Caregivers demand a role in fixing nursing homes

A caregiver walks with her patient down a nursing home corridor. (Photo: GagliardiPhotography, via Shutterstock)
Numbers tell one story of COVID-19’s toll on California nursing homes: Some 9,716 nursing home residents and staff died from the virus, amounting to one in eight COVID deaths statewide.

But there’s another story that can’t be told in numbers. It’s the story of what it was like to work in the pandemic’s most dangerous conditions: the stress, the fear, the heartbreak. It’s a chapter in California’s history that nursing home workers like me are determined to never repeat — and why we are demanding transformation of the industry that puts us at the table.

Caring for the elderly and people with disabilities in nursing homes isn’t for everybody. This work puts demands on your mind, your spirit, and your health.  Most people don’t know how common injuries are among caregivers.

It’s common to hurt your back, for example, moving residents’ bodies to change them, to help them from a bed to a wheelchair, or to bathe them. It’s especially dangerous when you are in a rush. And in a nursing home means you are always in a rush – because nursing homes were understaffed long before the pandemic.

Caregiving is also a job largely done by women who look like me: Black, Latina and immigrant women. For generations, nursing home owners have kept wages low by exploiting the labor of women and people of color. In the pandemic, these poverty wages became deadly because workers who must work multiple jobs to make ends meet unknowingly carried the virus from facility to facility.

That’s just one of the heartbreaking lessons we learned over the last two years. Knowing residents died without being able to see their children or that they died alone because there are too few staff to care for them weighs on me today. I’ve cared for as many as 50 patients at one time.

For many of my colleagues, the stress, the risks to our health, and the emotional toll of the pandemic – combined with poverty wages – were just too much to take. Sixteen thousand California nursing home workers have left the field since the pandemic began, and more than half say they are likely to walk out in the next year.

You can’t understand what it’s like to do this work without being on the nursing home floor. And that’s why nursing home workers like me have to have a meaningful role in overseeing this industry.

Last week, I went to the state Capitol with dozens of other nursing home workers to remember the colleagues and residents we lost to COVID-19 and to make sure the kind of devastation we experienced never happens again. Hundreds more rallied at nursing homes across the state with the same message to legislators: nursing homes are in crisis, and California can’t fix them without nursing home workers.

We are proposing a Skilled Nursing Facility Quality Standards Board, a formal structure where workers sit down at the table with nursing home owners, advocates for patients and families, and government agencies to create rules governing this industry.
Only when workers have a real voice in governance can we stabilize the workforce with better wages, benefits and training and implement standards to keep workers and residents safe.

At the same time, we are calling for action on two unsustainable and destructive trends in our industry. Nursing home owners have taken billions in taxpayer dollars meant to improve care, but instead lined their own pockets. And state regulators are handing out staffing waivers like candy – essentially giving nursing home owners a free pass to evade the minimum staffing rules.

California needs to tie public dollars to nursing home quality and workforce improvements, and enforce safe staffing standards that are directly tied to quality of care.
It comes down to this: Workers need to be valued and respected so we can do the jobs we love and the jobs that matter. Nursing home care must get better, and only workers who’ve lived it can lead the way.

Editor’s Note: Jesus Figueroa Cacho has been a Certified Nursing Assistant for 25 years. She works in Auburn.

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