What makes for a positive work experience?
McKnight’s Long-Term Care News addressed this question in its 2024 Market Trends Survey, resulting in an eye-catching range of responses. The insights gained from respondents could help industry managers more easily gauge future success, identify underlying concerns, and ultimately build a stronger skilled nursing workforce.
When asked about good things that have happened at work in the past year, the two answers tied closely: reduced use of temporary workers and improved atmosphere among staff at work. Over 36% of respondents chose these answers, with improved atmosphere coming in slightly ahead at 36.9%.
“For the first time, it really feels like we’re returning to normal,” one survey respondent wrote. “This is evident as existing vacancies are being filled and the use of agency staffing has decreased significantly. More staffing means a better environment, which translates to better care.”
Patient care has long been an uncommonly cited reason for staff dedication in increasingly regulated and taxing healthcare settings, and this year’s survey reinforces that premise while also offering a glimpse into the emotional connections nurse leaders and managers maintain with patients even after they move into supervisory roles.
Overall, the 2024 McKnight Market Trends Survey received 723 responses from nursing directors, assistant nursing directors, administrators and their assistants. The survey was distributed via email from late July to mid-August.
A victory that motivates workers
When asked about the most positive thing that happened to them at work in the past year, many shared specific patient experiences, especially those in which they overcame additional challenges. More than 450 responses were received to the write-in question.
Responses related to patient care made up approximately 13% of all positive events that occurred within the organization, a significant number given the variety of responses shared. For example:
A mentally ill patient received the right support and made a significant improvement A terminally ill patient received quality end-of-life care and passed away peacefully Staff switched to better skin care products for residents A patient wrote a heartfelt letter of thanks
Though sometimes simple, these events still empower workers through difficult times.
The only positives cited more frequently than care outcomes were improvements in staff pay, benefits, training and recognition. These responses accounted for just under 29% of responses. Many of those praising increased flexibility, education and pay were directed not at themselves but at others on their team.
“We are able to offer a competitive compensation and benefits package, which helps us attract and retain top talent,” one respondent wrote. “Our emphasis on employee development has led to the implementation of mentorship and career advancement programs,” another said.
“Staff participation in professional development opportunities has increased, demonstrating a culture of continuous learning,” added another employee.
Amy Stewart, chief nursing officer for the American Association of Post-Acute Care Nurses, said she was struck by how many people reported improvements in workplace climate and reduced levels of agency.
“It really comes down to culture. Is this an anomaly among the people surveyed? I hope not,” she says. “I’ve spoken to people who run facilities and organisations and I’ve said, ‘I would love to work for you in a heartbeat because quality is at the heart of everything you do. If you care that much about your residents, you’re sure to care that much about your staff.'”
“What we really need to focus on is caring for our staff and our residents together,” Stewart added, “and the quality will follow.”
Relationships are important
While many of the good things were tangible — pay raises, promotions, new office space — some were less tangible. Many respondents said it was softer changes that made this year more positive: “a better mood,” “happier people,” “teamwork that makes everyone happy at work,” and “the departure of toxic staff.”
Staff also took great pride in how their facilities and teams were viewed externally, with several mentioning improving star ratings, positive media coverage and strong community response to new services and patient success stories.
Dennis Boudreau, founder of aged care workplace culture company Drive, said time spent interacting with patients is crucial for developing leaders, especially in the nursing department.
“When we do focus groups, the No. 1 thing we ask people is, ‘What makes you proud to work here and what makes you want to come back?'” Boudreau says, “It’s always the people they connect with and work with.”
In her work in the field, she finds that staff consistently rank compassion and compassion among their top 10 values. So it makes sense that having the resources and time to deliver quality care would improve their work experience. And having a similar mindset about patient care goals also strengthens relationships with coworkers, Boudreau noted.
The survey backed this up with frequent references to improved relationships with management, DON collaboration, and “all departments working together.”
“We’re all passionate people, we help each other with the workload and try to stay positive, so we work together,” one respondent said.
Another factor that has clearly improved employees’ views of the workplace is the end of some of the COVID restrictions and clinical requirements.
Though it didn’t make the top five, reduced anxiety during the pandemic was frequently cited as the most positive thing about the workplace. “No more COVID in the building” and “We can take off our masks and move forward beyond COVID” were popular responses. Some also noted that a post-COVID census increase would be important for workplace morale.
“Meaningful” Losses
Despite finding many positives when asked, the percentage of respondents who agreed their work is “very meaningful” (66.6%) declined for the second consecutive year, down from 73.1% in 2022 and 73% last year.
When adding in those who think their work is at least somewhat meaningful, the total was 92.8%, down five points from 2023. Still, when broken down into subgroups, the “meaningful” rating among managers was very high at 97.5%, while nurses dragged down the overall average with a meaningful rating of 87.5%.
In terms of good things that happened to the individual (vs. the organization), feeling better and feeling less independent were followed by a significant pay increase (22.4%), more flexibility in work shifts/schedules (22.0%), and improved work hours (19.4%).
Nearly one in ten respondents used the write-in option for this question, with 38% of them using the space to express ongoing dissatisfaction with their job or to state that positive things were not happening at the workplace.
“Nothing really good is happening,” one person wrote, describing a situation familiar to many veteran industry insiders. “All I see is more regulation and more bashing of the industry in the press and by the government.”
This is the final of four articles in McKnight’s Market Trends for 2024 series. The first article, about diminished thoughts of retirement, was published on September 5, followed by the second article, about salary pressures, on September 9, and the third article, about regulatory burdens, on September 11. To view previous articles, visit https://www.mcknights.com/tag/mood-of-the-market/.
