Abstract:
The turnover rate of certified nursing assistants (CNAs) within the nursing home setting is greater than 100% in Kansas.
Understanding turnover is vital to the recruitment and retention of CNAs. The purpose of this study was to understand the
meaning of CNAs' experiences in a nursing home setting using the hermeneutic phenomenological research method. Student
researchers completed observations and interviews with four CNAs in one nursing home over a 3-month period. Using an
iterative reduction approach, hermeneutical interpretation of the data was conducted through thematic analysis and participant
other dialogue. Findings revealed that CNAs constantly strived to balance a dynamic tension between multiple opposing
forces. The metaphor, balancing dynamic tension, unified opposing forces in two thematic categories: Tension Between
Conflicting Cultures and Tension Between Job and Self. CNAs are expected to balance industry expectations of efficiency
with the patience necessary to provide individualized care, to discern between normal and unusual variations in the residents' well-being, and to maintain a sense of community while attempting to balance discrepant and shifting levels of valuing and voice afforded them within the nursing home. When experiencing tension between job and self, the CNAs job required both physical and emotional strength, self protection from injury, and maintenance of connections with residents. These findings
offered insights into CAN experiences such as feelings of loss and the need for protection. Support for CNAs may be
provided by listening and responding respectfully, recognizing CNAs as expert in knowing, valuing, caring, and increasing
CNAs involvement in planning resident care.
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