Sonya Huber - Two Eyes are Never Enough: A minimum-wage memoir

I moved to the East Coast with all I owned in the back of a red pickup truck and a strange wealth of work experience: secretary, waitress, garbage hauler, nanny, gardener, dishwasher, coffee pourer, environmental canvasser, art model, janitor, video-store clerk, and intern at the Department of Agriculture. Id just graduated from college, and, after a few months of temping and retail, I hungered for something that might feel meaningful.

I landed in a residential center for mentally ill teens, not living there but working, six overnights a week, for $7 an hour. It was 1994, I was 23, and my memories are a blaze of sunlight and dark at the wrong times, of sleeping in three- and four-hour bursts, of adrenaline-charged scenes in a slate-gray Victorian house. I mopped the floor in the quiet and made trays of lasagna at 2:00 a.m. I set out the breakfast dishes at 5:00 a.m. I listened to the wind test the seams of the house and the kids moan and shift in their sleep.

I went into direct care because I wanted to help people. I think I did help a few people, accidentally, mostly because I was a warm body, a set of eyes with emotion behind them, a pair of ready hands, and a mouth that fumbled syllables I thought might be comforting.

When I started the job, I had no idea I was about to become part of a national problem, a churning workforce, mostly womenill-protected, underinsured, underpaid, over-worked, and often injured. Most of these direct-care workers flee as soon as they can afford towhich, for many, means staying a lot longer than theyd like. The rapid staff turnover leads to a state of controlled chaos in many of these facilities, which include residential mental health centers (where I worked, with troubled teens), nursing homes, centers for the developmentally disabled, as well as in-home care for the elderly and developmentally disabled.

Yet as poorly as they are treated, we need these workers desperately. Working adults have less and less time off the clock to care for their aging, disabled, or chronically ill family members. Families are also having fewer children, which means there are fewer hands free for providing direct care within the home. More and more hands and hearts are desperately needed to do the work of caring for our most vulnerable: the elderly, the disabled, and those with serious mental illnesses. Yet skilled, committed workers are being driven out of the field as providers look for the person who will do one of the most dangerous jobs in the country for the fewest dollars per hour. In the chaos that ensues, these workers suffer, as do their clientsas do we all.

Women fill 88 percent of direct care jobs in the United States today. These women are mostly invisible, doing dirty jobs at odd hours. Many are the sole breadwinners in their families, often putting in double shifts, for a median wage of $10 an hour, or about $20,000 a year. What that translates to, according to the National Direct Service Workforce Resource Center, is a workforce in which around 20 percent of the employees in home-based settings are living below the poverty line, leading 46.1 percent of these workers to rely on public benefits to supplement their low wages.

Direct care is messy, challenging, and humbling. It is also dangerous. Department of Labor figures indicate that the rate of injury for employees of nursing and residential care facilities is 8.4 percent, nearly twice as high as in construction and logging, and three times as high as in mining.

Direct care is also mentally exhausting, and workers are prone to burnoutand worse. The isolating and demanding nature of their work, compounded by staffing shortages and low wages, can mean that workers take their anger and frustration out on the clients. The Direct Care Alliance, an advocacy group for these workers, maintains that the incidence of abuse against elders and other clients would decrease dramatically if care workers had appropriate training, adequate staffing, and other types of support.

The need for direct-care workers is voracious, enough that the persistent theme in the field for the last 15 years has been one of a staffing crisis, despite estimates of up to four million people already working in these positions, which include nursing assistants, home-health aides, direct-care professionals, and personal-care aides. The Department of Labor projects the field will increase by another 70 percent between 2010 and 2020, describing this growth as much faster than average. Its Occupational Outlook Handbook for 2012 sounds like a mixture of warning and enthusiasm: The relatively low skill requirements, low pay, and high emotional demands of the work result in high replacement needs. For these same reasons, many people are reluctant to seek jobs in the occupation. Therefore, persons who are interested in and suited for this workparticularly those with experience or training as personal care, home health, or nursing aidesshould have excellent job prospects.

The Direct Care Alliance estimates that by 2020, this group will be the single largest occupational group in the country. By 2050, they will be providing services to 50 million Americans.

This is stunning: the largest category of employment in the country. Yet they are largely invisible, and when they are exploited, they sufferas do their clients.

Carla Washington, executive director of the Direct Care Alliance, says, Direct-care jobs are not respected. When jobs are not respected, they are low-wage jobs. They've not been seen as real work but as womens work.

One night, not long after I was hired, I sat reading in a small circle of lamplight within a second-floor alcove. A temporary worker, sent to relieve our chronic staffing gaps, slept downstairs on the couch with the TV on.

A heavy door creaked behind me. A girl Ill call Nina stepped out of the front girls bedroom with a spacey and almost peaceful look on her face. She stood with her shoulders curled forward. I was transfixed by her floating eyes, which until now I had only seen narrowed in sarcastic scorn. After a few seconds I saw the red. She held her wrists together in front of her body, bright red blood smeared in streaks down her palms and fingers from cuts on her wrists.

I thought, This is my job. This whole situation is mine to handleblood-borne pathogens and a scared, dissociated, bleeding teenage girl.

I stood up slowly, faking what I hoped was an appearance of deliberate calm. I guided Nina with gestures and light nudges to sit down in my chair. Ill be right back, I said quietly.

I dashed down the carpeted stairs to the staff office, running my hand along the polished wood banister to steady myself. Keep breathing. I needed to get pressure on the cuts and stop the bleeding. If the cuts were really bad, there would be more blood, right? I had done sprints like this in soccerthe burst of motion from a position of rest. My high school soccer coach used to say, Dont think about kicking the ball, just kick it. Rely on your body to do its job.