For those on the front lines at Massachusetts nursing homes, the job stresses have grown. And the public cheering for health care workers is barely audible.
They report to work each day and don protective gear. They care for old and frail residents who are confined to their rooms, with sickness and fear all around. They help residents get out of bed, get dressed, eat, and go to the bathroom. And sometimes they sit by their side when they die.
To labor today at long-term care facilities, which have accounted for more than six in 10 of the state’s COVID-19 deaths, takes love and commitment, teamwork and grit — and perhaps, above all, an us-against-the world mentality.
“It’s very personal when your first patient dies,” said Diane Furey, a nurse practitioner with the North Shore Physicians Group who divides her time between two nursing homes, Abbott House in Lynn and Devereux House in Marblehead. “With this pandemic, it’s literally like going into a battlefield.”
Furey, whom colleagues call “PPE Santa,” has helped her fellow nurses and caregivers prepare for the battle by organizing a Facebook group that has obtained shipments of gowns and other personal protective equipment for nursing homes.
Many front-line nursing home workers have been sickened by the coronavirus, and at least four nurses and social workers have died, the Globe has reported. But the actual toll among the staff at long-term care facilities is unknown, because state health officials have not reported the numbers.
Some nurses who work in long-term care facilities say they feel forgotten by the public, even as they face constant risk and heartbreak and, as days blur together, make what they see as the most meaningful contributions of their lives. Some feel stigmatized by politicians and media reports that seem to suggest they’re at fault for the spread of COVID-19 in their facilities, despite having followed public health guidelines and precautions to keep the virus out.
When grateful multitudes clap from their balconies and military jets fly overhead in a show of appreciation for health care heroes, some don’t feel like the tribute is for them.
“All of the things that the hospital workers get glorified for are taken away from us in the nursing homes,” said Sandi Richards, a licensed practical nurse at Life Care Center of Nashoba Valley, who spent two weeks at home sick with COVID-19 but returned to work in April. "They kind of made us feel like we’re not as worthy as other people when we we’re doing the same job that people in hospitals are doing.”
Work at long-term care facilities, which are often understaffed in the best of times, has always been tough for the certified nursing assistants, dietitians, housekeepers, and others who log long hours for relatively low wages. In the era of COVID-19, that work has only gotten harder.
Certified nursing assistant Ritha Meritus has worked for more than 20 years at South Dennis HealthCare on Cape Cod. Now she has to change in and out of protective gear seven to 10 times a day as she goes from room to room at the home, where some residents have been infected with the virus.
“I used to spend 20 minutes with a resident,” Meritus said. “Now it takes twice as long. It’s so frustrating. I’ve got the mask on all day. When I get home, I have a headache.”
But for Meritus, a mother of five who lives in Yarmouth Port, the job has been a calling since she imagined her future as a girl growing up in her native Haiti. “Ever since I was young, this was my dream,” she said. “I enjoy talking to my residents, listening to their stories. It’s like a family for me.”
Meritus acknowledged her 12-year-old daughter is scared and worried when she goes to work. “She calls and texts me 10 times a day,” Meritus said. “'Mommy, I don’t want you to die.' I tell her I have to take care of people. When I get older, I want somebody to take care of me.”
At Life Care Center of Nashoba Valley, employees have felt like they’ve been under a spotlight. Twenty-two residents and one nurse have died of COVID-19. A sister facility in Kirkland, Wash., was the site of the first reported US coronavirus outbreak, in February, with dozens of deaths. The home in Littleton had been cited by inspectors for “isolated” infection-control deficiencies in August — management said they were quickly corrected — months before the virus appeared. A Washington Post story cited infection-control problems last month in 10 other Life Care facilities.
The stresses of the job were magnified in mid-April, when a letter written on a brown paper bag made threats against the Littleton nursing home. A police officer was posted near the entrance to keep out television cameras. Workers who remained on the job, even as more than 70 colleagues had left at one point due to sickness or fear, say they’ve tried to do their best but have felt the glare of criticism from public officials and even some friends and neighbors.
“You have to justify why you come to work every day,” said Jessica Seri-Solis, a certified nursing assistant at the Littleton facility. “We do it because this is what we do.”
For some, the sense of teamwork and camaraderie has offset the feeling of not being understood by outsiders.
“We’ve had stressful days where we’ve just lifted each other up, and to know that we have each other’s backs is really nice,” said Deborah Thrush, the Life Care activities director. Many of her co-workers didn’t know each other well before the crisis, she said, but "in the last four weeks, we’ve bonded.”
As staff shortages worsened, many workers stepped outside their normal jobs. Laundry workers and receptionists went into rooms to assist residents. One receptionist stayed late to sit with a resident who was succumbing to coronavirus for three hours, so she wouldn’t die alone.
When sick residents recover or sick staffers return after their quarantines, staffers stand and applaud.
“I was in bed for two weeks," said Sam Siawor, a licensed practical nurse who had to take sick leave last month. “I didn’t want to go to the hospital because I was scared to go to the hospital. But I recovered, and I came back, and I was so impressed when I saw the teamwork that was inside. It lifted my spirits up and made me realize that it’s worth it to work in this building, to work here.”
While their efforts are largely invisible to outsiders, those inside nursing homes recognize the role the workers have played in a pandemic that has upended everyday life.
“Nursing home workers have always been the unsung heroes,” said Dr. Larissa Lucas, of North Shore Physicians Group, who serves as medical director for nursing homes in Peabody, Lynn, and Marblehead. “But Covid has really brought their dedication to the forefront."