Shelly Hughes says three things are required to do her job: a strong back, a strong stomach and a big heart.

She’s a certified nurse’s aide at a nursing home in Washington state, which also means another requirement: To get her work done, she has to physically be there.

“You’re helping residents that may not be able to dress themselves, feed themselves, toilet themselves,” Hughes says. “The great stuff is that you get to know wonderful people. I have so many grandmas and grandpas now, let me tell you.”

For many companies, the first call to slow the spread of the coronavirus is telling employees to hunker down and work remotely. But that’s simply not an option for workers like Hughes — home or health aides, who look after some of the most vulnerable, sometimes themselves without health insurance and earning very little.

“We don’t have the luxury of telecommuting,” says Vanessa Jackson from Washington, D.C. She’s a direct support professional who helps people with disabilities navigate everyday life, like paying bills, doing laundry and going to doctor’s appointments.

The region has a severe shortage of workers like Jackson, says Danielle Darby, chief operating officer at Jackson’s company, RCM of Washington. If many start to quarantine at home, “this could potentially be catastrophic,” Darby says.

Shortages of professional caregivers are common across the country. Jobs for home, hospice and nurse’s aides are growing fast and employ millions, but often pay minimum wage or just above.

“I’m lucky because I actually have health insurance,” Hughes says. “Most of the other nurse’s aides in my facility — they don’t have health insurance.”

She says her company offers a high-deductible plan, but many can’t afford it. And she saysher state has a shortage of certified nurse’s aides — managers at her facility have been stepping in to fill the holes in the schedule. Hughes works the night shift alongside a nurse and a second aide.

“If one of us has a fever and is sent home,” she says, “it’s gonna be pretty hard to find somebody to come and work an eight-hour shift in the middle of the night.”

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