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CNA, Carla Mendoza
Misty Swift

Carla Mendoza is 51 years old and five feet tall with hazel eyes. At 6 a.m. on a typical work day Carla wakes, showers, makes coffee and takes her breakfast on the way in order to clock in promptly at seven. As a Certified Nurses’ Assistant, or CNA, in Pasadena, California, she starts her day changing sheets and diapers and logging vital signs on the care recipients’ charts. Once this is done there is an eight to eight-fifteen coffee break but as Carla points out, “If you talk with a patient a little too long or have some trouble with sheets or something, by the time you wheel the cart in, your break’s over.” Lunch is carted to the various rooms at twelve and afterward Carla has thirty minutes for lunch. She goes through the rounds again, clocks out at exactly three and makes the ten-minute drive to her second job where she starts at 3:30 and works until 11 p.m.

When I ask Carla how she got into her line of work she says smiling, “I really thought it was a good thing to do and I still do, but in theory. I want to do what’s right, I’m not about the money and I’m capable of a lot of love and nurturing and I’m a good worker.” She pauses. “But you just can’t do it and it’s frustrating. No one gives us the resources financially but even more importantly, mentally and emotionally.” Carla refers to the fact that the CNA's are in many cases the only people employed at the centers that talk to the patients every day and have relationships with the care recipients. Together, they talk about their lives, their children and even death. Sometimes Carla and other CNA's have been known to switch shifts in order to be on hand when someone is dying. Carla has never been given ways to cope with the subsequent emotional stress and has often grieved when a patient has died. “You can’t just separate yourself once you’ve made the connection (with someone) and it takes a lot of strength to go through it over and over again. But if you’re good, you do and I am good.” Most patients are in their seventies or eighties. But in recent years, more and more people with MS, widespread paralysis, and other non-age related conditions enter the center. CNA's are often lack adequate training or resources to deal with the care recipients changing needs. Exercise is a vital aspect of recovery for many of these patients and assisted exercise as well as administration of medicines, although legally unauthorized, is often administered by the CNA's. When I ask her why she assists when she knows such tasks are not included in her job description Carla says, “What’s the lesser of two evils? That I let someone go without there medication or watch their joints stiffen day by day, while every now and again a physical therapist rushes them painfully through their regimen, and I consequently jeopardize my own job? Or I can take some pride in my work, feeling I’ve done the right thing.”

Carla’s situation is not unique. CNA's are predominantly minority women in the state of California. Some, for fear of being terminated due to immigration issues are open to gross exploitation by their employers. Others simply do not feel that they have a voice to demand for fairer, more equitable compensation for labor and healthcare.
I sense that it’s time for a break and I ask her about her homeland in Central America. She tells me stories of her childhood, regaining her smiling, happy disposition. She talks about her husband, they’re newlyweds. Everything earned is spent but there’s food in the fridge and Carla has a new karaoke machine her husband bought her for her fifty-first birthday. At night she likes to sing Patsy Cline songs. The same Carla, who works over sixty hours a week still seems to have joy in her life.
Individuals like Carla would like to feel that their work is appreciated. Carla says, “I see the families come in and sometimes they act as if they don’t see me at first, dismissing my very presence and talking to the RN. However over time they come to know that the CNA's, like myself are the ones who really know what’s going on. How their parents or loved ones are feeling, how they’re eating, what they like, all that stuff. It’s that connection that goes unnoticed and what I believe to be the most important aspect of recovery, the human aspect”

CNA's are at the bottom of a rigid hierarchal structure prevailing in most care facilities. Often it’s the little things that systematically deprive CNA's feeling of worth within the workplace. For example, everyone except for the CNA's and janitors in Carla’s day job have their coffee mugs in the kitchen area. When a new CNA brought her commuter cup to work, she was told by her supervisor “CNA's cannot have mugs.” The CNA observed that there was little room in the cabinet and said she would take her mug home with her and store it in her bag. But that was not sufficient for her supervisor who maintained that CNA's drink their coffee out of small paper cups.

Carla fears that in years to come physical and emotional strains, as well as getting older will take its toll resulting in calling in sick more often and potentially being replaced by someone younger. Some days her body aches, especially her back. Other days the problem has been what she calls mental exhaustion and depression. “There have been times when the problem isn’t physical but I just can’t make it out of bed (because) I’m so depressed.”

Her first job pays for half of her basic health insurance; the other $150 is deducted from her paycheck on a monthly basis and does not include a vision plan. Her recent need for bifocals ran her $400. With some reluctance she tells me she brings home around $2000 per month, working both jobs, when she hasn’t missed any shifts. In fact in 2002, the average wage for CNA's in the state was among the Nation’s lowest, less than ten dollars per hour.

As a result, the past six years that Carla has worked in the health-care industry have left her in-debt, charging her credit cards with car repairs and various minor emergencies.
Carla smiles as she says, “At night I get so worried sometimes that I just stare at the T.V set and you couldn’t move me or talk to me if you tried. I don’t even talk to my husband half the time because talking about it just makes us both really upset and there’s nothing we can do about it.”

In writing this interview, I must admit I came to the subject with some reluctance after all hadn’t we all heard about the healthcare system, the unfair treatment of the elderly and infirm since the late eighties when it was the subject of news articles and 60 Minutes Specials? Yet the fact remains, little has changed. The system does not work. At the bottom you have the elderly and disabled and individuals in “recovery”. Doctors are paid by the state and insurance companies and taxpayers take-on the burden with little knowledge as to how the system truly functions.

And face it, to talk about what happens to most of us after we retire, after our spouses have passed away, when we’re fundamentally alone in the world is not a subject the younger populace likes to broach. Why should we? Even if we’re reluctant to find out for ourselves and take responsibility for the botched system we fuel with our money and ignorance. It’s them, not us. Simply stated, the system results in the exploitation of the elderly and infirm and to those who most directly care for them and not enough of us care to do anything to change it.

In talking to several CNA's (which will remain anonymous) they all said the checks set in place by the state were insufficient at policing the system. When an inspector did arrive the facilities always knew when, if not the precise date and time, they could narrow it down to a week or two in which, the quality of the meals improved drastically, the administrators and head nurses were suddenly smiling and involved with the patients, and activities shot through the roof. There’s a cog in the wheel, it’s obvious, it doesn’t work nor do I profess to have all of the answers but simple awareness is a good place to start and from there a demand for impartial checks at random from a state agency. The public can demand that more of their money go toward allocating resources directly for the recipients, not the higher-ups. We can demand that higher pay, health-care, and resources such as specified training and counseling be provided for the very same people that dress, feed, brush, shave, and tuck our elderly and unwell into bed at night. Why should they be deprived of sufficient pay and health insurance? Thinking about it doesn’t that make sense?

Misty Swift is an English major with interests in philosophy, mythology, lingiustics, and sound engineering. She is also editor-in-chief of Voices.

 

 

 

 

 
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