Working as Certified Nursing Assistants and Home Health Aides during the COVID Pandemic
Chenjuan Ma, PhD, MSN; Madeline R. Sterling, MD, MPH, MS; Faith Wiggins, MS; Sanjay Pinto, PhD
A growing body of scientific evidence has documented the dramatic impact of COVID-19 on the healthcare workforce in the U.S. However, frontline workers providing long-term and/or home- and community-based care to vulnerable populations have remained less visible despite their contribution to patient care.
To help fill this gap, between August and November 2020, researchers from Weill Cornell Medicine and NYU Rory Meyers College of Nursing partnered with 1199SEIU Training and Employment Funds' Ladders to Value Workforce Investment Organization to survey 252 home health aides (HHAs) and 208 nursing home certified nursing assistants (CNAs) on their experience during the COVID-19 pandemic. The survey was conducted via phone and resulted in several key findings:
Risk of COVID exposure. CNAs were much more likely than HHAs to report providing care to a person with known or suspected COVID-19 (80.1% vs. 11.4%). The vast majority (92%) of CNAs were tested for COVID-19, of whom around one third (32.5%) reported a positive result. Among HHAs, about half were tested for COVID-19, of which 23.0% were positive.
PPE access. Despite the risk of contracting and transmitting COVID-19 while working, about a fifth of both CNAs and HHAs reported not having access to enough PPE at work. HHAs were more likely than CNAs to have to provide their own PPE at work at some point since the start of the pandemic (78.3%) vs. (32.6%).
Mental health. COVID significantly impacted the mental health of both CNAs and HHAs. Nearly one in four CNAs and HHAs reported feeling emotionally drained from work every day. Owing to this, over half of CNAs and 42.0% of HHAs expressed that resources for dealing with stress and anxiety would be “very helpful.”
Working hours and long-term career plans. CNAs and HHAs experienced interruptions in their working hours due to the pandemic, but those interruptions varied by occupation. CNAs were more likely to report working longer hours (26.3%), while HHAs were more likely to report working fewer hours (20.9%). Some participants also expressed that the pandemic could affect their future career plans. Twice as many CNAs than HHAs report that they would be less likely to remain in the industry. Nearly one in five CNAs and one in ten HHAs have considered this change because of their work experiences during COVID.
Meeting basic needs. CNA and HHAs struggled to meet basic needs during the pandemic, nearly half of the CNAs and two-thirds of HHAs reported it was “a lot harder” or “harder” to pay for food, housing, and other basic needs during the pandemic. The majority of CNAs (58.8%) and HHAs (78.6%) said that help for paying for food would be “very helpful”
This survey is one of the first to demonstrate the impact of the COVID pandemic on both nursing home and home health care workers. The results document the physical, mental, and financial hardships that workers endured during the pandemic. Overall, the study findings point to the need for stronger workplace safety and mental health provisions, as well as improved compensation to ensure that workers providing critical care to others receive basic support that they require.