Nurse assistant mental models, sensemaking, care actions, and consequences for nursing home residents

被引:64
作者
Anderson, RA [1 ]
Ammarell, N
Bailey, D
Colón-Emeric, C
Corazzini, KN
Lillie, M
Piven, MLS
Utley-Smith, Q
McDaniel, RR
机构
[1] Duke Univ, Sch Nursing, Durham, NC 27706 USA
[2] Duke Univ, Sch Med, Durham, NC 27706 USA
关键词
unlicensed assistive personnel; case study research; nursing facilities; nursing; management practices;
D O I
10.1177/1049732305280773
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
In a nursing home case study using observation and interview data, the authors described two mental models that guided certified nurse assistants (CNAs) in resident care. The Golden Rule guided CNAs to respond to residents as they would want someone to do for them. Mother wit guided CNAs to treat residents as they would treat their own children. These mental models engendered self-control and affection but also led to actions such as infantilization and misinterpretations about potentially undiagnosed conditions such as depression or pain. Furthermore, the authors found that CNAs were isolated from clinicians; little resident information was exchanged. They suggest ways to alter CNA mental models to give them a better basis for action and strategies for connecting CNAs and clinical professionals to improve information flow about residents. Study results highlight a critical need for registered nurses (RNs) to be involved in frontline care.
引用
收藏
页码:1006 / 1021
页数:16
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