A congressional hearing heated up yesterday when 73-year-old Beth Ferris, quavering with rage, asked those in the packed Senate chamber to stand up if they shared her anger about low pay and understaffing at nursing homes. About half the audience rose and clapped.

The plight of the nation's 1.3 million nursing aides may seem an unlikely subject for high emotion, but the hearing before the Senate Special Committee on Aging generated tears, ovations and standing-room-only attendance.

"Until now, we've focused on those who receive nursing home care. Today we'll focus on those who provide it," said committee Chairman Charles E. Grassley (R-Iowa).

Grassley said a Washington Post series on nursing aides last weekend highlighted the low pay that leads to staff shortages and aide injuries. With an average hourly wage of $6.94, turnover is 94 percent annually. Aides, stressed by understaffing, have the third highest rate of serious injury among private industry workers.

"Does nursing home work have to pay so poorly?" Grassley asked. "This industry will receive $39 billion this year from the federal government to care for the nation's nursing home residents." Grassley is requesting a General Accounting Office study of nursing home finances to investigate why aides aren't paid more.

A year ago, understaffing issues drew blank stares from policymakers, nursing home activists said. Now, understaffing is a hot issue.

"When I am moving or changing one resident, it can take several minutes," Baltimore nursing aide Narcissus Jackson told the panel. "Meanwhile, someone else is waiting to go to the bathroom. Residents deserve more. It hurts their dignity to lie in their own urine and feces waiting for one of us to come change them."

Jackson and other aides testified in favor of federally mandated staffing requirements, as did relatives of nursing home residents. But industry representatives disagreed.

"Mandating numbers will not guarantee hearts. You'll get bodies, hands and feet," said Florida nursing home administrator Leslie Williams. "Assuming that a law dictating the number of bodies in my center on a daily basis will guarantee quality is a flawed concept. While it is logical that 10 nursing assistants can get more done than six, give me six who love what they do as opposed to 10 who are [just] collecting a check."

Ferris, the woman who inspired the audience's standing ovation, initially had not been scheduled to testify. But after listening to the testimony of industry officials, Ferris, president of Texas Advocates for Nursing Home Residents, decided to speak.

Ferris said that increasing the number of nursing aides--who provide 80 percent of the hands-on care at nursing homes--is critical to improving care. After the hearing, she added, "The industry talks about how all we need is aides with 'heart.' Well, 'heart' can't turn a patient, 'heart' can't feed a patient."

There is no federal legislation in the works to mandate staffing requirements. Rep. Fortney "Pete" Stark (D-Calif.) plans to introduce a bill this month that would require nursing homes to report how many nursing aides work on a shift--a step activists see as inadequate.