Journal of Gerontological Nursing
Vol. 34 No. 11 November 2008
By Lucy Takesue Fisher, PhD, RN; Margaret I. Wallhagen, PhD, GNP-BC, AGSF, FAAN
ABSTRACT
This qualitative study identified certified nursing assistants’ (CNAs’) perspectives of nursing home residents and how these perspectives translate into care practices. Data included observations of and interviews with 27 CNAs in three dissimilar nursing homes. All participants were people of color, and all but 3 were immigrants. CNAs constructed three views of residents: as fictive kin, as a commodity, and as an autonomous person. Although individual CNAs held one primary view of residents in general, select residents were viewed from an alternative perspective, resulting in variations in care practices. These findings suggest that such distinctions, in tandem with structural, organizational, and cultural differences in nursing homes, present opportunities for nursing leadership to affect the visible, everyday practice of nursing CNAs. To target interventions, further research is needed on how CNAs come to differentially view residents and how these differences influence CNAs’ care relationships with residents.
ABOUT THE AUTHORS
Dr. Fisher is Assistant Adjunct Professor, Department of Family Health Nursing, and Dr. Wallhagen is Professor, Department of Physiological Nursing, University of California, San Francisco, San Francisco, California.
Funding for this research was supported by The John A. Hartford Center of Geriatric Nursing Excellence Evercare Scholars Program and the University of California School of Nursing Century Fund.
The authors thank Judith C. Barker, PhD, for her thoughtful comments on the manuscript and the CNAs for generously welcoming the authors into their nursing homes.
Address correspondence to Lucy Takesue Fisher, PhD, RN, Assistant Adjunct Professor, Department of Family Health Nursing, University of California, San Francisco, Box 0606, San Francisco, CA 94143-0606; e-mail: lucy.fisher@ucsf.edu.
