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“We were short-staffed to begin with. Now it is a disaster”: A long-term care worker speaks out

This article was first published in the excellent RandkandFile.ca. Republished with the kind permission of RankandFile and the author

Nova Scotia’s essential workers have been sustaining the province during the COVID-19 pandemic. Among those on the front-line are Nova Scotia’s care professionals, whose employment requires that they jeopardize their health (and the health of their families) to tend to those most medically, financially, and structurally at risk. 

Care workers in Nova Scotia have been undervalued long before the arrival of COVID-19. The average salary for a care worker in the province is just $15.84 per hour, which is 14% below the national average, and over $3.00 less per hour than a living wage for the city of Halifax.  Low pay has resulted in high turnover rates and poor job satisfaction.  

Privatization and lax protocols

Privatization and chronic underfunding have made the work precarious, as well. Private, for-profit care facilities cut costs by hiring workers on a part-time or contract basis, which limits their sense of job security as well as their access to union protections. With inadequate government funding, not-for-profit homes are cutting costs as well, which has impacted the quality of care received by residents, along with the sustainability of the employment.

The poor state of long-term care in Nova Scotia has left workers unprepared and unsupported during this public health emergency. “We only started wearing masks and taking our temperatures before shifts in late April, so over a month into the crisis,” says Sarah Johnson, long-term care worker in Halifax who works at three separate group homes. “The masks we have are to protect the residents, not to protect us.  The residents aren’t wearing masks. I don’t feel safe”.

In both the private and public care sector, cutting costs means cutting staff. Low-staffing levels are compounding already unsafe working conditions. With more work being distributed among fewer employees, the risk of injury and infection has increased.  

“We were short-staffed to begin with.  Now it is a disaster,” says Johnson. Social distancing precautions combined with elevated health concerns means even fewer staff are on the job. “Of course, when someone feels sick, it is important that they stay home. But nobody is there to replace them.  The care responsibilities are falling on fewer and fewer of us.” 

When it comes to taking extra safety precautions, Johnson feels that her employer has not been proactive. “I asked my boss what would happen if a resident at one of the homes were to contract COVID.  There was no procedure in place,” says Johnson. “I was told that we, the care workers, would have to decide between ourselves who would become responsible for that client.  We would have to assess who would be least medically or personally at-risk, which is a huge and unfair decision to place on us. Many of us don’t have paid sick leave, so getting sick has financial consequences too.  It’s like survival of the fittest.”

Emotional manipulation

The coronavirus has highlighted the value of essential workers, which has resulted in their praise and glorification.  However, messages of gratitude cannot substitute fair pay and improved working conditions. “There is a lot of emotional manipulation going on,” says Johnson. “Everyone calls us heroes, but we don’t have a choice.  This is our job.”

In Canada, the field of care work is overwhelmingly female. According to a recent study by the Canadian Centre for Policy Alternatives, 86% of workers in Canadian nursing and residential care facilities are women. Women also represent 89% of workers in home health care services.  “The assumption is that we simply enjoy caring for vulnerable people. This is this understood to be our nature as women. We are expected to find pleasure in our work, despite poor wages and little support and protection,” says Johnson.  

Beyond the profession being mostly female, racialized workers are over-represented in the care-profession as well. Canadian nursing homes and long-term care facilities are disproportionately staffed by immigrant women, refugees, and migrant workers. These workers are mostly women of color employed on a part-time basis. To make ends meet, they are often forced to take jobs at multiple care facilities, which subjects them to increased health risks.

Inadequate pay and protections for Nova Scotia’s care workers may come with serious consequences to their residents. “When we are paid poorly, lack resources, and are forced to rush between clients, we are more likely to transmit the virus to those who are especially vulnerable,” says Johnson. “I work at three separate facilities and always worry that I might transmit the illness between homes.”

Long-standing issues in Canadian care facilities have become lethal. According to The National Institute on Aging, Canada has the highest proportion of deaths from COVID-19 in long-term care settings among 14 countries. “These lax protocols aren’t just harming us. It is clear that residents of the facilities are suffering enormously,” says Johnson.

Christine Saulnier of the Canadian Centre for Policy Alternatives stated on Twitter that the overwhelming majority of deaths were residents of nursing homes. Northwood, a long-term care facility in Halifax, has suffered with the largest outbreak of COVID-19 in the province; 345 cases between residents and staff, and a total of 53 deaths. 

No cash bonus, no CERB

To ease the daily stress that she and her co-workers face, Johnson has asked for wage increases. These have all been denied. “With a pandemic upon us, we’re being expected to behave like medical professionals.  But we are compensated very differently than most trained medical staff,” says Johnson. “If we ask for more, we’re made to feel greedy.”  

The federal government has developed a cash-bonus for health care workers supporting the COVID-19 response. However, many do not qualify. “Workers at adult residential centres and regional rehabilitation centres, like myself, are ineligible for this support. If we quit, we won’t qualify for the Canadian Employment Relief Benefit either. Many of us feel stuck.”

Messages of thanks and praise are deserved; but to properly recognize the sacrifices of Nova Scotia’s care workers, better workplace protections and fair renumeration are imperative. Not only would this help stabilize employment within the care profession and provide dignity on the job, but would in turn increase the quality of care provided to our most vulnerable.

See also: Authorities ignored early warnings from Northwood’s long-term care workers and unions

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