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CARE GIVERS |
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State and county governments are considering privatizing government-owned nursing homes and hospitals. Privatization’s promise of reduced costs may sound tempting. But, cost savings often come at the price of the well-being of society’s most dependent and vulnerable citizens. Imagine that you need to put your mom in a nursing home.
Nursing aides deliver most of the hands-on care. Their work is extremely demanding, both physically and emotionally. They help patients into and out of bed, bathe them, dress them, feed them, and perform any toileting and personal care tasks that patients cannot do alone. Aides reposition non-mobile patients every two hours and monitor food and fluid intake as well as the patient’s physical condition. They also communicate with family members. To find quality nursing home and hospital care, there are critical indicators to watch: staffing ratios, turnover rates, wages and benefits. Pennsylvania county governments
privatized county-owned nursing homes in the mid-1990s. Patients
and caregivers suffered the human cost of this failed experiment. According to the Philadelphia Daily News, state inspectors discovered numerous cases of unreported resident abuse by staff as well as “accounts of unattended bed sores, soiled clothing, expired medications, filthy floors, warming food freezers and inaccurate clinical records.” The Philadelphia Inquirer described the situation inside the nursing homes as “total chaos.” Caregivers’ quotes tell the horror story best. Wages “The private takeover cut wages down to $6. I’m not going to stick around for that. This is hard work, both physically and emotionally. If I’m going to make that little money, I could be flipping burgers and it would be a lot fewer headaches.” “The suffering you have to witness, the deaths – for $6.40 an hour, it’s really just nuts. The new hires were less conscientious. Instead of giving a bath they’d just douse them with powder. I’ve seen that happen a lot. I’d go in after someone had supposedly given a bath and the towel wasn’t even wet.” Staff Turnover and Continuity of Care “There were quite a few deaths in the first few months after they opened. Because it was traumatic, patients were depressed. They were used to all these aides and all of a sudden they’ve got all these different ones. They don’t know if they can trust you or not.” “We used to have the same patients every day. We’d get to know them as if they were family. We knew their likes and their dislikes. We knew their needs. And that’s very important to them because they don’t like sudden changes. Constant turnover makes it impossible to have a consistent relationship with a patient.” “It’s hard to do a thorough job of training someone when you know they will probably leave anyway, especially when you’re pressed for time yourself. We usually place bets like, in two weeks a person will leave.” “The other day a meal tray came out from the kitchen for a diabetic. That patient is supposed to get Sweet ’n’ Low instead of sugar, but somebody made a mistake and put sugar on her tray. This aide was new and of course she didn’t know, so she gave the sugar to the patient.” Patient Dignity “Aides have to be familiar with a patient’s desires in order to respect that person’s dignity. We have female patients who don’t like care being performed by a male. If I, being a male, go in to bathe a female patient who has that preference, it makes it difficult to do my job in a timely way because she won’t cooperate. My boss says: ‘It’s your job, do it quickly and don’t complain’.” Cost-Cutting and Supplies “Our administrator decided to halt the use of ‘Attends’ diapers to save $300,000 a year. What’s better – to be wearing a good quality plastic diaper with an absorbent lining that holds moisture away from your skin and that does not leak, or to be lying in your own filth on a mattress?” “They skimp on bed linen…It wears out, you know, to where it’s just frayed or torn, but they don’t replace it. We’ve been short on washcloths to where we had to use one end to wash them and the other end to dry them.” “The materials we require are either not available or they are of poor quality. When a patient takes a turn for the worse and you have to rely on faulty equipment, how can you get accurate information? Simple things like changing a battery in the blood pressure cuff.” Workers’ Rights “The way things are now, you just have to shut your mouth and do what you’re told. If you think there’s something not being done right, or something that’s lacking, you risk getting written up if you speak out. People are afraid to say anything. This company is just out to save money, to cut expenses. Our jobs just aren’t safe now.”” “Once we had a guy who had AIDS and we weren’t told about it. He was combative and he would bite, and he would ejaculate and there would be semen we’d have to clean up. We all wear gloves, but you want to take better precautions.” “My supervisor told me to shower a lady, to take vitals on her. I told her that the lady was very combative but she made me do it anyway. I got beat up. I was down on the floor getting beaten up and they had to come running to help. I would have gotten written up if I refused.” Quality Care vs. Profits “Management expects us to do more with fewer people, but they have no idea whether it’s possible. It’s just the almighty dollar now. In my opinion, the patients are nothing to them but dollar signs.” “Management doesn’t come back to see patients, except for a few that have money, the private pays. There’s favoritism there. They tell us to go out of our way for those who have money, even if it means we skimp on the Medicaid patients. That’s just not right.” “We used to have time to sit with patients, read to them, or just talk. Have a cup of tea or whatever…That’s really important for them. That’s all the interaction they may have in the course of a day. Who will talk with them if we’re too busy?” “When residents are there for the long-term…the first two weeks are critical. If you don’t get the resident to socialize, get into a living-type situation like at home – if you don’t get to that resident within the first two weeks you lose them. An aide needs to spend an hour with them when they first come in, basically just talking to them.” More Information Privatization experiments have failed in Massachusetts and Pennsylvania. To learn from their mistakes, read the following links. Nursing Home Privatization:
What is the Human Cost? Privatization of State Services
in Massachusetts: Politics, Policy, and an Experiment That Wasn’t. Author:
Bruce A. Wallin, Northeastern University, Boston, MA for the Economic
Policy Institute
To learn why we must put the public good ahead of private profits, read the following links. Government up for Grabs The Privatization of Everything: Selling Uncle Sam Privatization: Downsizing Government for Principle and Profit The Privatization Grab Bad Medicine: Privatization is Slowly Killing the British National
Health Service Privatization of Health
Care in Alberta, Canada: It’s Failure,
A Non-Story Health Care Privatization: Women Are Paying the Price
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Last revised: February 27, 2006 8:39 AM