What happens when the healthcare professionals who spend the most time with patients are often the last to be included in the conversation?

In this episode of Healing By Design, host Jennifer Bierhup sits down with Certified Nursing Assistant, healthcare advocate, and PAWSIC Board Member Isaac Zralii to discuss the critical role CNAs play in patient care, wound prevention, and preserving skin integrity across the continuum of care.

Drawing from more than 21 years of experience in acute care, long-term care, behavioral health, rehabilitation, and COVID relief efforts, Isaac shares a perspective that is rarely heard in healthcare leadership discussions. As the first CNA to serve on the PAWSIC Board of Directors, he brings valuable insight into the challenges, opportunities, and realities facing frontline caregivers every day.

Together, Jennifer and Isaac explore why CNAs are often overlooked in healthcare conversations, the communication barriers that exist between nursing assistants and nursing staff, and how education can empower CNAs to identify changes in patient condition before they become serious complications.

This conversation is a powerful reminder that improving patient outcomes requires listening to the people who spend the most time at the bedside. From early wound identification to preserving skin integrity and preventing avoidable complications, CNAs are often the first line of defense in protecting patient health.

In this episode:

• Isaac's journey to becoming a Certified Nursing Assistant

• Why CNAs are often overlooked in healthcare discussions

• The communication gap between nurses and nursing assistants

• The role of CNAs in wound prevention and skin integrity

• Why frontline caregivers need better wound care education

• Burnout, staffing challenges, and patient ratios

• The concept of the CNA as the "ultimate observer."

• Creating pathways for early wound identification

• Building stronger interdisciplinary care teams

• What healthcare leaders need to understand about CNAs

Interested in supporting CNA advocacy and recognition? Explore the official PAWSIC CNA Collection and help celebrate the frontline caregivers who play a vital role in patient care every day.

Shop the CNA Collection:
https://pawsic-shop.printify.me/collection/cna

Healing By Design is a podcast powered by PAWSIC that explores the people, processes, and perspectives shaping better outcomes across the continuum of care.

Why CNAs Matter in Wound Care | Isaac Zralii on Frontline Patient Care | Healing By Design EP 2

What happens when a patient spends more than three decades searching for answers?

In the premiere episode of Healing By Design, hosts Jennifer Bierhup and Therese Laub sit down with patient advocate Amy Rivera to discuss her extraordinary journey living with primary lymphedema. After 32 years of misdiagnoses, unanswered questions, and navigating a fragmented healthcare system, Amy finally received the diagnosis that changed everything.

Amy shares the realities of living with a chronic condition, the emotional toll of not being believed, and how her personal experience led her to become a nationally recognized advocate for individuals living with lymphedema and other chronic conditions.

Together, they explore the importance of patient voice, self-advocacy, care coordination, and why healthcare outcomes often depend on what happens between providers, care settings, and transitions throughout the continuum of care.

This conversation is a powerful reminder that healing is about more than treatment. It is about understanding, collaboration, and ensuring that no patient falls through the cracks.

In this episode:

• Amy's 32-year journey to diagnosis
• Living with primary lymphedema
• The impact of delayed and missed diagnoses
• Patient advocacy and empowerment
• Navigating complex healthcare systems
• The importance of care coordination and communication
• Finding purpose through lived experience

Healing By Design is a podcast powered by PAWSIC that explores the people, processes, and perspectives shaping better outcomes across the continuum of care.

32 Years Without a Diagnosis | Amy Rivera's Lymphedema Journey | Healing By Design EP 1

Healing By Design, hosted by Jennifer Bierhup and Therese Laub and powered by PAWSIC, is a podcast dedicated to elevating wound care through education, collaboration, and real conversation.

Each episode brings together clinicians, industry leaders, and patients to explore the full spectrum of chronic wound management. From evidence based strategies and interdisciplinary care models to the lived experience of navigating the healthcare system, the show examines healing from every angle.

Jennifer and Therese combine clinical insight with thoughtful dialogue, creating space for both professional expertise and patient perspective. By addressing rehospitalization risk, system gaps, access to care, and the realities faced by individuals living with chronic wounds, Healing By Design highlights what it truly takes to improve outcomes in today’s complex medical landscape.

This is where science meets humanity, and where better care begins with better understanding.

Because healing is never accidental.
It is intentional. It is collaborative. It is designed.

Post-Acute Wound & Skin Integrity Council

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