Healthcare today is complicated. Changing requirements, varying patient needs, an evolving work force, and new reimbursement rules. Sometimes it feels as though all we do is manage change. On top of this maelstrom, it is often a struggle to keep qualified staff who can deliver the patient experience organizations require.
CNA Turnover is a Major Problem for Healthcare
Nowhere is this more evident than in the CNA population. Turnover rates in CNA positions can be over 100%, with a conservative cost per employee of over $8000 in 2018 dollars. CNAs are also more likely to leave if they haven’t worked in a facility for at least a year. The most at-risk population of CNAs are the new ones – new to your facility or new to the industry, or both. Yikes!
Another finding from research is that your employees’ peers are as critical to the quality of the job as their managers. In a recent study, coworkers lead the pack in why CNAs disliked their job. Does that surprise you?
Here are the three top causes of CNA dissatisfaction with their job:
- Coworkers (30%)
- Workload (26%)
- Supervisors (23%)
Peer Mentoring to Reduce Turnover
Forward thinking organizations are adopting a different mindset to begin to stem this tide. The mindset is changing from “let’s find more people” to “let’s try harder to retain the ones we have.” At the same time, we see operators begin to realize that culture isn’t just what we do for patients and families – it’s how we treat each other.
Peer mentoring is a great way to build culture and involve seasoned CNAs in the growth of new CNAs. Carol Hegeman’s “Growing Strong Roots” model is one such example. Carol’s work sought to develop a peer mentoring model that could:
- Improve CNA retention rates
- Improve orientation processes so that they reflect the values of the facility
- Reinforce critical skills and behaviors
- Teach the value of caring
- Use exemplary aides to role-model exemplary care
- Support new staff as they make the transition team; and
- Provide recognition and a career ladder for experienced nurse aides
Her approach provides five hours of focused orientation for the person who is assigned to coordinate the project. A strong project lead is highly recommended as new mentor/mentee pairs may be unaccustomed to their roles. The project lead would also be responsible for program outcomes, tweaks to the program, a communication plan for the program and/or other directional responsibilities.
The program involves one full day of training for the mentors, followed by two 3-hour booster sessions at later dates. The training explains the roles of a mentor as a tutor, resource, role model, and source of support. The program teaches the skills needed to mentor peers successfully, including how to provide effective feedback.
Compensation for the mentors took the form of extra time off, a cash bonus, or a gift certificate.
A few highlights of this model are:
- Mentoring takes place after the CNA certification is complete. This mentoring is intended to supplement – not replace – the usual training of new CNAs
- The mentee and mentor have an active relationship for at least eight weeks. The intensity of the relationships will be highest at the beginning and will reduce incrementally as the new CNA grows into their role
- The mentor will focus on four areas of success with the mentee: acting as a role model for care, supporting their CNA socially, tutoring their CNA in areas of struggle, and acting as a peer resource when things get rough
- In the first week, the mentee and mentor will work together on the same shifts, with the mentee initially just observing care. The mentee will gradually take on more and more single-handed responsibility as they grow familiar with the facility and their role as a CNA. By week eight, the CNA should be mostly self-sufficient
- Mentor training makes clear that the mentor does not teach or reteach clinical skills. Formal education remains the responsibility of the in-service educator; the mentor is encouraged to notify training staff when retraining seems necessary
- Mentors model correct clinical skills and attitudes, time management, and direct care to residents. Additionally mentors reinforce formal policies and procedures as well as explain the more informal practices like breaks, lunches and telephone usage. The mentors should encourage new CNAs to use the facility resources to make their job easier and more understandable. Mentors are to be a friend and advocate.
Results reported at a recent joint conference of the American Society on Aging and the National Council on Aging stated that the facilities with a mentoring program improved retention rates over three months from an average of 59% at baseline to 84% after the implementation of the mentoring program.
Straightaway Can Help
Straightaway Health Careers can assist in how your new hires experience their new positions. We specialize in innovative training approaches that combine a real-world view of what the job entails plus mentoring and communication tools that help your new hires feel they made the correct decision in choosing you. If you’ve never considered a peer mentoring program, we encourage you to do so. Below you will find a few good articles where you can find more information on peer mentoring.
Carol R. Hegeman, Peer Mentoring of Nursing Home CNAs: A Way to Create a Culture of Caring, Leading Age, New York, 2008.
Elizabeth Villanueva, Evidence-Based Mentorship Program: Overview, Review of Evidence, and Approach, Walden University, 2015.
Heidi Splete, “Peer Mentoring Promotes CNA Retention”, Caring for the Ages, 2008.