The following handout was distributed at the State Presidents' Council Meeting in Denver, CO.

CNA Retention - What the Medical Director Can Do to Help

Problem:

• Virtually no other employer in the nation pays less for the level of responsibility demanded
• Employees usually work two or more jobs to make ends meet. They work for nursing homes for 30 years and not make $10.00 an hour.
• No other employer has so many staff members quit, with the exception of telemarketers, who have people hang up on them all day. (1)

Solution:

1. Advocate for the CNA
   
   1. While making rounds in the facility, look for the subconscious negative stimuli. For example:
      
      1. Administrator's posters that say "What Don't You Understand About The Word No?"
      2. Stress balls, coffee mugs that read "No Bitching, Moaning or Groaning," plaques that state "Our philosophy of work: work or be fired," on manager's desks and in offices.
      3. Pictures of only owners, board members, and management throughout the facility.
      4. Does the licensed staff have negative attitudes towards the CNAs? Is there a damaging perpetuation of the hierarchy of disciplines? Is there an unfair caste system? Do you add to it?
   2. Look at the employee break room. What message does it give?
      
      1. Is it a place where you would want to sit?
      2. Is it a pleasant atmosphere worthy of fine caregivers?
         

         Suggest to the administrator getting magazine subscriptions or even a television. Transform the negative culture of suspicion, distrust and negativity, ("The magazines will just disappear," or "They'll skip work to watch soaps"). After all, we're trusting them with the lives of the residents, what message is given if they aren't trusted on breaks?

   3. Observe for an unsafe work environment. CNAs are among the most injured group of workers in the United States.
      
      1. Cluttered halls and rooms.
      2. Are they so short staffed that they have to manually lift resident's without help?
      3. Does the facility have mechanical lifts available, and if so, is the staffed properly trained how to use them?
2. Communicate
   
   1. Set an example of communication with respect.
      
      1. Remember the names of the CNAs in your facilities.
      2. Say hello to the CNAs as you pass them.
      3. Show appreciation for how they take care of your residents.
      4. Ask them for information about your residents. Often they will have a better handle on your resident's functional status than the nurses do.
      5. Ask them if they like their jobs, and then why or why not.
3. Educate
   
   1. Look for any opportunities to help the CNA staff grow professionally.
      
      1. Give inservices just for the CNA staff. Make sure the facility provides for "special" refreshments for your inservice. This will give the message that you feel the direct care staff is special
      2. Share your "vision" of para-professionalism.

1. Take It to Heart. CNAs' Solutions to the Staffing Crisis. (c)2000 by Bethany C. Knight.

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