State Tested Nursing Assistants' Workplace Experiences That Threaten or Support Intent to Stay

Rehabil Nurs. 2020 Dec 1;45(6):323-331. doi: 10.1097/rnj.0000000000000232.


Purpose: Over 1 million Americans utilize skilled nursing facilities (SNFs) annually. Within SNFs, State Tested Nursing Assistants (STNAs) are primary caregivers; however, low retention rates are notable and threaten patient care.

Design: A phenomenological, qualitative study was conducted to explore intrinsic factors that influence STNAs' intent to stay in their positions.

Methods: Ten STNAs employed at for-profit SNFs participated in semistructured face-to-face interviews. Data were analyzed to identify broad concepts and recurrent themes.

Findings: Findings suggest that intrinsic factors supporting and threatening intent to stay included the fulfillment of basic psychological needs. Supporting themes included self-confidence, appreciation, positive relationships, and a willingness to go beyond required duties. Threatening themes included frustration, lack of support, and career advancement opportunities.

Conclusions: Findings provide an understanding of factors that influence STNAs' intent to stay.

Clinical relevance: The results may help guide the development of responsive strategies that improve quality and continuity of care in SNFs.

MeSH terms

  • Adult
  • Female
  • Humans
  • Intention*
  • Interviews as Topic / methods
  • Job Satisfaction
  • Male
  • Middle Aged
  • Nursing Assistants / psychology*
  • Nursing Assistants / statistics & numerical data
  • Qualitative Research
  • Skilled Nursing Facilities / organization & administration
  • Skilled Nursing Facilities / standards
  • Skilled Nursing Facilities / statistics & numerical data
  • Surveys and Questionnaires
  • Workplace / psychology
  • Workplace / standards