Recruiting and Retaining Nursing Home Staff

As the population ages, there will be a continued need for residential care settings and nursing staff to support them. With staffing shortages in nursing homes growing each year, finding ways to improve nurse retention and implementing new recruitment strategies is key to combat these challenges.

A June 2022 survey completed by the American Health Care Association found that 60% of nursing homes’ staffing situations had worsened since earlier that year, with 98% of nursing homes facing difficulties hiring new staff. With an absence of adequate staffing, many facilities have been forced to limit admission of new residents or place a higher workload on employees.

The issues with nurse turnover and retention have increased as the COVID-19 pandemic lingers. However, this dilemma has been an ongoing problem long before COVID-19. In a study of data from the U.S. Bureau of Labor Statistics, a steady decline in skilled nursing facility employees has been occurring over the last decade. This ongoing shortage has also factored into the decline in the health of some patients residing in these facilities, creating more instances of mental and physical health conditions.

By implementing changes to reduce turnover and increase recruitment and engagement, you can aid in shifting the direction of nursing home staffing to improve resident outcomes and invest in staff.

Effective and Supportive Leadership

Nurse managers and leaders in residential care environments, such as skilled nursing facilities, have a golden opportunity to positively impact nurses and other clinical staff. Leaders who are fair, practical, and motivating can factor into how committed staff will be to the organization.

To foster inspiring leadership styles, such as transformational leadership, it’s important to offer supportive actions and resources to accomplish this. This can include encouraging leaders to model the behavior they’re seeking in their staff, exhibit the integrity they have in their work with staff members, and engaging their employees by recognizing their strengths and goals.

Effective leaders think collaboratively and critically about the needs of their organization, staff, and patients. These individuals invest in their staff through recognition, development, and communication. Through these elements, you can create a more collaborative, open, and motivated work environment.

A 2020 study of leadership styles in nursing homes showed a need for transformational leadership as this style can increase retention, decrease burnout, and improve well-being among nursing home staff. Having encouraging leadership in nursing homes can translate into more positive outcomes for patients and higher job satisfaction with nurse staffing.

Strengthen Teamwork

As patient care and clinical needs become more complex, the need for teamwork in residential care settings will be more pertinent. In these environments, nurses are working alongside colleagues in various disciplines, collaborating for the benefit of each resident.

Effective teamwork utilizes the skill set of every member of your team to ensure patients’ needs are adequately and appropriately addressed. The level of teamwork in these settings can impact the quality of patient outcomes as well as the level of engagement and satisfaction nurses have in their roles.

One study in the Journal of Nursing Management noted a strong correlation between teamwork and job satisfaction. This study found that participants’ job satisfaction was higher when they rated their teamwork higher.

To improve teamwork, it’s important to consider the following:

  • Ensure open communication among team members and leadership. Having open communication will allow all members to provide feedback and input, increasing the efficiency of the team dynamic and lowering the risk of clinical errors.
  • Create goals with the team. With clear goals, such as shortening response times with residents, every team member has a goal to work toward, strengthening the group dynamic and function.
  • Make sure every team member has a role. With each nurse having a different role, each will each bring a unique component or specialty to the group. Specific roles can also aid in reducing gaps or duplicate procedures in resident care.
  • Allow room for flexibility and adaptability. Healthcare is full of unexpected situations, and allotting space for flexibility will support the team so that tasks can be reorganized and delegated in these unforeseen scenarios.

Achieving strong teamwork can be a challenge, especially considering nursing home staff and their current work climate. A 2021 study showed that by implementing team-building strategies, such as team recognition, there was improved job satisfaction among nursing staff, higher patient safety and satisfaction, and an overall improvement in care quality.

Nurses want to feel supported not just by their leadership but by their unit or team as well. Promoting and strengthening teamwork for nursing home staff improves retention, engagement, and satisfaction.

Clear Communication

Communication is a central element in the nursing profession. However, communication is a particularly essential component in skilled nursing settings. Nursing home staff, including registered nurses, licensed practical nurses/licensed vocational nurses, and certified nursing assistants, rely on clear communication to provide precise care for residents, to ensure they understand organizational protocols and procedures, and to establish relationships with colleagues and residents.

A study in the Journal of Long-Term Care indicated that a lack of effective communication in long-term care settings can lead to high staff turnover and negative patient outcomes. This study found that when long-term care staff felt there was effective communication in place, there were more positive and safer outcomes for patients and an increase in the support staff members felt from their team.

Ineffective communication can create concerns such as unclear role expectations, a lack of understanding of organizational protocols, inadequate recognition, or more demanding workloads.

A regular cadence of communication between staff and management — written or verbal — was highlighted in this study as a way to enhance employee morale, which can then be reflected in resident care. This could consist of allotting time for communication where staff members are validated or recognized for the work they’re doing, or a short period of the day for staff to communicate and refocus before moving onto the next task. Implementing these types of elements can aid in increasing engagement and job satisfaction.

With the shortage of nursing home staff, it’s significant to gauge additional elements that affect engagement and job satisfaction in nursing homes. By placing emphasis on the areas that encompass a nursing home employee’s day to day, such as leadership and teamwork, you can find and create strategies that will increase retention and aid in your recruitment.