Building a network of stayers.

Genevieve Gipson, RN, MEd, RNC, is director of the Career Nurse Assistants' Programs and the National Network of Career Nursing Assistants in Norton, Ohio.

Fix your staffing woes by giving good CNAs reason to slay 

PEOPLE OFTEN TALK ABOUT FTNDING GOOD NURSING ASSIStants as a problem of "recruitment and retention," but few stop to consider the meaning of the phrase. In reality, an administrator's focus should be the reverse: Retain employees first, then worry about recruitment. Until you put the spotlight on retention, you may never be able to create a stable workforce.

When recruitment takes priority over retention, too much time and money are spent interviewing, training, and orienting new workers. Initial hiring costs are estimated at between $2,000 to $4,000 per employee, but true costs are measured in more than just dollars. It takes at least six weeks before a new employee can begin to be truly productive. Another cost, often invisible yet significant, is the damage done to the morale of your stable employees, who put effort into training a constantly changing cast of new colleagues. What's more, public confidence in your facility can be damaged if it is perceived as the place nobody wants to work.

So what can you do to retain good workers? Here are a few suggestions:

* Validate efforts regularly. A recent study in Ohio found that the longer a person worked as a nursing assistant, the less likely he or she was to get feedback from supervisors or administration, leaving workers with a feeling of "Why bother? Nobody cares anyway. This is something that can be easily fixed with a conscious decision to give simple feedback on a regular basis. When you notice the good work your nursing assistants are doing, tell them. When you pass a CNA in the hallway, smile and make eye contact.

Likewise, anniversary dates can be pivotal points for nursing assistants. Give them tangible recognition of their achievement, such as a photo or a ring they can show their family. Sometimes nursing assistants with 20 years on the job suddenly decide it's time to move on, baffling their supervisors. "But she seemed so happy all the time--never made waves, never refused an assignment. Residents loved her. I can't understand why she wanted to leave!" the administrator may wonder in all sincerity. Perhaps she left because the thought of being invisible in the system for another 20 years was too painful to fathom.

* Build a community centered on caring for workers and residents alike. Awards ceremonies, bulletin board photos, pins, certificates, and special events can not only honor your nursing assistants but also promote the positive working environment you want residents and employees to take comfort in. Events like National Nursing Assistants' Week (June 3 to 10) give CNAs a chance to join with others nationwide to validate the work of experienced nursing assistants. Being a part of a larger group such as the National Twenty Year Club, the National Network of Career Nursing Assistants, a safety committee, or a nursing assistant peer group can provide additional validation and help build stronger ties to the job. (For more information on these activities, write to the Career Nurse Assistants' Programs at 3577 Easton, Norton, Ohio 44203.)

* Recognize and encourage "anchors." Experienced workers often come in pairs, buffering and supporting each other over the years. You can't force this bonding, but you can create a fertile ground that encourages it to flourish by asking nursing assistants to brainstorm and solve problems together.

* Ask your experienced nursing assistants to share ideas. Experienced nursing assistants are a well of wisdom about how the job needs to get done. They know how hard it is to find new workers, and they often want to be a part of the solution. Offer additional training and pay for experienced nursing assistants who become mentors or coaches to the new workers. Ask them to be on committees to recommend changes in areas such as recruitment, interviewing, selection, orientation, and assignment of workers. Involve them in decisions such as how mealtime management is integrated into daily work routines, or in developing backup plans for problems such as bad weather.

The greatest resource any facility has is its stayers, the workers who remain in their positions over time. They are the historians of what works. Getting good people to stay requires an investment of time, effort, and money, but that effort pays off with dividends. As more attention and support is directed to the stayers, your best workers will draw other competent and caring people to you, and the needs of both workers and residents will be provided for in considerate and meaningful ways.