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

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Abstract
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.

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