Nursing Assistants' Job Commitment: Effect of Nursing Home Organizational Factors and Impact on Resident Well-Being

Bishop, Christine E.; Weinberg, Dana Beth; Leutz, Walter; Dossa, Almas; Pfefferle, Susan G.; Zincavage, Rebekah

doi:10.1093/geront/48.supplement_1.36

Cited by 116 publications

(122 citation statements)

References 32 publications

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“…3 Research has demonstrated that when direct care workers' wages are increased, recruitment and retention improve. [23][24][25] However, long-term care employers have a diminished capacity to increase wages and benefits, because more than 70 percent of financing comes from Medicaid and Medicare, which seek to limit costs regardless of labor-market conditions. Compensation for those employed in longterm care is even lower than for licensed professionals caring for older adults in acute and primary care, which has been recognized as inadequate.…”

Section: 35mentioning

confidence: 99%

“…Not surprisingly, licensed practical nurses and direct care workers do not feel that their jobs are respected-a perception that contributes to job dissatisfaction and high turnover rates. 25,27,28 Other workplace challenges include inflexible work flow and job design, ethnic and racial tensions because of the high degree of cultural diversity in long-term care settings, and a paucity of career advancement opportunities. 25,28,29 Principle 2: Recognizing A Distinct Long-Term Care Workforce…”

Section: 35mentioning

confidence: 99%

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Improving The Long-Term Care Workforce Serving Older Adults

2010

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There is a worsening shortage of competent, committed, paid long-term care workers who are able to meet the needs of older adults. Efforts to address the shortage must be informed by a conceptual framework that acknowledges the unique circumstances affecting these workers. These include nontraditional market forces, low compensation and prestige, limited career opportunities, and inadequate preparation for evolving roles and responsibilities. Applying this framework, we identify strategies that can reverse current trends by expanding worker supply; improving education, training, and developmental activities; and making delivery of long-term care services and supports to older people a more attractive alternative to employment in acute and primary care settings.O ne essential element of long-term care policy has, until recently, received relatively little attention: ensuring the availability of a competent paid workforce to deliver needed long-term services and supports. The empirical and policy literature, and the authors' observations and many years of experience in long-term care policy development and research, suggest that future workforce planning and improvement initiatives should be guided by four principles. These are as follows:(1) Conventional rules of supply and demand and traditional sources of labor cannot be counted on to resolve future workforce shortages.(2) To compete for and properly develop workers, long-term care must be recognized as a distinct sector within the larger health care sector.(3) Workforce roles and responsibilities must be responsive to a new array of service delivery models and to the increasingly complex and diverse needs of clients.(4) The competencies that are needed to work in the long-term care field must be defined and put into practice before careers in long-term care can be widely recognized as worthy, and workers accorded a status equal to that of their peers employed in acute and primary care.In keeping with these principles, we present a framework for improving the supply of paid workers available to deliver long-term care services and supports to people age sixty-five and older. Such people differ somewhat from younger populations with respect to needs, preferences, and goals-particularly in the areas of school participation and employment-and, therefore, merit separate consideration. Yet several of the points raised, and recommendations offered in the following pages, are as applicable to paid caregivers serving children and workingage adults as to those serving older adults. Who Provides Paid Care To Older Adults?The paid ("formal") long-term care workforce serving America's elderly population is made up of licensed professionals and unlicensed direct care workers who manage and deliver longterm care services in nursing homes, assisted living facilities, other residential and commu-

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Section: 35mentioning

confidence: 99%

Section: 35mentioning

confidence: 99%

Improving The Long-Term Care Workforce Serving Older Adults

2010

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“…Home health care workers (who have roles similar to that of CNAs, but do not have the formal training) have begun to join fast-food workers in these widespread strikes and the only-slightly-less-marginal CNAs might find inspiration in these kinds of actions. The case for better working conditions for CNAs is bolstered by evidence that nursing home resident well-being is greater where CNA job satisfaction is higher (Bishop et al, 2008). …”

Section: Discussionmentioning

confidence: 99%

The Impacts of Worktime Control in Context

Stein

2015

Sage Open

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This article examines the relationships between workers' control over their working time and their well-being, looking at how these relationships differ across a set of health care occupations that are stratified by class, gender, and race (physicians, nurses, emergency medical technicians [EMTs], and certified nursing assistants [CNAs]). Across occupations, workers' ability to control their schedules decreases their job-related stress. The results show that different dimensions of worktime control (WTC) affect workers in different occupations in distinctive ways, offering a corrective to prior work that combines workers who occupy different locations in the system of social stratification. Among nursing assistants-the most socially marginalized group in the study-the relationships between particular aspects of WTC and job stress were distinct from those associations among the other three occupations, reinforcing the importance of examining these relationships in occupationally specific contexts. This kind of comparative perspective illuminates the ways distributions of intangible resources such as WTC both emerge from and reinforce existing patterns of social stratification. The implications of these differences for research and policy are discussed.

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“…Second, wages are not the only factor contributing to the high rates of turnover in the nursing homes. A large number of factors are associated with turnover including characteristics of the worker, the nursing home and the environment [174][175][176][177][178][179][180]. In addition, Mukamel found that high turnover was associated with net savings for nursing homes, which may explain the persistence of high turnover over the last decades [181].…”

Section: Hypothesis Testingmentioning

confidence: 99%

Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

Xing¹,

Mukamel²,

Glance³

et al. 2016

WHM

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2013ii Biographical SketchThe author was born in Shanghai, China. She attended Shanghai Second Medical This dissertation provides evidence that linking Medicaid reimbursement rate to each NH's own expenditures and incentivizing NHs to invest in direct care were effective ways in achieving quality improvement. Refinements of current Medi-Cal reimbursement policy might be needed to encourage NHs to make larger investments. However, maximizing NHs' spending on direct care cannot be relied on as the only policy strategy to improve quality of care. vii Contributors and Funding SourcesThis work was supervised by a dissertation committee consisting of Professors

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Nursing Assistants' Job Commitment: Effect of Nursing Home Organizational Factors and Impact on Resident Well-Being

Cited by 116 publications

References 32 publications

Improving The Long-Term Care Workforce Serving Older Adults

Improving The Long-Term Care Workforce Serving Older Adults

The Impacts of Worktime Control in Context

Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

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