Healing Together, Creating Connections

AMDA created Healing Together—including resources and webinars—to address the grief and trauma we’re all feeling in the wake of the COVID-19 pandemic. Richard Juman, MD, opened the most recent webinar in the series, What Your CNAs Want You to Know: A Collaborative Approach to Improving Care in PALTC, with an eye-opening recollection: “The last time I addressed a room full of medical directors and attending physicians, I asked them, ‘Would you rather have a wonderful CNA or a wonderful physician if you were in a facility?’ Everyone raised their hand for the CNA. Obviously, CNAs are where the rubber meets the road in terms of care.”

During the webinar, participants heard from experienced CNAs, who were pleased to share their thoughts on how to ensure the best possible care for residents while maintaining a strong and viable workforce. Lori Porter, CEO and co-founder of the National Association of Health Care Assistants (NAHCA), said, “CNAs have been called heroes during the pandemic, but it’s more than a word. Heroism is ingrained in how they act, work, think, and feel every day. They do not have jobs; they have relationships.”

Ms. Porter noted that CNAs often are underrated and unappreciated. “CNAs have been marginalized time and again by supervisors and management. And, too often, they’re ignored by other team members,” she observed. Yet during the pandemic, she said, CNAs “were honored to hold their residents’ hand at the end when no one else could, despite all the trials, challenges, and risks… Maybe the best thing to come out of the pandemic is a new model where CNAs and medical directors work together.”

Sherry Perry, NAHCA Board chair and a long-time CNA, said, “The average CNA does not feel as though they can approach a medical director. They must follow the chain of command. That ends with the administrator and doesn’t include the medical director.” She added that many CNAs may not even know what a medical director is. “They just know the doctor is here,” she said.

“Lead a transformation in the culture of the care team,” Ms. Perry urged Webinar participants. “Strongly encourage CNAs to be included in care planning meetings. Identify certain pieces of information they can bring to the table, seek their input, and listen to their ideas and comments.” She also suggested that practitioners bring a CNA familiar with the unit to accompany them when they make rounds.

NAHCA Board member and CNA Sheena Bumpas brought a unique viewpoint. She explained, “My medical director happens to be my personal physician. I enjoy a professional relationship with him at our facility because I know him. I have never thought about my fellow CNAs not having that relationship and how important it is to me as a CNA.” She suggested that clinicians, “Build a robust professional relationship with your CNAs. Thank them when you see them, understanding that they normally only get recognition from residents and their families.” She stressed, “Help us be the best we can be, whether through recognition or education. Take us on rounds, invite us to a seminar, and include us on a regular basis in care planning and problem solving.” She further recommended, “Take a few minutes to walk in our shoes. For instance, pass trays with us.”

Chris Leach, a NAHCA Board member and a nursing home CNA, suggested taking “a role in CNA development and onboarding. I cannot stress enough how medical directors are the most respected member of the care team. Your message matters.” She also recommended using a “town hall concept,” taking a resident case and talking through it with CNAs. “Ask what their difficulties are and/or their challenges in caring for this resident. Then really listen to their responses.”

Several medical directors also participated in the discussion. “I am enlightened by what you’ve said,” Tim Holahan, DO, CMD, said to the CNAs. He added, “One particular thing I’ve been trying to do is culture change. As part of this, I’ve had some great conversations with CNAs and received some valuable insights into their day-to-day experiences that I was missing before.”

Swati Gaur, MD, MBA, CMD, observed, “Essentially every member of the team is important. I’ve rounded with CNAs, and it was incredibly powerful for me.” She stressed, “I want CNAs to come and alert me if they are seeing something that concerns them.” She recalled a CNA informing her about a patient who seemed nervous and was complaining his hands were tingling. Dr. Gaur ordered labs, and he actually had life-threatening hypocalcemia. “She saved this man’s life,” Dr. Gaur said. 

Watch the recording of the CNA webinar. The final Healing Together webinar is set for January 6, 2022. The topic is Having Conversations with Difficult Family Members. Register now.