There’s a group, in the landscape of health care, that has long been passed over by the spotlight shone on doctors and nurses: certified nursing assistants, or CNAs.

These are the direct-care workers whose job it is to do the physical and emotional labor of providing medical care. They’re often charged with up to 22 patients at once and given the responsibilities of feeding, bathing, dressing, changing and repositioning them while also tasked with communicating, comforting and protecting them.

CNAs are the ones “on the floor,” who don’t walk away when grieving, angry, family members vent their pain and frustration at a system that seems to have to offer but nothing but insurance forms, medication updates and confusing abbreviations.

They’re not saints or heroes but men, women and non-binary individuals from all walks of life who do the hands-on work of caring.

The disparity between the demanding nature of their work and the compensation they receive is stark: for navigating physically and emotionally taxing responsibilities, their wages pale in comparison to those of other professions. They toil in the trenches of care, often for the same amount of money as a dish washer. They were the ones who showed up during the pandemic, risking their health and well-being, while many doctors and administrators worked from the safety of their homes.

According to PHI, a leading advocate organization for the direct care workforce, more than 4.8 million direct care workers provided assistance to millions of individuals in 2022, yet, despite this crucial role within the health care system, direct-care workers earned a median hourly wage of just $15.43. As a result, 39% of direct care workers live in or near poverty, and 46% rely on public assistance programs to make ends meet.

They often work in poor conditions with no union representation to advocate for their rights and well-being.

If we don’t start rewarding direct-care workers in a manner appropriate to their significance, the lack of support (indeed, the disdain) for the “un-glamorous” work of direct care – from a medical system committed to extending life beyond meaning or dignity – will eventually break our long-term care system. We cannot afford to continue minimizing roles that are becoming more vital as our population ages and the demand for care grows.

As a society we must commit to supporting and empowering direct-care workers; we must fight for fair wages, better working conditions and access to essential resources. We need to give workers the tools to do their jobs safely and well. As a community, we need to take a stand to fight for financial recognition, professional respect and meaningful CNA staffing standards to truly honor the invaluable role that direct-care workers play in caring for our loved ones.

We need everyone to heed the call to action and rally behind the backbone of this billion-dollar industry. Stand with the CNAs; amplify their voices and work to create a future where direct-care workers are valued, supported and celebrated for the invaluable professional contribution they make to the health care system. Our well-being as a society depends on it.

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