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CNAs and the 100% Turnover Rate

CNAs Can't Quit Quitting
 
Certified nursing assistants don't have it easy; jobs in nursing homes are unglamorous, low paying, stressful, and low on the prestige scale. Who wouldn't jump at the first chance to get out of this scenario?
 
The turnover rate substantiates how dismal the job can really be. The Center for Disease Control published a large-scale study after interviewing 3,017 CNAs, and the results of the survey weren't pretty (www.cdc.gov).
 
And the Survey Says...
 
Turnover among direct care workers is high and can reach rates of over 100 percent in some organizations.  That's right, one hundred percent. The nursing home industry has been plagued for decades by an inability to recruit and retain nursing assistants.  Long-term care providers are reporting more than 52,000 vacant nursing assistant positions. Gaps in staffing disrupt the continuity of patient care, worker morale, worker safety, and quality of care.
 
Turnover of CNAs has other repercussions as well: it is costly to the provider and to the payer.  Both direct costs (recruiting, training new employees, and hiring temporary staff) and indirect costs (reduced productivity, deterioration in organizational culture, and morale) associated with turnover can compromise the quality and continuity of clients' care.  Further, costs for recruiting and training new direct care workers may be reflected in the demand for higher government reimbursement rates to maintain adequate care quality.
 
While the significance of the direct care worker's role in the provision of long-term care has become more recognized by long-term care professionals and researchers, CNAs experience stressful working conditions, little career mobility, and are among the lowest-paid workers in the health care field.  Long-term care organizations, therefore, face considerable difficulty in recruiting and retaining direct care staff.  As the demographics shift toward a larger aging population and greater demand for direct care workers, the recruitment and retention problem is likely to intensify. 
 
What Can be Done?
 
There is not much evidence about what could stop the turnover. Wage improvements may help, but some states that implemented raises still did not see any improvement in CNA retention. And Medicaid cuts don't always make pay increases feasible. States and providers are looking at solutions such as peer mentoring, career ladders, enhanced staff-family communication, alternative labor pools, multi-faceted initiatives (public awareness campaigns, career enhancements, quality improvement initiatives), and culture and managerial changes.
 
At this point, the silver lining to this black cloud may be that there is no place to go except for up for CNA professionals.

By Rita Henry
Get CNA Jobs, Contributing Editor

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