Retention Culture: Antidote to C.N.A Turnover in LTC

Kathy Dreyer penned a terrific post last week about Long Term Care Certified Nursing Assistants and turnover. This issue has been identified as a crisis. I submit that it is also a tragedy, because, we have ignored the problem with the lack of a national strategy.

Certified Nursing Assistants are the backbone of care in long term care. They provide care for those that nobody else can, or will.

Our nation's 1.3 million nursing home residents depend on C.N.As  365 days of the year for personal care of all types and levels. This is not an easy job. But those that continue to do this work know that it is also soul-filling and rewarding. But, what else makes some stick with it?

Retention Through Culture and Respect

A 2009 study found that an organizational culture that respects and invests in their workers inspires retention. To that end, I submit that Certified Nursing Assistants in Long Term Care do not receive the recognition they deserve.

Nationally, nothing has been done to advance the vocation. Additionally, at the state level, dismal Medicaid reimbursement has a disastrous effect on wages. Consequently, all we can directly control is our organizational culture.

If we truly value our seniors, we should vigorously value the people who are taking care of them, day in and day out.  An article in Provider Magazine speaks to the importance of respecting certified nursing assistants as individuals to retention.

Concrete Steps

• Invest in training and education. Help C.N.As grow,  and acquire new skills (refer to previous blog for more ideas).
• Tell their wonderful stories. Profile C.N.As who live the values of your organization and contribute to a high quality of life and care.
• Lift them to your residents, family members, and the larger community.
• Arrange for regular scheduled time off the floor with coverage to participate in QAPI initiatives.
• Ask for their opinions, ideas, and find ways they can contribute to decision making.
• Intentionally incorporate into their schedule time for relationship building. In addition, allow them to spend time with elders outside of their job as a caregiver- as a human being that enriches life.
• Find ways that your C.N.As can share their gifts and talents with co-workers, residents and family members.

Ponder whether your organizational culture truly respects not just the work, but the personhood of your Certified Nursing Assistants. In doing so, you may realize improved retention, the antidote to turnover.

Julie has worked in Aging Services for over 30 years and has been a Licensed Nursing Home Administrator since 1990. She is a Certified Master Trainer with the AGE-u-cate Training Institute. Through her company Enlighten Eldercare,  Julie provides training and educational programs on elder caregiving for family and professional caregivers.  She is an instructor and the Interim Director of Gerontology at Northern Illinois University and lives in the Chicago Northwest Suburb of Mount Prospect, IL.