This summer, Gabriel Winant, an assistant professor of history at the University of Chicago, interviewed Shantonia Jackson, a certified nursing assistant (CNA) who works at City View Multicare Center in Cicero, Illinois. CNAs like Jackson provide general care (making sure patients eat and shower) and are often the only people that offer support and companionship when residents need someone to talk to.
City View experienced a major COVID-19 outbreak: 253 residents out of 315 contracted the virus, and many of them died. Jackson’s colleague, a 64-year-old woman named Camelia Kirkwood who was supposed to retire in June, was among those who contracted COVID-19 and died. Before coronavirus, the two oversaw 35 residents apiece. Now on her own, Jackson provides care for 70 men in an all-men’s unit.
Winant and Jackson’s conversation in Dissent reveals what it’s like to work in a nursing home, and the challenges and exploitative conditions hardworking healthcare workers like Jackson face, especially during the pandemic.
She describes how she felt after her colleague, Camelia, died from the virus, and the lack of support from the nursing home’s management:
It just devastated me when she passed away. I really, really took that very hard. But I had to come back and explain it to the residents, because they wanted to know where she was. They were hearing that she was sick or she died, but one by one I would talk to them and let them know she was in a better place. And you have to do that with psych and behavioral patients, because they can kill you. They could take the fire extinguisher off the wall and just bash it up the side my head, you know what I’m saying? So I develop a rapport with them.
Management never came upstairs on the floor with me to see what I was dealing with. They would come upstairs and yell at me, “Well, you need to give a shower.” I already gave thirty showers out of seventy people. I can’t make sure seventy take a shower. Because I’ve got to still pass trays. I’ve got to still make beds. It’s hard.
Even with the kitchen. Even with laundry. Who wants to have bugs? It’s supposed to be clean, but the nursing home industry is so cheap. We sometimes don’t have a housekeeper on our floor. It’s like, really? Call somebody in. But you don’t want to, because you don’t want to pay them. That’s crazy.
It’s common for nursing home workers like Jackson to juggle more than one job, often at other care facilities or in people’s homes, which is one of the ways the virus spreads.
I took a leave, because I felt like I didn’t want to take the virus from City View, with 253 infections, to Berkeley, which didn’t have one case. So I took it upon myself. And the nursing home industry is so fickle, and selfish, and disrespectful, because they were actually angry at me for leaving. I thought my director of nursing would be appreciative, because what if I came over here and I transmitted to all these elderly people? They all would have died. And they have the nerve to be mad at me, and calling me, saying, “You’re not going to come back?” No! I’m dealing with 253 cases over here. I want to be careful for the grandmas and the grandpas.
Later in the interview, Winant asks: “If you could make nursing homes change in any way, what would be your vision?” Jackson describes:
My vision would be to make sure that every CNA had at most only five residents. I would make sure it would be properly staffed. And that way we can comb their hair, brush their teeth, lotion their body, change them every two hours, make sure they get their needs, so we can do what we were put there to do, when their family members couldn’t do it. The residents would get proper food. You should see some of the food that they feed them. I wouldn’t feed that to my kid. Why would you feed them this? In America, we don’t care about the elderly; they’re about to die anyway, we don’t care. We should have respect, because they have wisdom.
When Winant asks how Jackson manages to care for all her patients, she responds, “I’ve got a strong mind. You just have to have a strong mind. It’s all I can do.”