The certified nursing assistant job “was something that I wanted to use as a stepping stone to get into nursing school,” she said. “But it just always ended up being that it was never enough pay.”
She knows she would need money saved up to afford paying for school and cutting back on work hours, but she can barely get by now providing for herself and her teenage son. “It ended up being a cycle I was unable to get out of,” she said.
White is part of a workforce that is increasingly in demand but consistently underpaid: those working in nursing homes caring for the elderly and disabled. According to a new report from the Paraprofessional Healthcare Institute (PHI) shared with ThinkProgress, nursing assistants earn just $11.51 at the median — meaning half of the 650,000-strong workforce makes less than that. The national median wage, on the other hand, is over $17 an hour. And things have gotten worse over the years, not better. Adjusted for inflation, nursing assistants’ wages have fallen 7 percent over the last decade.
White started out making about $9.40 an hour, and over the last five years she and her union have won just a handful of 15-cent raises. “By the time taxes are taken out, you don’t even notice that you’ve got it,” she said of the raises they fought and won for. “It’s not enough to live on.”
To get by, she tries to shop at places that sell nearly expired food for cheap and borrows money from family members when she has to. “When I’m done paying everything each month, I’m down to gas and a couple of dollars for groceries.”
To maximize her income, White puts in overtime and works long hours. But she worries what that means for her son, even if it might help her better provide for him. “You spend so much time working, you’re not spending the time that you need parenting,” she said. “At my son’s age — he’s 14 — this is the time you really have to make sure you’re around and planting those seeds.”
“We’re overworked, underpaid, and unappreciated,” she said.
Scheduling is a problem throughout the industry: less than half of the workforce has a full-time, year-round position, according to the PHI report, but at the same time more than half report earning overtime hours. Coupled with low pay, the lack of full-time hours means that they often don’t take home enough money to live on. Average annual income is just $19,000 a year, under the poverty line for a family of three; in fact, nearly one in five nursing assistants lives in a household that’s below the poverty line, and about half are in households making less than 200 percent of the poverty line. On average, nursing assistants earn 47 percent less than what would constitute a living wage for their region, and a third relies on public programs like Medicaid or food stamps to get by.
Lakesia Collins, who works at a nursing home in Chicago, has been doing the same job for ten years but still makes just over $10 an hour. She, too, got in it thinking it would lead to a high-paying job. Pregnant with her first son, she attended a six-week class. “At the time I needed help paying my bills,” she said. “I was thinking that because I have to take care of other human beings, I would be paid a lot of money.”
She was dead wrong. Her low pay qualifies her and her three sons for food stamps, but even that often isn’t enough to make ends meet. “I have growing boys,” she said. Sometimes she doesn’t have the money to buy them new shoes to replace the ones with holes in the bottoms. Other months she has to choose between paying the light bill and the gas bill. She often can’t send them on field trips or to fun weekend activities. “I can’t provide for them the way I want to,” she said. “It hurts me and embarrasses me that the most precious gift that I ever had, I can’t tend to them the way I want to.”
The rampant low pay has deep roots tied to who performs the work and how society sees the work itself. Nursing assistants are 91 percent female and mostly people of color — predominantly black women. Meanwhile, taking care of the elderly and disabled has long been seen as “women’s work” that was done for free inside the home. Racism and sexism have combined to keep the workforce poorly paid and poorly treated.
“Caregiving work has been undervalued historically in our country regardless of whether it’s being performed in homes, communities, or nursing homes,” said Abby Marquand, director of policy research at PHI. And, she added, “A marginalized group of people has always been doing this work [so] there’s been less urgency around improving job quality.”
The jobs are often seen as unskilled or entry-level, prompting employers to pay them less and simply tolerate high turnover rates. Yet they are difficult and require both physical and mental abilities. Nursing assistants lift, carry, bathe, and feed their clients while at the same time offering emotional support to people who might be suffering from dementia or depression.
The work is “absolutely critical, it’s the basic activities of daily living that this workforce is charged with providing,” Marquand said. “It is so important, but absolutely undervalued.”
At the same time, workers report getting little training or support. The residents at White’s nursing home face issues that “we may not be really equipped or trained to deal with,” she noted. Employees suffer abuse at the hands of their clients. Yet her employer only takes action in response to a crisis, not before it happens, and even so resorts to asking its employees to read a handout or watch a video. “I don’t believe we get the proper training,” she said.
On top of that, many nursing homes are understaffed. PHI estimates that more than three-quarters of nursing homes fail to meet the staffing levels for nursing assistants that are recommended by the federal Centers for Medicare & Medicaid.
All those factors combine to create high injury rates: nursing assistants are in the top six occupations — next to police officers, firefighters, correctional officers, construction workers, and truck drivers — for workplace injuries. Their injury rate is more than three and a half times the national average and they suffer musculoskeletal injuries — often incurred from the heavy lifting and similarly taxing tasks — at nearly six times the rate.
Collins is a young woman, but her body has suffered the consequences of this backbreaking work for a decade. “When I started when I was 20 years old, I had a lot of energy,” she said. “Thirty, and I feel like an old woman.” She washes, changes, feeds, and grooms the residents at her home while also tending to their emotional needs with counseling and puzzles to keep their minds active. “It tends to make you weak,” she said.
Meanwhile, she suffers anxiety thanks to how understaffed her nursing home is and how few supplies she and the other nurses are given. She and her coworkers will sometimes buy soap, gloves, and even diapers when the supply runs out and the owners won’t buy more.
The low pay, high injury rates, and lack of training and support all lead to an incredibly high turnover rate: the industry loses more than 50 percent of the workforce every year, even though it costs $3,500 to recruit and train each new employee. Nursing homes now report that recruitment and retention for these positions is one of the biggest challenges they face.
Those challenges couldn’t come at a worse time. There’s already 1.3 million people living in nursing homes today, and the populations that are most likely to need that care are set to grow exponentially. Americans over the age of 85, who are most likely to suffer from diseases like Alzheimer’s and need nursing home care, are projected to nearly triple in number over the next three decades. The current ratio of people ages 45 to 64 who could care for each adult over the age of 80 is expected to drop from its current level of seven caregivers to one elderly person to a low of three to one by 2050, necessitating far more assistance for people in old age.
“All of these issues are essentially coming to a head,” Marquand said. “These jobs need to stay competitive to make sure we have enough people to provide care to some of our nation’s most vulnerable.”
White and her coworkers have decided to go strike on Thursday, alongside millions of other low-wage workers in fast food, child care, and other industries, to demand better pay for their coworkers and themselves. They’ll be joining the Fight for 15 movement demanding at least a $15 minimum wage, hoping to ensure that people make enough to stay out of poverty. “We’re not asking to become rich, we’re not asking to live a lavish lifestyle,” she said. “We’re asking for bare necessities.”
Collins is also in the fight to win a living wage for all nursing home assistants. And while a $15 minimum wage wouldn’t solve all of her problems, it would get her a good deal of the way there: she thinks she’d finally be able to afford to go to school, while she could stop picking up extra shifts and instead spend the time with her three kids. “I’d be able to at least pay my bills on time,” she said. “It would take away a lot of stress on my body.”
If Thursday’s strike doesn’t get the message across, White won’t be deterred. She’s prepared to keep fighting. “If we don’t get what we want, we’ll be back,” she said. “We’re not going to make a shallow fight here…we are in the fight until we get what we deserve.”
“We’re tired of asking for cents,” White said. “Now it’s time to demand dollars.”
Original Article
Source: thinkprogress.org/
Author: Bryce Covert
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