Nursing staff pour love into jobs few people want to do

Nursing care homes have trouble recruiting and retaining staff, but those who stick it out provide a valuable service in the era of an aging population.
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ZHANG Xinhui, 47, starts her work day at 6:30am by preparing breakfast for elderly residents at the Shanghai No.1 Social Welfare Institute.

She cuts the food into small, bite-size pieces and spoon feeds her patients, taking care that no one chokes. That is the first challenge of Zhang’s 12-hour shift.

Zhang and another nursing worker care for about 10 older women living in Room 606, one of the institute’s “special-care units.” All of their charges are in their 80s and 90s. Nearly all suffer from dementia, are bed-ridden and can’t eat, bathe or even go to the bathroom by themselves.

“Many people might look down upon this job, thinking it inferior” says Zhang. “But I feel so happy taking care of them.”

Nursing staff pour love into jobs few people want to do
Wang Rongjiang / SHINE

Zhang Xinhui helps a senior drinking water.

Most nursing workers at the institute quit after a year or two to pursue jobs that are better-paying and less stressful. Zhang is among a handful who have stayed more than five years.

The daily routine for Zhang sounds mundane but is hard to do well. The elderly residents are bathed twice a week, and some are so heavy that it takes two nursing workers with special training skills to lift them. Every Monday, the bed sheets are changed, working around the elderly still in bed. Seniors suffering constipation are given enemas.

Staff need to keep a close eye on dementia sufferers who are still mobile because they can wander off or fall.

“All of us are very observant and always alert,” Zhang says. “None of these seniors can afford any risks.”

Sun Hongyan is the leader of the entire special-care team. She worked as a clinical nurse in a hospital for 17 years before accepting the job at the institute to be closer to a child at home who needs special attention.

“In the beginning, I thought the job wouldn’t be much different from my work in the hospital,” she says. “But I was wrong.” She explained, “The seniors aren’t like my former patients, who would come and go. Rather, they are like family. In fact, we spend much more time with them than with our own families.”

Nursing staff pour love into jobs few people want to do
Wang Rongjiang / SHINE

Sun Hongyan (left) with a senior at the institute

Nursing workers sometimes have to grit their teeth when families of patients come to visit. Many come to the facility, perhaps only once a month, and throw their weight around.

Sun tells the story of one daughter who was always quick to blame nursing staff for anything and everything.

“She insisted that her mother’s temper tantrums, which are actually quite common in dementia patients, were the result of poor treatment,” she says. “Then, one day when the daughter was with her mother, the old lady lost her temper out of the blue, and the daughter realized there were no external triggers.”

Patience and a big heart are the key contributors to quality care. Sun Jie, who has been with the team for nearly 15 years, has both.

She’s in charge of a ward with seniors whose conditions are less severe physically than those in Room 606 but who suffer big mood swings.

“There was once a senior, who stayed here for about 30 years until her death, who used to constantly curse loudly at the door,” she recalls. “The entire hallway would be filled with her shouting. And she would slap me in the face when she was unhappy. I had to endure it all.”

Sun Jie worked in clothing sales before she joined the institute. Unlike her once unruly patient, her own temperament has smoothed over the years.

“My daughter says, ‘Mom, you are not as easily triggered as before,’” Sun says.

The bonds between staff and patients are normally close.

Sun Hongyan says not long after she took the job, a top management team from the institute came to visit the seniors. While they talked with the elderly residents, they would fix their hair or straighten their collars.

“I thought they were trying to put on a show with such cheesy behavior,” Sun says. “But later, after working with the seniors for a long time, I found myself starting to do those same little things spontaneously. Then I realized that it is a bond we build through time, and it’s not easy to disentangle.”

Nursing staff pour love into jobs few people want to do
Wang Rongjiang / SHINE

Sun Jie does feet massage for a senior.

The institute faces a chronic shortage of able staff.

Tao Hongxia, deputy director of the institute, says these are jobs few people want to do anymore, especially young people and Shanghai natives.

“It’s hard to find good nursing workers, and even when we do recruit them, they aren’t likely to stay beyond a year or two,” Tao says.

Last year the city launched a long-term care insurance program for seniors, with funding for in-home caregiving services.

“It seems that nursing workers who provide services in the homes of the elderly are paid more than us,” Tao says. “Therefore, we lose many workers to the in-home care program.”

On many fronts, Shanghai is struggling to cope with a rapidly aging society. The Health Research Development Center carried out an assessment of more than 13,500 seniors in the city in 2016. It found that nearly 30 percent of about 5,420 seniors staying in welfare institutes suffer from dementia.

“About 70 percent of all the dementia patients need institutional care because their families can no longer care for them at home,” Ding Hansheng, deputy director of the center, told a recent seminar on dementia.

Ding said there are still stigmas attached to dementia. Many families are ashamed to ask for help, even though the problem doesn’t go away by ignoring it.

“The service system for dementia patients is not complete, and welfare institutes are always in need of workers,” Ding said. “Different institutes are doing their best to handle their caseload on their own, but there is too little liaison and communication among them to form a cohesive, coordinated institutional care system.”

Nursing staff pour love into jobs few people want to do
Wang Rongjiang / SHINE

A nursing worker on night shift updates information on residents’ conditions.

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