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DOI: 10.1177/1049732305280773 Nurse Assistant Mental Models, Sensemaking, Care Actions, and Consequences for Nursing Home ResidentsDuke University School of Nursing, Durham, North Carolina
Duke University School of Nursing, Durham, North Carolina
Duke University School of Nursing, Durham, North Carolina
Duke University School of Medicine, Durham, North Carolina
Duke University School of Nursing, Durham, North Carolina
VistaMar School, Los Angeles, California
Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina
Duke University School of Nursing, Durham, North Carolina
College of Business, The University of Texas at Austin 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.
Key Words: unlicensed assistive personnel • case study research • nursing facilities • nursing • management practices
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