The Impact of Covid‐19 on Certified Nursing Assistants in New York City: A Cross‐Sectional Study

RESEARCH OBJECTIVE: In December 2020, the New York Times reported that nursing home (NH) residents and workers accounted for 38% of COVID‐19 related deaths in the U.S. Despite this toll, research documenting the impact of the pandemic from a worker perspective is limited. Focusing on the experience of certified nursing assistants (CNAs), the primary providers of direct care to NH residents, this study examined the physical, emotional, and financial impact of COVID‐19 and identified resource needs in the pandemic context. STUDY DESIGN: A phone survey was conducted between September and December 2020 with CNAs who are members of 1199SEIU, the largest healthcare union in the U.S. To be eligible, CNAs had to be union members and care for patients at NHs in New York City, Long Island, or the Lower Hudson Valley during the pandemic. The survey included 42 questions and focused on COVID‐19 exposure, mental and physical health, family economic security, and workplace resources and training. POPULATION STUDIED: This study focused on 216 CNAs working for unionized NH employers in downstate New York. PRINCIPAL FINDINGS: A total of 216 CNAs from 98 unique NHs participated in the study. 78% of participants were between 40–69 years old, 93% were women, 87% were Black, and 61% had more than 10 years of experience in NHs. In addition to their role as paid care providers, 81% reported providing care or financial support to family members. With regard to COVID‐19 Exposure, 93% reported being tested since the beginning of the pandemic, with 33% testing positive. Significant majorities were “very concerned” about exposing themselves (75%), family members (86%), and patients (80%) to COVID‐19 given the nature of their work. With respect to Mental Health, 76% reported feeling emotionally drained and 60% reported feeling fatigued on a regular basis. 52% said support dealing with stress and anxiety would be “very useful.” Concerning Family Economic Security, 29% said the pandemic made it harder to pay for basic needs (e.g., food, rent, etc.) and 48% said it was harder to care for family members. Majorities said help accessing affordable housing (61%), paying for food (58%), and paying for work‐related transport (52%) would be “very useful.” With regard to Workplace Resources, 81% said they currently had enough PPE, and 33% reported having to provide their own PPE at some point during the pandemic. 92% experienced patient deaths in their unit or NHs during the pandemic, while 40% said services were made available to provide support in the grieving process. With respect to Training, most were “very interested” in training on stress management” (58%) and treating patients with COVID‐19 (55%). CONCLUSIONS: Our survey results show significant challenges and resource needs among unionized CNAs in downstate New York. IMPLICATIONS FOR POLICY OR PRACTICE: Unionized CNAs have significant resource needs in the pandemic context, and other data suggests that the needs of non‐unionized CNAs may be even greater. To better support this workforce, action by public health officials and policymakers is warranted, particularly with respect to workplace safety and protection, mental health, compensation, and access to basic resources.