To understand the dark brew simmering amid the long-term care nurse manager core because of pandemic stresses, one needs to look only at slipping satisfaction with pay rates and growing discontent over workloads.

Nurse leaders, compared to their administrator counterparts, registered significantly more pessimistic responses in the McKnight’s 2021 Mood of the Market Survey when asked about compensation and duties.

At the top end, nearly the same said they were either “very well paid” or “somewhat well paid” in 2021 (52+%) and 2020 (53+%).

But then the middleground and bottom fell out. This year, only 26% said they are paid “average,” compared to 33% a year ago. Worse yet, 17.5% said “not so well paid” and 4% said “not at all well paid” in 2021, notably up from 12% and 0% in 2020, respectively.

Answers from nurse managers only: Disenchantment grew for many.

Administrators actually showed greater satisfaction with their pay levels during this second year of the pandemic, compared to 2020. Just under 62% said they were either “very well paid” (26%) or “somewhat well paid” (36%) compared to 59% a year earlier (23% “very well paid” and 36% “somewhat well paid”).

Meanwhile the “average” and “not so well paid” categories fell 2% each this year (to 25% and 11%, respectively). The “not at all well paid” response was the only non-bright spot in administrators’ answers, rising slightly to 2.2%, from 1.4% in 2020.

Responses from all respondents (307 nurse managers and 320 administrators).

The third annual McKnight’s Mood of the Market Survey gathered the attitudes of 627 long-term care administrators and nurse managers, a 65% rise in participants over last year. They answered 15-question surveys between July 28 and Aug. 3, 2021. A random drawing for five $100 gift cards was offered as incentive to participate.

The pay picture could be the most vexing for operators. Total Compensation Solutions principal and senior consultant Matt Leach told McKnight’s Long-Term Care News that many operators have told him their “biggest problem right now” is figuring out how to pay managers and employees enough to remain sufficiently staffed.

Heavier burdens

Among other survey findings, there were notable slippages in respondents’ satisfaction with workloads, feelings of appreciation and career advancement opportunities.

Overall, there was a 6% rise (to 56% from 50%) in affirmative responses to the question, “Do you think you’re asked to do too much at work?” Nurses (63%) were far more vocal in those response choices than administrators (49%). Nurses saying “very much so, yes” grew by nearly half (to 20+% from 14%) over a year’s time, while administrators actually fell to 9% from 13% for the same choice. A greater percentage of administrators, however, shifted to “generally yes” they are asked to do too much (40% this year vs. 30% in 2020) compared to nurse managers (42.86% this year vs. 42.94% last year).

“I’ve heard a couple of [directors of nursing] talk about just the additional reporting requirements for COVID — not only what they have to do [clinically] but the regulatory reporting that’s been added to it,” explained compensation and benefits expert Mark Heston of Heston & Associates. “There’s weekly reporting on vaccinations, cases and testing. That’s all additional work. That’s all getting pushed down to DONs. You have to couple that with the value: Are we doing enough to recognize and appreciate everything the DONs have done?”

Some attitudes remained relatively static between 2020 and 2021. Overall answer rates were virtually identical in all response choices between the years for the question, “How much do you think your contributions at work are valued by your colleagues?” After registering identical 82% rates in 2020, nurse managers noted a slight rise to 85% under “a great deal” or “a moderate amount” in 2021, compared to a 5% drop for administrators who saw “a great deal” and “a moderate amount” rates each fall nearly 3%.

When viewing how much latitude they have over the work they do and how it is to be done, overall numbers also remained static, although nurse managers again noted marginally more optimistic feelings than did administrators.

Coming Thursday: What would improve job satisfaction, and judging supervisors and company support.