How to Position, Attract and Retain Registered Nurses in Nursing Homes: A Qualitative, Explorative Study

Abstract

In most countries, registered nurse retention and role development in nursing homes is a challenge. Objective: To obtain insight into factors contributing to successful retention of registered nurses in nursing homes and into how to differentiate the role of vocationally trained registered nurses and baccalaureate-educated registered nurses. Method: A qualitative, descriptive, explorative study. In June 2019, World Café was held, a method for hosting group dialogs, in which direct care professionals, managers, human resources employees, and teachers participated. A theme-based content analysis was used to analyze data. Findings: Identified factors expected to contribute to retention were role clarity, role content, role model availability, room for professional development, learning on the job, a match between education and actual work, management and board-level support, adequate salaries, and a positive image of working in nursing homes. Vocationally trained registered nurses were considered to perform a key role resident care by serving as case managers. Baccalaureate-educated registered nurses were considered to focus on indirect care (e.g., coaching staff, stimulating evidence-based practices, implementing innovations). Limitations: Due to the limited sample size and the qualitative, explorative nature of the study, findings can only be generalized with caution. Implications: To refine registered nurse roles in nursing homes, it seems crucial to rethink the current roles and hierarchies. Even though management and human resources departments are considered responsible for contributing to role clarity and the creation of supportive practice environments, the registered nurses themselves are also expected to come up with their role.

Dejavniki zaviranja in spodbujanja zaposlovanja v dolgotrajni oskrbi

“…Študija dejavnikov zadovoljstva pri delu in fluktuacije med izvajalci pomoči na domu je pokazala, da na zadovoljstvo pri delu vplivajo dejavniki, kot so plača, ugodnosti, podpora nadrejenih, podpora sodelavcev in spoštovanje stanovalcev (Butler idr., 2015). Novejša nizozemska raziskava je pokazala, da so ključni dejavniki za uspešno zadržanje zaposlenih pozitivna podoba poklicev v DO, ustrezna plača, jasnost in ustrezna vsebina vlog, podpora s strani vodstva, možnost strokovnega razvoja, usposabljanje na delovnem mestu, ujemanje med vsebino izobraževanja in delom v praksi (Backhaus idr., 2021). Evropska študija kaže, da je privlačnost zaposlovanja v DO nizka v vseh državah, saj je zaradi slabih delovnih pogojev in prekarnosti zaposlitve (nizki dohodki, pomanjkanje usposabljanja, velika delovna obremenitev in visoka stopnja stresa) pogosto to področje prikazano negativno, kar vodi v hudo pomanjkanje kvalificiranih strokovnjakov (Spasova idr., 2018).…”

Nurse staffing and deficiency of care for inappropriate psychotropic medication use in nursing home residents with dementia

“…The missed care was related to RNs' burnout and job dissatisfaction (White et al, 2019), which contributes to staff turnover (Labrague et al, 2020). Supportive work environment, provision of professional development, compensation, appreciation, flexible schedule, role clarity, and teamwork were cited as key drivers of staff retention (Backhaus et al, 2021; Gilster et al, 2018).…”

Care‐home Nurses' responses to the COVID‐19 pandemic: Managing ethical conundrums at personal cost: A qualitative study

“…Across the world, older people needing support with personal and social care frequently move into long‐term care facilities, such as care‐homes, where care is provided 24/7 by a care assistant workforce, many of whom have minimal clinical qualifications (Backhaus et al, 2021; Ibrahim & Aitken, 2021). Where additional, specialist nursing care is required, these facilities are often designated as nursing homes, staffed by RNs.…”

“…Often, RNs are in leadership roles in care‐homes, working in isolation from other health professionals, with variable support from wider healthcare support systems, while continuing to provide care in a largely underfunded environment (Langins et al, 2020; Wild & Szczepura, 2021). The complexity and specialism of care‐home RNs is often unrecognized and undervalued by their nursing and medical colleagues, with this area of nursing frequently viewed as an unattractive career option, leading to issues around recruitment and retention (Aloisio et al, 2021; Astle et al, 2021; Backhaus et al, 2021; Embregts et al, 2020; Szczepura, 2021; Wild & Szczepura, 2021). It has also been suggested that the perceived unattractiveness of care‐home nursing is related to ageism and the way in which societies view older generations (McGilton et al, 2020).…”