Tips for Retaining SNF Caregivers from Millennials to Boomers

Younger certified nursing assistants (CNAs) tend to have different complaints about the skilled nursing workplace than older CNAs, and awareness of these generational differences could be the first step toward more effective retention efforts.

That’s one key takeaway from a small study out of Armstrong State University in Savannah, Ga. Researchers surveyed 100 CNAs at four skilled nursing facilities, asking about their perceptions of administrators, supervisors, and co-workers. The respondents were classified as belonging to the Millennial generation (18-34 years old), Generation X (35-50), or the Baby Boomers (51-69).

There’s some good news in the findings: Most CNAs of all ages feel a sense of accomplishment, or “intrinsic satisfaction,” from their work.


The CNAs generally reported feeling that direct supervisors are satisfied with the CNAs’ work, and know how good they are at their job. But the Baby Boomers were more likely to believe that their direct supervisors do not understand their work problems and needs, compared with younger CNAs.

Across the board, the CNAs’ perceptions of their administrators were not so positive. All age groups complained that administrators do not call in additional help when needed, don’t show very much concern for CNAs’ health or their families, and aren’t accommodating when family emergencies occur.

When it came to co-worker interactions, Millennials in particular have negative perceptions of workplace climate. They also were more likely than older workers to report hearing staff talk about co-workers behind their backs.


Bridging generation gaps

The study findings did not come as a surprise to Terry Davis, RN, a success coach for directors of nursing at Louisville-based Signature HealthCare, one of the largest skilled nursing providers nationally. For instance, she observed first-hand that it takes concerted effort for administrators to forge strong ties with CNAs.

“In general, unless the administrator works really hard at it, there does tend to be a disconnect,” she told Skilled Nursing News.

Davis concurred with several methods that the study authors proposed to improve CNA satisfaction and reduce turnover:

  • Supervisors can act as “buffers” when workload increases, and they can share with CNAs how administrators may be struggling to find help
  • Administrators should seek out ways of showing concern for CNAs’ health and families
  • Baby Boomer CNAs should be afforded ways of mentoring younger workers, and should be recognized for this type of support
  • Gossip and a culture of disrespect could be stamped out through positive coaching of perpetrators, staff in-services to cultivate positivity and teamwork, and problem solving teams that address low morale

In addition to these techniques, Signature requires all administrators to become CNA-certified in their first year on the job. Company executives have become CNAs as well.

“They have a better perspective on the workflow for CNAs, and it means they can physically help the CNA,” Davis said. “Without that certification, they might not be allowed.”

Furthermore, Signature holds town halls at the community level, so administrators and frontline staff can communicate directly; the direct supervisors sometimes play a role in these meetings to bridge the gap between these two groups.

Training at Signature also is tailored for different generations, being more digitally-based training for millennials and paper-based for boomers.

Still, it’s important that there are also company-wide standards that unite the generations, Davis said. At Signature, one way this is accomplished is through the company’s “sacred six” values of compassion, integrity, teamwork, respect, positivity and patience, which form the foundation of its mission.

Overall, it’s crucial that SNF leaders have an understanding of generational differences, the study authors concluded.

“When staff and supervisors do not understand each other’s generational culture, styles, and backgrounds, conflict may arise,” the study authors wrote. “Older baby boomers may consider Gen X workers as slackers and consider Millennials as demanding and disloyal. Likewise, Gen X workers may not respect the experience and stability Baby Boomers bring to their daily tasks.”

At Signature, part of administrators’ training involves teaching them some of the different motivators for various generations, to ensure workers of all ages feel respected, while supervisors can more effectively weigh the expectations and needs of staff members of different ages, according to Davis.

Click here to read the complete study findings.

Written by Tim Mullaney

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