“Two weeks after I started my job in long-term care, I tested positive”: a PSW tells her story

“Two weeks after I started my job in long-term care, I tested positive”: a PSW tells her story

Ebti Nabag

Tina James is 39 and has been a personal support worker for 10 years. When Covid hit, positions began to open up in long-term care homes, and James accepted a role at a for-profit facility in May. Two weeks later, she tested positive for Covid. Here’s her story.

—As told to Andrea Yu

I was born in Alberta and my family relocated to Burlington when I was 10. Four years later, we moved to Toronto and I’ve been living in the northwest end of the city ever since. I had two sons, in 2000 and 2001, and got married in 2004.

My first career was as a cleaner. I had my own business doing homes and offices, and we were pretty successful. My husband had a business refinishing floors, so we incorporated our businesses together. But I didn’t really feel fulfilled by the work.

In 2010, my husband had to return to St. Lucia, where he is from, to attend his father’s funeral. While he was there, he was assaulted and ended up in the ICU. He had multiple contusions, blood around his brain, and he was placed into a medical coma. He shared a room with three other patients in the ICU, but they weren’t being taken care of properly. The room smelled like rotting meat. The patients weren’t being cleaned and their bandages weren’t being replaced often enough. It was really traumatic to witness.

Sadly, my husband’s heart failed nine days after the assault and he passed away. That experience was partly what inspired me to change careers and become a personal support worker. I took an eight-month certificate program with a practicum at a long-term care facility. I enjoyed the work there, but I knew full-time jobs in long-term care were hard to come by. So when I finished the program in February 2011, with honours, I signed up to work with several different homecare agencies in the city. Most PSWs need to have several jobs in order to make a living wage. I was getting paid between $14 and $16 an hour, and I would usually get about 20 to 30 hours a week.

My clients were all elderly people who needed help with daily life in their homes. Each client has a specific care plan that has been put together by health care professionals in consultation with family members. Most people required assistance with bathing, dressing, feeding, grooming and toileting. If they’re bedridden, they may need to be turned every two hours. Sometimes I would just help a client with breakfast and stay for a few hours. Other times I’d spend the whole day. It was always something different, and I enjoyed helping people, even if it was just sitting and talking with them and listening to their stories about what life was like 50 years ago. Something as simple as making a client a cup of tea or playing a game of Crazy 8s or Scrabble with them would put a smile on their face. It’s nice to know that you’re able to fill a void for someone when they’re lonely.

I continued to work as a PSW for nine years. When Covid hit, I was still doing homecare through agencies, and I started wearing PPE to work. I live with my partner, who works in a manufacturing warehouse, and my two kids, who are now 20 and 21, and I was terrified of infecting them. I would bag all of the clothes I wore to work and put them outside until I did laundry. I sprayed everything down with alcohol before entering my vehicle and showered as soon as I stepped through the door at home, disinfecting as I went along.

Last May, a friend of mine who was working in the kitchen of a for-profit long-term care facility in Toronto told me they were looking to hire support staff. The pay was better—I would earn $17 an hour plus $3 per hour for pandemic pay, compared to $16 an hour in homecare. The schedule was more regular, and I was guaranteed at least 40 hours a week. I have diabetes, so I’m at greater risk for complications due to Covid. At the time, the nursing home had nine residents who had tested positive for Covid, but they were all isolated in one ward, and I was told I wouldn’t be working directly with them. I had to weigh the risks and the benefits. Of course I was concerned about exposure, but I’d already established a safety routine, and the opportunity to earn a steady and better income won out. Still, every day I went into work, I had knots in my stomach because I didn’t know what to expect.

I initially took a position as a resident support attendant or RSA. The facility was large, with about 400 residents and roughly 100 staff working in shifts. I was on the morning shift, which was from 7 a.m. to 3 p.m., on a floor with three wards that had 60 to 75 residents in total. I assisted with all of them during my shift.

The beginning of the day was always the most stressful. After our morning meeting, we had 90 minutes to get 12 residents up for breakfast by 8:30 a.m., when meal trays would be brought to their rooms. I would help them brush their teeth and sometimes shower (residents get two showers a week), comb their hair and dress them. Even though there were no Covid-positive residents on my floor, we had to treat everyone as if they had Covid. We wore fabric isolation gowns, gloves, a surgical mask and a face shield. We changed our isolation gowns and gloves in between each resident and sanitized our face shields. But we were instructed to change our masks only when they got wet, based on public health guidelines. I got two masks when I entered the building, so I’d only change my mask once a day, after my break.

After the breakfast rush, I helped out with whatever tasks needed to be done. I might bathe residents who were bedridden, help to facilitate FaceTime conversations with families or keep the isolation stations stocked. One resident would cry anytime they got to see their loved ones on a video call, and I had to try so hard to hold back my own tears. In order to prevent the virus from spreading, we needed to keep everyone in their rooms. I was working in a ward that had residents with dementia, and it’s very hard to keep them in one spot. They’d wander the hallways and I’d try to gently redirect them back to their rooms. But sometimes they’d get upset because they wanted to go for a walk. Everyone was so tired of just being in their rooms, and who could blame them?

Initially, I felt safe at work. And I was excited to be in a long-term care facility where I could interact with more people. But the mood at work changed very quickly after I started the job.

Every day, more and more residents tested positive. During our morning meetings, when the staff would get updates, you could see the look of worry in their eyes. Someone came in to give us Covid tests once a week, and it was extremely stressful waiting for those results. As soon as I had been tested, I would check my phone for results almost every waking hour. A lot of PSWs stopped showing up for work because they were scared, or because they had been exposed to a resident who had Covid and needed to isolate at home. The facility tried to fill those vacancies by calling in casual employees or going through agencies. The staff was changing over a lot, but we were still always short-staffed, and that put more pressure on the people who did show up for work.

We followed public health guidelines strictly and took actions to keep people safe, yet after two weeks, our numbers increased from nine Covid-positive patients to almost 30. They needed to open up another Covid ward, and they decided to do that on my floor. I wasn’t assigned to that ward, but I was in and out of it all the time, whether it was to restock the isolation rooms or help relocate residents and their belongings. One resident passed away from Covid, and I had to help put him in a body bag because funeral staff weren’t allowed to come into the facility. It took four of us to do it because he was on the heavier side. We were all scared, but in the moment, something inside me kicked in and I was able to turn off my emotions so I could focus on what needed to be done. I had to help bag three bodies during my time at the long-term care facility. None of the residents who died were directly under my care, but I knew them, and then they were just gone, one after the other.

After close contact with multiple positive residents, I didn’t want to wait for the next staff Covid test. On May 18, two weeks after my first day on the job, I went to a drive-through clinic after work to get tested. I reported to work the next day, and as I was helping a resident get up and ready for breakfast, I started feeling dizzy, like I was going to pass out. I called my supervisor and let her know I wasn’t feeling well. I thought maybe I had a sinus infection, so I went out to my car to call my doctor and book an appointment. But the first thing I did when I got in my car was check my phone for my test result. It was positive.

I was stunned. My eyes immediately welled up, and then I just started to panic. I called my sister in St. Catharines. She cried with me over the phone. Next, I called my mother. We’re super close—we talk every day—and giving her the news was heartbreaking. She’s 65 and has high blood pressure and heart problems. My sister doesn’t drive, so I’m really the only person who could take care of my mom if she got sick. I was afraid for myself and my family. The effects of Covid were so unknown at that point.

To keep everyone at home safe, I stayed in my bedroom and wore a mask all the time, while my partner disinfected everything I touched. I was so sick and exhausted that I couldn’t even shower myself at one point, and my partner had to help me. It was a scary time, but it made me appreciate my partner so much more. He went above and beyond to take care of me. Two weeks after getting sick, I gathered my family over a video call and started making arrangements if I had to go into the hospital. I have two dogs, and a close friend was going to take one dog while my mom would take the other. I made arrangements with my sister to make sure our mom was taken care of if anything happened to me. That was definitely the hardest conversation I’ve ever had. Even thinking about it now, I get choked up.

We were lucky. My kids and my partner never got sick. And after about a month, I started to feel better. I was still testing positive, but because I was no longer symptomatic, my supervisor said that I had to go back to work. By the time I got there, the mood was eerie. Ten more residents had died from Covid while I was gone. A few PSWs on my floor had tested positive at the same time that I did, so some of them were still off, and there were a lot of new workers in the building.

By July, I was promoted from a resident support attendant to a personal support worker. My hourly rate went up to $20, but I now had more responsibilities. In addition to taking care of residents, PSWs have to log information about each resident into a device. Every time they intake fluids, every time you toilet them, or if you notice changes to their skin from things like dehydration or bed sores. It was a lot of work. And I didn’t get much training, so I wasn’t confident that I was doing everything I should be doing. It all felt very disorganized.

On top of that, I was experiencing long-haul symptoms of Covid. I had a lingering cough and the brain fog that a lot of other long-haulers have mentioned. I’d forget things if I didn’t write them down, so I was constantly setting my phone alarm and posting sticky notes to remind myself of things. I couldn’t seem to stay focused for long, and sometimes I’d totally lose my train of thought mid-sentence. I still had shortness of breath, so doing my daily tasks while wearing a mask was extremely difficult. I also became overwhelmed much more easily after I got Covid. My emotions were all over the place. Normally, on a frustrating day, I could just brush things off. But rushing around constantly, unable to catch my breath, would often reduce me to tears. I would just have to run and hide somewhere to cry for a few minutes before I could get back to work.

One day after work in September, I had an emotional breakdown and I realized that I couldn’t work in long-term care any longer. I was sad to hand in my resignation, because there are parts of the job that I loved. There was one elderly woman in my care who loved to sing. And another resident always blew kisses and waved whenever I passed his door. When you work so closely with people, taking care of their most personal needs, you become very close to them. But I also felt a tremendous sense of relief to be leaving such a stressful environment.

I’m now back in homecare. I have one client who I work with in their home for about 44 hours a week, so the exposure risk is minimal. I had to take a pay cut, so I’ve picked up gigs as a cleaner to help make ends meet, but it’s worth it for the peace of mind.

Reading the headlines about outbreaks in other facilities breaks my heart. I know how bad it is in these long-term care facilities. And I know how quickly Covid spreads. Once it’s in, it wreaks havoc. I have a lot of friends still working in long-term care, and they’re struggling. They’re overworked and underpaid and the facilities are terribly understaffed. The public doesn’t hear much about what goes on inside for-profit facilities because workers tend to stay tight-lipped for fear of losing their jobs.

I hope the pandemic sparks much-needed changes. The expectations of PSWs are unrealistic. We do such physically hard work and get paid so little. And the PSW-to-resident ratio needs to improve—for the sake of the workers and the residents. You can’t realistically provide proper care to that many people. Since Covid hit, the government would only allow PSWs to work with one employer. It was the right thing to do, to help prevent the spread of the virus, but it also highlighted how PSWs need multiple jobs just to make a living wage.

It’s great that long-term care workers and residents are getting vaccinated for Covid now. But I wish it could have happened sooner so that there wouldn’t have been so many lives lost. I lost one co-worker to Covid and I know many more who tested positive. I think about my friends still working in long-term care every day, and I worry about them. But I guess this is part of a daily fear we’re living with until Covid is gone.