Today’s column is written in appreciation of CNAs, LVNs and housekeeping personnel, especially those working in skilled nursing facilities. These are health care workers who are often overlooked and underappreciated.
When we think of health care workers, we often focus on doctors and RNs (registered nurses), who, of course, are essential to the well-being of their patients.
But after spending 45 days (when a close friend was in rehab) observing certified nursing assistants (CNAs), licensed vocational nurses (LVNs) and housekeeping staff at a skilled nursing facility, I have realized more than ever how important they are, especially to older, disabled or injured adults.
It’s not easy working in a skilled nursing facility (also known as nursing homes and/or rehabilitation facilities). The patients there require a lot of patience. Some have incurred a serious fall or other injury and experience a lot of pain. Some are older adults who need 24-hour care and come to the facility because their family members don’t have time or stamina to take care of them.
In addition, funding is a challenge for skilled nursing facilities; it’s hard for them to keep operating in the black. Medicare and Medicaid often provide the bulk of funding, with private insurance or private pay supplying the rest.
From my experience, the best skilled nursing facilities are nonprofit. Some of the worst are for-profit institutions, where shareholders are considered more important than patients, and expenses are reduced to a bare minimum so that revenue generates the most profit for the corporation running them.
Nonprofit skilled nursing facilities, however, face fiscal challenges, because patients in these facilities require a lot of care, and the leaders of these facilities (in some cases nuns) understand the amount of compassionate care needed. The facilities need to rely on LVNs and CNAs with wages that are often spartan to avoid going into the red, and they need low-paid dedicated housekeeping staff to keep the rooms and hallways clean and hygienic.
One example of fiscal challenges nonprofit skilled nursing facilities face occurred in Dos Palos a few years ago. The Dos Palos Skilled Nursing Facility, which took care of my brother Frank, was extraordinary. The staff treated the patients there with great care and compassion.
But that facility, unfortunately, went broke and had to close. Its funding was not sufficient to pay the expenses necessary for the compassionate care of its patients.
Besides the administrators facing fiscal challenges, the staff at skilled nursing facilities face challenges of their own. Often their work is unpleasant. Their patients, who can become cantankerous, require a lot of assistance in doing everyday tasks like showering, using the toilet, getting dressed, and so forth and so on.
Each patient also requires a range of medications — some prescribed, some over-the-counter — that have to be carefully administered and monitored.
The skilled nursing facility I observed for a month and half is a nonprofit institution which has been astute over the years in hiring people who are compassionate as well as competent. In spite of many challenges, they love working with and for patients who need care, and as a result they don’t mind the often difficult work.
When I asked a CNA how she has the patience to help these patients, even grumpy ones, she said, “I think of them as members of my family, like a parent or grandparent. I take care of them not as a random patient but as a family member.”
In talking with an LVN, I asked her if she considered going on to earn her RN degree and getting a job that paid more money. “I thought of that,” she said, “but I realized how much I love this job, taking care of these patients. I feel as though it’s my calling.”
The CNAs, LVNs, and housekeeping staff I’ve met have a variety of personalities. Some are very quiet, and I have to listen carefully when they talk. Some are very outgoing, and I have no trouble hearing them saying hello or engaging in a conversation or even singing while they work.
One of the patients in the facility is a 95-year-old woman resident whom I happened to have known years ago when she was active and alert. Now she has little energy, says only a few words and easily becomes anxious. But the staff treat her with great kindness, understanding and dignity.
One of the biggest challenges LVNs in skilled nursing facilities face is the proper administration and monitoring of medications to as many as 30 patients in their charge. It’s a particular challenge helping a patient who is in severe pain, trying to administer enough medication to relieve the pain according to a doctor’s orders, without causing serious side effects.
Although I have not mentioned the names of the health care workers I have praised, I hope that those who might read this column recognize who I’m talking about and how much I appreciate them.
And before I end this column, I also need to thank other people who work in skilled nursing facilities that I have met and observed — including social workers who serve as office managers, physical therapists, registered nurses and the overseeing doctors. They all are important to form a team that can provide comprehensive, as well as compassionate, care for their patients.
REMINDER: Friday, March 6, is Arbor Day, with a Milliken Museum Society breakfast from 7 to 10 a.m. at the Los Banos Community Center and an outdoor City of Los Banos celebration at 4 p.m. in Citrus II Park (315 N. Second St.) It will be a great way to show an appreciation of trees.
On a related note: Kudos to the Milliken Museum Society for a memorable event at the Los Banos Arts Center Feb. 25 honoring local veterans who served in wars and combat. The speakers – Paul Loeffler, Mike Hughes, retired Air Force Col. Paul Setnor and history professor Tim McNally — provided a lively program, and the museum society had many photos, posters, quotes and articles reflecting how Los Banos participated in war and combat missions.
John Spevak’s email is john.spevak@gmail.com.
