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Abstract
Over one million Americans utilize skilled nursing facilities (SNFs) annually. Nursing assistants (NAs) are the direct care workers within these facilities. Low retention and high turnover among NAs threatens care provision. Factors influencing retention and turnover are distinct, however, a model representing NA’s intent to stay in their positions does not exist. The purpose of the research was to preliminarily test a new conceptual framework to determine the salience of factors related to intent to stay among nursing assistants prior to finalizing and testing the new model in a larger sample. Seven NAs employed at for-profit SNFs in the Midwestern United States participated in face-to-face interviews. The semi-structured interview covered 3 domains: basic psychological needs; physical and psychosocial well-being; and organizational commitment. Interview transcripts were analyzed and coded by two researchers to identify broad concepts, recurrent themes, and quotes. In the final stage, the coding framework was applied to all data. Basic psychological need fulfillment was experienced by NAs through caring relationships with residents. Occupational injury and protective protocols were their most important physical health concerns; and psychosocial health was impacted by job and personal stress. Experiences of workplace support and recognition for achievements influenced organizational commitment. These preliminary findings provide a more comprehensive explanation of NA’s intent to stay. Salient factors from each domain identified from prior research and NA interviews will be included in the final model. Understanding NA’s intent to stay in their positions enables improved quality and continuity of care for older residents in SNFs.
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