In long-term care facilities, privacy is often at a premium for residents and employees. But when it comes to nursing mothers, I heard a story recently that made my hair stand on edge.
To back up, let’s make sure we’re clear on the basics of pumping. Plastic cups are strapped onto one’s breasts and a machine suctions away the milk into bottles. If it sounds a) uncomfortable b) something you’d like privacy for and c) something that makes you feel like a dairy cow, you have a basic sense of what’s involved.
Amazingly, somehow the last doesn’t mean a maintenance person making jokes about putting up “Dairy” signs is appropriate. Nor is pumping an activity one can easily do standing above a table, next to a bathroom, next to someone’s hairnet they left on your table, or in fear someone will come barging in while you are half naked.
These are all things that have happened to Brittany Wade, a physical therapy assistant in Missouri.
I have skin in this game, as Wade, 25, and I connected through a working mothers who breastfeed group. She returned to work a month ago, when her daughter was 12 weeks old. For a little while, she and two other mothers pumped in an office that no one was using.
The office, however, was unceremoniously taken away upon a new hire, and executives, according to Wade, basically shrugged and told her to figure it out. For about a week, one of the aides pumped in her car, while Wade was able to use her supervisor’s office. It’s also worth noting Wade told me she’d sometimes go retrieve a fellow mother and certified nurse’s aide from her floor, as the latter would sometimes feel unable to leave. Wade would remind her it was her right to pump, and that she’d get ill if she didn’t. Millennial women are going to save us, y’all.
Eventually, due to Wade’s prodding, a table next to a bathroom was established as a pumping area. I’ve seen photos, and the area is depressing. The door needs paint, it took badgering to get a lock on the door (one person asked, “Why can’t you pump with the bathroom door open?” and the maintenance man asked if it was offensive to hang a cow picture in the pumping room. (Wade made it clear that, yes, it was offensive. To the best of my knowledge, she didn’t follow that with an expletive-laden tirade, which is what I might have done.)
Since the executive director of the nursing home didn’t return my calls, I’m not naming Wade’s facility here, but I hope that every administrator and top manager reading this cringes. It’s a judgment call whether Wade’s facility meets the federal requirements, which state that workers must have a “space provided by the employer [that] cannot be a bathroom, and it must be shielded from view and free from intrusion by coworkers or the public.”
But even if no federal regulator is going to visit the nursing home to tell it to clean up its act, or discipline anyone for sexual harassment, this is a situation that makes me want to whack my head against the wall.
That’s because administrators and industry executives tell me — all the time — how hard it is to retain good employees, specifically aides. It’s always about money, they tell me.
Well, news flash: When one of your clinicians goes to her car to pump, she is not sitting and thinking about money. She’s thinking about whether there’s a different employer that might offer her a room with a sink, a more comfortable chair and enough privacy where she can take a deep breath and pump food for her baby, who is probably a main motivation for sticking it out through tough days.
As Wade told me, “I”m not asking for a chaise lounge and a margarita bar.”
I understand space is always an issue at a nursing home, which is why I would encourage facilities to consider options such as Mamava pods, which are freestanding lactation suites. If the money isn’t available for that, sometimes temporary options are available: A resident room can be fitted with a lock, for example, or a vacated office. One thing to remember is that pumping is not forever, and facilities can, under law, adjust based on the needs of their employees.
It’s also clear that the only people who are going to make this an issue are mothers themselves, because industry advocates don’t seem to have much interest. The American Health Care Association’s Lyn Bentley, MSW, AHCA Vice President of Quality & Regulatory Affairs told me in a statement, “AHCA believes all nursing center employees must be assured of the rights to which they are entitled by state and federal law.”
But when I pushed as to what someone like Wade should do, the response was that the association focuses on education, regulatory compliance, nursing home quality and reimbursement-related issues.
“We do not generally address labor-related issues,” she said.
LeadingAge directed me to the DOL Fact Sheet, and encouraged the nursing homes to follow the law.
Right. I would gently suggest both of these answers are short-sighted. At both the AHCA and LeadingAge conventions in October, there were convenient, clean and private places to pump. While that’s a function of the convention center, it’s very important to note that I met no shortage of other mothers at the shows in need of a pumping station. The need is there.
At the end of the day, it’s not really about pumping at all. It’s about respect. We talk about it every day with regard to our residents. I’m confident providers can come up with a way to better respect the needs of working mothers.
Follow Senior Editor Elizabeth Newman @TigerELN.