Nursing Assistant Resources On The Web

An article about the long term care, nursing home industry’s hope for the immigration bill (which is now dead):

Research repeatedly confirms that the quality of long-term care depends on staffing levels. Technology and evidence-based practices can make important contributions, but the ability to provide assistance and services to people who have significant limitations and health problems ultimately rests on having enough staff to respond to their needs.

For this reason, the long-term care industry has been very attentive to policy changes and proposals affecting the availability of personnel. Some of these changes involve reimbursement levels that constrain the ability of nursing homes to hire staff in a tight labor market. In 2007, however, the major focus of Capitol Hill is on those sources overseas of people who could eventually work in long-term care.

I don’t believe the reasons listed here are truthful. I do think the profit motive is driving this attention; the labor market would not be tight if staff were paid decent wages. I don’t expect them to pay us union demand wages, but certainly something more of substance than the usual $8, 9 or 10/hr…

This situation has motivated lobbyists for the nursing home industry to become fairly reliable advocates for policies that will increase the availability of workers from Asia, Central America, Mexico, and the Pacific Islands. American Health Care Association in particular has expressed frustration over the slow pace of the immigration reform that President George W. Bush had described in 2001 as a top priority of his administration. That priority was derailed by post-9/11 issues of national security and by outrage among members of his own party over the millions of Mexicans, Central Americans, and Asians who have illegally arrived and settled in the United States.

I remember this being one of Bush’s big pet projects when he was campaigning for office. Back then I was suspect of this whole thing.

The first question is surprisingly difficult because long-term care actually faces two separate staffing problems. Nursing homes face a systemic shortage of nurses and other clinical staff; they cannot compete with the salaries offered by hospitals, outpatient practices, and managed care companies for the shrinking pool of trained clinical and clinical support personnel. Nursing homes depend heavily on low-skill, low-wage workers to provide affordable support services such as laundry, housekeeping, transportation, and food preparation. Some of these low-income personnel are employed directly by the long-term care industry, but many are outsourced from companies that supply nursing homes with necessary goods and services. Ideally, an immigration reform package would address both of these staffing problems by making it easier for nurses to cross borders to work in the United States, while ensuring a steady supply of dependable, motivated, low-wage support workers.

THAT last sentence shows us what the policy makers and movers really think of American and legal immigrant nursing home staff: Undependable? Unmotivated? High wage ($12/hr????) demanding? Hmm. CNA’s should be mad as hell about this. So should nurses and all other nursing home staff. I’ve seen how these nursing homes get by with having illegal immigrants: They do outsource. A private hiring group (much like Manpower) does the hiring, background checks, ect…and the workers just show up at the facility to do their thing. No hassles for the nursing home- which- if raided by ICE, would face fines and all sorts of trouble.

I have a lot of personal concerns about illegal immigrants and the drain I believe they place on the US- resources, federal means tested programs and health care and the lot. But I also realize these people are human beings. They come to the US to work; we have many employers who hire them, illegally and treat them poorly. They exploit them; pay them even dirtier wages than we get; they don’t pay them for overtime and demand they work 7 days a week. The immigrants feel compelled to put up with all of this because it’s still better than what they had in their home countries and they fear being deported. BUT…at the same time these people are depressing the overall wages of nursing home staff- nurses, aides, housekeepers, dietary…Jobs Americans used to do until the industry decided to get more greedy. Our jobs are being given to those who will work for less and who expect less, and we will never stand a chance of bringing our work up to a higher standard.

Another concern I have is the safety of our residents. I have worked with a few illegal immigrants. They made serious mistakes and were lazy. They didn’t or couldn’t or wouldn’t read and understand English. So they couldn’t understand care plans. So they didn’t do what they were hired to do…and the errors were serious enough to cause the death of one resident; the aspiration of another and many many family complaints. The residents themselves refused the care of those who they could not understand. These immigrants used their “race” card as a defense too, claiming racism when confronted with the errors and terminations- after investigations by in house and state authorities.

It’s a tough call…but in my opinion utilizing immigrants is a bad idea. We’re dealing with human lives, not heads of lettuce or the packaging of meat products. We are trusted to care for frail and sick people who trust us to them good…why risk this?