Jessica Sather knew Thomas Nelson’s coffee order before he could remind her.
Black—no cream, no sugar.
As she helped him into his hospital gown, Sather listened to Nelson talk. His topic that day was Norwegian culture.
Norwegian fighters never wore horns on their helmets as people often think, Nelson told her. In his opinion, he said, Norwegians make the best caretakers.
During the conversation, Sather stopped to answer the bulky gray-and-blue cellphone attached to her leg. She held the phone between her ear and shoulder, talking briefly to a nurse while she prepared Nelson for his afternoon walk.
After the call was over, caretaker and patient resumed their chat, poking fun at each other and bantering like old friends.
But Sather and Nelson had known each other only a few days. Nelson was recovering from surgery at SSM Health St. Mary’s Hospital-Janesville, and Sather was his certified nursing assistant on the medical/surgical floor.
When Sather left the room to get Nelson’s coffee, she stopped at the supply closest to get pants for another patient. On her way there, she answered the cellphone again and stopped to talk to a nurse.
Sather’s to-do list constantly evolves over the course of her 12-hour work shifts. She rarely accomplishes a task before several more are added.
Sather is one of 830 certified nursing assistants in Rock County, according to the U.S. Bureau of Labor Statistics. The job is second in health care employment to registered nurses.
Rock County has more nursing assistants than elementary teachers, bartenders and accountants, according to labor bureau data.
Demand for them is high across the state. Nursing assistants make up 13 percent of hospital employees in the state but account for 21 percent of vacancies, according to the 2017 Wisconsin Health Care Workforce report.
The Wisconsin Assisted Living Association and Residential Services Association of Wisconsin reported vacancies of 14.5 percent in the caregiver category, according to the report.
A day in the life
Going in to work blind is one of the worst things a nursing assistant can do, Sather said. She spends the first half-hour of her shift with the overnight nursing assistant to learn what happened during the night.
The 37-year-old Afton resident has held the job for almost four years. Before that, she spent about 15 years as a personal care assistant.
Sather said she chose the job because she loves people. Her favorite part of any day is when a patient’s face lights up as she enters the room.
Nursing assistants at St. Mary’s are assigned eight to 10 patients each day, said JoLyn Zamora, director of medical/surgical services.
They spend their mornings helping patients get ready, eat breakfast and meet with their doctors and specialists. It is by far the busiest time of day, Sather said.
Afternoons are a little slower. On one recent afternoon, Sather stopped by Shane Clark’s room to help nurse Amy Bonman check his vital signs.
Sather and Bonman moved around the room like dance partners, working side by side but never getting in each other’s way. The sound of laughter and careful instructions filled the room.
Becoming a CNA
High demand for nursing assistants has prompted Blackhawk Technical College tweak its curriculum.
The college’s nursing assistant program is a 120-hour, three-credit program that includes labs, clinical experience and a state certification exam, said Moira Lafayette, dean of health sciences and public safety at Blackhawk Tech.
The program regularly reaches capacity at its three campuses, Lafayette said, and additional sections are often offered in summer.
In recent years, the state Department of Health Services, which sets curriculum and certification standards, has increased its efforts to develop the personal care and nursing workforce.
In tandem, Blackhawk Tech has reached out to its community partners to expose more people to health care careers, Lafayette said. Outreach to high school students has been a high priority, and students as young as 16 can become certified nursing assistants.
In Rock County, the median hourly wage for nursing assistants is $13.05 an hour, more than $5 over the minimum hourly wage, according to the workforce bureau.
Many nursing assistants at Blackhawk Tech are students in other health programs. They work as nursing assistants because they can work while going to school, Lafayette said.
CNAs and an aging population
The college also partners with the Department of Health Services on WisCaregiver, a program to attract and retain caregivers for nursing homes, Lafayette said.
Those types of caregivers will continue to be in great demand.
In 2015, 20.1 percent to 25 percent of Rock County’s population was 60 years old or older, according to the health care workforce report. That age group is projected to increase to 25 percent to 30 percent of the general population by 2030.
Nursing assistants in long-term care facilities have different jobs from those in hospital settings, Zamora said. They often work more independently and have more patients to care for during a shift, she said.
Sather started her career at a nursing home. She said she left because it was hard to cope with the deaths of residents she considered friends.
Her worst memory is of the death of her favorite resident—a woman she called “Mom”—who died after two years of working with Sather.
“They say you’re not supposed to get attached,” Sather said. “I say, if you don’t get attached, you are not right for the job.”
Stepping stone to nursing
In Shane Clark’s room, Sather gave clear, concise instructions as she positioned his legs into circulation leg wraps. She joked around as she worked to make him feel comfortable.
An ideal nursing assistant is someone who enjoys people and has a positive attitude, Zamora said.
“I feel like you can train skills, but you cannot train a person’s personality,” she said. “When I am looking at a good fit or good hire, I am looking for that person to fit into our culture here, so being approachable, being upbeat and positive, having a good attitude.”
Working as a nursing assistant is often the first step people take toward a career in health care, Zamora said.
The job exposes people to working with patients, and people learn quickly whether they are cut out for the field or not.
Nursing assistant experience is not required to become a nurse, Zamora said. But she has seen multiple nurses—who were never nursing assistants—quit soon after starting their careers because it was not the right fit, she said.
Zamora encourages anyone considering a nursing career to first become certified as a nursing assistant.
When Zamora was a nursing assistant, some of her co-workers chose to stay in the career for life. Today, it is rare to see someone stay in the job for more than a few years, she said.
Sather believes the job is the right fit for her. She plans to continue working as a nursing assistant until her body tells her she can’t do it anymore.
However, her dream is to become a pediatric nurse.
After leaving another patient’s room, Sather pulled a piece of paper covered with scratches and scribbles out of her pocket. She calls it her “brain.”
The “brain” keeps track of all of her patients, what their needs are and when they need assistance.
As she examined the paper, a call light went off down the hall. A patient was trying to get out of bed.
A nurse then asked her to clean a room for someone who had been discharged.
Then she needed to check the vitals of another patient.
Then a room needed to be set up for a new patient.
The list kept getting longer.
This work is all Sather knows and is what she loves. Like her to-do list, Sather will keep going—and growing.