“If I had only one sentence, this would be it: Direct support work is a highly skilled job,” says Amy Hewitt.
“It’s not viewed that way by society - or, frankly, by many employers - but not everybody can do this job. You have to be smart; you have to be able to problem solve; you have to be flexible and a quick thinker. You also need patience and empathy and creativity. We’re not going to get anywhere in terms of policy advocacy or getting the supports we need in place without clearly articulating that this is a highly skilled job.”
Hewitt is a senior research associate at the University of Minnesota’s Research and Training Center on Community Living. The center’s mission is to support community living for people with intellectual and developmental disabilities - and that has led to a focus on strengthening and supporting the direct support workforce.
Continue reading ‘Amy Hewitt: Direct Support Work is a Highly Skilled Job’
“My passion for working with people with dementia, for making life better for them, has been my major motivating factor. But over time, I keep saying to myself: ‘It’s the direct-care worker, stupid,’” says Joanne Rader. “The only way to make the lives of people with dementia better is to improve the working lives of the direct-care workers. We need to put the things in place that let them provide relationship-based care.”
Now a consultant, Rader has helped pioneer key advances in reducing the use of restraints and finding conflict-free ways of bathing in long-term care. The co-author of Individualized Dementia Care: Creative, Compassionate Approaches and Bathing Without a Battle, which won Book of the Year awards from the American Journal of Nursing in 1996 and 2002, she is one of the founders of the Pioneer Network.
She learned to appreciate the contributions made by direct-care workers early in her career. “I’ve always had a tremendous amount of respect for the work they do, and also for the informal power they have. I might have had the best solution in the world, but if I didn’t have their buy-in, it wasn’t going to get anywhere.” Continue reading ‘Joanne Rader: “It’s the Direct-Care Worker, Stupid”’
“Most of the people that get into this work are women, and they have kids,” says Patti Green of her fellow direct-care workers. “A lot of them are single. They need to earn a decent hourly rate of pay, and they need to have health insurance.”
“That would attract more people, and then if they had the good screening and training we could weed out those that don’t really have a heart for it.”
“They listened to me - I was kind of surprised”
A natural leader, Green has become an expert on the state of direct-care work in America by running what amount to online break rooms for direct-care workers. Nursing Assistant Resources on the Web, the blog she started 10 years ago and now runs with the help of two other direct-care workers, is a trove of free articles, thoughtful blog posts, FAQs, and useful links. And at NursingAssistant@yahoogroups.com, the online community Green launched around the same time and still moderates, 750-plus members engage in a lively exchange of ideas, asking questions, venting frustrations, and offering each other affirmation and support.
Continue reading ‘Patti Green: We Have to Learn to Speak Up’
“There has been a lot of paternalism about direct-care staff – the notion that they are not really adults,” says Anna Ortigara. “People wonder: Are they really capable of being in a lead role? Can they be trusted to make good decisions? Are they capable of self-direction?”
Instead of these questions, Ortigara believes, we should ask ourselves: “How can we possibly think we are going to improve long term care without involving frontline workers? We need them at the table in order to achieve cultural transformation - and why wouldn’t we want them at the table?”
A Chicago-area nurse with a master’s degree in gerontological nursing and over a quarter of a century’s experience in long-term care, during which she has created pioneering curricula for training and supporting direct-care workers, Ortigara has a passion for improving job and care quality. She also has a talent for asking Socratic questions about what keeps us from making more progress. Continue reading ‘Anna Ortigara: We Need to Treat Direct-Care Workers Like Adults’
“I’ve seen a tremendous change in the view of direct-care workers,” says researcher Barbara J. Bowers. “I don’t think you’ll find a lot of people in long-term care any more who say ‘They’re lazy, they’re incompetent, they don’t know anything.’ I think there’s a tremendous amount of respect.
“The trouble is, managers think it’s their job to come up with a solution when there’s a problem, and they don’t think to include the frontline workers. And that’s partly because the workers don’t have any time, because they’re usually worked to death.”
Looking at CNA work like an anthropologist
A professor at the University of Wisconsin in Madison, Bowers has been studying how people live and work in long-term care facilities for nearly three decades.
After earning a master’s degree in nursing and a PhD in sociology, Bowers published her first study of direct-care workers “around 1980,” she says. Few others were researching the workforce at that time. “People were looking at what people did, but not what the experience was like. So I did a field study around 1984 where I looked at the work essentially like an anthropologist, working as a CNA for four months in a nursing home.”
Continue reading ‘Barbara Bowers: Studying CNA Work Like an Anthropologist’
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