Understanding Trauma in the Context of Direct Care Work in Nursing Homes.

Direct care workers (DCWs) experience job quality challenges such as heavy workload, low pay, and few benefits. Layered risks such as the COVID-19 pandemic and systemic racism have impacted DCWs, made them more vulnerable, and increased turnover and the precarity of the long-term care system and residents' care. Drawing from qualitative interviews collected from 25 direct care workers, this study seeks to understand and describe the DCWs' experiences of trauma during COVID-19 and how these experiences affect their ability to provide care. Findings suggest that DCWs are often crippled with challenges stemming from the impact of COVID-19, work-related factors, and personal factors. Understanding the intersection of trauma provides a detailed contextual description of care work, which is important for developing practical coping strategies, either at the personal or organizational levels, and developing more refined trauma-informed initiatives to build resilience and support DCWs.