Study examines the impact of COVID-19 on nursing assistants

During the COVID-19 pandemic, most of the public’s focus on healthcare workers has been limited to nurses and physicians. Less attention has been given to nursing assistants, who are often seen as an invisible workforce but make important contributions to patient care. 

In hospitals, home care, and nursing homes, nursing assistants help patients with their daily activities like eating and getting dressed, monitor patients' vital signs, and work as part of the health care team with registered nurses.

"They are the eyes and ears of the clinical staff and can readily alert them of changes or declines in a patient’s condition," writes Jasmine Travers, assistant professor at NYU Meyers and the coauthor of a new study in BMC Nursing on nursing assistants during COVID-19.

Even in non-pandemic times, nursing assistants are subject to challenging physical labor, disrespect, low pay, and limited opportunities for advancement, all of which increase the risk for turnover and an unhappy workforce. In their study, Prof. Travers and her colleagues sought to understand what the pandemic has meant for these frontline workers.

Through interviews with 13 nursing assistants at an academic medical center in March and April 2020, the researchers explored the relationship between organizational empowerment practices and the psychological experiences of empowerment among nursing assistants. They found that:

• Information—or lack thereof—provided to nursing assistants influenced their feelings of fear, preparation, autonomy, and competence. 
• Resources such as protocols, equipment (including PPE), and staff made it easier for nursing assistants to cope with overwhelming emotions, and facilitated their ability to do their jobs. Limited resources drove them to take on new roles, including those that usually fall under housekeeping and environmental services.
• Support from nurses made nursing assistants feel appreciated and valued and consisted of listening, communicating, and collaborating in ways that have been advocated for by many for decades. While nursing assistants expressed they could ask leadership questions when needed, several nursing assistants shared that they felt leadership did too little to show that they valued their role and contributions.
• Opportunity to take care of COVID-19 patients yielded a diverse array of emotions, exposed advances and gaps in the preparation of nursing assistants, and enabled them to innovate and develop new practices and processes such as clustering care and developing kits.

Prof. Travers recommends that healthcare leaders ensure that nursing assistants are included when sharing important information with staff; pay attention to the mental health and social support needs of nursing assistants to avoid burnout; and create supportive environments where nursing assistants feel empowered to communicate and collaborate with healthcare teams.