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Nurse Assistants and Their Resident Patients: When is a Relationship Not a Relationship?

The science of relationships focuses primarily on romantic liaisons, but significant relationships come in all shapes and sizes (e.g., family, friendships, hookups, etc.). Recent research underscores this point, demonstrating that many of the basic concepts of relationship science characterize the relationships between certified nurse assistants (CNA) and their resident patients.1 Such work is important: according to the United States Department of Labor Bureau of Labor Statistics, there are approximately 1.5 million nursing aides/attendants, and the number of new jobs in the profession over the next 10 years is expected to grow significantly.

To better understand the complexities of the roles CNAs fulfill, researchers interviewed a sample of CNAs for 90 minutes, asking a series of questions regarding their relationships with their residents (the CNAs worked in either assisted living facilities or nursing homes). Trained coders examined the in-depth interviews for comments that indicated CNAs and residents experience strong cognitive, behavioral, and emotional connections (i.e., they are interdependent).  

Not surprisingly, CNAs describe their residents as “family” and feel strongly connected to them. These strong connections result in unique boundary issues not seen in romances or friendships; the fact that CNAs are paid employees can create ethical and legal problems when residents come to feel too close. For example, is it okay for CNAs to accept gifts from residents? Or, is it acceptable for a CNA to spend time with residents off the clock? These behaviors certainly seem reasonable when you consider the strong personal relationships that develop between CNAs and their resident patients -- these are exactly the types of things we do with friends and family with whom we have similar deep connections. But such actions may be in violation of professional ethic norms, putting CNAs in an awkward position. This research could prove useful for helping CNAs understand their feelings and how to best approach and set boundaries when necessary. Additionally, ScienceOfRelationships.com can’t help but think these findings apply to other work relationships where co-workers, particularly those where one individual holds power over another, come to view each other as family.

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1Medvene, L. J., & Coleman, C. K. (2012). Exploring the applicability of interdependence theory to CNA-resident relationships. Research in Gerontological Nursing, 5, 43-54.

Dr. Tim Loving Science of Relationships articles | Website/CV
Dr. Loving's research addresses the mental and physical health impact of relationship transitions (e.g., falling in love, breaking up) and the role of friends and family during these transitions. He is an Associate Editor of Personal Relationships and has been funded by the National Institute of Child Health and Human Development.

image source: www.theschwartzcenterblog.com

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Reader Comments (1)

Good article. I like how it lays out the limitations and boundaries of CNAs and their patients. Thanks!

August 15, 2013 | Unregistered CommenterJen S.
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