Employer benefits include salaries, health insurance benefits, flex time schedules, paid vacations, family leaves, personal business days, death benefits, employee assistance programs, stock options, savings plans, and pension plans that are designed to recruit and maintain regularly scheduled full time and part time nursing assistants.
According to national U.S. Labor Department data, current nation wide salaries for nursing assistants range from $12,000 to $24,000 per year for salaried employees. As health care systems change and develop, higher nursing assistant salaries will become the norm. Health care employers will use higher salaries to recruit and maintain high quality nursing assistant services. Societal needs for nursing assistant services will grow because of the rising numbers of frail elderly people and the need for more rehabilitative services.
Salaries differ among local, regional, and national employers. They tend to be higher in northern states and cities across the nation. Psychiatric hospitals and mental health centers pay the highest wages, followed by Veteran's Administration hospitals. Higher wages are paid by hospitals because of their extremely stressful, ever changing work environments.
Nursing homes pay less than hospitals, but on the average, they often pay higher rates than home health agencies. Salary estimates in nursing homes range from $12,000 to $16,000. The middle 50 percent of nursing assistants earn from $11,600 to $14,400 per year, according to The Buck Survey. In general, salaries are rising, and future trends predict they will continue to rise during the beginning years of the twenty first century.
Hospital sponsored home health agency salaries range up to $18,000 a year for full time, salaried nursing assistants, according to a recent study conducted by the National Association of Home Care. The majority of these nursing assistants tend to be per diem workers who receive an hourly wage from $8 to $10 per hour. They work for a fee only, which means they are not eligible for other employer benefits (health insurance, vacations, etc.). The home health industry is aware of these salary discrepancies and plans to consolidate services to raise salaries and offer better employee benefits.
According to recent future of work trends, congregate housing communities will provide higher salaries for nursing assistants. The Marriot Corporation has congregate housing communities with available nursing assistant services. Public demands for nursing assistant services are expected to continue. Based on proven business principles of supply and demand, this trend is expected to produce higher wages, better working conditions, personal recognition, and job satisfaction.
Health Insurance Options
Personal and family health insurance plans are available for full and part time nursing assistants, according to some employer trends in Human Resources and Personnel Management. Employer benefits, including insurance plans, traditionally begin after a three month probationary period. During this time, employers decide whether to maintain or terminate the employment agreement. Good performance keeps nursing assistants employed; poor performance causes them to be fired.
Employer provided health insurance plans require employee contributions through payroll deductions. The majority of employers sub scribe to health maintenance organizations (HMOs). Many of these insurance plans do not allow employees to choose personal physician services. Some insurance companies do allow for personal choice, but they tend to have higher subscription rates that require higher employer/ employee contributions. Currently these practices are under investigation by the federal government, and positive changes in HMO delivery systems are expected in the near future.
Disability insurance, which is provided for adults under the age of sixty five by federal/state governments and the Social Security Acts, requires employee contributions through payroll deductions. Disability insurance ensures that financial benefits will be available after health insurance benefits have been exhausted, should an employee become ill or injured.
Workers' Compensation Insurance
Workers' Compensation Insurance is a payroll deduction system designed to provide financial support for employees who are injured on the job or experience illness because of proven environmental hazards that are injurious to health and well being.
Nursing assistants traditionally can choose to work one of three eight hour shifts (days, evenings, or nights). Those who choose to work the evening or night shift are eligible for a shift differential a financial benefit. The majority of hospital/nursing home employed nursing assistants are off every other weekend and are scheduled off during the week based on facility staffing needs and personal preferences. It is not legal to require nursing assistants to work more than forty hours per week, unless they agree to do so. In these situations, they should be financially compensated for their services.
Short Staffed Work Situations
Constant employer requests to work double shifts or around the clock create unsafe conditions for patients due to probable staff inattention caused by lack of sleep and/or rest. The need for overtime is usually caused by short staffed work situations that happen in every occupation. However, chronic short staffed conditions are employer problems that require immediate corrective interventions, other than using overtime as a workable solution.
The majority of health care employers in urban areas offer four day workweek options. Staff can choose to work ten hours per day, four days per week. In this employment setting, nursing assistants would be required to work four days and then be off duty for three days, a nice option when an off duty weekend is coming up. Flex time schedules are available for students and part time workers who are employed elsewhere.
Job Sharing Options
Many employers offer job sharing options, and this trend is expected to continue. Job sharing means that one job is divided between two people. An example of this system would be two nursing assistants who work regular part time hours. One would agree to work a four day week and the other would work a three day week. The following week the work schedule would change so that the person working four days would work three days, and the person working three days would work four days. This arrangement is one example of a job sharing option.
Part time Options
Part time options attract students, mothers of young children, people in job transitions, and retirees. Each of these work groups has opportunities to work part time, flex hour work schedules.
Vacations differ among employers within each state. The majority of nursing assistant employers offer two week paid vacation time each year. Some employers offer more paid vacation time; some offer less.
The majority of nursing assistant employers provide time off for family emergencies, death in the family, accidents, and other unforeseen events that are impossible to predict or plan for. Maternity/paternity leaves also are available by most employers. Personal business days are provided for employees to attend to business affairs that normally could not be done because of work hour commitments. As a general rule, most federal employers offer non-paid family leaves for three days a year, and these can be taken as needed. Veterans' Administration hospitals provide "friend timely leaves" or the use of sick time benefits to assist friends in need.
Employee Assistance Programs
Adult workers sometimes experience personal/family problems that can create emotional trauma and cause them to feel helpless, alone, and unable to focus on their work tasks. Workers who are depressed and/or fearful because of personal experiences, such as pending divorce, sick children, or financial problems, often cannot function effectively at work. Employee assistance programs offer confidential counseling services and referrals to community professionals, such as social workers, psychiatrists, psychologists, and R.N. nurse specialists who help distressed adults to regain emotional stability, a sense of purpose, and the ability to continue to remain productive workers.
Stock Options and Savings Plans
Stock options and savings plans are usually available from the majority of nursing assistant employers, especially those who run corporate operations with national hospital/national nursing and home health businesses. Smaller facilities might not have the financial resources to offer these benefits.
Pension plan options are usually available for regularly scheduled full time and part time nursing assistants who can earn vested rights toward pension funds after five years of regular employment.
Part time and Pro Rated Benefits
The majority of large, corporate hospitals/nursing homes/home health agencies provide pro rated benefits for part time and per diem nursing assistants based on hours they worked per calendar year.
Training and Certification Opportunities
Large corporate hospitals/nursing homes/home health agencies hire and train nursing assistants without any previous training or job experience. Smaller employers hire certified nursing assistants only, because they lack training funds.
Nurse Assistant Certification Processes
Many nursing homes train and prepare nurse assistant candidates to participate in the certification process. This process has two parts: Candidates must successfully complete a skills test, supervised by an R.N. evaluator. Upon successful completion, candidates complete a written examination proctored by an R.N. evaluator. The written test is scored by a legitimized agency. Successful candidates become C.N.A.s. They receive an identification number that is placed in a national C.N.A. registry. This registry is recognized by nursing assistant employers across the United States. Certification is a career ladder option.
Federal/state funded psychiatric centers, VA hospitals, and corporate hospital/nursing home/home health agencies provide tuition assistance programs for those who desire to earn degrees in health care professions. Smaller employers may offer this job benefit. Their decisions are based on financial constraints.
Financial Support for Continuing Education
The majority of employed nursing assistants are eligible to attend prepaid continuing education courses at local schools and colleges. Employers pay tuition fees for courses that enable nursing assistants to gain new knowledge and job skills that further career ladder opportunities.
Professional organizations support members in their professional development and offer information and counseling regarding career advancement and personal empowerment.
Multifunction Workers: Opportunities for Lateral Moves
Multifunction workers are people who can perform different job functions. They are cross trained, which gives them options to move within the departments they work in or across departmental lines combining job tasks from several departments. C.N.A.s have opportunities to become cross trained and move from nursing unit to nursing unit or combine C.N.A. skills with job skills performed in other departments (for example, medical assistants tend to be C.N.A.s). Multifunction workers are employer assets because they can be utilized to complete different categories of job tasks. Combining job skills and services for lateral moves saves time and money and produces positive patient care outcomes, including patient satisfaction for quality nursing assistant services.
Case Study: A Multifunction Nursing Assistant
Wendy Cokes is a fictional character, a composite of several C.N.A.s who had positive attitudes about their jobs, were willing to learn new job skills, and became valuable multifunction workers. Wendy, a single mother of two young children, needed a job because her husband abandoned the family and his whereabouts was unknown. Both of her sisters were nurses. They encouraged her to get a job in a local nursing home, because working as a nursing assistant would help her make a decision about nursing as a career. Wendy was hired by a home where she received nursing assistant training and became a C.N.A. She was a quiet person who got along well with residents, families, and staff. The nursing unit's head nurse observed how she approached her tasks in an organized and intelligent way and was pleased by patient care outcomes. When the day shift supervisor was looking for a nursing assistant to cross train as a multifunction worker, the head nurse recommended Wendy. She agreed to accept new job responsibilities and worked on other nursing units, too, where she had opportunities to learn new skills and gain more job know how. As she developed professionally, Wendy had more opportunities for job advancement and salary raises. She was trained to work in the physical therapy department as a physical therapy aide and in the home's dental and podiatry clinics as a clinic aide. Wendy also worked for the R.N. educator as an in service aide. She became a self confident asset to herself and to her employer. Wendy was approached by the home's director of nursing to become a grant participant. The home offered to pay her educational expenses to become a licensed practical nurse. Wendy decided to forego this offer because of her family responsibilities. She continued to work successfully in a lateral career track until her children were older and she could pursue other career options.
Multifunction workers like Wendy are more likely to have opportunities for upward mobility. This career move supports workers in their decision to move up the career ladder by getting more formal education that will qualify them to work as professionals. Nursing assistants who show that they are mature, capable, and interested in upward mobility career opportunities will be assisted to reach their goals through tuition assistance programs, flex hour schedules, and on the job mentors who will coach them to apply practical knowledge while they are learning professional theories and practices at schools or colleges.
After a few years, subsidized by tuition assistance and federal grants, Wendy went to college. She became a registered nurse and then enrolled in a health administration degree program. After completing educational and licensing requirements, Wendy took a job in a large city nursing home, where she worked as an assistant administrator. Eventually she gained upward mobility and became the home's administrator.
Although Wendy is a composite character, success stories are real life experiences for nursing assistants who choose to work smart by seeking opportunities to perform job functions as multifunction workers and by continuing their education to ensure future career successes.
Personal Development and Empowerment Issues
Every day nursing assistants have opportunities to empower themselves at work. Their self confidence will get a boost when they develop skills and get job satisfaction. Nursing's work processes offer learning opportunities to master: time management and organizational skills, communication skills, conflict management, diplomacy, critical thinking, mentoring, motivational counseling skills, and grief counseling.
Time Management and Organizational Skills
Nursing assistants learn how to organize their work tasks to save time and personal energy. At the beginning of each eight hour shift they receive work assignments and decide the most expedient ways to complete them. Nursing assistants know who to care for, what to do, how to do it, and when to complete it. When in doubt, they discuss job tasks with their immediate supervisors.
Communication Skills and Techniques
Nursing is a people service business, and nursing assistants must be come skilled communicators and diplomats adept in dealing with people of all ages who are experiencing health problems caused by illness, in jury, and/or disability. Communication skills are learned proficiencies that include the ability to send and receive clear and audible messages, interpret body language, and read and write with clarity.
It is difficult to send ideas from one person to another. Life experiences, cultural differences, and nonverbal messages through body language might influence how patients respond to treatments and how well nursing assistants work alone or with others.
Nursing assistants learn assertiveness techniques. Assertiveness is a communication technique that enables care providers to treat others with respect and dignity without giving up personal needs for respect and dignity. This skill requires patient persistence and can be readily adapted for personal interactions.
Nursing, like other professions, uses a common language that is based on its specialized knowledge and skills. Nursing principles and practices are universally interpreted and implemented because of nursing's universal, standardized patient care vocabulary.
Nurses and nursing assistants work independently and together to create therapeutic environments that support the healing process. Interpersonal conflicts are inevitable whenever people work together. Each person is responsible for his/her behavior, and proficient conflict managers know when and how to respond to negative messages in positive ways. Disagreements can and do result in new and better ways of doing things when discussion and dialogue occur at the right time in the appropriate forum. It is inappropriate to argue in front of patients during the completion of patient care tasks. It is appropriate to agree to discuss matters at a later time when tempers have cooled. Sometimes mediation assistance from immediate supervisors help to clarify and rectify work related disagreements.
Art of Diplomacy
Webster's defines diplomacy as the tact and skill of dealing with people. This is not an easy feat when dealing with people who are in crisis because of pain and discomfort due to injury, illness, or disability. Diplomacy is the learned knack of compromise that allows people to discuss issues without losing personal dignity. Diplomatic nursing assistants know how to prevent a confrontation or disagreement without loss of personal esteem. Let us say a nursing assistant is confronted by a head nurse in front of others and accused of not doing her job. This is an embarrassing situation that offers two choices of response. The first and most natural response is to respond in an angry manner. The second and preferred choice is to respond with diplomacy by taking a deep breath and saying, "When you confront me in an angry way in front of others, I feel devalued as a person." In this situation the head nurse was out of order, not by her accusations, but by the way she presented them to the nursing assistant. Choosing a carefully thought out response, the nursing assistant pointed out the nurse's negative message, and by her actions, refused to engage her in a verbal confrontation.
Criticism as a Positive Critique
The majority of nursing assistants need minimal supervision by others who have more knowledge and experience. Direct observation of work tasks by licensed nurses helps nursing assistants know what tasks they do well and what tasks need improvement. Objective discussion develops good give and take work habits and teaches nursing assistants how to accept constructive criticism in positive ways. Nursing assistants who encourage supervisor input show they are mature adults interested in doing a good job.
Critical Thinking Skills
Nursing assistants are taught to observe their patients for some possible reactions to established treatments and to report their findings to their immediate nurse supervisors. They use their senses of sight, hearing, taste, smell, and touch to observe patients' responses and look for potential problems. Problem identification and problem solution techniques are hallmarks within the nursing profession. These learned skills can be adapted to all job tasks and become useful in personal lifestyles as well.
On the job mentors are employee teachers. Experienced nursing assistants are often requested to work with those who have little job experience situations that offer mutual benefits. When experienced nursing assistants mentor others, they perfect their skills and learn how to interact with others in positive ways. When inexperienced nursing assistants observe and perform job tasks while supervised by experienced workers, they learn how to communicate and perform job skills correctly and with expertise.
Mentors are motivational counselors for less experienced nursing assistants. They are often called "buddies" and have administrative support to create good learning environments. A good learning environment is a place where people can learn without fear of embarrassment or reprisal. Mistakes are part of the learning process. Motivational counselors supervise others in positive ways. They correct mistakes as they happen in non judgmental conversation; they explain how to make needed work changes without appearing to be bossy. Motivational counselors don't make jokes about others' mistakes. They allow people to learn while maintaining their personal dignity. The work of motivational counselors is akin to parenting. Children often make mistakes, and effective parents know how to assist them to correct mistakes in positive ways.
Nursing assistants assist the dying and are taught to listen and to encourage family members to express sad feelings without being judgmental. Feelings of grief are not limited to those who are dying or to their family members, who must helplessly watch their loved one's death. Feelings of grief happen during different times of life whenever people are experiencing feelings of loss loss of jobs, lost personal relationships, job transfers that cause people to lose friendships and living in an area they enjoyed, children who must place their beloved aged parents in nursing homes because they are no longer able to care for them at home. These are examples of grief that can happen during our lifetimes. Grief counselors have learned the skill of being active listeners. Giving grieving people opportunities to vent their feelings is a healing experience for them and offers nursing assistants opportunities for personal growth as active listeners.
Job enrichment happens when nursing assistants approach their jobs in positive ways, looking for opportunities to learn and develop themselves. Learning and gaining new job knowledge and know how improves job performance and increases opportunities for job advancement and personal recognition.
Job satisfaction is knowing that you are doing your job to the best of your ability and are recognized and rewarded for your personal efforts.