What makes for a positive work experience?
McKnight’s Long-Term Care News featured that question in its 2024 Mood of the Market survey, and the broad range of answers was eye-catching. The insights respondents offered could help sector managers spot easy future wins, identify underlying concerns and, ultimately, build a stronger skilled nursing work workforce.
When individuals were asked about good things that happened at work over the last year, two responses ran neck and neck: less use of agency staff and better mood among staff in the workplace. More than 36% of all respondents chose each of those answers, with better mood slightly ahead at 36.9%.
“I truly feel for the first time that we are getting back to normal,” one survey-taker wrote. “This is evidenced by us filling our existing vacancies and utilizing temp agency staffing much less. More bodies make for a better environment, which means better care.”
Care for patients has long been given as an anecdotal reason for staff commitment in an increasingly regulated and burdensome field. This year’s survey bolsters that assumption, while providing a glimpse into the emotional connection nurse leaders and administrators maintain with patients even after they move into supervisory roles.
Overall, the 2024 McKnight’s Mood of the Market survey drew 723 responses from directors of nursing, assistant directors of nursing, administrators and their assistants. It was distributed by email from late July to mid-August.
Triumphs driving workers
When asked the most positive thing that has happened at their workplace over the last year, many shared specific patient experiences. There was a particular preference for patients who triumphed over extra adversity. The write-in question received more than 450 responses.
Patient care responses made up about 13% of all positive organizational happenings, which was substantial given the array of answers shared. Examples included:
- A patient with a mental health issue received the right support and showed significant improvement
- A patient with a terminal illness had high-quality end-of-life care and passed away peacefully
- Staff switched to better skin care products for the residents
- A patient wrote a heartfelt letter of appreciation
While sometimes simple, such events are powering workers through still-challenging times.
The only positive thing cited more often than caregiving outcomes was improvements to staff pay, benefits, training and recognition. Those responses accounted for just under 29% of answers. Many individuals praising added flexibility, education or pay extended to others on their team, rather than themselves.
“We have been able to offer competitive compensation and benefits packages, helping to attract and retain top talent,” wrote one respondent. “Our organization’s commitment to employee development has led to the implementation of mentorship and career advancement programs,” said another.
“We have seen an increase in staff participation in professional development opportunities, demonstrating a culture of continuous learning,” added yet another.
Amy Stewart, chief nursing officer at the American Association of Post-Acute Care Nurses, said she was impressed by how many respondents cited improving mood in the workplace and less use of agency.
“It comes back to culture. Is this an anomaly among folks that took this survey? I hope not,” she said. “I’ve talked to individuals who run facilities or an organization and I say, ‘I’d work for you in a minute because quality is at the heart of everything you do. And if you care that much about the residents, I have to believe that you care that much about the staff.’
“That’s really what we need to look at: caring for the staff and the residents together,” Stewart added. “And if you do that, the quality will follow.”
Relationships matter
While many of the good things were tangibles — raises, promotions, new office spaces — others were decidedly less so. Multiple respondents cited softer changes as making their year more positive. Phrases included “better mood,” “people who are happy,” “teamwork that makes everyone happy to be at work,” and “departure of toxic staff.”
Staff also took significant pride in how their facilities and teams are viewed from the outside. Several mentioned improvements in star ratings, positive media coverage, strong community response to a new service or patient success stories.
Time for patient interactions is critical for building leaders, especially on the nursing side, said Denise Boudreau, founder of the senior care workplace culture firm Drive.
“When we do focus groups, that’s the number one thing we ask people: What makes you proud to work here or what keeps you coming back?” Boudreau said. “It’s always the people that they connect with and work with.”
In her field work, she consistently sees staff rate caring and compassion among their Top 10 values. It makes sense, then, that having the resources and time to deliver quality care would improve the workplace experience. And being similarly minded about patient care goals can also strengthen co-worker relationships, Boudreau noted.
The survey bore that out with plenty of mentions of improved rapport with management, supportive DONs and “all departments working together.”
“Those of us that are passionate all work together to help each other with workloads and try to keep each other positive,” one respondent said.
Another factor that clearly improved how staff view their workplace? The end of some COVID regulatory and clinical requirements.
Though not in the Top 5, easing COVID-era concerns were still frequently listed as the most positive thing to happen at a workplace. “No COVID in the building” and “taking off the mask and being able to start moving on past COVID” were popular responses. Others indicated post-COVID census gains as being important to their workplace morale.
‘Meaningful’ losses
Despite finding many positives when asked, the share of respondents (66.6%) who agreed their work was “very meaningful” continued a two-year slide, down from 73.1% in 2022 and 73% last year.
Combined with those who consider their work somewhat meaningful, the total clocked in at 92.8% — down 5 percentage points from 2023. Still, when broken into subgroupings, “meaningful” ratings among administrators remained extremely high at 97.5%, with nurses pulling down the overall average with their 87.5% meaningful rating.
When it came to good things that happened to individuals (vs. an organization), better mood and less agency were followed by a healthy pay raise (22.4%), more flexibility in work shifts/schedule (22.0%) and better work hours (19.4%).
Almost 1 in 10 respondents used a write-in option on that question. And among those, 38% used the space to express ongoing frustrations with their jobs or cite a lack of good happenings where they work.
“No real good things have happened,” wrote one, calling out circumstances that may be familiar to many veteran sector participants. “All I see is increased regulation and blame placed on nursing communities by the press and government.”
This is the final of four articles in the 2024 McKnight’s Mood of the Market series The first on fewer thoughts of quitting appeared Sept. 5, followed by the second on pay pressures on Sept. 9 and the third on regulatory burden on Sept. 11. To see previous years’ coverage, visit https://www.mcknights.com/tag/mood-of-the-market/.
