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Nursing homes are especially vulnerable to Covid-19. Here’s what it’s like to work in one.

A third of US coronavirus deaths have happened in nursing homes. Here’s what workers are doing to keep residents safe.

A person accompanied by a standing caregiver sits in a wheelchair facing a glass door.
Nursing homes around the country have been hit hard by Covid-19.
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The nursing home where Amanda works, in St. Louis, is currently Covid-19 free. She fights to keep it that way every time she clocks in. Amanda, who requested we only use her first name for professional reasons, is a receptionist, but like everyone else, she arrives at her job in full PPE and follows a rigorous disinfectant schedule. She no longer checks friends and family into the facility to see residents; instead, loved ones wave at each other through a window. If visitors bring gifts, Amanda and her colleagues put them on a three-day hold to ensure that any lingering germs are dead before being delivered to their rightful doorstep. But despite all of those precautions, Amanda describes her workweek as a deeply stressful experience. Disaster can strike after a single slip-up.

The coronavirus first made American headlines in late February after an outbreak in a Seattle-area nursing home. In the months since, more reports surfaced about how uniquely vulnerable care centers are during this pandemic. On May 9, the New York Times determined that one-third of confirmed US Covid-19 deaths occurred in nursing homes — a total of 28,100. Amanda has followed the coronavirus story since February and believes that her facility dodged a bullet. The entire staff is especially demanding in their social distancing measures. Amanda hardly ever goes to the grocery store and her four kids haven’t hung out with their friends in months. The health of the people under her watch is just that delicate.

On May 4, the state of Missouri lifted its stay-at-home order. Restaurants and bars are operating at limited capacity, same with barbershops and nail salons. Missouri has only around 10,000 confirmed cases of the coronavirus, but Amanda still feels like the government is leaving her behind. The faster her city opens up, the more it will put her seniors at risk. Read our conversation below.

When did things start to get weird at work? When did the pandemic become a reality?

It was right about the time when they started saying things needed to shut down [on April 3]. But I stay up on the news, and I was panicking in mid-February. I asked my administrator, “Do you want me to start making masks?” back then. She said, “What for?” Once they started recommending that our residents shouldn’t have visitors, that’s when things started to change. There were so many people who were angry, but just as many who were like, “Oh good, I’m glad you’re doing this.”

The moment the coronavirus really started making headlines in America was after it started circulating in a care center in Washington. What was your reaction to that news? How did it feel knowing that nursing homes, in particular, were vulnerable to this pandemic?

We started having staff meetings where we were making sure everyone knew about the PPE and how to use it. We talked about cleaning all the surfaces. [In February] they were already telling us all the safety precautions. Then they started talking about how, when you’re not working, to not go places. Get someone else to do the grocery shopping, things like that. Our administrator was giving us great information, and I truly believe that’s why we haven’t had an outbreak in our facility.

You’re 42, so you don’t fall into a high-risk demographic. But your job puts you in contact with people that are every day. Has that caused you to be more stringent with your social distancing? Do you try to limit your time outside more than other people around your age?

Yes, I won’t let my kids see their friends. A lot of people are letting their kids see other kids, but I nipped that in the bud right away. My colleagues have done the same. We also definitely wear the masks. If I do shop, I try to get everything and anything we could possibly need.

How has that affected the culture in the facility? Is there a feeling of stress or paranoia, given the fact that you’re in an extremely high-risk environment?

Yes, we’ve had people that have quit because of this. We’ve had people that have cried. I’ve cried at work before, it’s just so stressful. But we’ve had a lot of people gear up and help keep the morale going. We have a great activities director who’s been trying to find things that we employees can do to entertain the residents. They’re not able to see their families, so we do special dress-up days and contests, and that’s countered the awful feeling of this pandemic.

How are the residents responding to all this?

I believe in our rehab side there’s been some residents that are frustrated. But we do allow the families to go to the window and knock and wave, and talk on the phone. For the most part they’ve been accepting of the situation. I know some of the residents don’t want to keep their masks on outside of their room. We have to remind them. But a lot of them have memory issues, they don’t remember why they’re wearing masks in the first place. We’ve just been trying to keep the communication between the residents and the families as best we can.

Right now, most states in the US are opening up in some capacity. I would imagine you would have an interesting take on that policy, given where you work. What’s your reaction to that trend?

I think it’s absolutely ridiculous. I understand that people need to make a living. But if you sit and watch how germs spread, I mean, a bar is one of the worst places to be going to right now. You talk louder when you’re drinking, you get closer when you’re drinking because the music is loud. It’s just a spiral. People might feel perfectly fine and don’t understand that they have the virus. For Mother’s Day, when families were bringing in presents, we were putting them on a 24- to 72-hour hold, and not letting them touch them until they were clean. If we’re still doing that, why are they opening bars? It doesn’t make sense to me.

Is there a feeling that right now nursing homes are not being thought about enough by state governments?

I believe that our government hasn’t done anything. Absolutely nothing. The only thing that’s happened has been some restrictions, but there’s no backup for it. I really think that this administration has blood on its hands. For them to act like coronavirus was nothing back in February, when clearly it was something. Why don’t we have rapid testing in our facility right now? They should be in every hospital, every nursing home, and they should continue to produce them until they’re in schools and courthouses. We should have rapid testing for everyone right now, not just for the president of the United States.

Personally, I’d feel so guilty if I got someone old and immunocompromised sick. I would guess that you feel that pressure. What’s that like? Does the guilt factor get in your head?

Every second of the day. I can’t sleep nowadays because I dream about being the cause of people dying. That’s a horrifying thought for me. I’ve written up my resignation several times. But I don’t have the heart to do it because they need me there. Those nurses don’t have a choice, they have to do it. So I get back in there. But every minute of the day, I’m terrified that I’m going to be the one.


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