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What we know about staff satisfaction

February 2, 2010
by Susan D. Gilster and Jennifer L. Dalessandro
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Securing and retaining staff, keeping them happy and content continue to be a major and very expensive problem in assisted living and long-term care. Despite decades of research and examination, millions of dollars are spent every year when staff members leave a facility. Turnover is rampant, found in all staff positions and at all levels in all departments. Average direct-care worker, supervisor, and leadership turnover in assisted living and long-term care ranges from 40% to over 100%. Why?

For the last 30 years or more staff have participated in identifying specific components of their work and environments that they require to be happy and satisfied. And for over 30 years they have repeatedly told us the same things. In essence, what employees in assisted living and long-term care want has not changed. So what is the problem? Why do we continue to conduct research to find the answers remain the same? Why isn’t anyone listening?

Many believe that money and benefits are what drive staff satisfaction in long-term care. As such, assisted living and long-term care leaders attempt to secure and retain staff with monetary incentives such as high salaries, sign-on bonuses, lump sums for attendance, and being selected as the “employee of the month.” All of these tangible items are helpful, and the need to have competitive salary structures is essential. However, one does not have to be the highest paying facility to recruit and retain staff. You cannot “buy” commitment and performance—money comes in third, fourth, and even lower on most staff satisfaction surveys. Despite popular belief, the top satisfiers are not money, benefits, and promotion. The only change over the years in staff satisfaction research results is a greater emphasis on healthcare benefits.

Money is not the ultimate satisfier. Unless heavily prodded by the satisfaction survey to address monetary issues, employees desire non-tangibles items: respect, appreciation, meaningful work, serving others, a vision, education, involvement, communication, and a caring, nurturing leadership—all of which do not cost anything but time and commitment.

Respect and appreciation are top on the list. How sad that the number one desire is simply to be respected. It seems like so little of employees to ask, yet clearly employees lack respect. Employees crave, and deserve, respect from supervisors, managers, administration, leaders, residents, families, and one another. Regardless of position, role or tenure, respect in an exemplary facility is an expectation and foundational.

Your staff wants to feel valued, to have meaningful work and know that they are making a difference in the lives of another human being. They come to this profession to serve, to enhance health, ease the pain, maximize abilities, and promote happiness. And their ability to do so does not come without planning and a vision—it does not happen by chance. Incredible accomplishments are found in organizations that have a vision and move purposely, collaboratively, and collectively towards that vision.

Staff also wants to be skilled and educated. They want to know what to do, and they want to know why. They desire the ability to be prepared and educated for their work, initially and continuously. Employees enjoy working for organizations in which they continue to learn and grow. They are motivated, feel valued and confident with new knowledge, and are enabled to conduct their work in the very best way possible.

Communicating organizational standards and expectations for performance are important to staff. They truly want to know what is expected and to conduct their work in the manner in which the organization desires. Most often, employees want to please those who employ them.

Organizational commitment and performance is enhanced when staff has a voice in the organization. Employees want to be informed and included in decisions that are made, particularly those that affect their work. Who knows better the best and most efficient means of accomplishing a task than those who are conducting the work? Outcomes improve when employees are included in the decision making process.

Communication is key, and should be routine, respectful, open, and honest. When everyone is informed and all voices heard, all activities flow better. Operations will be more consistent, care improved, standards adhered to, messages consistent resulting in improved process and procedures along with higher staff, resident, and family satisfaction. These are but a few of the items affected by consistent, routine communication.

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