Dr. Eleanor Barbera

Once, when I worked for a managed care company, I rode down a packed elevator with the CEO, who commented drily on the crowd, saying, “It must be 5:01.”

What I thought, but did not say, was that there were reasons his staff members weren’t staying more than a minute past the hour. It was a reflection of a disengaged workforce without connections to the job or each other that might extend to a post-work conversation. (It should come as no surprise that I left my position shortly after this elevator ride.)

To stem the tide of departures, it’s important to find out why certified nursing aides are flying out the door either for the evening or for good. Here are some methods for getting the inside scoop:

1. Ask them — It might sound obvious, but it isn’t often done. The National Nursing Assistant Survey (NNAS), conducted in 2004, is an eye-opening view into the lives and challenges of working as an aide on a national level. Adapting the NNAS questions for use in a particular facility — or using an assessment company to measure employee satisfaction — can help determine, among other things, whether the initial training programs you offer meet the needs of your staff or if transportation problems are interfering with their ability to report to work. Such information could lead to relatively easy fixes that reduce turnover.

2. Join them — I spoke with Sarah Poat Stewart, LNHA, CNA, an administrator who trained as an aide and recently worked the 3-11 shift. Stewart, who is based at Signature HealthCARE’s Oakview Nursing & Rehabilitation Center in Kentucky, finds her participation as an aide reduces the barriers between management and employees and leads to more respect on both sides. In a video about Signature’s goal to have all staff trained as CNAs, managers who worked on the floor had a better understanding of the jobs done by aides and the tools they need to do so.

3. Read the minds of those who stay — If you can’t roll up your sleeves and help a resident into a Hoyer lift yourself, reading CNA Edge is the next best thing. The book is a “best of” collection of essays from the website of three aides who are passionate about and committed to their work, yet realistic about the challenges they encounter. While authors Alice, May and Yang might not be “your” CNAs, they give voice to the thoughts and experiences of every aide, maintain hope for the profession, and offer suggestions for improvement that, if followed by coworkers and management, can make a real difference.

4. Read the minds of those who leave — Granted, if your workers quit, chances are they were dissatisfied with their jobs. Some of them might even be holding grudges, but there are often kernels of truth in their words that current employees aren’t telling you. Find out what workers are saying about your company by reading the reviews on Glassdoor. A side benefit is improved hiring, another solid means of stabilizing your staff. According to a Forbes magazine article about Glassdoor, potential new employees often read the site before accepting a job. Consider following the lead of one CEO in the article who personally replies to each comment and has even made policy changes in response to reviews. He believes that positive reviews on the site have increased his workforce by 20%.

You needn’t be a mind reader to find out why CNAs are leaving your company; one part Sherlock Holmes will do. The above techniques will help you deduce the main sources of CNA dissatisfaction so you can get started on making targeted changes that will reduce turnover.

Eleanor Feldman Barbera, PhD, author of The Savvy Resident’s Guide, is a 2014 Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Gold Medalist in the Blog-How To/Tips/Service category of the American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with nearly 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at MyBetterNursingHome.com.