One of the greatest misnomers in the nursing home industry may be that of the CNA.
NA, of course, stands for nursing assistant. For a great many of those who hold the title the C might stand for clumsy. It might stand for cantankerous. It might even stand for crude.
The C is supposed to stand for certified. But in actual practice the activities of many CNAs could led one to question a) who is doing the certifying and b) how did these people ever achieve it.
Under Kentucky statute, CNAs are supposed to complete 18 hours of training before receiving certification. One of the leading providers of such certification is the state’s Community and Technical College System. The process requires that applicants complete 18 hours of classes in subjects including human anatomy, interpersonal communication and computers. All in all, certification could theoretically be completed in one strenuous semester.
So far, so good. But in actual practice, many patients have reason to wonder how successful that training was.
Below are listed some of the run-ins I have had with CNAs:
- Because I currently lack one leg I require some assistance adjusting my clothing after using the commode. The vigor with which some aides pull up said items of clothing has led me to conclude that they are unaware that about half the population has reproductive organs which are convexed, not concaved.
"Are you ok?" one of them will ask after such an attempt.
"Just fine," I said as tears streamed down from my eyes.
Still others will respond to my call for help by opening the door, seeing me seated on the commode and asking, "What do you need?"
"Well, I was hoping you could tell me what the capital of South Dakota is?" Some questions simply aren’t deserving of a straight answer.
- Interpersonal communications is an area that seems to challenge many of the staffers who hold the title of CNA. Far too many seem bound and determined to use language to create a dispute rather than alleviate it. During one session in which I sought to get help the aide actually pushed me down onto the commode chair when I sought assistance. After being pushed for the third time with enough force to jar the commode chair I was using I raised my voice to a scream in an effort to be understood. The aide was asking a medical question and my response was as follows: "I thought you people received briefing at shift change."
Instead of taking my point about the briefings, the aide instead took exception to the phrase "you people," which she took to be a racist remark. I can see how the phrase in question could be considered racist in another context, which was surely not my intent in this case. She threatened to walk out and leave me in my predicament before finally returning to do the simple task I had requested.
Still another CNA routinely refuses to communicate at all with nursing home residents. She goes about her work with great efficiency while she hums to herself. But her refusal to acknowledge a simple greeting from a resident can leave a resident feeling like they are simply a slab of meat.
Don’t get me wrong. I have met several CNAs who truly care about the patients and care about projecting an attitude of professionalism. The ones who don’t seem ready to assume that anyone living here has no mental faculties – an attitude that is distasteful to those of us whose minds remain sharp.
The situation seems to deteriorate even more when staffers aren’t required to have any kind of certification at all. Just the other day, two housekeepers entered my room to begin a loud and animated discussion of their respective New Years Eve festivities. When I turned up the volume on my television so I could listen to a program instead of their discussion, I received a glare from one of the housekeepers.
"This is why I don’t like to clean rooms when residents are in them," she huffed. She turned around and stormed out of the room, never to be seen again.
And for this kind of treatment, at least some of these people have received training in interpersonal communications?
I understand that the CNAs’ job is not always easy. I appreciate that some of the residents suffering from dementia are truly difficult to deal with. I understand that staffing levels are inadequate. But all of that doesn’t excuse the failure by too many staffers to appreciate the dignity of each resident.
I suppose that hiring in this place is done by placing help wanted signs in the windows. But for too many residents, help wanted is a plea that draws an inadequate response if it draws a response at all.