Nursing assistants' perceptions of their role in the resident experience.

The aim of this study was to examine nursing assistants' perspectives of their role in the nursing home resident experience. Recent efforts to improve nursing home quality are focused on providing person-centered care and improving the resident experience. However, the literature on nursing home quality lacks the perspective and experiences of nursing assistants themselves, despite their crucial role in the resident experience. Semistructured interviews were conducted with 25 nursing assistants from 17 organizations and seven states. Data were analyzed using an interpretive approach that identified relevant codes and themes. Respondents perceived that they play a pivotal role in the resident experience by providing choices, communicating important information, comforting, and living within the daily reality of cognitively impaired residents. Nursing assistants' challenges included using non-verbal communication, balancing personal care while maintaining boundaries, and dealing with a perceived lack of trust. Nursing assistants are integral to interpersonal engagement with residents and relationship-based activities, such as communication, caring, and protecting. Increased nursing assistant input into programs and policies to improve the resident experience is warranted. Quality assessment should incorporate direct input from residents and nursing assistants regarding person-centered care.