A Misstep On the Floor: Lessons from a CNA

nursinghome1The following piece  is written by Miami IWW member, Luz Sierra. In this article she provides an anecdote of her recent organizing experience as a C.N.A. It shares powerful insights of the harsh conditions healthcare workers face, the  lack of care provided to patients, and the oppressive behaviors of employers within the health system. Not only that, she also adds experience being laid off and facing unemployment. Overall, it a very penetrative piece with great advice for organizers.


By Luz Sierra


Six weeks ago I resigned from my former job. I worked as a Certified Nursing Assistant (C.N.A.) in a residential home for the elderly for about four years. I decided to resign once my boss removed me from the schedule. Her reasoning was that my availability was suddenly unacceptable for her and she did not approve of my performance any longer. This strangely occurred two weeks after I attempted to organize an action at my workplace, so the rationale behind my indirect firing seems obvious. I believe that in my organizing I made some mistakes that I hope to illustrate and analyze in this piece.

The setting is a recognized and prestigious retirement facility in Florida. It is known for its luxurious physical appearance and top health care service. Yet, underneath that ostentatious layer was repression for its employees. As a young employee, I was appalled of what I saw in the facility. There was surveillance almost everywhere. Constant supervision and pressure to work despite threats of pay cuts, repudiated bonuses, or being suspended from work were commonplace. Unsafe working conditions where C.N.A.s were encouraged to lift heavy residents without proper equipment or assistance was something we had to do every day. Furthermore, the low staffing ratios made our work nearly unbearable since we usually worked with only two C.N.A.s per shift and no medical supervisor while having at least twenty four residents to take care of.

Even though I was sometimes treated fairly better than others, it was not pleasant to see my coworkers disrespected by insults, foul language, and unfair accusations from my boss. I have witnessed coworkers in tears after being scolded, in pain from unsafe lifting, under stress after their raises were taken away or their bonuses denied, and depressed after being fired for dubious reasons. I did not have it easy either, I suffered as well. I would come home with intolerable back pain and extreme anxiety as I feared that I had not performed my job well enough. I also became insecure as my boss was not fond of the sound of my voice and did not shy away from brutal criticism about it.

Yet, above all the issues in my workplace, my coworkers and I managed to build strong relationships. Whenever someone needed to be replaced, or to be lent a helping hand writing a report, or even just someone to talk to, we were there for each other. Even though there were certain C.N.A.s who preferred to work with specific coworkers and a few had conflicts with one another, we were able to form a solid nursing team and find ways to help each other. I felt that after four years, I had gotten to know every C.N.A. well, but that wasn’t quite true when I attempted to create my first and last action in that facility.

Four months before I was laid off, I joined the IWW without any knowledge of workplace organizing. Through weekly workshops meetings where members mapped their workplace, read pieces related to organizing, and shared advice with one another, I was able to obtain some knowledge and learn some strategies on how to organize at my workplace. From such great collective work in the IWW, I was inspired to develop some organizing experience and witness how my politics could be applied to my life and that of my coworkers. Therefore, I began to practice many strategies. I tried to structure my conversations with coworkers in ways that would agitate them about recent abuse from our employer. I also shared insights and examples of how employees worked together to fight against bad working conditions and unfair wage, and lastly, I provided emotional support and solidarity whenever my boss insulted one of us. Of course, I was aiming to go through the organizing process slowly and wisely. I was constantly revising my workplace map, making small talk whenever it was safe to do so, and also patiently waiting for good opportunities to set one-on-ones with coworkers.

A new issue stopped me in my tracks. One day, as I entered my workplace, I was informed one of the residents was not doing well. She was refusing to eat, had a fever, and was basically unresponsive. Like any medical worker, I asked my fellow coworkers for any updates and read all the shift reports available, yet no one notified me she was in our facility in order to decease. Being unaware of such information, I was petrified and concerned about the resident’s condition. This facility did not have any proper care for her. My coworker was an inexperienced Registered Nurse and was afraid to communicate with my boss. I was the only C.N.A. who was able to check her vitals every hour and supervise her conditions whenever I had some time available while simultaneously taking care of more than twenty residents. I suggested to my boss that we send her to the hospital for she was in serious conditions, but she refused to allow me to send the patient to the ER. The resident’s family also did not want to send her to the hospital due to financial circumstances (which is strange since they are very wealthy).

Inevitably, I was forced to see this resident die under my watch. She did not eat all day and had not stopped sleeping.  It was a really horrible situation to witness since this was a human being purposefully being neglected of medical attention. Personally, it was horrendous and emotionally draining. I became very furious and nervous and as a result, I made a decision to send a text message, that same day, to a few coworkers stating that we should take direct action soon by confronting my boss in her office. Soon after, one of them called me and spent a whole hour sharing her frustration of what was happening and agreeing to take action. I was very glad to hear that she was eager to fight and was hoping others would agree as well.

The next day, I returned to work, and saw that my coworkers were stressed out. The resident had not died yet, but my boss demanded that we feed her when the resident clearly did not open her mouth and was refusing to eat. When we placed her on a wheelchair, her head was completely down and we had to lift it and force food in her mouth. My coworkers were not comfortable with such orders and the situation in general, and shared sentiments of raising this issue with my boss.

I had three coworkers willing to fight and was enthusiastic to discuss how to take this further as a group, but the next day the resident was placed under hospice care and after one dose of morphine she passed away. I was very sad to hear such unfortunate news, as that was truly one of the worst deaths I had witnessed as a medical worker. However, the coworkers that I contacted to take action viewed her death in a different manner. They saw it as a relief and lost interest to take action. They shared concerns of being fired and did not feel it was necessary anymore. This was shocking to hear and I decided to slow down and continue with the previous organizing process that I had left behind.

The following week, I began to witness a change in behavior from my boss toward me. She seemed to be very hostile by rarely communicating with me and not trusting me anymore. For instance, when a resident appeared injured after the shift after mine, she asked me how that occurred. I responded that I was not aware she was injured and that under my shift she was perfectly fine. She was not satisfied with my answer and even threatened to make me take a polygraph test. The week after that she asked me for the first time how many residents I had showered, and I told her three. She became very upset and stated that I was supposed to shower eight. I had to pressure residents to allow me to shower them so that I could appease her. Finally, after a couple days from the previous situation, my manager informed me that my boss removed me from the schedule. That was a very painful day.

I wasn’t prepared to be laid off. As someone who is part of a working class family and is one of its main financial providers, I felt like I had lost a leg. A couple of comrades were glad that I was no longer working in that facility since it was a horrible workplace, and urged me to view this turning point as an opportunity to get a better job and take advantage of the new free time that I now had. Yet I felt like I was in a nightmare. I’m now forced to use my savings and ask for loans from school which my parents don’t react kindly to. They ask me every day if I applied to any jobs and question my calmness towards the situation.

The first three weeks, I slowly became emotionally unstable and depressed once again. I eventually had an emotional breakdown for an hour after reading the article “The Monster of Unemployment” which talks about the psychological torture of not having a job. I began to view myself as useless since I was no longer working and my ability to help my family had decreased. I truly felt like shit and wanted to end that feeling somehow. Luckily I was able to talk to my therapist and began to view this moment in life differently. She made me realize calling myself unemployed and desiring to return to my former job was ridiculous for I really hated that job; I was always complaining to her how overworked and mentally abused I was. Therefore, she enlightened me about being capable of moving on and finding more decent employment. Not only that, she told me that I am not simply unemployed. I am a hardworking full-time student and a job-seeker instead of an unemployed individual. She convinced me to call myself a job-seeker rather than unemployed which ironically changed my mood. I know a word cannot really change my current circumstances, but it motivated me to stay positive and help rebuild my composure. I am now looking for jobs with ease and taking advantage of the time I have on my hands now.

At the end, I have learned valuable lessons and gained insights by the mistakes I made from my recent organizing experience. For starters, I admit that I organized the previous action the wrong way. I should not have texted my coworkers and instead contacted only a few. I needed to inform every C.N.A. about forming an action and done it by phone or face-to-face. It should have been planned and leaded by everyone as a collective and with more ease. Secondly, I did not think before I acted. I allowed my frustration and anxiety to push me into making irrational decisions. I should have controlled my emotions and handled the situation more cleverly. Lastly, I assumed my coworkers position before ever having in depth conversations of organizing and analyzing their view of direct action. Even though I have known almost everyone for four solid years, I should have spent more time scrutinizing their willingness to fight, discovering how they view such oppression at work, and providing at least some form of political program or dialogue. It takes more than four years to build strong relationships with your coworkers especially when they are accustomed to harsh treatment in the workplace, and when there is little hope for change as many cannot find better jobs and are dependent on their employment for economic stability for their families.

Overall, even though I did lose my job and am currently in shaky economic circumstances, I have learned valuable lessons organizing and about life in general. I have recognized the struggles faced by low paid health care workers in retirement facilities. I’ve become aware of how the elderly are mistreated by administrators, medical insurers, and families, and I’ve also come to find out how difficult it is to organize within the health system. Besides the previous, I realize now, in the light of it all, that I am more than just a labor entity. As many may have experienced, we tend to think that our life revolves around our employment. We see it as something inevitable and representable of whom we are, but that is not true. We are more than just the value of our labor power. As a result, I had unconsciously forgotten that I was more than just a C.N.A. I am also a full-time student, a daughter, a sister, an aunt, a friend, and a devoted militant. I see now that this is a form of violence that surrounds our daily lives under capitalism and the power of the state. We lose touch with ourselves, our lives, and our world, and instead are more connected with our wages. So for those who are unemployed or never capable of working, do not allow this toxic idea of worth linked with labor to destroy you. We are more than just robotic machines that produce value. We are social beings whose presence, wisdom, and aide are important to the people in our lives. With these new realizations, I hope to move forward in life and obtain another C.N.A. position, where I will make sure to organize more intelligently and use my experience as a tool to face difficult cases and repression. I hope to have provided useful advice about organizing from the perspective of my mistakes and helped individuals to face unemployment in more positive ways.