CNA’s and STNA’s living below poverty level

CNA’s & STNA’s are among the lowest paid workers in the healthcare industry, yet they face some of the highest rates of injury and illness. And when the pandemic hit, Covid 19 really enforced the need for many of them to reconsider their positions. This has had the backlash of an even bigger burden on an already short staffed workforce.

“U.S. Census Bureau Releases 2019 Population Estimates by Demographic Characteristics

JUNE 25, 2020 — The U.S. Census Bureau today released estimates showing the nation’s 65-and-older population has grown rapidly since 2010, driven by the aging of Baby Boomers born between 1946 and 1964. The 65-and-older population grew by over a third (34.2% or 13,787,044) during the past decade, and by 3.2% (1,688,924) from 2018 to 2019. The growth of this population contributed to an increase in the national median age from 37.2 years in 2010 to 38.4 in 2019, according to the Census Bureau’s 2019 Population Estimates.”

*65 and Older Population Grows Rapidly as Baby Boomers Age (

Consider this….why do people go into care? Typically it’s because the family can no longer handle the load of caring for a grown adult with multiple health conditions. For instance, grandpa wanders off in the middle of the night. Or it’s a matter of not having the physical strength to take grandma to the bathroom. A lot of times it’s because people have to work and they can’t be in the home to care for them. Sometimes their family member is violent and they can no longer handle it. Other times…they simply have no family. There’s an endless list of reasons why someone may enter care. At the end of the day, it boils down to one person cannot handle it on their own.

And yet an STNA or CNA (both the same thing but the title changes based on the state you live in), are often times required to care for ten to forty grown adults based on the facilities staffing. The laws in place to protect them from physical injury are typically thrown out the window. “Oh…that person’s a two assist transfer? Sorry we have no staff and the nurse is busy”.

Injuries ranged from cuts and back injuries to black eyes and human bites, and resulted from a variety of causes, including lifting, bathing and handling residents; resident aggression; and accidents involving facility equipment.

CNAs in Nursing Homes experience High Risk of Work-Related Injuries | RTI

Picture this: You’re trying to wash up a resident. They are extremely confused, they weigh maybe 250 lbs and carry a contagious illness or a virus. Prior to you getting in the room, they have dug into their brief and now have feces beneath their fingernails. As you go to turn them over to wash their peri area, they reach out and claw through your arm scratching beneath your skin.

Here’s another: The resident is Hep positive, very confused and it’s your job to feed them. Upon tasting the mashed potatoes, they’ve decided they don’t like them and spit them out in your face.

Or maybe try this one: Family brought dad in because he’s extremely combative and can no longer handle his brutal assaults. He’s put on the unit to be cared for by whichever CNA/STNA has that set for the day. The aide who weighs around 110 lbs, now is tasked with caring for the 200 lb man. Fully undressing, bathing and redressing him…all while he’s lashing out and taking swings. If she walks away to keep herself from being harmed and family comes in to visit…the first question they inevitably ask is: “Why isn’t my dad wearing clean clothes? That’s why I brought him here so it would get done!” The family not taking into consideration that not only is that one aide tasked with handling the one man that they could no longer handle, but yet another 20 just like him in the same hall. While law requires frequent check and changes, every two hours to prevent bed sores…there is never enough staff or time to do so.

Yet oddly enough, the people taking on these long hours, excessive staff to resident ratios and physical injuries often cannot even AFFORD health insurance?!?! The same people caring for others on a daily basis, are neglected in their own needs. Many live below the poverty line, even qualifying for food stamps. Some have to frequent food banks in order to put food on the table. They’re typically treated as the low man on the totem pole. I’ve actually heard the words “they wipe asses for a living”.

STNA/CNA’s are predominantly female and minority. And years back, I truly didn’t grasp the whole fight for equal pay issue.

Over time…

I opened my eyes.

The truth is, if this were a male dominated job, the pay would be a lot higher. I’ve asked several men over the past few months if they would want the job, the response was the same “hell no”. That said, there are still men who do work as STNA’s and CNA’s all over the country, but it’s very few in comparison to their female coworkers.

And when everything went dark back in March 2020 and these workers were faced with COVID 19, they had no choice but to work through it. Their jobs were essential with the greatest amount of contact with Covid infected individuals. People didn’t just stop needing personal care due to Covid. And dementia units were filled with contagious adults who simply could not grasp the need for a mask. Six feet apart does not apply to the nurse aide who needs to feed and change them. It’s virtually impossible. And yet, McDonalds workers were making more then these workers who were actually working in Covid filled nursing homes. That’s not to say that McDonald’s was/is wrong. People deserve a livable wage. But look at the absolute insanity of the pay these healthcare workers receive. 12$ an hour to maybe 15$ an hour? And don’t by into the ads you read on Indeed. A sign-on bonus typically means one thing: You will be so overworked that you will never make it to that three month mark to collect it. Which is exactly why they offer it. It rarely gets paid out. Some companies offer Walmart or Target Gift Cards if the aide picks up an extra shift. But those gift cards don’t pay the now overdo electric bill. Sure they can save money by using the card, but only if they actually need something at Walmart.

Add to that, many of these healthcare workers were watching others from the sidelines, not only receiving unemployment, but an extra 600$ on top of that. Again, not saying that was wrong, but simply pointing out that these healthcare workers were told they could not collect unemployment as their job was a direct need. They were exempt from claiming their job was too dangerous, even though it was literally one of the most dangerous during the pandemic.

If you ignore Covid and throw it out the window, it changes nothing in this article. There are numerous contagions that these workers are exposed to:

People assume that PPE is the cure for everything. Have you ever showered somebody with gloves on? Or maybe you put them in the bathtub, where they had a bout of diarrhea in the water. Your gloved hands are submerged in the water. Maybe you have a cut on your finger. Water get’s inside your gloves and under your bandaid. And so does urine and liquid vomit. Of course you wash your hands, but at the end of the day your hands and any possible wounds, still came in contact with another individuals feces.

Now I realize that this article is blunt and to the point. Obviously STNA’s and CNA’s do the job as a calling. Nobody in their right mind would do it for the money. Reason being: The money does not match the work. You have to want to care for others. Your heart needs to be in it 100%.

When Mrs. A is in tears because she can’t see her family, you need to be fully present in that moment to reassure her that she is not alone.

You need pure empathy to lead you.

IE: You need to understand that when that 200lb man is trying to physically assault you, it is because he is afraid! His dementia makes him see you as total stranger whose basically trying to pull his pants down. You need to understand that he may have a history that triggers his aggression. And you will never know what that is, because even he does not remember. You need to have compassion in the face of his fear.

And all of this requires an understanding on par with a psychology degree and yet, STNA’s and CNA’s are nowhere near that pay grade.

I’ve heard it said that STNA’s/CNA’s are entry level jobs. I assure you….they are not. Those who do the job as a calling, they’re in it for life. And these are the people we want caring for our elderly. These are the people who genuinely want to help. And although younger kids attempt it and actually want to make a difference, sadly, after what they’ve witnessed in staffing and low pay…many never take a second glance at healthcare. I’ve met many aides who had initially became aides as a bridge into nursing, but found they simply didn’t make enough to pay for even one college class after their other bills. And during Covid, these aides along with other healthcare and housekeeping staff, stayed to care for total stranger’s parents… risking every single member of their own household. .

STNA’s/CNA’s are often single moms. And many went home from Covid units, not only to their children but to their own aging at risk parents. And what does it say about us as human beings, when we aren’t pushing to pay our countries caretakers an actual livable wage. Those who care for the elderly and ill.

Even if you don’t care about the elderly right now….what about when it’s your turn? Who will take care of you? Who would you want taking care of you? Someone with a smile on their face and is glad to be there? Or someone who is disgruntled and angry because not only are they covered in your latest bout of diarrhea, but they flat out are unable to feed their children. When you’re confused and disoriented…when your cocking back to throw a punch because you have zero idea where you are…which worker do you want handling that situation. Which worker ends with the best outcome? The angry and anxious one? Or the one with a decent well rounded home life with less anxiety and anger?

Let’s look at a similar situation and break it down:

Childcare ~

Causes of child abuse can include:

  • isolation and lack of support — no family members, friends, partners or community support to help with the demands of parenting
  • stress — financial pressures, job worries, medical problems or caring for a family member with a disability
  • unrealistic expectations — a lack of understanding about a child’s developmental stages and behaviour
  • intellectual disability or mental illness — parents may be unable to adequately care for their child
  • lack of parenting skills — parents may not know how to care for their child or may believe it is acceptable to use excessive physical force to discipline or punish a child
  • drug, alcohol or gambling problems — addiction or substance abuse may affect a parent’s ability to meet their child’s needs
  • low self-confidence — parents may doubt their ability to meet their child’s needs and find it hard asking for help
  • past childhood experiences — parents may have experienced abuse as a child in their own families, which could have caused them to develop an insecure attachment style
  • mental health problems.

If we mirror the typical causes of child abuse to the typical causes of elder abuse , we see a pattern.

*A parent struggling to put food on the table can be a catalyst for abuse. Then can it stand to reason, those same issues create a higher rate of abuse on the elderly? Bare with me. Low pay for a hard job, breeds frustration which leads to anger.

*Lack of skills = being an STNA/CNA should not be considered an entry level job. You do actually need to know what you are doing. When you don’t, you will make mistakes. And in healthcare, mistakes=injuries.

*mental health problems go hand in hand with flat out being unable to pay the bills. Granted, they’re considered an environmental mental health problem and not a biological mental health problem, but both are mental health problems. Consider that being able to pay for a fun night out (environmental) creates a boost in serotonin (biological)…and well I’d say they can often go hand in hand.

*isolation and lack of support = This is the same as not enough staff on the floor. And overwhelmed aide caring for too many residents. Why? Because the job doesn’t pay enough for what it involves.

Does this mean that nursing homes are inherently dangerous? Of course not! The vast majority have the best of intentions.

AND….Most elder abuse does not take place in nursing homes.

In almost 90% of elder abuse and neglect incidents, the perpetrator is a family member. 2/3 of perpetrators are adult children or spouses.[7]

11 Facts About Elder Abuse |

(Which again points to lack of experience, financial burdens etc...I will say again: It is not an entry level job)

If anything, the above statistics reinforce the need for nursing homes….and PROPERLY TRAINED, PHYSICALLY AND MENTALLY HEALTHY STAFF…. in order to give overstressed families relief.

The list goes on. We could mirror these patterns into hundreds of pages. The reality is our countries caregivers are not being cared for. And the vast majority are the most caring, considerate and selfless people you would ever meet. Often bringing in clothing, grooming supplies, shoes and gifts paid from their own pockets….for a resident who may have no family and their Medicaid isn’t paying enough. These are the people who would give you the shirt off their back if you needed it, also making them the easiest targets to be taken advantage of by greedy corporations in the multi-billion dollar industry of geriatric healthcare.

In summary: It should be seen as an absolute disgrace to the healthcare industry, if even one of these workers cannot afford to keep their lights on.

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