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Columnist John Paradis: At Soldiers’ Home, the CNA is the lifeblood

  • The entrance to the Soldiers' Home in Holyoke. Photographed on Tuesday, March 31, 2020. gazette file photo

Published: 4/7/2020 3:14:20 PM

Ask family members about the Soldiers’ Home in Holyoke and you’ll hear the same comments.

“The nurses are amazing.” “They provide compassionate care with honor and dignity.” “Everyone there treats my parent with great respect.”

I would know. I worked there, and one of my jobs at the state-run facility was to review all the comments from family members.

Which is why the COVID-19 outbreak at the Soldiers’ Home is even more devastating. Because, if there is one thing about the Soldiers’ Home you should know, it’s that the nurses at the Home are among the most selfless and passionate health care workers you will find anywhere.

You should also know that nurses are dying across our country due to the contagion that continues to spread. The least we can do as citizens is make sure they get the support they need.

Sadly, from the comments pouring out from the Soldiers’ Home in the aftermath of news that 25 veteran residents have died amid a coronavirus outbreak, that has tragically not been the case.

At the Soldiers’ Home, the center of gravity is the certified nursing assistant, or “CNA.” They are trained caregivers who help elderly and chronically disabled veterans perform daily life activities like eating, bathing and getting around.

At the largest facility in New England for long-term care for veterans, where the average age for residents is near 90 years old, the lifeblood is the CNA.

Yes, it takes a team to deliver care at a nursing home like Holyoke and that includes doctors, licensed and registered nurses, and others. High on the list are the housekeepers, recreation staff, dietary services, social workers and maintenance folks. 

But if you don’t have trained and committed CNAs, you can forget all those comments I mentioned at the top of this column.

They are the medical team members who interact most frequently with residents.

I left state government in December 2015 as the deputy superintendent in a highly publicized resignation. One month later so did my boss, the superintendent, Paul Barabani.

Of all the things we said to the higher-ups in Boston, and there were many, the most important one was that if you aren’t taking care of your most valuable care providers then you aren’t doing the mission. And if you aren’t doing the mission, you are placing elder veterans who fought for our country at risk.

During my time at the Soldiers’ Home, I witnessed CNAs rush from veteran to veteran with barely enough time to provide basic physical care and often very little time to deal with a veteran’s emotional needs. And veterans have some of the highest needs among any nursing home resident you will find.

A CNA at the Soldiers’ Home is busy from the time she or he walks to their care center to the time they walk out. It’s physical, heavy work. They take care of veterans who may be stable one minute and then crash the next. They may need to hoist a large man from his bed using a Hoyer lift. Some veterans require one-on-one supervision. There is no idle time.

Nurses at the Soldiers’ Home have long insisted that they aren’t staffed anywhere close to where they need to be. Many have noted that conditions there are unsafe.

As you might imagine, there is also a shortage of CNAs. Low pay and the strenuous, stressful nature of the job, particularly at a facility like Holyoke, perpetuates the shortage.

Gov. Charlie Baker, the former CEO of Harvard Pilgrim, came into office in 2015 with an intent to slash state positions and cut programs.

Within a few months of taking office, the Soldiers’ Home lost 48 experienced employees, including 26 nursing positions, due to the governor’s early retirement incentive program.

There is this fantasy, somehow, in state government that you can still deliver high-quality nursing with less staff and less money if you just use the latest cost-cutting techniques from private health care or from manufacturing.

Trust me, I was directed to look everywhere for cost savings with vocabulary and terminology similar to what you would find on an assembly line. Nurses are shift workers; residents are numbers.

To make up the difference in the budget, you do things such as reduce the census — or the number of veterans you admit. And you do it at a time when the demand for long-term care for Vietnam-era veterans, in particular, is at its highest. That’s right; our Vietnam veterans are getting the shaft again.

Another accounting move is to avoid paying the cost of hiring and replacing nurses who leave. But that’s not even the worse move you can make. You then force your already overworked CNAs to work overtime to make up the difference. How’s that for morale?

In long-term care, the results are ultimately projected to the residents in the form of urinary tract infections, pneumonia, bedsores, falls and medical errors.

For every additional resident in a long-term care facility that a nurse is tasked to care for, residents face a greater risk of dying.

Add in a contagion that can spread through a large facility like Holyoke like wildfire and the consequence as we now see are catastrophic and horrific.

The tragedy of the coronavirus in Holyoke is not the fault of the exceptional care team at your state veterans’ home. It is the fault of state government for not properly resourcing the team there and taking care of Job 1, which is taking care of the CNAs.

These are people who right now continue to put their own lives on the line as they work on the front lines of the battle against COVID-19.

The years of level funding and cost-cutting experiments at the Soldiers’ Home in Holyoke has failed. State administrators and number crunchers do not understand that providing care for some of the most vulnerable citizens in our state is predictably unpredictable.

But what I can predict is that there will be more crises with tragic consequences unless the state gets its act together.

John Paradis, a retired U.S. Air Force lieutenant colonel, lives in Florence and writes a monthly column for the Gazette. He can be reached at columnists@gazettenet.com.


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