Friday, 22 February 2019
Research into turnover and retention of certified nursing assistants (CNAs) has a long history, yet the annual turnover rate exceeds 70% nationally. Despite numerous studies, CNA turnover remains problematic. Purpose of study: The purpose of this study was to explore perceptions of negative factors reported by CNAs working in nursing homes. Design: This qualitative study revisited the problem of CNA job dissatisfaction, by capturing personal testimonies of tenured CNAs in two southern states. Seventeen CNAs were interviewed either in their home or their place of employment. The CNAs who participated in the research worked in four different nursing homes in two adjoining southern states. The interviews were audiotaped and transcribed verbatim. An iterative process of content analysis was used to analyze the qualitative data obtained in interviews. Results: Two research questions: “What do you like the least about your job?” and “What do you find the most difficult about your job?” revealed negative factors of poor compensation and benefits, inconvenient scheduling, heavy workload, frequent managerial turnover, poor supervision, and a lack of respect by managers towards CNAs. Two overarching themes, Culture of Disrespect and Unsupportive Facility Practices, emerged. The qualitative findings of the study were compared to published quantitative data. This study provided a human voice to the quantitative statistics found in many other studies of CNA turnover. Implications for practice: Findings from this study are consistent with the principles of culture change. Results indicate that additional education is essential for supervisory nurses to learn managerial techniques in order to build and model a culture of respect. Consensus building by nursing home administrators that includes CNAs in planning changes to care practices, scheduling, and workload might reduce turnover of valuable employees. By improving the working conditions of individuals who care for elders, the quality of life for both employees and residents of elder care facilities could be enhanced both nationally and globally.