Quality of care and the burden of two cultures: when the world of the nurse's aide enters the world of the nursing home.

Using ethnographic data, the two worlds of the nurse's aides were examined, the world in which they live and the world in which they work. Because the institutional culture of the nursing home often adds to the adversity of their personal life, the nurse's aides move between the two milieus in a self-perpetuating negative cycle. Aides carry to the bedside of elderly residents the affective and psychological burden these two worlds place on them.