Wages and Compassion




The issue of low pay comes up frequently on the CNA Facebook pages. While it is widely accepted that caregivers are underpaid, there is a counter theme running through these discussions that can be summed up thusly: “It’s not really about the money, we love what we do.” In and of itself this is a commendable sentiment and without it long-term care could never hope to find and retain enough workers. It’s difficult enough as it is.

Some take it a step further and claim that if you seem too concerned about what you’re getting paid, it’s an indication that you lack compassion and you shouldn’t be working in this field at all. As if compassion isn’t possible without self-sacrifice and that talking about money only taints the nobility of what we’re doing. That in fact, we should feel ashamed to expect more.

I reject that notion. As a CNA, you should never be made to feel ashamed simply because you recognize that you’re underpaid for the work you do. While the work can be fulfilling on a personal level, it has value beyond the emotional benefit you receive from it and you have every right to be compensated accordingly. There is nothing about expressing that opinion that means you’re less compassionate and caring then those who happily accept low pay. And it doesn’t mean that you’re there “just for a paycheck.”

The idea that we must be willing to sacrifice monetarily to keep our motivations pure is actually a form of backdoor egoism. It puts the focus on us and our motivations and intentions. The real value of what we do derives not from what we sacrifice or why we care, but from how the residents experience the care we provide and the quality of our interactions with them.

Some would argue that it is not possible to create quality care and interactions without the “purer” kind of motivation. I submit that there is nobility in working hard to support your family – and yourself – and that things such as a sense of duty, an awareness of the value of the individual and a profound respect for the trust you’ve been given are powerful motivations to excel as a caregiver, quite apart from one’s willingness to struggle with an inadequate income. 

To be sure, there are disaffected caregivers who look at our work according to George Carlin’s dreary dictum: “Most people work just hard enough not to get fired and get paid just enough not to quit.” But it’s a mistake to lump those of us who expect to be paid fairly for an honest day’s work in with those who skate by doing as little as possible.

One problem is that we are confusing two separate issues. Let me put it this way: once I walk through that door to go to work, the residents are going to get the same commitment and same level of care from me whether I’m making $8.00 an hour or $20 an hour, but to get me through that door in the first place is going to take something closer to the $20 then the $8.00. Some high-minded caregivers would regard the second part of that as a kind of blasphemy. 

Some are concerned that higher wages would result in retaining workers who really don’t care that much about the residents. The logic here is baffling. Workers can be dismissed or otherwise disciplined according to their performance regardless of what they’re getting paid. The real problem is that on one end we constantly lose good workers who leave for better wages and on the other end employers are left to hire from a smaller pool of candidates. It’s a bad combination.

The reality is that most caregivers who work in long-term care need every single penny they can get. They give so much of themselves every day and while society can nod and smile and call them angels for the wonderful work they do – or alternatively, demonize them based on media reports – the system they work for does not deem their contributions significant enough to offer adequate compensation. Some are paid just above minimum wage. Many work second jobs or put in several hours of overtime each week just to help make ends meet. “Fortunately,” there is plenty of opportunity for overtime due to a chronic shortage of direct care workers – see the preceding paragraph.

The combined effects of long hours, physical and emotional stress, and financial struggle can wear down a caregiver often making him or her feel used and used up. As if the system regards its front line workers as disposable. That’s the real shame.

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