title: The first year: employment patterns and job perceptions of nursing assistants in a rural setting.
abstract: OBJECTIVE
  The aim of this study was to follow rural certified nursing assistants (CNAs) (n=123) in the United States for 1 year post-training to identify retention and turnover issues in the long-term care (LTC) setting by exploring the CNAs' perceptions of the LTC work experience.
  
  
  BACKGROUND
  Turnover among CNAs impacts the quality of care, imposes a financial burden on facilities and taxpayers, and creates increased stress and workloads on those who remain.
  
  
  METHODS
  A longitudinal survey design was used to track individuals completing CNA training for 1 year.
  
  
  RESULTS
  At 1 year post-training, 53.7% of respondents currently worked in LTC, 30.9% worked in LTC and left, and the remaining 15.4% never worked in LTC.
  
  
  CONCLUSIONS
  While the training site does not appear to impact retention, the first 6 months of employment appear critical. The CNAs cited pay as a reason for leaving LTC, but better pay did not characterize the jobs taken by the CNAs who left. Implications for nursing management. This study highlights the importance of the first 6 months of employment to retention and provides practical information for nurse managers evaluating the resource-effectiveness of hosting training programmes. Additionally, the key issues influencing retention were identified and practical suggestions for nurse managers to improve retention are provided.
authors: Assistant Professor, Department of Geriatric Medicine/Gerontology, Heritage College of Osteopathic Medicine, Ohio UniversityAssistant Professor Research Associate, Voinovich School of Leadership and Public Affairs, Ohio, USA.
authors: Deborah
authors: D
authors: Meyer
authors: Holly
authors: H
authors: Raffle
authors: Lezlee J
authors: LJ
authors: Ware
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D004651:Employment; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008134:Long-Term Care / Q000458:organization & administration; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009728:Nursing Assistants / Q000523:psychology*; D009735:Nursing Homes / Q000458:organization & administration / Q000592:standards; D015279:Organizational Culture; D010465:Perception; D010563:Personnel Turnover / Q000706:statistics & numerical data; D012424:Rural Population; D011795:Surveys and Questionnaires; D014481:United States
keywords: health manpower; long-term care; nurse aides; retention; turnover