Dr. El

As I reviewed the many recent long-term care happenings and articles to select a topic for this week’s blog, my mind kept returning to the fascinating column by researchers Lindsey Creapeau and Jennifer Johs-Artisensi, “Nursing assistants’ perspective holds the key to solving your staffing woes.” 

Their study asked nursing home administrators, directors of nursing and certified nursing assistants their perspectives on the staffing challenges in the field. While they all agreed upon the need to raise wages, there were significant discrepancies between nursing home leaders and staff members. 

While the administrators and DONs pointed to “competition (other long-term care sites or even those in other industries), low wages, shortages of candidates to apply, the physically and emotionally demanding nature of the job, and low federal/state reimbursement” as the main factors affecting recruitment and retention, CNAs focused on dissatisfaction with job training and the work environment. 

In addition, CNAs wanted more emotional and practical support in their jobs but didn’t express as much distress regarding workloads as the leadership groups anticipated. The aides had many suggestions for improving the work environment, such as increased control over their schedules, onsite childcare and assistance with transportation to work.

I was struck by the disparities between leaders and workers. 

It was as if the groups spoke different “love languages,” leading me to imagine this scene:

Administrator, thinking staff spoke the love language akin to “receiving gifts”: “I thought you left me because you could get more money for easier work at the fast-food place down the block.”

CNA, valuing the love languages akin to “quality time” and “words of affirmation”: “No, I was devoted to my residents, but I left because you never listened to me.”

The study shows the value of asking and listening to staff, illuminating areas where administrators and DONs could direct their time, attention and funding to make the greatest impact. 

For those who don’t have the opportunity to be part of a similar research study, there are many other ways to get feedback from workers, including the ideas below:

  • Survey employees: Hire a consultant to solicit and compile worker perspectives. If tackling this in-house, bear in mind that the way in which questions are asked can affect responses and that staffers will feel more open about sharing their thoughts if some level of anonymity is assured.
  • Use a suggestion box: This could include a means of anonymously submitting electronic comments, or an actual box near the administrator’s office, complete with paper and pencils to facilitate commentary. Staff feedback and suggestions could be encouraged in meetings and with reminders in paystubs, with the best encouragement being publicly following through with suggestions.
  • Conduct exit interviews: Staff members often show their dissatisfaction with the facility by walking out the door. Before they depart, glean valuable information about their perceptions by asking why they’re leaving and what might have been done to keep them on staff. 
  • Ask your consulting psychologist: The psychologist has a role and education unlike other staff members — trained in interpersonal dynamics, they spend their days moving from unit to unit, talking with residents and staff and observing day-to-day interactions. Chances are that they could offer suggestions about how to better meet staff needs. 
  • Sleep over: As I wrote in “LTC leaders gain remarkable insights from the Sleepover Project,” leaders who spent the night in their facility learned dramatic and unexpected lessons about their work culture, reporting that the culture of their high-quality facilities wasn’t as good as they’d thought it was — and that the needed changes were easily within their power to manifest.
  • Create an Experience Officer position: Some hospitals have a Chief Experience Officer whose role centers on improving the experiences of patients, families and staff; nursing homes could do the same. 

This study and the experiences of leaders who participated in the Sleepover Project indicate that there’s a disconnect between management expectations and what staff would actually find helpful in maintaining their employment. The best way to bridge this disconnect and save time and money on well-meaning but misdirected efforts is to ask staff members what they need. 

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition and a Gold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements, visit her at EleanorFeldmanBarbera.com.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.