LaToya Francis, 34, a certified nursing assistant, has, in the eight years she has worked at nursing homes, been yelled at, kicked at and had faeces thrown at her for little more than the minimum wage. She endured it but is not sure she can hold out much longer.
As the omicron variant of the coronavirus drives record staff shortages at nursing homes in the United States, Francis has increasingly found herself alone on her 12-hour overnight shifts at Bridgepoint Healthcare’s skilled nursing facility in Southwest Washington, fighting off panic attacks as she tries to feed, clean and rotate more bed-bound residents than she can handle.
“I’ve never, ever felt this disrespected,” Francis said.
Frustration is surging among the low-wage workers who make up the backbone of America’s nursing home industry, as tens of thousands of their colleagues call out sick with covid-19, inflaming shortages that already were at crisis levels. Hailed as “heroes” during the early months of the pandemic, these workers, most of whom are women and people-of-color, say they’re facing untenable levels of pressure.
According to the U.S. Bureau of Labor Statistics, the nursing home industry has lost more than 42,000 jobs since the start of COVID, reducing its workforce to the size it was 15 years ago.
Some employees chose to retire early rather than face the intense workload and coronavirus risks at their jobs. Others have been lured away by companies, including Amazon, that offer wages which nursing homes say they cannot compete with.
At community colleges, interest in skilled nursing courses has plunged, with some class sizes dropping to half what they were before the pandemic. Of those training to become nursing assistants, many are avoiding nursing homes, where they would earn a median annual wage of $30,120, according to federal data, and are looking instead for jobs as travel nurses or home health aides.
With what the U.S. Census Bureau calls the “gray tsunami” looming, with all baby boomers — a take-off base of more than 70 million people — set to be at least age 65 by 2030, officials say that workers such as Francis are essential but underpaid and overworked.
“This is a crisis on steroids,” said David Grabowski, a Harvard Medical School researcher who studies the economics of aging and long-term care. “The long-standing issue of underinvesting and undervaluing this workforce is coming back to bite us.”
The District of Columbia, Virginia, and Maryland have reissued states of emergency to ease the nursing staffing shortages, including by extending the expiration dates for nursing licenses and allowing nursing graduates to start work more quickly.
Neely, who previously worked 30 years as a housekeeper, said she passed the virus on to multiple members of her family in the fall of 2020, when she decided the nursing home job wasn’t worth it. “No one wants to stay for the money that they’re paying,” she said.
Davis, who was a cook for 19 years, said she’s passionate about caring for older adults but grew sick of spending vacation days working because her supervisors were taking months to replace employees. Davis said what she grew to resent was the inequity. Nursing home workers are the lowest paid in the health-care industry. “Whether you scrub the floor in a nursing home or cook the meals, it matters,” she said. “It matters to the residents.”
Grabowski, the Harvard researcher, said the low pay for nursing home workers partly reflects the type of work and the type of worker that the country values. “There’s some ageism, classism and racism at work here,” he said.
In an ideal world, Francis said, she would be working during the day and taking classes at night to become a registered nurse. Other registered nurses had told her she’d be great at it, and she knew she would be, too. But she couldn’t afford the time or the money, so she was stuck, she said, in a job that felt impossibly hard but far from “heroic.”