Guest Columns

CNA speak: Take time to learn the language

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Lori J. Porter
Lori J. Porter

In my 32 years of careful study regarding the divide between administration and certified nursing aides, I have learned many things. One of the most important discoveries is that there are two separate languages spoken between them. Seriously, I am talking about English, but sometimes these two groups might as well be speaking Pig Latin considering the relationship gaffes caused by poor communication.

I call them “CNA Speak” and “Administrator Speak” and neither takes the time to understand the other. Ask a CNA what she wants to make her happy and she'll typically start with something like, “A thank you once in a while would be nice.” 

When I hear that, I always think, “Wow, I used to say that when I was a nursing assistant.” Then when I became an administrator, the CNAs I worked with said the same thing, even though I was out working with them side-by-side, passing trays in the dining room, thanking them and high-fiving with them daily.

So, despite my actions that I thought would be a display of my appreciation for them and their service, the CNAs continued to complain about not getting any recognition or respect from administration. The very things I said I wanted as a CNA I was doing for the CNAs on my team, yet that is not what they wanted. That's when I first realized we were speaking two different languages.

Along my journey from CNA to administrator, I found a sense of self-respect I had never felt before. I believe this sparked my transition from CNA Speak to Administrator Speak. As a nursing assistant, I knew how I wanted my work and service to make me feel, yet I didn't know how to communicate that. Or what I wanted or needed to help me achieve those feelings.

So it was easy to say, “A thank you once in a while would be nice.” And then the burden was placed on the administrator to try to figure out what that meant, and what she should do for the CNAs to say “thank you.”  And it seemed that usually, no matter what she did, it wasn't what we thought we wanted. So, once again, the administrator felt defeated and we, the nursing assistants, felt unfulfilled.

Throughout my career, I have seen many examples of this language barrier play out. One that readily comes to mind is a conversation that took place before my very eyes. I was meeting with an administrator in his office and we were finalizing a yearlong plan to develop CNA Leaders and Preceptors within his care center.

It was payday and there had been quite a bit of traffic through the office and there had been several interruptions. One of those was a CNA who politely knocked on the administrator's doorframe. He motioned for her to come in. She had her paycheck in hand and somewhat tearfully explained to him that her paycheck was 10 hours short. He told her to see Phyllis, the bookkeeper, and that she would see that it was added to her next check.

The deflated CNA pleaded, “Can't I get it sooner? I've got bills!”  The administrator replied, “I've got bills, we've all got bills.”

The CNA was telling the administrator that she has to pay the electric bill tomorrow or it would be cut off, and there are few groceries in the house. It's nearly a hundred dollars and I need it.  The administrator was thinking, “As long as she got the 10 hours pay on her next paycheck, everything should be fine. After all, it will only be two weeks and it isn't a large sum of money.

I was flabbergasted by the exchange. The CNA left his office with a sigh and her head drooping.  I knew I had to use this as a “teachable moment” with the administrator, who actually very much appreciates and respected the CNA team. That's what our whole meeting was about.

I just didn't want to come off too harsh. So I fished out my wallet and started counting all the cash I had on hand. After searching my brief case too, I came up with $87. The administrator said “What are you doing?” I replied, “If you pitch in the other $13, we can really help this CNA out.”

Realizing what he had just done, he quickly pulled a hundred dollars out of his wallet and said, “She's one of my best. I've got this.” And he delivered the hundred dollars, along with an apology to his best CNA.

Learning from my experience, I now instruct CNAs on “Administrator Speak” every day so they can learn the business of long-term care and better support the licensed leadership roles and responsibilities. To get to a healthier relationship with your CNAs, take time to learn the language and if you need a translator, you know where I am ...

Lori Porter is a former certified nursing aide and nursing home administrator with more than 30 years' experience in long-term care. She is co-founder and CEO of the National Association of Health Care Assistants, a professional association of and for nursing assistants. A nationally sought-after speaker on frontline caregiving issues, she also is the author of the book “Everything I Learned In Life I Learned in Long Term Care.”

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