Category Archives: low pay

All about the money…except it’s not


The world of long-term care is changing. CNAs are no longer a silent workforce, an easily replaced part of the machine inside healthcare, and labeled “ass-wipers” outside. Earlier this month, CNAs around the country raised their voices together for better pay. For the most part, the response to this was positive.
And yet, there were still seemed to be some who were blindsided.
“Where’s this coming from? You said you weren’t in this field for the money!” “So I guess money is what you care about after all.”
“If you want real money, get a real job.”
Even worse, I think, are the unspoken accusations: a good, selfless CNA shouldn’t be concerned by how much money they make an hour. A good and selfless CNA isn’t in this for the money.

You see, it’s not really about the money. It’s about what the money represents: respect. Call us angels or ass-wipers, but still we are shoved under the rug, forgotten in the corner. But we do not stand alone. Behind every stressed out CNA there are 10-20 residents. People who are soiling themselves because there are not enough aides on the floor to meet their needs in a timely fashion. People are often quite aware that their needs have been placed very low on society’s priorities.

“But with the current pay and workloads, the job is still getting done!”
I hear this one a lot. It’s true, I suppose: CNAs work jobs that have pathetically low pay and where they have to care for over a dozen residents by themselves.
The workloads go hand in hand with low pay: we’re often paid a less than living wage to do the work of two or more people. But fewer people are willing to do this anymore. There’s a CNA shortage, and a turnover rate that is mind boggling…well over 50%.

So many of us work multiple extra shifts a week or struggle just to keep our families fed. It might seem an “acceptable budget measure” to keep the pay and staffing low,but I assure you, it is not “acceptable” on the reality of the floor. You cannot give from emptiness and there is little as draining as exhaustion and stress. And yet we are still expected to provided the best care or else…here come the ambulance chasers. Here come the lawsuits and state complaints.

Policy makers, I’m speaking to you personally. If you truly believe that excellent, personal care can be provided to 12+ people by an exhausted, stressed out and fiscally struggling caregiver…come be my resident. Come live in the world you have created. Come be my resident, dependent on me for everything and having to share me with 12+ other people. Tell me then that below average pay for caregivers is an “acceptable measure”. Tell me then that my residents are not worthy of enough respect to give their caregivers a living wage and good working conditions.
Tell me then that pushing for higher wages is a sign of greed; that pushing for better resident-to-aide ratios is a sign of laziness.

It’s not about the money. It’s about what the money represents: respect. Respect for me, for my chosen field…respect for the elderly and disabled that I care for. They are worthy of having a caregiver who isn’t scrapping by. They are worthy of having a caregiver who isn’t a few double shifts away from having a nervous breakdown. They are worthy of my time and they should be worthy of the money it will take to give them proper and personal care.

Why are CNAs so Poorly Paid?





This 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 a Wednesday article for 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.

It’s true that the technical skills of a caregiver can be taught relatively quickly. Things like the principles of basic hygiene, taking vitals, infection control practices and proper body mechanics are pretty straightforward and don’t require a lot of advanced study. However, while formal training serves to create a basic necessary skill set, the real education for a caregiver doesn’t begin until he or she starts working with residents and fellow coworkers. The art of caregiving is learned through a combination of practical experience and mentoring from other workers. For those open to it, this is a learning process that can last the duration of one’s caregiving career.

The real value of experienced caregivers cannot not be found in their technical skills – or in anything that formal education could provide. Rather, it is in their capacity to perform well under difficult – often unreasonable – circumstances without losing their basic sense of humanity. It can be found in their ability to engage residents on an emotional level while under the duress of constant time restraints. It can be found in their willingness to support and sometimes lead their fellow coworkers in an environment that lacks adequate formal supervision. It can be found in their desire to serve as an example of how one human being should treat another without regard to roles or circumstance.

Good caregivers have a monetary value to the Long Term Care industry beyond what their technical skills and education can provide. The industry could not exist in its present form without their effort and caring. CNAs are truly the backbone of LTC. And their heavy lifting does not always involve transferring a resident.

The real reasons why caregivers are so underpaid are rather complex and go beyond educational requirements or even greedy nursing home operators. It is a very real social problem with direct implications to the well-being of our elderly and disabled citizens and should be treated as such.