Caring on Stolen Time: A Nursing Home Diary

Caring on Stolen Time: A Nursing Home Diary

Our bodies’ need for a short respite was pitted against our residents’ immediate bodily needs. Either choice we made, we blocked out something deeply human—either our care for our own bodies or our care for others. Caring should not feel like stealing time.

Graphic by Imp Kerr

I work in a place of death. People come here to die, and my co-workers and I care for them as they make their journeys. Sometimes these transitions take years or months. Other times, they take weeks or some short days. I count the time in shifts, in scheduled state visits, in the sham monthly meetings I never attend, in the announcements of the “Employee of the Month” (code word for best ass-kisser of the month), in the yearly pay increment of 20 cents per hour, and in the number of times I get called into the Human Resources office.

The nursing home residents also have their own rhythms. Their time is tracked by scheduled hospital visits; by the times when loved ones drop by to share a meal, to announce the arrival of a new grandchild, or to wait anxiously at their bedsides for heart-wrenching moments to pass. Their time is measured by transitions from processed food to pureed food, textures that match their increasing susceptibility to dysphagia. Their transitions are also measured by the changes from underwear to pull-ups and then to diapers. Even more than the loss of mobility, the use of diapers is often the most dreaded adaptation. For many people, lack of control over urinary functions and timing is the definitive mark of the loss of independence.

Many of the elderly I have worked with are, at least initially, aware of the transitions and respond with a myriad of emotions from shame and anger to depression, anxiety, and fear. Theirs was the generation that survived the Great Depression and fought the last “good war.” Aging was an anti-climactic twist to the purported grandeur and tumultuousness of their mid-twentieth-century youth.

“I am afraid to die. I don’t know where I will go,” a resident named Lara says to me, fear dilating her eyes.

“Lara, you will go to heaven. You will be happy,” I reply, holding the spoonful of pureed spinach to her lips. “Tell me about your son, Tobias.”

And so Lara begins, the same story of Tobias, of his obedience and intelligence, which I have heard over and over again for the past year. The son whom she loves, whose teenage portrait stands by her bedside. The son who has never visited, but whose name and memory calm Lara.

Lara is always on the lookout, especially for Alba and Mary, the two women with severe dementia who sit on both sides of her in the dining room. To find out if Alba is enjoying her meal, she will look to my co-worker Saskia to ask, “Is she eating? If she doesn’t want to, don’t force her to eat. She will eat when she is hungry.” Alba, always cheerful, smiles. Does she understand? Or is she in her usual upbeat mood? “Lara, Alba’s fine. With you watching out for her, of course she’s OK!” We giggle. These are small moments to be cherished.

In the nursing home, such moments are precious because they are accidental moments.

The residents run on stolen time. Alind, like me, a certified nursing assistant (CNA), comments, “Some of these residents are already dead before they come here.”

By “dead,” he is not referring to the degenerative effects of dementia and Alzheimer’s disease but to the sense of hopelessness and loneliness that many of the residents feel, not just because of physical pain, not just because of old age, but as a result of the isolation, the abandonment by loved ones, the anger of being caged within the walls of this institution. This banishment is hardly the ending they toiled for during their industrious youth.

By death, Alind was also referring to the many times “I’m sorry,” is uttered in embarrassment and the tearful shrieks of shame that sometimes follow when they soil their clothes. This is the dying to which we, nursing home workers, bear witness every day; the death that the home is expected, somehow, to reverse.

So management tries, through bowling, through bingo and checkers, through Frank Sinatra sing-a-longs, to resurrect what has been lost to time, migration, the exigencies of the market, and the capriciousness of life. They substitute hot tea and cookies with strangers for the warmth of family and friends. Loved ones occupied by the same patterns of migration, work, ambition, ease their worries and guilt with pictures and reports of their relatives in these settings. We, the CNAs, shuffle in and out of these staged moments, to carry the residents off for toileting. The music playing in the building’s only bright and airy room is not for us, the immigrants, the lower hands, to plan for or share with the residents. Ours is a labor confined to the bathroom, to the involuntary, lower functions of the body. Instead of people of color in uniformed scrubs, white women with pretty clothes are paid more to care for the leisure-time activities of the old white people. The monotony and stress of our tasks are ours to bear alone.

The nursing home bosses freeze the occasional, carefully selected, picture-perfect moments on the front pages of their brochures, exclaiming that their facility, one of a group of Catholic homes is, indeed, a place where ”life is appreciated,” where “we care for the dignity of the human person.” In reality, they have not tried to make that possible. Under poor conditions, we have improvised for genuine human connection to exist. How we do that the bosses do not understand.

We CNAs also run on stolen time. It is the only way that the work gets done. When I started my job, fresh out of the training institute, I was intimidated by the amount of work required, the level of detail and thoroughness that each task required. I held on to my care plans tightly. My residents’ specific transfers, their diets, their habits, whether or not they wore hearing aids or glasses, their shower schedules, whether they needed alarm mechanisms when they were in their wheelchairs, whether or not they needed footrests, hand splints, blue boots, catheters, portable oxygen tanks set to level 2, or was it 3? All this information had to be absorbed. Harder still was trying to figure out how to cram the schedules of eight residents with different transfer methods, including the use of machine lifts, toileting needs every two hours or less, unpredictable bodily functions, two hours for meals, and one shower per shift, into an eight-hour day.

Under poor conditions, we have improvised for genuine human connection to exist. How we do that the bosses do not understand.

I received a lot of help and support from the other new hire, Saskia, and the two other CNAs who were in the same unit. Jess and Maimuna counseled, “Don’t rush. It’s OK. If you rush, it gets harder and you forget things.” Never mind that we were still always running down the hallway trying to get the work done. As long as in our minds we kept a grip on our stress levels and took deep breaths, we would be less anxious and more careful with the residents.

The worst was when there were episodes of Clostridium difficile (C. diff), a bacterial infection that spreads easily among residents on antibiotics. The clearest symptom of C. diff infection is loose bowel movement, or diarrhea. My second week of work, five of the residents I was assigned to had bouts of C. diff. No matter how much mental stamina and mindfulness I tried to keep, for a week, I was a running around like a chicken without a head. Cleaning, scrubbing, changing soiled diapers, bed pans, machine transfers, dressing the resident, undressing the resident, changing the bed sheets. Repeat, repeat, repeat.

Nevertheless, the work made me appreciate my co-workers, whom I was just getting to know. Saskia and I bonded over many episodes of diarrhea distress, and my growing friendship with her gave me access to a wealth of knowledge about workplace dynamics. The trust we built and solidarity we offered one another during the hectic times on the job immersed me in relationships with other Ethiopian co-workers who similarly offered advice about the ins and outs of the work. Saskia, the college graduate from Ethiopia, newly arrived in America, was full of excitement to live the American Dream. This nursing home job was meant only to be her first stop and I, an Asian immigrant who had lived here for the past ten years, was one of her first non-Ethiopian friends. As Saskia translated the hard-learned lessons shared over break times in Amharic, I learned to appreciate the importance of “having eyes on my back.”

Over time, I would also learn that reporting the health hazards, safety violations, and broken equipment to the overworked staff nurses or the arrogant charge nurses was useless. Only when someone got injured would it matter. Unless the state inspectors were conducting their annual visit, no one updated the care plans, gave us crucial information about new residents, thought it important to train us in health precautions, or bothered to fix faulty wheelchairs in a timely manner.

We had to push hard, ask relentlessly, and document, document, document our attempts, so that when some avoidable accident did happen, we would not be blamed. Too many times, we had to strain our backs and arms to compensate for lack of equipment and training. We had to fight and argue to get protective gear even when our residents had bouts of C. diff. “You just have to be careful it [the diarrhea] doesn’t splash on you. You don’t need a protective gown now,” or, “Are you sure it’s C. diff and not just diarrhea? You know you only get the protective gowns when it’s C. diff.” For a cheap, protective paper gown and an ever cheaper mask, one had to be ready to have a standoff with the charge nurse.

When Jess and I complained one too many times over a two-month period about a faulty automated machine lift that was dangerous to us and the patients, we were called into the Human Resources office for being disrespectful toward upper management. According to Sabrina, the lanky white woman who was the Human Resources director, we were inappropriately expressing our viewpoints in public. “Chain of command,” she reiterated. We were supposed to be thankful that it was only a written warning.

I had been baffled at and shocked by the degrading insinuations of our stupidity and management’s lack of concern for the well-being of the residents; now I was seething with anger and resentment.

Caring for eight residents and giving a shower to one of them every shift was not easy, but with multitasking, lost break times, help from other co-workers, and unending brisk walking throughout the shift, it was doable. Back then, even as we complained about our lost break times and our exhausted bodies, we grudgingly gave them up to complete our tasks. We looked forward every day to the time when we could sit down and sign off on our charts at the end of the shift, chat with one another and the residents, and clock out.

In October, things changed.

Roseanne, the new director of nursing services (DNS) announced that instead of four CNAs on the floor, we would now have three. The fourth CNA would be the shower aide. Showers that had once been distributed among the different shifts would now all be completed in the day shift. Three CNAs take on the residents that four CNAs used to care for.

“It’s not that different from what you have now,” she said, smiling. “I am new here and want to improve things. It’s more efficient this way. Come to my office if you have any concerns.”

“Is it possible to hire another person to work as a full-time shower aide? We really need four people on the floor,” I blurted out.

“No. If we hire one more person, we will have to cut all your hours. Would you want that? Come talk to me if you have any more questions.”

My co-workers and I exchanged looks. If we went in to her office one by one, we would be targeted. It was a trap.

Back in the dining room later that day, Lorena, the administrative assistant, agreed to talk to Roseanne on our behalf.

We wanted to back her up. By the end of the week, all twenty-five of the dayshift CNAs had signed a petition against the new staffing ratio. We calculated that the new plan would leave us with a mere twenty-five to thirty minutes of care for each resident per eight-hour shift. We were determined to make the case that it was neither safe for us nor the residents for us to be so rushed on the job.

When eight of us marched down the shiny bright hallway, into the boss’s office, the few short steps marked a longer journey. For the first time, we were going to speak up collectively. We were all nervous. We did not know how this would go down.

Our answer came the next day, when the director of the nursing home called us all to a huge meeting.

“If you form unions, we will have no choice but to fire all of you.”

End of meeting.

Before this, we had been willing to sacrifice break times to get the job done. Now we realized that no matter how much we worked, no matter how much we gave up to make this place more livable for the residents, in the eyes of management we were expendable, the easily replaceable pillars of the nursing home industry.

When we were calculating the time it took to complete our work, we found out that we were required under labor and industry law to have two paid fifteen-minute breaks, in addition to our unpaid thirty-minute lunch. Failure to provide those breaks by the employer constituted a violation of labor law.

To the outsider, fifteen minutes might seem short and insignificant. For us, it meant that we could take a short break from the mind-numbing cleaning, from the brisk walking, from being at the beck and call of the nurses. There is always more, more, and more for a CNA to do. The job never ended, unless we left the floor. Those short breaks made a difference between a stressed-out, flustered attitude and a calm, patient compassion. It was incredibly important. And we were determined not to give it up anymore.

“Go for break! I’ll take over here,” we would remind one another. Supporting one another going on break in the midst of the chaotic workload became our symbol of mutual aid. Battling that inner voice urging us to tough it out and actually taking that break was also sign of solidarity with other co-workers to set the pace on the job at a reasonable rate, so they, too, could take their breaks without being targeted as less efficient. Without this kind of self-regulation, we would all be pushed to work as fast as the fastest CNAs, even if doing so were unsafe.

So we took our mandatory breaks.

But the inner turmoil didn’t end. Every day, we asked ourselves, “Can I squeeze in fifteen minutes of break time and be done in time?” Call lights were going off, residents were asking to be toileted, the required daily vital signs log was still incomplete. The one automated machine lift that six CNAs used was free right when it was time for the break.

Our bodies’ need for a short respite was pitted against our residents’ immediate bodily needs. Having to weigh this moral dilemma every day was mentally exhausting. Either choice we made, we blocked out something deeply human—either our care for our own bodies or our care for others. Caring should not feel like stealing time.

CNAs are often told that we are the “eyes and ears of the nursing home.” But we are more than that. Our emotions and psychological well-being are also the sacrificial lambs of the nursing home bureaucracy.

It is one thing to relate to anxious family members, understandably concerned and worried about the condition of their elderly loved ones. That takes empathy and endurance on our part, but it is a welcome human challenge. Similarly, cleaning up soiled diapers and diarrhea mishaps takes patience and experience.

It is another thing entirely to have to tell anxious family members that we need to go for a break, and have them judge that our rest is mutually exclusive with the well-being of their loved ones. We are then labeled as the “selfish, lazy, immigrant workers” who somehow have different care and hygiene standards from the superior white society. We are reminded of that especially when these family members march off to confirm the latest discovery of this predominantly foreign character flaw to the white bosses.

It is one thing to be doing menial labor that is meaningful even if tiring. It is another thing to be cleaning up crap under the pressures of charges who ask why you aren’t done yet. After all, ten minutes to thoroughly and gently clean a resident who has soiled her diaper is more than enough. Taking longer would mean you are too slow (and so not suitable for this job) and susceptible to being fired; taking longer would suggest that maybe you are slacking and intentionally wasting time to reduce your workload. This ticking time clock obliterates any dignity from the work, the worker, and the resident. It degrades us all.

I try to embrace the challenges of empathetic caring, while rejecting the pressure to work like a machine in the name of management’s definition of care. What’s hard is the murkiness between them.

Empathy stretches the boundaries that constitute who we are, enabling us to embrace the commonality in all human experience, especially experiences that we may not personally undergo. For a front line healthcare worker, it is empathy for another’s pain—the desire to alleviate suffering—that distinguishes our work from jobs that involve the production of inanimate objects, such as manufacturing. Factory workers and CNAs both keep society running; our work is not more important than theirs, but it is different. The factory worker’s alienation comes from producing a product in ways over which she has no control and that will be distributed to, and consumed by, people she will never meet; her production is dictated by her bosses’ profits, not by human needs. If the boss forces her to speed up and the product ends up becoming unsafe, she may never see what will happen to the consumer who is hurt by it. For CNAs, our alienation comes from the fact that we interact with the people affected by our labor, and we do see what happens to them when we can’t care for them the way we know we should. In the face of this contradiction, we need to nurture and develop our sensitivity to empathy, so we remain open enough to respond flexibly and justly to a patient’s needs.

The nursing home attempts, in its own warped way, to drill a superficial empathy into us. The bosses always end their service training with the motto, “Now, treat the residents like you would your own parents. You wouldn’t want them to have to wait for their call lights to be answered!”

But rather than be inspired, I, along with many of my coworkers, snigger cynically.

By invoking our distant family members, managers invade yet another space in our psyche, trivializing the obstacles that so many of the workers encounter. Much of my time with co-workers is spent talking about distant family members: reminiscing, discussing the burdens and challenges of trying to bring them over to America to join us, or worrying about supporting them with our meager salaries.

We discuss organizing ourselves to demand more staffing, so we won’t have to rush, so that we will actually have time to provide our residents with the care that we believe our own families deserve. Yet the managers themselves have made it clear that if we organize ourselves we could be fired, which could have a devastating impact on our ability to care for our own families. The fear of losing the income to list in that damned Form 864I Green Card Application to bring our families over weighs on our spirits. We are torn from family, and yet our shameless bosses try to milk our love for family to serve the speed-up.

We are not the only ones who lament the loss of agency in the nursing home environment. In fact, our infantilization by the bosses is only a reflection of the way the elderly and people with disabilities are treated. Genuine support for the elderly and thoroughness of care that respects their self-determination would require more labor-time, labor that the bosses are unwilling to pay for, and in many cases the resident’s own families couldn’t afford because their own wages are not high enough. The ticking time clock and the money-saving blueprints don’t allow for human agency or rhythm.

As workers, we find ourselves in a crossfire: on the one side, an unyielding, brutal bureaucracy overworks us, and on the other side, residents genuinely need our assistance. Every decision related to our work is filled with an exaggerated moral dilemma between how refusing the former will affect the latter.

Our infantilization by the bosses is only a reflection of the way the elderly and people with disabilities are treated.

To silence the daily moral ambiguity of whether or not to prioritize our own needs or the needs of the residents, many of us erect walls in our hearts and minds to block out emotions that we cannot handle.

“I don’t care anymore, it’s not my fault. I know someone needs me, but it’s not my fault. I can’t be there for them.”

We blame the bosses. Once, twice, and then too many times. Over time, this rationale kills what is tender and living in us. Over time, it is used to justify actions that are not even consequences of management’s policies. It is used instead to mask sloppy hastiness, by giving it pseudo-political cover.

Some erect walls so high that even painful screams cannot shake us. “It’s not my fault,” is sufficient rationale for the mistreatment of residents. Being too tired, too pissed off, erases the daily moral choices of our job. “What do you mean I’m rough? There are no bruises. No bruises, no evidence.” Their walls are so thick that even the rebukes of fellow workers cannot penetrate. Fear of punitive action is the only limit that remains.

Others have built lower, thinner walls and recoil at the pain we cause through rushing; we bring home guilt about the bedsores that develop on the residents’ skin as a result of improper care. The cringe on a resident’s face as we approach reminds us to slow down. The chiding of other co-workers to be gentle reignites our conscience.

Some say that the longer you work at the job, the higher those walls become. I think of people like Alind and Maimuna who prove that wrong. I know what has kept them going for so many years has been the combination of individual conscience and the support and recognition of their work from their communities inside and outside the workplace, including religious communities. Their communities continually inspire them and hold them accountable to good care for the elderly.

There is a need for moral accountability that even extra time and labor will not buy. Most of my co-workers share a set of values and principles, a work culture that emphasizes the well-being of our residents. The workplace rumor mill points out and vilifies those who fail by these unwritten standards. Yet, there is no space to talk about this openly, because any talk of accountability is monopolized by managerial power and exercised with racism and cold harshness. Left on our own, we could hold each other by our common standards, create sustainable conditions for the work, and not allow each other to harm residents. But for now, whatever methods of accountability we do have remain hidden in whispers, glances, and conversations in Amharic that the bosses won’t understand.

The deadline we had given to management for a meeting about staffing ratios came and went, with no response to our petition. So, in our weekly meetings, some of us devised Plan B. We would publicize the abject working conditions in the nursing home. Our flier stated, “Our working conditions are the elderly’s living conditions.” We hoped family members would support us. Fearing retaliation, we sought help from friends and contacts, to distribute the leaflet we created. The flier was to remain anonymous so it wouldn’t be linked to us.

It was a Sunday when our friends and supporters stood outside the doors of the nursing home to hand the flier to the family members and volunteers attending Sunday services with their elderly relatives.

Some were sympathetic, others not so. Some people saw this as a unionizing effort and worried about how that would increase the medical fees they would have to pay.

“This is all unfounded,” said the nursing home’s paid pastor, as he shooed our supporters away from the front door. One of the nice white women in pretty clothes tore down the posters on light poles and sign posts that lined the perimeter of the home. The new DNS and other administrators drove in from their suburban homes for an emergency Sunday evening meeting.

Inside, we were anxious. We did not know what to expect. We hoped this action would make the bosses rethink their new policy.

We did not anticipate the level of psychological pressure that management would exert. They had clearly sought the advice of union-busting manuals and experts. It was something I, personally, and we, collectively, had not prepared for.

A few days later I was called to Sabrina’s office, where she, another administrator, and my charge nurse played good cop, bad cop.

“We are trying to help you. People have thrown you under the bus by naming you. Why do you want to protect them? They don’t deserve it. You don’t have to sacrifice yourself like this. If you tell us their names, you won’t be the only one taking the blame.”

“If you don’t tell me who the others are, we will fire you.”

“Are you going to let the others off for ratting you out?”

“You know, you and all the other people involved are breaking federal law by doing this. You are exposing the conditions of the private lives of the residents. You are violating HIPA. This is illegal. You can be fired and jailed. You can lose your license.”

My refusals and denials invoked only fiery glares.

“Sign this. Otherwise you will be fired.”

The document stated that I had been in violation of company policy for distribution of unsolicited material.

I wrote on it that I was being forced to sign and threatened with my job over a collective job action.

When I went home that day, I cried. Then, I went to the National Labor Relations Board to submit a complaint. Weak as labor law is, maybe it could save me my job.

The bosses saw this as a mainstream union’s effort from the outside, in part because mainstream unions have been leaders in public labor actions, and in part because they could never believe that we on our own, could organize. They thought that they could smother years of resentment from overwork and disrespect with lottery prizes of Snickers and Kit Kat bars in our monthly staff meetings. They thought they could buy us off with $50 vouchers so we would trip over each other to become the Employee of the Month. They thought they could win our hearts over the way they win the public over with banners saying “We love our CNAs” hung over the doors of the home. So when we decided to change things on our own, they were not prepared

What got me through management’s attempts to isolate me from my co-workers were the relationships we had built with one another before the organizing. Our friendships consisted of more than risky political actions. They consisted also of support and solace, advice on how to handle relationships, how we planned to return to our home countries to visit our families, and how we each adapted to America. At other times, we talked about U.S. imperialism in Iraq and Afghanistan, the Tunisian revolt and Egyptian uprising. “We need Tunisia here, in this workplace!” Alind would joke.

They thought that they could smother years of resentment from overwork and disrespect with lottery prizes of Snickers and Kit Kat bars in our monthly staff meetings. They thought they could buy us off with $50 vouchers so we would trip over each other to become the Employee of the Month.

Those days of running around like a chicken without a head, of sharing a culture of solidarity so each of us could go on our breaks, of each of us taking up extra tasks so someone else who had a long day could rest—those moments of mutual aid and solidarity paid off. When labor struggle is low, a militant can only count on her reputation. This is hard because reputations are such subjective things—someone might like you while another might not for some random reason. In a workplace where gossip is rife, and where the stress on the job creates many opportunities for misunderstandings and tension among co-workers, it’s hard to have a clean reputation.

That said, reputation is always rooted on some fundamental issues: How are you on the shop floor? Were you able to put aside personal drama to help out a co-worker? Are you the type that talks smack about co-workers? Are you the type that sucks up to the boss or do you handle things outside, to talk things out with your co-workers? Do you bear grudges? Do you think about other people when you do your work? Do you take out your stress on your co-workers and on the residents? Building the relationship bonds that can withstand the attacks by management means that in our everyday lives we have to strive to be better people, deserving of respect from one another, accountable to one another. This requires daily emotional and mental resilience and discipline.

To me, this is in part what Karl Marx meant when he said that in the process of class struggle, the working class will transform itself. We can only truly succeed if we are also transformed into better human beings who are good to one another. This transformation has stakes, in the context of class struggle. You can’t fake it because people see through fronts all the time.

The few organizers and I earned the name “chigri fetari,” or troublemaker in Amharic. I am sure some people said it sarcastically, but others said it in a respectful and endearing way, a term for those who resist. I remember vividly how the workplace became polarized. I had friends, and I also had haters. The period when the bosses cracked down on me by following me on my job, inspecting every small thing I did, selectively enforcing every small rule at the workplace, writing me up for taking my break five minutes early, or when I was back from break a few minutes late, was extremely stressful. “Why won’t they just fire me?” I asked myself a few times. But I was too proud to quit on my own. Jess, Maimuna, Saskia and others, knowing that I was being especially targeted, helped me pick up the slack and warned me when the bosses were coming.

In the meantime, Sabrina, the Human Resources director, showed us how “divide and conquer” works. To Benny, a relatively timid Ethiopian coworker, she offered help with the immigration process for him to bring over his entire family. This was unprecedented. She made sure we all knew about this by giving him the paperwork in the dining room where we all gathered.

To Joanna, the Filipina co-worker who had snitched and offered our names to management, she gave a pay increase and flexible hours.

The price of organizing was exorbitant, both mentally and emotionally. We now had mandated break times that we were each allocated to. Instead of an uneven distribution of staffing ratios where someone would have nine residents while another would have twelve residents to care for, we now all had ten residents each to care for. The shower aide, previously required to give ten showers a shift, now had seven. Were these changes victories? It was an ambiguous situation. On my end, I was lucky I still had a job.

“Use labor law as a shield, not a weapon,” is a slogan I have often heard in labor organizing circles. It gets at how labor law in the United States is no substitute for collective action by politically conscious, courageous workers. At times, labor law even serves to suppress militant action. That said, labor law could be useful during low periods of struggle, to buy time and space for organizing. The National Labor Relations Act Section 7 gives workers the right to concerted action around working conditions. If one can prove that management retaliates for such collective organizing, then the employer will be mandated to post a letter in the workplace informing workers about their legal right to organize.

The posting that the National Labor Relations Board mandated my bosses to put up for three months didn’t save me from their covert harassment, but it did save my job.

I may not have been fired, but overall gains were dubious. We were demoralized. We felt some self-respect and gained some experience, none of which was truly tangible or quantitative. But otherwise, the organizing was dead.

That December, for the first time ever, most of the workers boycotted management’s Christmas lunch. No fake smiles and false wishes this time. It drenched their ungodly Christmas cheer, and they were pissed.

The lessons from this failed organizing attempt were hard earned. My co-workers and I were too hasty. We were not prepared for backlash, and I personally became too obvious as a leader and target. Of course, management is always going to find someone to vilify, as scapegoating one person gives the others an opportunity to back off from the organizing.

In the end, our mistakes seem small in the context of the obstacles we faced. Our workplace, where we spent a chunk of our life silencing our own instincts and intelligence to conform to the rules and regulations of a top-down hierarchy, where any individual expression subjects us to mental torment and coercion, and where willingness to subject ourselves to overwork becomes a criterion for how compassionate we are, is somewhat like an abusive relationship. There is emotional exploitation and financial coercion, but you can’t leave the relationship because you depend on this other party for your livelihood. If this were about two individuals, it would be considered domestic violence.

But engaging in this necessary struggle was important. First, it injected fear into this racist, ugly bureaucracy. It let them know that we could come together, and when we did, they had a lot to lose. It made them a little less arrogant, and it gave us some dignity.

I never got fired for my organizing, and neither did my co-workers. What saved me was a combination of my co-workers’ refusal to sell me out and their willingness to help me out on the floor. When I would give up and let yet another unjustified write-up slip by, my co-workers would persuade me to keep fighting. “You don’t deserve this black mark on your file. Don’t give up.”

The support I got from the community of independent, rank-and-file labor organizers around me, such as the Industrial Workers of the World, was essential. Many had been through similar experiences and shared their expertise and strategizing with me at all times. Knowing I was part of a bigger team gave me the strength to survive yet another day of management’s mental warfare.

“Go home to where you came from, you stupid girl!” Eleanor yells at Maimuna and me as we transfer her into bed after her meal.

Jeannie mutters in her drowsy blur, “Where is that colored girl? I want my food.”

Joseph, the army veteran who brandishes his discolored American flag tattoo every so often, bellows, “Speak proper English, I don’t know what you’re talking about!”

We CNAs, are people displaced, moving— in many ways forced—from our home cities, farmlands, families, into this nursing home, a job that falls short of our American Dream. Divided by our languages and backgrounds—Filipino, Ethiopian, Chinese, Eritrean, African American, white American—we seek some temporary moments of cohesion and solidarity with each other. As soon as we come together, the bosses try to split us into neat blocks of yellow, black, brown, white through coercion or favoritism.

The mostly white residents are people displaced in a different kind of way. Their old ideologies were shaken by the civil rights movement, Black Power, and the Vietnamese resistance. In addition, they were thrown off by the deindustrialization that closed down the cities they came from and the workplaces that ground their bodies down. Some of them reminisce about the good old days of the postwar industrial boom, when the racial pecking order gave them first dibs. Theirs was a time when America was on top, an image shattered by CNN news reports that blare in their dining room.

Their memories of the good old days are fading as dementia or Alzheimer’s take hold. Their dignity in their last days cannot be secured by white memories alone; it will only be secure if America’s memories of itself do not fade as fast as theirs; if we actively remember the racism and violence that have brought us to this point, the fire hoses and attack dogs in the South and the napalm in Vietnam, the racism and industrial accidents in the plants, and all the other parts of the boom years that resist nostalgia.

Their years of laboring in the boom era are measured now in Medicare and other insurance policies that pay for their last years here. Some who are still mentally aware try to escape, others make the best out of their circumstances, participating in the home’s activities. All know that when dementia or Alzheimer’s settles in, their fate will be the same as others’. Their whiteness may have saved them from some of America’s miseries, but it has not saved them from this place, and it will not save them from the grave. They have witnessed too, with their own eyes, ears and bodies, how America runs on stolen time.

We cross paths in the nursing home, an environment built for the outcasts. Mass-produced meals, mass-produced standards, mass-produced workers dying on America’s scrap heap. In this mess, we all lose some aspects of who we are. Perhaps by uniting (on stolen time), we can regain what we never wanted to lose.

JOMOis the pseudonym of a certified nursing assistant who is now in nursing school. JOMO wishes to acknowledge the support of co-workers in the struggle described above for their solidarity and support. A longer version of this article originally appeared at

All names used in this article have been changed, and some characters have been written as composites in order to protect their identities. Art by Imp Kerr.