The Raging River: Certified Nursing Assistants’ Experiences in Rural, Long-Term Care

Abstract

Purpose: Certified nursing assistants (CNAs) are essential, direct caregivers within the long-term care (LTC) setting. When traumatic events occur within LTC, CNAs are often involved, resulting in potentially negative consequences for the CNA. There has been limited research about rural LTC CNAs, which is a concern due to CNAs’ important role and rural disparities they encounter. The purpose of this study was to explore the experience of CNAs who have faced a traumatic event while working in the rural LTC setting.

Sample: Nine CNAs were purposively recruited from two rural LTC facilities in a predominately rural upper Midwest state. Inclusion criteria included being a CNA, having experienced a traumatic event in a LTC workplace setting, speaking English, being at least 18 years old, and working in a rural area as defined by HRSA.

Method: This study used an interpretive phenomenological design. Semi-structured interviews occurred via Zoom. Analysis involved an iterative process that included dwelling with the data and the use of a hermeneutic circle.

Findings: All participants were white females, which is consistent with the CNA demographics within the area. An overarching theme of The Raging River emerged, along with the five supporting themes of Forward Motion, Nourisher, Drowning, Cold Resources, and Desperation for a Lifeline.

Conclusions: The CNAs described complex experiences, demonstrating both their strength to continue forward and their vulnerability and necessity of support. Caring for residents in the rural LTC setting brings unique challenges. This study demonstrated a clear need for future research to provide better support to rural LTC CNAs.

DOI:  https://doi.org/10.14574/ojrnhc.v25i1.789