The need for long-term care services is exploding as the population of the United States ages and many individuals are projected to live beyond 85 years of age. Certified nursing assistants (CNAs) provide assistance with activities of daily living for seniors living in nursing homes. National turnover rates of CNAs in nursing homes range from 40% to 160% and direct costs of turnover ranges from $2.5 to $4.1 billion dollars annually. Published literature has focused on the reasons CNAs leave nursing homes, yet there is limited knowledge of what fosters retention in nursing homes. The purpose of the study was to explore reasons tenured CNAs remain employed in nursing homes. A sensitizing model, the dual-driver model of retention enhancement and turnover prevention, guided the study. An ethnographic approach revealed specific factors and motivators that promoted employment retention of CNAs working in four nursing homes in two southern states. A sample of 17 was recruited using a modified snowball technique. Individual interviews were audiotaped and transcribed verbatim. The use of qualitative software, Ethnograph version 6, facilitated data organization and analysis. Using content analysis, the data revealed five global factors that positively promoted employment retention. CNAs related a sincere love for job/elderly persons, personal attachments, receiving spiritual/religious calling, work environment, and esprit de corps. These global factors were aggregated into two key themes of Selfless Devotion and Nurturing Work Environment. A secondary analysis of interview data revealed five negative global factors of insensitive supervisors and administrators, lack of respect for CNAs, heavy workload, poor pay and benefits, and inconvenient scheduling. These negative global factors were aggregated into two key themes of Culture of Disrespect and Unsupportive Facility Practices. Findings from this study corroborated previously published studies, and provided a `voice' to statistical data found in large quantitative surveys. This study revealed vitally important data with pertinent implications for practice that are crucial for the retention of devoted CNAs who work in nursing homes. Keywords: certified nursing assistants, nursing homes, turnover, retention, qualitative
|Commitee:||Beck, Cornelia, McAtee, Robin, McSweeney, Jean, Tsai, Pao-Feng|
|School:||University of Arkansas for Medical Sciences|
|School Location:||United States -- Arkansas|
|Source:||DAI-B 75/05(E), Dissertation Abstracts International|
|Keywords:||Certified nursing assistants, Nursing homes, Qualitative, Retention, Turnover|
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