The care delivered by nurse aides greatly influences the quality of services in nursing homes. Therefore, attempts to improve the performance of nurse aides are key to improving nursing home care. Inadequate pay and preparation are often cited as the reasons for inadequate aide performance. Perhaps even more basic to the problem is the undervaluation of the work aides perform. Pay and expected preparation reflect the value assigned a service. Why is nurse aides' work undervalued? Who does not value their work?
One way value is expressed is through language. Nurses speak of the nurse aides on their units saying, "The girls are doing a great job." Aides refer to themselves saying, "We girls cannot continue to work like this." Residents and families speak of aides saying, "The gjrJs are doing the best they can with the amount of help they have." Now I ask you, would you expect the same level of performance from a girl as you would from a woman? The dictionary defines a "girl" as a youngster, young, unmarried, or servant. These definitions connote inexperience, need for direction, and dependence.
The demographics of nurse aides at our facility do not fit these descriptions. In a sample of 158 nursing staff, the mean age was 35.2 years; two thirds of the group were married and another 1 7% of them were divorced, often managing a family as a single parent. The average length of employment was SV2 years. Why do they call themselves girls, and why do others refer to them as girls?
Reference to women as girls reflects society's overall view of women and is not unique to nurse aides. The idea that what you call someone influences how they view themselves and how they are viewed by others is often thought to be a "stupid feminist" notion. However, it is interesting to note that women in power and prestigious positions are not referred to as girls. Reference is never made to Sandra Day O'Connor as, "The first girl appointed to the Supreme Court." Men are seldom referred to as boys except when they are going out for fun "with the boys."
Increased awareness of these implications can be a first step in recognizing the women who work as nurse aides and their important and critical contribution to quality care. The value issue must be addressed along with increased training and pay if the probiem is to be resolved and quality care attained.