If you want to reduce nursing assistant turnover at your facility, you need to improve working conditions — maybe hire more direct-care staff, give your supervisors management training, or include direct-care workers more in decision making and care planning. But motivating nursing assistants to stay in the profession long-term requires a whole different set of incentives. According to a new study, stemming the flow of workers from the profession will require system-wide changes like higher wages, better benefits, and more career advancement opportunities for all direct-care workers.
Many previous studies have analyzed nursing assistant turnover within a facility, but few have looked into why workers leave the profession. “Staying the Course: Facility and Profession Retention Among Nursing Assistants in Nursing Homes,” a study published in the Journal of Gerontological Research Series B: Psychological Sciences and Social Sciences, used data for 2,328 nursing assistants (NAs) from the 2004 National Nursing Assistant Survey to compare the reasons for both.
More than two in five respondents (43%) said they didn’t expect to be in their current job one year later, and one in five (20%) percent said they were actively looking for another job. The six most important reasons given by those who expected to leave their jobs soon were:
- poor pay
- already have a new or better job
- problems with working conditions or policies
- too many residents to care for
- poor benefits
- problems with supervisor
But none of those factors were linked to intending to leave the profession. Nearly half of the respondents (48%) did not expect their next job to be as an NA. The main differences between them and their peers who intended to stay were personal traits such as age, race, and household income. Those who intended to leave the profession had higher levels of education and were more likely to be non-white than those who intended to stay. They were also far more likely to have higher household incomes (more than $50,000 a year.)
These finding show that “financial compensation and benefits for NAs must be competitive relative to other occupations” to attract and keep an adequate supply of workers, conclude researchers Sally C. Stearns and Laura P. D’Arcy of the University of North Carolina at Chapel Hill.
Their study also demonstrates the need to improve working conditions and the quality of direct-care jobs and to provide more career advancement opportunities within the profession, the researchers say.
Elise Nakhnikian, Senior Online Editor
enakhnikian@phinational.org
Question: Would having a mentor for the first three months of hire help with retention? It appears that new NA’s are thrown into a heavy work environment and don’t know how to deal with it. Perhaps a mentor could help with this?? Any thoughts?
Peer mentoring definitely helps reduce facility-level turnover. And it does seem like it might lead some people to stay in the profession who would otherwise give up on it, though that’s just a guess.
PHI has a peer mentoring curriculum for workers in home- and community-based care, since most programs seem to be designed for nursing homes. It’s based on a program that’s been in use for several years at CHCA, the home care agency that we grew out of, and I know they find it effective. Their turnover is relatively low, too, though it’s hard to say how much of that is because of peer mentoring…
My company has a “group” that has been meeting once every other month to study the retention issue and find some solutions. One of them was the “Peer Mentoring” idea. It was written about in the company newspaper (that hardly anyone reads, and just ends up being used in lieu of scratch paper for writing down phone messages) as starting in August. Hopefully this will at least slow some of the turnover.
The real problem behind my facility and all it’s turnover is the lack of leadership. At last count, there has been five different supervisors that have come and gone in the last eighteen months. Due to the inconsistent enforcement of company standards, we have lost most of our experienced staff.
I am crossing my fingers that this new plan may work a little bit.
Mentoring is a great idea not only in the beginning of ones career but throughout. Providing a Registered Apprenticeship program to Nursing Assistants and other Direct Care occupations has been shown to reduce turnover and increase the workers job satisfaction. Recruitment and retention come at a high cost. Implementation of apprenticeship programs has helped employers retain employees and save money. Investing in improving worker skills is less costly than recruitment and apprentices appriciate the willingness of employers to invest in them by paying for training, providing incremental wage increases as skills improve and offering opportunities for them to advance to higher positions. That reduced employee turnover means that employers experience cost savings; they do not have to constantly recruit and train new employees for the same positions. The Apprenticeship model is a strategy to help health care providers deliver the best possible care to patients and residents. Employees are given better training, which directly affects patient care. Additionally employers are making an investment in apprentices by paying them increased wages as their skills improve and, thus, providing concrete pathways to advance in their careers. This all contributes to better employees who provide better care to patients.