Nurses’ Aides Are Still Undervalued
By Albert B. Kelly
A couple of years ago, I discussed the fact that we completely undervalue home health aides. I don’t think much has changed since that time in terms of how much we value them, but what has changed is their value to us and this includes nurses’ aides working in facilities. I say that even as we’re still in the middle of a global pandemic with a fair amount if the sickness and dying happening among those in the medical profession whether doctors, nurses, aides, or support staff.
I am singling out nurses’ aides because of the unique position they hold in the medical food chain. Nurses make a good living and have a variety of options open to them in terms of a career path and doctors are doing alright as well. But at the bottom of that hierarchy are nurses’ aides, including home health aides, who are very much on the front lines with all that this implies but without much recognition and without the wages or supports.
This pandemic has brought the issue into sharp relief. We expect nurses’ aides and home health aides to show up for work even when the risk of becoming infected and dying from Covid-19 has made the job something of crap shoot. Aides, whether working in the home or in a facility earn between $25,000 and $35,000 a year, give or take, and the increasing minimum wage has been a step in the right direction. Despite this, a fair number of them still need public assistance just to make their bills. Many also have little in the way of health insurance.
Part of why we undervalue both nurses’ aides in facilities and home health aides is because they are generally associated with the dirty work of medicine. By that I mean they empty bedpans and urinals, change soiled sheets, turn and lift patients, encounter and clean up all manner of mess and squalor that the human body can produce. Though many of us won’t admit it, we assume that anyone who does such work can’t do much better because we certainly wouldn’t choose it, so those who do must be limited in some way. So we undervalue the work.
Yet for all of that, we want to call them heroes on the front lines, especially when the job comes with a fair risk of dying and so they are. But more than just the lower part of a medical hierarchy that does the dirty work of medicine, these aides are often the first person our loved ones see in the morning when they wake up and the last ones they see before they go sleep. When the pandemic hit, at least early on, they were often the only ones our loved ones saw doctors and nurses notwithstanding.
What price are we willing to place on companionship or human warmth and contact? Is it worth noting that the position of nurses’ aide is almost always held by women and just as likely to be held by a black or brown woman as not? Could this be part of why it is undervalued and undercompensated? That would be my guess.
It’s not that gender, race, and ethnicity has to be part of every discussion, it’s just that it already is whether we want it there or not. Because of other systemic problems, such as deficient schools, over-policed communities, disparities in sentencing, lack of access to credit, exploitative lending practices, and many other things that gut communities- including low expectations, nurses’ aides are more likely to be female minorities than not because that’s the rung of the ladder available to them. This is part of why the job is undervalued and undercompensated.
A couple of years ago, I mentioned that one of the things that caught my attention was the fact that many home health aides, and now I include nurses’ aides in facilities, are part of the most difficult, profound and intimate moments in the lives of their patients, i.e., our loved ones. And with the pandemic and the inability of family to visit relatives in hospitals or nursing homes, how much more valuable is the compassion and companionship of nurses’ aides? This pandemic has brought their worth, like that of doctors and nurses, into clear relief and we would do well to acknowledge that value with a little more respect and better pay.