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Making the Leap from Custodian to Nurse Practitioner


Hospital custodians, cafeteria workers, and other essential employees often don’t get the attention and support they deserve. The coronavirus pandemic has been challenging for everyone in the medical industry, and these workers are no exception, often working long hours without adequate PPE while their colleagues get credit for saving lives and comforting family members.

However, they are just as important as caregivers and providers, especially in the middle of a viral outbreak. They are there decontaminating surfaces and make sure these spaces are safe for both patients and providers.

One woman is speaking up about her experience as a hospital custodian with dreams of becoming a nurse. 

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Jaines Andrades always knew she wanted to help people as a registered nurse, but getting her medical license felt like a long way off. Ten years ago, she was working at a fast-food restaurant when a local hospital, Baystate Medical in Springfield, MA, asked her to interview for a custodian position. Cleaning up after patients wasn’t her dream job, but she thought it would bring her closer to patients. She worked there full-time while going to school for her nursing license.

“Even if it was cleaning, as long as I was near patient care I’d be able to observe things. I thought it was a good idea,” she recalls, speaking to a local new outlet.

It was the intimacy of nursing that ultimately steered her towards the profession. “When do you let a random stranger into your life? Into the most personal parts of your life? Rarely. As a nurse, we get that. I just really love the intimacy with people.”

She finally earned her nursing license, but she decided to take her career to the next level. Just this last month, she became a nurse practitioner at the very hospital where she used to clean up after patients and staff.

Life as a Hospital Custodian

We know that custodians and building cleaners make an average of just $13.19 per hour, according to the latest figures from the U.S. Bureau of Labor Statistics, with a median salary of $27,430 a year.

Meanwhile, a four-year nursing degree (BSN) can cost anywhere from $40,000 to over $100,000 a year for private institutions and large universities, but Andrades found a way, even on her tight salary. Custodians also tend to work off-hours when most of the rooms are empty or patients are asleep, which adds to the challenge of balancing school, work, and a personal life.

The coronavirus has only exacerbated these inequities. Multiple reports show facilities prioritizing nurses and doctors over environmental service workers when it comes to distributing PPE.

Even as businesses and restaurants offer giveaways to nurses and front-line workers, custodians and other environmental service workers say they’re often left out.

Luis Padilla, an environmental service tech at Los Angeles County-USC Medical Center, recalls going through the drive-thru at McDonald’s when the company was giving away “Thank You” meals to first responders and essential workers.

When the cashier saw his badge, he says he was turned away. “This is not for you,” Padilla remembers the cashier saying. “This is for doctors, nurses, and police. Don’t be trying to get free food.”

It wasn’t having to pay for food that upset Padilla, it was the humiliation and lack of respect. “No one is thinking about custodians at all,” he says of the incident. “People have no idea what we do. We’re not just picking up trash.”

Jane Hopkins, executive vice president of Service Employees International Union’s Northwest chapter, one of the largest unions representing custodians and service workers in the country, says these individuals are vital to the entire system. “In a hospital, they’re just as important as a doctor – they’re just doing a completely different job,” she said in June.

Paving the Way for Other Aspiring Nurses

Now that Andrades has achieved her goals, she’s standing up for other hospital custodians that dream of becoming nurses. She recently posted a photo to her Facebook page showing all three of her IDs over the years, including as a custodian, RN, and finally as a NP. 

She says working as a hospital custodian can be a great introduction to the field of nursing. “It’s tough to be the person that cleans. If I had to go back and do it again, I would. It’s so worth it.”

However, we can’t expect custodians to pay their way through school on such a meager budget. From PPE to higher wages, these workers should get the respect they deserve.

The next time you see a custodian at work, remember that they could be on their way to becoming an RN, or even a NP,  just like you. As Andrades puts it, “Nurses and providers, we get the credit more often but people in environmental and phlebotomy and dietary all of them have such a huge role. I couldn’t do my job without them.”

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