CNAs are at heart of Good Sam community
At 6 p.m. on a Tuesday evening, the dinner hour is almost over at Good Samaritan Society-Socorro. Outside, flags are flapping in the wind, doves coo and a tiny rabbit scurries across the grass. Inside, residents are gathered in the dining room over the remains of their evening meal, and a sleepy peace prevails.
Flora Lucero, a Certified Nursing Assistant, sits with four ladies at a table, encouraging them to eat and drink, wiping up spills and making light conversation in a mixture of English and Spanish.
“Drink, mamacita, drink your juice,” she says. “Will you drink it for me?”
Hydration, Lucero explained, is very important — more important at this hour than eating.
“They have a really big breakfast, and a good lunch,” she said. “And they have snacks. Then for supper, they kind of pick at their meals. It’s OK. We understand.”
Lucero grew up in Socorro, and graduated from Socorro High School in 1976. Many of the residents here are people she knew growing up.
“Her, she was my mother’s friend,” Lucero said, pointing across the room. “And I knew her, she lived down the street. I know their kids and their grandkids.”
They know her kids, too, and they ask about her son, who’s graduating from Socorro High this year.
After dinner, it’s time to start getting the residents ready for bed. Some get to their rooms under their own power and begin making their own preparations. Others need more help. In the evening, there are three CNAs in the front half of the building, to care for about 40 residents. In the back, in the Special Care Unit, there are three more CNAs, for the residents with Alzheimer’s, who are cared for separately.
Pushing one woman down the hall in a wheelchair, Lucero passes a room where a small lady sits quietly by the door.
“How are you feeling tonight, mama?” she asks.
“I feel kind of down,” comes the answer.
Lucero stops to give the lady a hug.
“I have to take care of some people right now, but I’ll come back later, OK?” she asks. “We’ll talk.”
Before she can come back, she has to take care of half a dozen or so other residents, each of whom might need 15 or 20 minutes to get settled in for the night.
“We need more CNAs,” Lucero said.
Depending on which hallway they are assigned to on a particular night, the aides each have their own routines. Lucero prefers to start with the heavier residents, who require the most physical strength to lift or need special equipment to help transfer them from wheelchair to bed.
Sue Padilla, who is on the north hall this evening, has her own approach.
“Some of them are on oxygen, and they really need to lie down,” she said. “I take care of them first.”
Others would rather be moved to a recliner in the main hallway and sit for a while before turning in.
“This is their home, and we’ve got to respect that,” Padilla said. “You can’t just do what’s convenient for you — you have to pay attention to what they want.”
Padilla, who is originally from Alamo, has worked at Good Sam for more than a decade. She left once, for a year, but came back.
“I like to work with old folks, because they tell you a lot,” she said. “When you listen to them, it makes a difference — you make a difference to them, and they make a difference to you.”
The job itself isn’t glamorous. Although CNAs have the most one-on-one contact with the residents, they aren’t the highest paid people on the staff, and much of their time is spent feeding, wiping and helping residents with bodily functions.
“Sometimes it seems hard, but I can’t really explain it,” Padilla said. “There’s a lot to learn about elderlies. They can really tell you about life.”
It would be difficult to find another job where the employees are so constantly aware of how much they are needed and counted on. Padilla mentioned a resident who has been at Good Sam for a long time and has seen CNAs come and go.
“He was worried about who was going to take care of him,” she said. “I told him, the regular CNAs that work here, we’ll take care of you. We’re your family. It’s like you’re taking care of your grandma and grandpa.”
Humor and Heart
Outside, a roadrunner comes out from under a tree and is chased back into the shadows by a Gambel’s quail. With most of the residents settled in, at least for the moment, the CNAs can take turns having a short break outside in the evening air.
“This place is wonderful,” said Oniz Miranda, who’s in charge of all the aides and works alongside them, taking extra shifts. “The residents, the CNAs, the dietary staff, housekeepers — we’re a family. But we need more staff.”
Miranda has worked at the facility for more than two decades.
“I tried to get a job here for three years — back then it was all in who you knew,” she said.
After 20 years, Good Sam is home for Miranda, and she wouldn’t work anywhere else. But, she said, it’s not for everybody. It takes a special kind of person to work with elderly people.
“They’re not going anywhere. This is the last place they’re going to be,” she said. “You’re going to have to wipe them, bathe them, you have to have the heart for that.”
“You have to have a sense of humor,” said Kenneth Hollar, who has slipped outside to light a cigarette. Hollar is young, not long out of high school, and thinks about doing other things with his life.
“I want to, but I got too close to my residents already,” he said. “In the back, I deal with all the Alzheimer’s residents. They crack me up all the time. I have so much fun.”
Talking to the aides, a theme emerges — they’re here because of the residents.
“You wish you had more time during the day to be able to spend time and care for them and listen to their stories,” Miranda said. “They need that ear, for you to be able to hear them.”
Often, as they tell each other their stories, the residents and their caregivers become very close. CNAs often seem to find themselves going out of their way, on their own time, to do nice things.
“You get attached to them. There was one who always asked me for a cheeseburger, plain and dry with a pickle,” she laughed. “Last week, one in back, she wanted something to eat. I said, what do you want? She said, what have you got?”
After quite a bit of back and forth, it turned out the resident wanted some menudo, so Miranda went to a restaurant and brought back menudo.
“She ate it all, too,” Miranda said.
Being attached means you share both the happy and the sad.
“The hardest part is dealing with emotional problems,” Hollar said. “When I see my residents cry, it makes me want to cry.”
Deaths can be difficult to deal with, too.
“It’s hard when you have residents that are about to pass, and there’s no family here, and you have to be there, to reassure them,” Lucero said. “That’s the hardest part. When there’s family here, we step back, but when there’s no family here, we’re their family.”
Occasionally the family members need caring for too. Miranda, like the others, has spent her own time helping families make funeral arrangements and seeing them through a few difficult days and nights.
Training to be a CNA isn’t very expensive, and doesn’t take very long. The state requires CNAs to complete a minimum of 75 hours, some of which is done in the classroom, and the rest in hands-on clinical experience. Classes are offered through UNM-Valencia, and Alamo Navajo School students who take them can receive dual-credit.
As of June 15, Good Sam will offer the clinical experience portion of the program, so students won’t have to travel to Belen or other parts of the state to get hands-on training at a nursing home or long-term care facility.
Finding enough regular CNAs to work at Good Sam has been an ongoing problem with an expensive solution. Ryan Mertz, the center’s director, said Good Sam has had to rely on staffing agencies to provide help, and besides being temporary, those staffers are more costly. In the few months that he’s been in Socorro, his number one concern has been to find a way to replace temporary agency staff with permanent, full-time local employees.
It’s a “Catch-22” situation. If the monthly agency bill wasn’t so high, Mertz would be able to offer more competitive wages to attract new permanent employees, but until he has more permanent employees, he can’t eliminate the expensive agency staff. He said he may be able to announce some changes to the pay scale soon, but in the meantime, there are other incentives that he hopes prospective CNAs will find attractive.
For example, he said, there are shift differentials — CNAs make slightly more for evening, weekend and overnight shifts, and there’s an hourly bonus if they pick up extra shifts beyond their regularly scheduled hours.
“We offer a pension, and PTO — that’s paid time off,” Mertz said. “If they want, they can sell it back and have cash in their pockets.”
Mertz said CNAs can also improve their pay rate by taking advantage of free online training in specialty certifications, and they can get financial assistance to work their way toward LPN or RN degrees through a Good Samaritan Society program called “Growing Our Own.”
“The foundation will pay one-third, the center will cover one-third through a combination staff scholarship and loan, and the student covers one-third,” Mertz said. “We have someone right now who’s taking advantage of that.”
The classes are offered through a University of South Dakota distance learning program, and the clinical experience happens on the job.
Beyond just the everyday concerns of having enough staff to provide the necessary quality of care, Mertz said, he wants Good Sam to be a center where people grow in their health careers. In the short term, though, Mertz has 15 CNAs and needs about eight more. Although Good Sam has 66 beds, right now it can fill only 55 due to staff-to-resident ratio requirements, and there’s a waiting list.
Meanwhile, the long-term members of the Good Sam family, residents and staff alike, care for each other day in and day out, and take pleasure in sharing the little things.
Dietary aide Travis Barnett began at the center doing community service, and stayed for the stories.
“There are 10 here, off the top of my head, that can tell me their first car was a Model T,” he said. “We have a WWII pilot, and one lady who was a nurse at Pearl Harbor. There are three that have been to Vietnam. We have a coal miner’s daughter here, from Virginia. It’s a fun place.”
“I like it when you tell them a little story, like you ran out of gas, and it reminds them of a time in their life when something happened, and they tell you a big story back,” Lucero said.
Being a CNA has its rewards, but it’s not for everyone.
“It takes a special person to be a CNA,” said Mark Hererra, who has worked at Good Sam for years, and seen many people come and go. “If the little things make you go ‘ew’ then you don’t belong here. You have to have a heart.”