White Coat Supremacy: Nursing Homes as a Model of Oppression

Last week, I arrived at the Nursing Home job that I still maintain on weekends to a disturbing discovery. A nurse pointed out to me that sometime during the previous shift, someone had scrawled the eleventh letter of the alphabet three times on a bookshelf in permanent marker. You can determine for yourself what letters they were. They were too high up to be reached by a resident.

Attempts to remove it were futile, until I was forced to score the wood away with a brillo pad and degreaser. The CNA staff and nurses, many of whom are first and second generation Americans from the Caribbean, West Indies, Jamaica, Haiti, Latin America, and elsewhere, need not be reminded of the ignorance of others on a daily basis. Of course, such ignorance runs deeper than just letters on a bookshelf.

One of the reasons I love the job so much is because of the diversity of my fellow employees. They have taught me so much, and I have grown to love and admire them for their passion, humor, and kindness. They truly have been a gift to my life.

Further, I am struck constantly by the juxtaposition of predominantly Caucasian residents being cared for — indeed, being kept alive — by predominantly People of Color. I reflect daily on what that experience must entail. I recognize too the hierarchy of administrative staff and supervisors, who are mostly white, and the status quo of healthcare that pits nurses and CNAs against one another, vying for resources and a voice in a system that often leaves them short-staffed and overworked.

With a lack of proper equipment and staffing, CNAs rely on Body Mechanics to lift and transport dead-weight residents, leaving both vulnerable to injury and disability. With shifts that can last 14hrs or more, these caregivers are susceptible to exhaustion, sleep deprivation, and emotional distress.

Compassion Fatigue and Vicarious Trauma are constant threats, forcing many to become apathetic and unempathic in order to do their jobs. This paves the way to neglect, abuse, and indifference. Everyone suffers.

All of this is a result of an exploitative, racist, and prejudiced healthcare system that emerges from a larger history of white supremacy and oppression. The implicit and explicit biases that exist within these systems, whether conscious or not, inevitably set them up for failure.

The irony is palpable. Elderly and geriatric citizens are an alienated, marginalised, and discriminated population in our society. Perhaps the greatest tragedy is that we co-opt yet another oppressed group and expect them to take care of our loved ones for us. Rather than empower both, they are left to reconcile their individual internalized victimhood, grapple with the anger and depression that saturate their lived-experiences, and bicker amongst one another for any semblance of control.

This. This is the silent battle that is waged every day in nursing homes across the country. This is the frustration fleeting moments of joy and triumph are measured against. And when someone feels the need to etch a hateful abbreviation on a bookshelf, an object meant to combat ignorance with knowledge, the silence becomes deafening.

Yet… perhaps they only succeed in reminding us of what we already knew.

Please. Please, please, please. Reach out to someone you know who is a CNA or a nurse and invite them into your life. Sit down, have a conversation with them, open a dialogue. Ask them what they need, offer emotional support, and build empathy and compassion for their experiences, without judgement. Do the same for your loved ones in nursing homes or those who live alone. Listen. Listen with your heart and mind. Listen to their silence. Offer your time. Offer your patience. Offer your kindness.

And, when the time is right, demand better working conditions for their caregivers. Demand that the culture change around how we treat the aged and dying in our world. Demand that the implicit racism that has permeated so many helping professions be uprooted, sanitized, and scored away from society for good.

Please.

Photo by oer_training