Supervision, job satisfaction, and retention among nursing assistants

Purpose. As the primary providers of care for residents in nursing homes, recruitment and retention of direct care workers (DCWs) is important for improving quality in longterm care. This study aims to make two contributions: first, to examine the relationship between supervisor support and job satisfaction in a growing and increasingly important occupation and, second, to explore how basic organizational characteristics, such as type of ownership, affiliation, and employee turnover, influence supervisor support and job satisfaction. Methods. I employ a mixed-method approach, using data from surveys, focus groups and semi-structured interviews with nursing assistants and semi-structured interviews with managers in 18 nursing facilities in North Carolina. Survey data is analyzed using random effect models which allow us to examine individuals nested within organizations. Interview data were analyzed using a constant comparative approach and thematic coding using NVivo 7.0. Results. The quantitative analysis of the survey data shows that higher levels of supervisor support is related to improved job satisfaction (p=.000), and this is supported by the qualitative data. Both managers and nursing assistants stressed that positive relationships between nursing supervisors and DCWs is important for both patient care and worker satisfaction. However, supervisor support is not a significant predictor of intent to stay or actual retention, suggesting that other job characteristics, such as low wages, poor benefits, and heavy workloads, also need to be addressed in order to make significant improvements in worker retention