Nursing Assistant Turnover in Nursing Homes and Need Satisfaction

Caudill, Marian; Patrick, Maxine

doi:10.3928/0098-9134-19890601-07

Cited by 33 publications

(13 citation statements)

References 3 publications

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“…Recruitment and retention of health care workers are significant challenges that require strategic action. There are many factors that influence job satisfaction in the workplace and role ambiguity and negative attitudes from other staff members are seen to adversely impact upon job satisfaction (Caudill & Patrick 1989, Friedman et al. 1999, Jervis 2002).…”

Section: Discussionmentioning

confidence: 99%

The role of the support worker in nursing homes: a consideration of key issues

Baldwin

Roberts

Fitzpatrick

et al. 2003

Journal of Nursing Management

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The aim of this paper is to critically consider the role of the support worker in the nursing home sector and with particular reference to the United Kingdom situation. With the expansion of the nursing home sector, there is an increasing population of support workers in this field. Literature in this paper covers the period between 1989 and 2002, beginning with the build up to the introduction of the National Health Service and Community Care Act (available at: http://www.hmso.gov.uk), which necessitated a major shift between public and private sector employment. The findings of this paper indicate limited research, investigating the role of support workers in general and specifically those working in the nursing home sector. The literature suggests that the majority of the role focuses on direct patient care, however, a lack of role clarification was evident and differences emerged between the views of support workers and Registered Nurses regarding the place of support workers in the care process. In particular, support workers saw their role as similar to that of the Registered Nurse, although Registered Nurse regarded 'basic nursing care' as the key remit of the support worker role. The paper also indicated inadequate preparation and subsequent supervision of support workers. These key findings indicate that role clarification, appropriate preparation and a process of continuing development require careful consideration by managers if the positive contribution of this group of care workers is to be fully realized. Furthermore, while there exists no central source of funding to finance the role preparation and mentorship of support workers, training provision will remain ad hoc. Obtaining core funding would allow for the training and education of support workers to become standard practice, which, in turn, is more likely to lead to improvements in the planning and resourcing of care provision. Equally, further research is needed if the support worker role is to be used effectively and efficiently within the expanding nursing home sector.

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Section: Discussionmentioning

confidence: 99%

The role of the support worker in nursing homes: a consideration of key issues

Baldwin

Roberts

Fitzpatrick

et al. 2003

Journal of Nursing Management

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“…[28][29][30] Despite their important role, CNAs have limited training and orientation to their complex, stressful jobs; moreover, a high school diploma or its equivalent typically is the minimal level of formal educational preparation needed. 24,31 Among licensed NH staff, licensed practical nurses (LPNs, or LVNs) generally outnumber registered nurses. The formal educational preparation for an LPN usually takes 12-24 months and includes only limited content on geriatrics and palliative and hospice care.…”

Section: Challenges To Providing Eol Care In Nhsmentioning

confidence: 99%

The Challenges and Opportunities in Providing End-of-Life Care in Nursing Homes

Ersek

Wilson

2003

Journal of Palliative Medicine

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Approximately 20% of deaths in the United States occur in nursing homes. That percentage is expected to increase as the population continues to age. As a setting for end-of-life care, nursing homes provide both challenges and opportunities. This article examines factors that impede the delivery of high-quality end-of-life care in nursing homes, such as inadequate staff and physician training, regulatory and reimbursement issues, poor symptom management, and lack of psychosocial support for staff, residents, and families. In addition to discussing hindrances to providing end-of-life care, this article explores characteristics of nursing homes and their staff that support the care of terminally ill residents. Also included is an overview of models for delivering end-of-life care in nursing homes, including provision of hospice services, specialized palliative care units, and consultation services. Finally, this article discusses educational programs and current educational initiatives to enhance end-of-life care in nursing homes.

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“…Two studies found that, in the absence of adequate staffing, caregivers often cut corners in care delivery (Bowers & Becker, 1992;Riggs & Rantz, 2001). The constrained fiscal resources in nursing homes and the regulated environment may also prevent optimal practice patterns (Aday & Andersen, 1974;Schnelle, Cruise, Rahman, & Ouslander, 1998) while encouraging a rigid, static environment with high staff turnover, poor communication patterns, and difficult nurse recruitment (Caudill, & Patrick, 1989;Chopoorian, 1986;Cohen-Mansfield, 1997;Walker, Porter, Grunman, & Michalski, 1998).…”

mentioning

confidence: 96%

Pain Assessment Practices With Nursing Home Residents

2004

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The purpose of this research was to describe the kinds of pain assessments nursing home staff use with nursing home residents and the characteristics and behaviors of residents that staff consider as they assess pain. Twenty-one focus groups were held in 12 nursing homes. Nurses and other nursing home staff attended the focus groups. Coding techniques consistent with ethnographic methodology were used for data analysis. Four themes identified an underlying uncertainty in assessing residents' pain, the staff relationship-centered approach to pain assessment, the resident cues that alert staff to pain, and residents' characteristics important to the nursing assessment. Composition of focus groups made a difference in participation of certified nursing assistants in focus group discussion. Urban and rural differences were noted across the focus groups. Research is needed to further refine pain assessment techniques specifically for nursing home settings.

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Nursing Assistant Turnover in Nursing Homes and Need Satisfaction

Cited by 33 publications

References 3 publications

The role of the support worker in nursing homes: a consideration of key issues

The role of the support worker in nursing homes: a consideration of key issues

The Challenges and Opportunities in Providing End-of-Life Care in Nursing Homes

Pain Assessment Practices With Nursing Home Residents

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