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 Nurse Assistant Hiring Up, While Wages, Benefits Lag Behind

A new PHI (Paraprofessional Healthcare Institute) report, “U.S. Nursing Assistants Employed in Nursing Homes: Key Facts,” suggests that while more caregivers are entering the field, there is room for improvement in terms of wages and benefits.
“We need to put our heads together and determine what we want the system to look like moving forward,” says Abby Marquand, PHI director of policy research. “I hope to see more innovations such as child care centers and scholarships”—efforts that may seem experimental at this point but which can pave the way for more programs that can help attract and retain nurse assistants.
According to the PHI report, wages for nurse assistants have not kept pace with inflation. Average wages actually have decreased, from $12.22 in 2005 to $11.87 in 2015, and the median annual income is $19,000. However, while salaries are down, rates of health insurance coverage are up 11 percent among skilled nursing center caregivers.
The trend toward residents coming to nursing centers “sicker and quicker” from hospital stays seems to be having an effect on caregivers. According to the PHI study, nurse assistants suffer job-related injuries at more than three times the rate for the average U.S. worker. The majority of these are sprains, strains, tears, and musculoskeletal disorders, although back injuries also are fairly common.
“Short of paying higher wages, there are other things we can do to attract and retain caregivers,” says Marquand. For example, “Research points to a relationship between supervision and turnover/retention, so high-quality supervision is important,” she says.
Susan Misiorski, PHI’s national director of coaching and consulting services, notes that facilities need to make sure that when employees are promoted to supervisory positions, they receive specialized training about how to be good managers. “We need to train supervisors how to be successful, relationship-centered managers who can support and inspire workers and help them feel valued,” she says.
Elsewhere, Marquand says, some organizations connect workers with services and agencies so that they can receive supports such as child care, food stamps, tax preparation, or transportation. Others offer workers tuition reimbursement, scholarships, and career ladders.
Misiorski stresses the need for at least one facility leader to have some knowledge about the public support system, community services, and non-profit agencies in the region. “Employers need to understand how to counsel employees and help maximize their compensation package in a way that gives them the most opportunity for support. This can make a big difference.”
Misiorski stresses the need for a workplace culture “where job quality and satisfaction truly can thrive.” Toward this end, she suggests three main areas to focus on: compensation, opportunity, and support.
While all of these efforts are valuable, Marquand says, “We have to look at the bigger picture. We need to align to use our political power to work for improvements such as better reimbursement rates. We need to think about how we want the system to change and work toward those changes.”
Nursing care centers are expected to add approximately 59,000 new nurse assistant jobs between now and 2024. This is more than twice the anticipated number of new registered nurse jobs to be added in this setting.
For more on this report, go to
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