Lori J. Porter

I’ve been employed in long-term care for 32 years. I started my career as so many others have, as a nursing assistant — before the days of certification. I went on to earn my administrator’s license and work in operations, but my heart has always been with the nursing assistants.

There have been many changes in long-term care over the course of my career, most of them positive moves that have improved care. I have always welcomed change, as I truly believe that growth and progress require it.

So, why do I have such a hard time embracing an occupational title change for certified nursing assistants? I guess it’s because of the suggested titles and terminology. 

One of the most common suggested titles that is already being widely used: direct care worker. The word “worker” is insulting to the CNA profession.

According to the Merriam-Webster dictionary, the definition of worker is “a person who does very hard or dull work.” I agree that CNAs work very hard, but the work is anything but dull — it is challenging, difficult and rewarding, all at the same time. 

Now, I don’t have the dictionary memorized, but I do know that when I hear the word “worker,” it brings to mind assembly lines and factory jobs, neither of which resemble the service of a CNA. The synonyms for worker that Merriam-Webster lists include drone, drudge, grub, grunt, peon and serf, to name a few.

There are many people and organizations representing different segments of long-term care that have adopted the “direct care worker” title. These individuals and groups also acknowledge that the CNA position is deserving or respect and recognition. How much respect comes with the title “direct care worker”? There is a reason why a physician is called a physician or doctor and not a “human body worker” or “health maintenance worker.”

Now, who wants to be called a “worker”?

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.”