Nurses Aides, Medical Assistants and Home Health Aides are important paraprofessionals and members of the healthcare team upon whom nurses must rely for crucial patient care. These individuals must be treated by all nurses with the respect and dignity which they deserve. 

 

Just as doctors rely heavily on nurses to carry out orders, assess patients, and document crucial data vis-a-vis patients’ care, nurses often rely heavily on Home Health Aides (HHAs), Medical Assistants (MAs), and Certified Nurses Aides (CNAs) to provide optimal patient care.

Over the last seven years, medical assistants were crucial to the fulfillment of the multitude of tasks I needed to carry out in my most recent full-time work as a Nurse Care Manager. In overseeing the healthcare of more than 80 chronically ill patients, my MA was indispensable in assisting me in following up with patients, maintaining open lines of communication with both patients and providers, encouraging patients’ adherence to bloodwork schedules and medical appointments, and tracking healthcare maintenance data central to preventive healthcare. Without her---and the ubiquitous lists of tasks for her to carry out which I added to daily---my work would have been tantamount to impossible, and I was sure to let her know just how invaluable she was on a regular basis.

Now, having entered a per diem position in a small residential hospice---my first direct-care nursing position since graduating from nursing school in 1996---I can see that skilled Home Health Aides are truly the backbone of this particular facility. Between meal preparation, personal care, laundry, housekeeping, and the frequent turning and repositioning so central to the care of bed-bound patients, I as a nurse need a HHA who is highly skilled, organized, compassionate, thoughtful, and able to shoulder multiple tasks and responsibilities throughout the duration of an 8-hour shift. In this particular venue, a Home Health Aide who embodies these (and other) traits is worth her weight in gold.

Another of my per diem positions involves work in a inner-city community health center which serves a population which is 90% Latino, the majority of whom are Puerto Rican. The MAs in this particular facility perform multiple functions which include setting up and stocking the exam rooms, screening patients, managing providers’ schedules, booking appointments with health center providers and specialists, scheduling diagnostic tests, phlebotomy, translation for providers who are not bilingual, assisting the nurses with certain tasks, and managing the overall environment of the health center. Most importantly, 100% of the MAs in this facility are Latino themselves, and their crucial task vis-a-vis patient relations is serving as “culture brokers” who essentially bridge the gap between the patients and the health center and its providers, setting patients at ease and effectively translating and filtering patients’ complaints into language which providers can understand. This cultural bridge of human connection is central to the success of the facility, and these MAs are truly the unsung heroines of the care which is delivered throughout the year. While patients may give the doctors credit for saving their lives or managing their illnesses with skillful knowledge, it is the MAs who create and hold the space where those therapeutic interactions take place.

Interestingly, the U.S. Department of Labor Bureau of Labor Statistics website states:

“Nurse aides employed in nursing care facilities often are the principal caregivers, having far more contact with residents than do other members of the staff. Because some residents may stay in a nursing care facility for months or even years, aides develop ongoing relationships with them and interact with them in a positive, caring way.”

With growth in jobs between 2006 and 2016 for HHAs and CNAs projected to exceed 28% (much greater than the national average overall), it appears that the lion’s share of job opportunities will be in home health care as the Baby Boomer generation begins to demand home-based care during their latter years of life. However, with a median hourly rate of approximately $10 per hour for most aides regardless of facility type (with regional variations, of course), the earning potential vis-a-vis the rising cost of living will certainly not keep up with inflation. Thus, despite demand for skilled care, these hard-working women (and a smattering of men) will often continue to work multiple jobs in order to feed their families.

So, as nurses, what is our moral, ethical, personal, and professional responsibility when it comes to our relationships with Medical Assistants, Home Health Aides, and Certified Nurses Aides? My experience and my heart tell me several things.

First, we must treat these workers with the utmost respect and professionalism.

Second, we must be sure to praise the aides with whom we work for a job well done, and learn to correct undesirable behaviors or errors with kindness and nonviolent forms of communication . (We must also not simply wait for Medical Assistants Week to gift our favorite Aide with a token of our appreciation.)

Third, we must advocate for these important workers vis-a-vis their fair treatment by employers, the need for fair wages and cost-of-living increases, and the maintenance and/or development of positive work environments (and intervene when we feel an injustice has occurred or is still occurring).

Fourth, we must encourage aides and paraprofessionals with whom we work to pursue further education if so desired, and provide mentorship and guidance to those pursuing such advancement.

Despite the fact that nurses often feel overlooked by doctors, overworked by medical institutions, and poorly remunerated in terms of hourly pay, overtime or vacation days, we must not translate that cynicism into our relationships with the valuable workers upon whom we so closely rely. If we are required by our licenses to supervise and take full responsibility for the work of our non-licensed coworkers, we must also take responsibility for the nurturing and care of those very individuals. Successful working relationships between nurses and their non-licensed brethren are crucial to positive patient outcomes, job satisfaction, and overall personal satisfaction related to one’s employment. I urge every nurse to reach out to the workers who carry the ball for so many of us in a multitude of healthcare settings, and make those relationships as positive, professional, growthful, and satisfying as they can be. As we care for others, we care for ourselves. And in that caring, we care for the world at large.

 

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NurseKeith is a nurse, blogger, writer, and consultant. Please feel free to visit his blog, Digital Doorway .  

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