Here at Straightaway Health Careers, we realize developing better CNAs is only part of the retention equation. We also must help front-line supervisors be better – do better. One area where we can provide guidance is helping entire organizations learn to recognize and fix blind spots in their culture.
As we study the data surrounding turnover, particularly turnover of front-line workers, we see that managers of front-line staff can have blind spots that are far more likely to directly impact CNA retention than any absence of skills by the CNAs themselves. You may be wondering, “Blind spots…what blind spots?” — don’t worry. Often there is a disconnect between CNAs and their managers.
You’ll notice below we have a few terms listed out for you. Take a moment to review these terms. Which do you think would fall under the category, What CNAs want and need from their managers and which would fall under the category, What nurse managers think their CNAs want and need. Keep in mind, there are six terms per category.
|Help empathizing with residents||Help with handling difficult residents||Praise|
|To feel welcome and wanted||Grief and loss training||Memory care education|
|Feedback on performance||Help with communication (peers + residents)||Time management|
|To have a say in the work||Validation||Help in becoming well- developed|
How’d you do? Did you have to think about it a minute or two? We all have internal biases influenced by our environments, work experiences, and existing cultures. It’s important to check our biases at the door when managing people, particularly when working with high risk, high turnover positions.
|What CNAs want and need||What Nurse Managers think CNAs want and need|
|Feedback on performance||Help empathizing with residents|
|Help in becoming well-developed||Grief and loss training|
|To feel welcome and wanted||Help with handling difficult residents|
|Praise||Help with communication (peers + residents)|
|To have a say in the work||Memory care education|
There is a clear disconnect between what CNAs typically need from their managers and what their managers typically provide. While nurse managers tend to think that CNAs need more skills-based support, the CNAs themselves are looking for morale support. In long-term care, we have a habit of mistaking a need for support to be a need for more training. But we keep training – and they keep leaving. If we never stop to ask what our employees really need, the turnover cycle will go on and on. It’s like gardening – if your plants need sunlight but you just keep watering them, they will drown.
Think about it from your CNAs’ perspective. They are most often brand new to a setting that is completely foreign as well as totally overwhelming. We at Straightaway are resolving these issues by providing real world training and expectations for new CNAs. The weight of the job is something that no one can really change – it’s the nature of long term care. What we CAN do is give these new incumbents what they need – support, development and feedback in real time. Feedback must be immediate, fair and equally weighted between corrective information, praise and validation. It’s vital in the first 90 days to provide new hires with a safe space to learn and grow. If you have that, they are more likely to bond to you and your organization and make it through the tough days we all have. The bond is key! Your CNAs must master the skills, of course, but the bond is what keeps them around. Be bond builders.
Here is a snippet from one of the CNA characters in our training series for nurse managers:
“Well, I would change the way we are treated, first and foremost. I understand we can’t change everything but just to have good, honest feedback when we do wrong or right would be wonderful… I’m still feeling the sting of leaving orientation and seeing a completely different world on the floor. Sometimes I don’t know if I am doing what they want or not until they bark at me. I’m afraid to ask and have them think I’m stupid. My supervisor for sure is like that. And even some of the other C.N.A.s who have been here longer do it too. There was only one that has been helpful – present company excepted, of course. I love it when we work the same shift. At least I know I’ll have somebody to work through things with if I need them. You know, a little validation, a little praise now and then.
This was taken from real feedback we received from front-line caregivers.
Examine your culture and your own biases. Help build bonds that keep them with your organization. We have the capability. Nearly everyone you know in this industry is proud we don’t build widgets, we care for people. We have culture in spades. Leverage that with your workforce. You’ll be glad you did.