The Cynical Pharmacist.  Also on Facebook.

Honorary Grandparents

By May, Certified Nursing Assistant

It’s always strange, coming back to work after extended time off. . .anything longer than a three day weekend. I always seem to think that I’ll lose some skills (or worse, speed) when I come back. I’m not sure where I acquired this idea, nor why I hold onto it.

On the one hand, nothing changes while you’re gone: there’s still too many residents and not enough aides. The work doesn’t change. On the other hand, a lot can change in almost a week. One resident can pass away, another could fall. Mr. J can change from being a standing lift to a hoyer. The residents with more advanced dementia can forget me entirely, others assume the worst from my absence.

Take Mrs. N for example. As soon as she opens her eyes and sees me standing by the foot of her bed, an expression of pure relief floods her face.

“May, you’re back! Did you decide not to abandon us after all?” she asks, grasping my hands as soon as I set her tray down at her beside table.

I’m still worn out from the week I’ve has, so I convey my confusion about her inquiry with an ineloquent but effective syllable: “Huh?”

“You left us,” she says reproachfully. “But I suppose I can forgive you as long as you don’t quit again and leave me.”

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20 Years of Standing, Mostly 12 Hours a Day, 5 Days in a Row, Takes Its Toll

By H.P., Pharmacist

I don’t feel like my MIND is getting old, in fact, all the contrary.

I don’t think I LOOK as old as my parents did when they were in their early 40s… but I suppose that is relative.

My hips and lower back, on the other hand, well, let’s just say that being a pharmacist has taken it’s toll on my joints, primarily my hips which throb at night, and creak and pop along with my knees.

2015 was my 20th year, “on the bench!”

I blame the 12 hour days, 5 in a row, for the first 15 years of my career, standing put, on my feet for this current state.  Over the last 2 years, I have had a variety of workups, from Lyme (I was + and had the doxy), stopped a statin as an experiment, discovered L4 through S1 lower back stenosis evidenced in an MRI, XRay, bulging disc and 3 months of Physical Therapy, and epidural injection, all which didn’t help. That is an old issue.  The hip pain is new.

The hip (joint) doctor  sent me to a back doctor for those back injections. Then I went to a back doctor who said it is my hip, and she (the back doctor) did hip injections.  Sounds bass ackwards.  But, finally, I had some relief, not for long, maybe 2 weeks of relief.  In fact, the back doctor ordered more tests, and determined I have labral tears.

Answers.  That took a while.

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By Ellie McGill, Paramedic

Everyone wants to talk about overdoses these days.  My job is now not known for daring rescues and fiery crashes, but our menial contribution to a disease that has finally caught public attention.  I am baited upon meeting new people and I fall for it.  “What’s your most common type of call?”  “Have you ever been on a heroin overdose?”  “Do you carry narcan?” Ah, damn!  Next thing I know I am in a conversation about the good old days, how kids are spoiled, or ‘why don’t they all just quit?’.

One of my first calls as a student was for an overdose.  My first.  My preceptors 5000th. “Pump the brakes”  I am told. No, you won’t get to intubate this patient. At best you will finish this call and not have been punched or yelled at.

So, no, giving narcan is not news to me. Giving it on the regular in a town of 6000 residents, that is noteworthy.  That is something we’ve all noticed.

One thing I resolved to do was not “allow” these patients to refuse. Any patient who is alert and oriented may refuse care and transport to the hospital. The opposite of that is kidnapping and I’m not into that.

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Underneath our Scrubs

By Alice, Certified Nursing Assistant

Underneath our scrubs beat hearts that celebrate each success and bleed for each loss of those within our care. We know that our time with them is limited and we can not cure them. We can’t turn back the hands of time and we can’t change the situation that led them to our care. But we walk with them. We do what we can to improve their quality of life. We tell them they are not alone. We try to coax smiles from weathered faces worn down by time and experience. We listen. We translate. And when they pass, we grieve.

Underneath our scrubs are muscles that ache from running up and down halls or up and down stairs as we do the work of three people because of short staffing. Sweat runs down our face as we prioritize needs on the spot in order to provide the best care we can in an imperfect situation. Carefully compartmentalizing the very real frustration that comes from being overworked and underpaid; constantly facing impossible situations and feeling unappreciated, as if what we do is of little value. As if we are disposable. And isn’t that how those in our care feel? Invisible? Overlooked? So we run harder. Try harder. Uphill battles become our bread and butter.

Underneath our scrubs are souls of true grit. Whatever we look like, whether we wear it on the inside or out, we do not give up. Caregiving does not stop for holidays or inclement weather. It is not nice and neat. The most important and necessary tasks fall between the lists of activities of daily living. We face our own mortality every single shift. We face worst case scenarios and see the people beneath; see the strength and courage of those living through them and their strength fuels our own.

Underneath our scrubs, we are tired. We are weary. We are disgusted with the poor pay and misunderstanding of what we do and why we do it. We are tired of being dismissed. Tired of those in our care being misunderstood and dismissed. Tired of “it looks good on paper” mentalities and tired of people with little experience on the floor and no real world knowledge of those in our care deciding what is best for them without our input. We deserve better. Our residents certainly deserve better. And until we get better, we will be relentless and consistent in speaking our truths.

Reprinted with permission from CNA Edge.

Pediatric Trauma: Pedro and His Mets Baseball Cap


By Jo Cerrudo, ER Nurse

August 1997…

“This is EMS. You’re getting a 9-year old boy in traumatic arrest after a direct blow to the chest with a baseball. He’s intubated; we’ll be there in 2 minutes. ” My hands shook when I replaced the EMS notification phone.

After years of dealing with gunshot wounds and stab wounds in our Level 1 Trauma Center, I was not easily fazed, but taking care of pediatric patients scared me. I worked at the Adult Emergency Room but hospital policy dictated that pediatric traumas come to the Adult side for the initial rescue interventions. Many of the ED staff have young children at home, and cases involving kids always evoked strong responses among the parents in our group. I could almost imagine some of the parents in my staff calling on the phone for their family.

The baseball stunned our patient’s heart, and it was being squeezed to life by the frantic efforts of the paramedics who initiated cardiopulmonary resuscitation at the field. Commotio cordis describes a sudden cardiac arrest from a blow to the chest. The baseball had caused a disruption on the heart rhythm at a critical point during the cycle of a heartbeat resulting in ventricular fibrillation. The quivering heart did not produce a heartbeat. There’s a 65% mortality rate. A nightmare coming to our doorsteps.

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The Effects of Nursing on Nurses

By Grimalkin, RN

This morning, while I was giving report to the day shift nurse taking over my patients, she burst into tears.

She’s going to miss her children’s hockey play offs due to our strictly enforced every other weekend schedules. You work every other weekend, no more, no less, unless you are going to college (I work every weekend because I’m in college). She’s their hockey coach, and inevitably, each year, their last game falls on a day their mother has to work. I’ve come in early for her before.

So I offered to come in on my night off for an hour and a half so she could get to the game. I’m coming in that early because I know she won’t be done charting.

She turned me down until another day RN got involved. I reminded my coworker I only live a mile from the hospital, and it really wasn’t a big sacrifice for me. She finally agreed, and calmed down. We got permission from the charge nurse.

Nursing is one of the largest professions in the world. If you don’t know a nurse, I’m really surprised. Nurses talk a lot about the rewards of nursing. Catching that vital sign, saving lives, providing comfort, but nurses, by nature, are taught to martyr themselves on the altar of nursing.

When I was a new grad, I hated coming to work so much that I would wish I’d get hit by a car on my way to work just to get out of work. One night, while checking medication sheets, I confessed this to some experienced nurses and found out some of them still felt the same way.

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