They Like The Nurse, But Love The Nursing Assistant

It is National Nursing Assistants Week and an opportunity to celebrate and acknowledge their contribution to healthcare. This week is also a great time to raise awareness around the healthcare industry’s undervaluing of nursing assistants. Read on to learn about the highs and lows of this caring group.

They Like The Nurse, But Love The Nursing Assistant

The 42nd annual National Nursing Assistants Week provides an opportunity to showcase and celebrate the tremendous contribution of this devoted group. Every day, nursing assistants create a community of caring for those who are most vulnerable. They bring experience, compassion, patience, humor and caring attitudes to the patients and residents’ daily lives. Ethical and well-meaning, nursing assistants often use their voice to advocate for other

This week also provides an opportunity to raise awareness around the healthcare industry’s undervaluing of nursing assistants. Despite being one of the top 10 most in-demand jobs, nursing assistants continue to struggle with low pay and lack of benefits. There is also a lack of research on important issues surrounding NAs.The Paraprofessional Healthcare Institute (PHI) released an analysis, in 2017, of U.S. nursing assistants working in nursing homes. PHI identified these key points:

  • Nursing assistants are 3x more likely to be injured on the job than typical workers
  • Average wages have been stagnant- $12.34 in 2016 compared to $12.35 in 2006.
  • More than half work part-time for part of the year.
  • 17 percent of nursing assistants live below the federal poverty line compared to 7% of all U.S. workers.
  • 39% rely on some form of public assistance
  • The uninsured rate among nursing assistants is 14%. Only half are insured through employers and one-fourth rely on public coverage (i.e. Medicaid)

Despite a growing demand, the poor working conditions often make it hard to attract and retain nursing assistants.

Where It All Began

The American Red Cross created the Volunteer Nurses’ Aide Service during World War I. This historical program trained individuals to assist nurses during the war. In 1987, Congress passed the Omnibus Reconciliation Act to ensure nursing assistants hired to work in Medicare and Medicaid Certified facilities were well trained and skilled.

Nursing Assistants Provide Stability

Nursing assistants work in many different settings including hospitals, nursing homes, adult care facilities, physician offices, personal residences, assisted living facilities and hospices among others. It is estimated 80 to 90% of residents direct care in long-term care facilities are provided by a nursing assistant. Regardless of the setting, nursing assistants bring stability to care. The Stayers Studies (1997-98), funded by the Administration on Aging, National Institute of Aging found nursing assistants to be “Stayers” and having these characteristics:

  • 28% stay 5 years or more in NA positions
  • 12.6% stay 10 to 55%
  • Maintain positive relationships with residents
  • Value job security and relationships with peers
  • Often considered health experts in their own families
  • Most had a positive experience early in life with an older person which contributed to the decision to become a NA

They May Really Like the Nurse, but Love the Nursing Assistant

Early in my nursing career, I had a humbling moment while working in homecare. My supervisor explained “patients will really, really like you, but they will love the nursing assistant”. Nursing Assistants help people with the basic living activities that just make life better. This role may seem straightforward but doing this while promoting dignity is a gift nursing assistants possess. They help the patient with self-care that improves quality of life. Other roles include:

Listener

Nursing assistants listen to the health concerns of patients and relay important information to the nurse. People often find it easier to talk with the NA and share feelings of grief, loss, hope and fear. Through listening, NAs provide opportunities for others to reminisce and share the highs and lows of their lives.

Data Collector

Nursing assistance measure vital signs and often notice trends to report to the nurse. Nurses have often been alerted to changes in a person's condition by the NAs observation “Something just isn’t right.”. But their data collection extends beyond vital signs to pain, skin conditions and mobility or behavioral changes.

Teacher and Role Model

Patients/Residents and caregivers are often anxious when learning how to do things different to accommodate for illness and debility. Nursing assistants provide supportive instruction and demonstration for day-to-day functioning. Because of this, NAs make great role models.

Team Player

Nursing assistants are on the front lines, but not always recognized as part of the healthcare team. They provide the assistance that allows nurses to focus on their own job roles.

What You Can Do to Support Nursing Assistants

Make a conscientious effort to personally thank the nursing assistants you work with for their contribution. Stay up to date on relevant information regarding the work challenges of nursing assistance so you may advocate for better conditions. If you are in a management position, support your staff through competitive wages, advocating for health insurance and providing consistent shifts with full time hours.

Share Your Thoughts, Experience and Ideas

How do you support, advocate and show appreciation to this deserving group? What would you like to share in celebration of National Nursing Assistant Week?

Resources

PHI Nursing Assistants Employed in Nursing Homes: Key Facts

National Network of Career Nursing Assistants (Website)

Five Responsibilities of a Certified Nursing Assistant

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J.Adderton

About J.Adderton, BSN, MSN

(Columnist)

I am a RN, MSN with over 25 years nursing experience. I have been privileged to work different setting in varying positions including bedside nursing, management and educator. I enjoy writing about topics and hopefully, providing another perspective. Feel free to check out my Allnurses.com blog.

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Specializes in icu,prime care,mri,ct, cardiology, pacu,.

So true. Said they’re not paid more, and where would we be without them?

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

The CNAs I worked with in the long-term care facility where I worked for five years are worth their weight in gold. The good ones were some of the hardest working, most caring people that I have ever known. There were lazy ones, and they usually didn't last. Sometimes the PCTs I work with in the hospital complain about their jobs and part of me wants to tell them they have no idea what hard work is with their six patient assignments of mostly alert and oriented people. There were nights where we had one CNA for all SIXTY long-term care residents on our floor. They work HARD. They develop such close relationships with the people they care for, I can't say enough about these men and women I have had the privilege to work with. I wish that they were paid in accordance with their worth. Everyone wants to fight for workers at McDonald's to make $15 an hour, I don't hear any rally cries for CNAs, I know I would march for them!

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Specializes in Clinical Leadership, Staff Development, Education.
1 hour ago, JBMmom said:

The CNAs I worked with in the long-term care facility where I worked for five years are worth their weight in gold. The good ones were some of the hardest working, most caring people that I have ever known. There were lazy ones, and they usually didn't last. Sometimes the PCTs I work with in the hospital complain about their jobs and part of me wants to tell them they have no idea what hard work is with their six patient assignments of mostly alert and oriented people. There were nights where we had one CNA for all SIXTY long-term care residents on our floor. They work HARD. They develop such close relationships with the people they care for, I can't say enough about these men and women I have had the privilege to work with. I wish that they were paid in accordance with their worth. Everyone wants to fight for workers at McDonald's to make $15 an hour, I don't hear any rally cries for CNAs, I know I would march for them!

There was very little research surrounding CNAs and pay, it was very eye opening. It does have me thinking what I could do to advocate for additional pay.

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When recently hospitalized, it was the nursing asst who informed me that my vitals were out of whack. When I brought the subject up with one of the doctors with the nurse present, she acted visibly annoyed as she had no intention of saying anything. She also spoke of an abnormal lab result to one of the doctors in front of me and then did not want to discuss it with me later. I had to tell one of the doctors that “no, such and such did not occur after the abnormal lab result”. I find it telling that the nrsg asst did a good job of providing me with useful information about my care while the nurses seemed to just be in a hurry to get out of my room. This is in keeping with the work behavior I encountered from good nrsg assts when I worked in long term care. Good commentary on good nrsg assts, sad commentary on nurses who are supposed to be the ‘professionals’.

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Don't have to tell me twice - did it for three years before moving up to LVN. Got one of my classmates a CNA gig at an LTC facility I was working in. Came close to passing out a couple of times, 'til I gave her some tips on how to pace herself. Vastly underrated in their importance, and I don't begrudge them a bit of what they get. Wish I could give 'em more. ❤

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Being a CNA is one of the toughest jobs out there. I salute all CNAs!

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Specializes in ICU, trauma, neuro.

Nursing assistants and unit secretaries do so much to improve patient safety, satisfaction, and reduce stress for RN's and MD's that it is impossible to give them adequate credit. Since our ICU did away with both patients get turned less, call's (both telephone and call lights) take longer to answer, falls are more likely, to name but a few of the issues that I have noted. I believe that nursing assistants should advocate for laws that require specific education and regulations that mandate their usage in acute care facilities. Over time this would help to contribute to higher wages. Hospitals will never pay more "out of the goodness of their heart" or even out of concerns like "patient safety" most of the time. Don't kid yourself if laws didn't require it hospitals would pay nursing assistants $10,00 per hour and have then write the orders (like MD's and NP's), and pass the medicines (like RN's) the only reason that they don't are the legal restrictions that have been put in place over many decades.

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Specializes in Clinical Leadership, Staff Development, Education.
48 minutes ago, myoglobin said:

Since our ICU did away with both patients get turned less, call's (both telephone and call lights) take longer to answer, falls are more likely, to name but a few of the issues that I have noted.

I think this is a frequently experienced across healthcare. Thanks for sharing.

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Specializes in kids.

I bow down to the LNAs I have been blessed to work with! I work perdiem in LTC and they are absolute rockstars. I respect what they bring to the table. And we all work well together.

Enjoy your week!!! I hope you are all remembered for the great job you do!!!

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Specializes in Geriatrics, Dialysis.

A good CNA is worth their weight in gold. I work LTC and if it weren't for the CNA's that I work with there are a lot of things I would miss. They are the front line, they are generally the first to see when something is "off." I certainly don't have time to do full head to toe assessments on every resident every day. It's those CNA's that spot a reddened area or an open area and alert me about them so something can be done. More often than not it's a CNA that says "something just isn't right" that alerts the nurse to investigate further and prevents a small issue from becoming a huge one.

This doesn't even touch on the importance of CNA's just helping these vulnerable people with basic ADL's. Imagine needing to use a bathroom and being unable to get there alone. Imagine how it would feel to soil yourself simply because nobody was available to help you get to the bathroom. Imagine not being able to clean yourself, dress yourself, even feed yourself. How miserable would that be without a dedicated CNA to help you?

Imagine that's your mother or father in a nursing home that needs help. The quality of care they are receiving from these dedicated professionals will go a long way towards allowing you to sleep well at night knowing your loved one's are well cared for when you can't be there. Find a good facility staffed with good people and you truly can have some peace of mind knowing there are people that genuinely care about your loved one's well being and are working hard to make sure they are comfortable, safe and happy in their space. None of that would be possible without the CNA.

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