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Community Strengths, CNAs' Challenges, and Health Risks

MM is a thirty-seven-year-old, female Cuban immigrant. She has been here for ten years and currently lives in a home owned by her bother who is a nurse. She is married to a mechanic and has two children both female, ages fourteen and 12. MM works full time (40 hours a week) as a CNA in a ALF. She previously worked at Walgreens before obtaining her CNA certification. She does not have any injuries but does suffer from lower back pain from time to time and is overweight. She has not changed jobs due to her back pain or any other injury. At her job, she is responsible for the resident’s ADLs, laundry, feedings, bathing and skin care. She takes vital signs and informs the resident’s nurses of their families if there are ever any medical issues. (Pfefferle & Weinberg 2008). At her job she is exposed to alcohols and cleaning products. She uses PPE such as gloves, gowns and face shields/masks when there are respiratory diseases in the ALF. Her work environment is typically clean and ventilated by a normal air conditioner system. Her lunch breaks are spent in the kitchen or in her vehicle. Her job requires a uniform (scrubs) which she washes at home. She washes her hands very often at work, such after any exposure to fluids, waste and always before and after any patient contact. She does not shower before leaving work. Her job does not expose her to any grinding, welding, soldering or polishing. At home she has a normal AC unit and an electric stove. Her home was built in the year 2014 and does not have any recent renovations. There no pesticides used in her home. MM enjoys hobbies such as drawing with her children, TV and music. There are no industrial plants, landfills, sources of air pollution, toxic spills or waste sites close to her home. Her drinking water comes from the tap/public source. MM’s family structure consists of herself, her husband, her two children and her brother. Her children are in middle school and high school. Her family would be considered lower to lower middle class. Their recreation activities consist of TV, drawing, visiting water parks, movies and they have been to Disney a few times. Both parents and MM’s brother are employed. Their home is in good condition and the family has each other for support as well as a church community and work friends.

This family communicates very well. The children are taught values such as honesty, hard work, studying to go to college. Both mother and father are a unified team with the father taking the lead in the family and the mother taking on a supporting role. The power in the family is balanced between them and as per MM, this works well for them. Their children are respectful and value good grades and respecting their elders. They as a family, believe in God and try to be good people with good values. The value honesty and hard work. There are no family conflicts. The children are well adjusted and the family is unified, with a desire to make each other happy. The children are valued within the family and are above all else, encouraged to study and go to college. The older child has a desire to be a nurse like her uncle. The family has a good understanding of health care as several members work in the health care system. MM is in charge of meal planning, shopping and cooking. Their overall physical activity could be better. They do not have many active hobbies. There are no drugs or smoking in the house. Dental health could also be better. Typically, they visit the dentist every 4 years or so. Vaccines are up to date for all family members. They have an overall healthy family history. There is diabetes on the mother’s side (grandmother) but not in any of the core family members discussed here. Both parents and children have health insurance and there are no active health problems to address.

Job related stress affects MM but not her husband. MM does not have a specific way to deal with her stress and until recently had not considered ways to alleviated it, instead she focuses on doing her best for her children. The children do stress about receiving good grades as they both plan to go to college. They cope by interacting with their peers and by working at their hobbies. In the past, MM’s husband used to smoke. He has since quit (six years ago).

JR is a thirty-six-year-old female Cuban immigrant. She has been here for twelve years. Her husband is a boat repair man and also installs panels. They have one child together, male aged eleven. They have been here for twelve years. JR works full time (40 hours a week) at an ALF as a CNA. Before working in this ALF, JR used to be a private duty for an elderly woman. JR has pain in her right wrist that sometimes requires the use of a brace due to her profession. She is otherwise in good physical health. She has not changed jobs due to this injury. As a CAN she is responsible for ADL’s of the residents, feeding them, bathing them, doing their laundry and skin care. She takes vital signs daily and informs the appropriate parties if there are any health concerns. (Pfefferle & Weinberg 2008). As a CAN, she is exposed to alcohols and cleaning products. She uses PPE such as gloves and gowns. Special equipment such as face shields/masks are also used when there are respiratory diseases in the ALF. Her work environment is typically clean and ventilated by a normal air conditioner system. JR prefers to spend her lunch breaks in the backyard of the ALF. She is required to use scrubs at work, which she washes at home. She washes her hands very often at work, always before and after any patient contact, or after exposure to any fluid/waste. She does not shower before leaving work. Her job does not expose her to any grinding, welding, soldering or polishing. Her home is ventilated by a normal AC unit. JR and her family rent a small two-bedroom apartment. She is not sure when it was built but it is in good condition. JR enjoys watching movies at home with her husband. She also enjoys cooking. There no pesticides used in her home. There are no industrial plants, landfills, toxic spills, sources of air pollution, or waste sites close to her home. Her drinking water comes from the tap/public source. JR’s family structure includes herself, her husband and her child. Her son is in middle school. This family would be considered lower to low middle class. Their recreation activities consist of TV, social media, and going to the movies. Both parents are employed. Their home is rented but in good condition. The family is very close and has each other for support as well as neighbors and work friends.

The family is small and they communicate well. The power is balanced between them with both of them taking equal part in decisions. Their child is mild mannered and well adjusted. He values his friends and his parents. He doesn’t like school very much and wants to be a tradesman like his dad. The family is not very religious but they do believe in God and strive to be good, honest people. Both JR and her husband value their child above all else and want another one in the near future. The family has a fair understanding of health care. JR is in charge of meal planning, shopping and cooking. She enjoys cooking not only for her family but also as a hobby. Their overall physical activity is good and they are all in good physical health. There are no drugs or smoking in the house. Dental health is good. The parents make sure that the child goes to the dentist at least once a year. Vaccines are up to date for all family members, although they are skeptical regarding the Covid vaccine. JR thinks this vaccine was developed to quickly. They have an overall healthy family history. Both parents and the child have health insurance and there are no active health problems to address. Job related stress affects both parents. JR works a very demanding job and her husband worries when there isn’t steady work. JR does not have many ways to cope with her stress but will hopefully acquire them through this project. Their child does not worry about school much and isn’t stressed by it. There have been no maladaptive ways to cope with stress in this family.

The environment, home and family in both cases were assessed through self-reports/interviews. The main participants of this study (the CNAs) face significant risks due to their jobs. These include physical strain from lifting and caring for residents, exposure to infections due to close contact with patients, and emotional stress from forming close bonds with residents and their families. There are also safety concerns for these participants. They include environmental hazards in diverse neighborhood conditions to potential aggression from residents. Limited training opportunities, cultural and language barriers, and resource constraints, especially to manage stress. These risks are difficult to address and ongoing training and safety measures are needed to ensure mental well-being and quality care provision and workplace safety. (Walton, A. L., & Rogers, B. 2017).

As gathered previously during this course long project and through the windshield survey, we know that Homestead Florida has diverse housing options, a large immigrant population, and proximity to metropolitan facilities. (Data USA n.d). For the chosen members of this study, these strengths are important, especially as immigrants themselves. Weaknesses include socioeconomic disparities and safety concerns across different neighborhoods. The Certified nursing assistants in the local ALF bring strengths as employees and community members. The have experience in healthcare, cultural competence, and a strong commitment to community care. They face challenges including workplace hazards like physical strain and emotional stress, and health risks such as infections. They need support from their employers to overcome these issues. They need support systems, better training, and implementing effective safety measures.

References

Pfefferle, S. G., & Weinberg, D. B. (2008). Certified nurse assistants making meaning of direct care.  Qualitative health research,  18(7), 952–961. https://doi.org/10.1177/1049732308318031