Job satisfaction influences CNA turnover more than pay

Certified nursing assistants’ (CNAs) attitudes toward job satisfaction and their overall wellness are better predictors of employee turnover than pay scale, according to a group of researchers from several universities.

The researchers from Rice University, the University of Pittsburgh and Baylor College of Medicine say that previous findings on CNAs misjudge turnover in long-term care. Such studies have found exceptionally high turnover rates in the industry, between 23 and 36 percent. This new study, published in The Gerontologist, instead found that only 5.8 percent of CNAs left the industry and 8.4 percent switched to another facility within a year.

“Many of the past studies mix full-time and part-time workers and tend to overestimate the turnover rate in the industry,” said Vikas Mittal, co-author of the study and professor of marketing in Rice’s Jones Graduate School of Business.

Researchers lumped the 620 certified nursing assistants they studied into three groups: stayers, who were in the same job for the same organization a year after they were first surveyed; switchers, who continued to work at least 30 hours per week as CNAs but for a different organization a year after they were first surveyed; and leavers, who were no longer in the direct-care industry or left the workforce entirely.

Of the respondents, 532 remained in their jobs, 52 switched to another facility and 36 left the industry.

The study found that leavers were more likely than switchers to report physical health problems as their primary reason for leaving their jobs (65.6 percent versus 21.1 percent). Switchers were more likely than leavers to quit their jobs to pursue other opportunities (87.2 percent versus 63.3 percent).

Switchers were similar to stayers in terms of job factors, such as the amount of paid leave and health insurance they received, but differed from them in terms of key attitudinal factors and reported greater emotional distress, lower job satisfaction and less respect for supervisors. The switchers reported positive outcomes—lower emotional stress and greater job satisfaction—after switching jobs, even when switching resulted in lower pay. Job satisfaction remained unchanged for stayers.

Funding for the study was provided by the Jewish Healthcare Foundation of Pittsburgh, the Pennsylvania Department of Labor and Industry, the Heinz Endowments, the University of Pittsburgh Research Council and the National Institute of Nursing Research.