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CNAs Are Speaking-But Are You Listening?

March 1, 2006
by Sandra Hoban, Managing Editor
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        With spring around the corner, now is an ideal time for reflection, renewal, and new beginnings-both personal and professional. As the earth bursts with new growth and blossoms, throw open the windows and refresh the environment-the long-term care environment. You may think that your facility, whether it's a nursing home, assisted living community, rehab center, etc., is doing just fine. Surveys are satisfactory, residents and families are content, and employees seem to be happy. But is it fine? While you, as an administrator, are often mired in the countless duties, drudgeries, and decisions critical to operating a first-class facility, the people who put a face on care-your CNAs-are your "eyes and ears."

And they see and hear it all. CNAs also have a voice, and they have plenty to say-to you!

Relax, it's not all bad, as I discovered in September when I attended the Ohio-based Alliance Training Center's 16th Annual Nurse Aide Convention and Nurse Aide Olympics in Clinton, Ohio. Attendees ranged in age from 19 to 64, with new caregivers interspersed among many others with years of experience. I learned that this conference is the highlight of the year for attendees. It is an opportunity to learn, to share, and to celebrate their achievements.

And celebrate they did. Themed "The Sky's the Limit, The Endless Possibilities of Caregiving," 154 enthusiastic CNAs participated in sessions covering topics such as resident mobility, service, and more. They had a chance to compete using their caregiving skills, visit exhibit booths, and go home with fresh ideas, along with an assortment of gifts and prizes.

"That's nice, but where do I fit in?" you might ask. Well, you-the administrator and DON-were the subject of the opening session, "What Would You Change If You Could?" Leah Klusch, executive director of the Alliance Training Center and the driving force behind the conference, gave the audience the opportunity to "talk" to you. She urged the CNAs to tell you about themselves, the peaks and pitfalls of their jobs, and their relationships with their coworkers, and to offer you suggestions on how you could improve their jobs and overall organizational efficiency.

The nationally known Klusch, a dynamic educator and presenter, urged the audience to speak up and be heard. The session, supplemented by a questionnaire included in the attendees' conference materials, provided a lot of information, insight, and advice from CNAs that a savvy manager would do well to consider. Remember, they don't have your top-down perspective, but they do offer an enlightening look at your operation from the ground floor.

Who Are Your Aides?
Do you know your CNAs just by name tag, or have you taken time to get to know the people behind the badges? Their diversity in backgrounds, purposes, skills, goals, and achievements makes each one unique. It's not just that they're trying to make a hard-won living. Whether they made long-term care their career choice based on personal experience with caregiving, from an inborn desire to comfort those nearing the end of life, or for spiritual fulfillment, most CNAs given a chance turn out to be dedicated, committed caregivers who do their jobs for pure, unselfish motives. As one aide so poignantly said, "It's an honor to give part of my life to someone who needs it." Another attendee, Sylvia J., says she likes to take care of people, and being an aide is as close as she can get to being a nurse without having a GED. "But I'm working on that," she adds confidently.

A type of "generation" gap exists, however, between longtime CNAs and new hires. The more experienced aides believe that new hires are cut from a different cloth than in the past. They believe that there is a lack of compassion, dedication, work ethic, and sense of teamwork. On the other hand, new hires often feel that experienced CNAs use tenure to pass off their less desirable duties on them. Although this dichotomy is surely not universal, it was often mentioned in the questionnaires.

Of course, longtime CNAs know firsthand how their roles have evolved over the years. Where once resident care was their first and foremost responsibility, they now have to be familiar with computers, regulations, and privacy matters. Steven D., a 13-year veteran, comments: "More laws have come into play over the years, and we have more responsibilities than when I entered the field." Melissa E. agrees: "We have to know, understand, and follow more regulations, such as HIPAA, which means more paperwork." Along with the additional paperwork and documentation, Mary S. notes that "residents are more demanding today." Because of these added responsibilities, Gladys P. regrets that she cannot spend more quality time working with the younger aides.