Job dissatisfaction and burnout among nurses is fueled by “out of touch” managers and “disconnected” senior executive leadership, according to a new report from the Massachusetts Institute of Technology.
Researchers from the MIT Sloan School of Management analyzed 150,000 Glassdoor reviews by nurses at 200 large healthcare organizations, including senior living, skilled nursing and home healthcare providers, as well as staffing agencies, hospitals and healthcare systems.
That data were used to create the Nursing Satisfaction Index to compare how nurses evaluated the employee experience from the beginning of the pandemic through June 2023.
Although workload and compensation were identified as root causes for nurse-related staffing challenges in healthcare settings, they weren’t the only factors influencing job satisfaction. Other factors contributing to a poor work environment included a toxic culture, inflexible work schedules, lack of communication, limited learning and development opportunities, and little organizational support, according to the report.
The researchers also found that perks and reminders about corporate mission statements were “unlikely to move the needle” in improving the workplace experience.
The rankings, they said, are not designed to “name and shame” but rather are meant to inform healthcare leaders of the magnitude of the gap between organizations’ performance and what is possible in terms of providing a healthy workplace for nurses.
Providers ranked
Eleven organizations were included under the “senior living and rehabilitation” category of the report, which also included skilled nursing providers. Home healthcare and hospice providers were included in a separate category.
Trilogy Health Services rated highest overall in the senior living and rehabilitation category among Glassdoor reviews from nurses, ranking No. 1, whereas Genesis HealthCare ranked lowest, at No. 11. Sunrise Senior Living (No. 7) and Brookdale Senior Living (No. 8) were the only majority senior housing-focused organizations on the list, although other organizations have senior living among their offerings.
Sunrise had 156 reviews included in the analysis, revealing that nurses had negatively discussed toxic culture, senior leadership, workload and compensation in their reviews. Organizational support saw more favorable mentions among Glassdoor reviews for the organization.
Sunrise Senior Living Manager of External Communications Heather Hunter told McKnight’s Senior Living that the organization “deeply values” the insights shared by employees, especially nursing staff members, and that the company’s goal is to remain a “supportive, fulfilling and nurturing environment for all, including our hard-working nurses, who play a vital role in our communities.”
“Our commitment to fostering a positive work environment is reinforced by a robust listening strategy, wherein we actively seek and appreciate feedback from our team members, including considering this Nursing Satisfaction Index,” Hunter said. “We take all feedback seriously and use it to inform continuous improvement.”
She added that the organization is proud of its consecutive recognition on Fortune’s 2023 Best Workplaces in Aging Services list for large senior living and care employers, calling the achievement “a testament to our ongoing efforts to create a workplace where every team member can thrive.”
Brookdale had 283 reviews in the report, showing that nurses negatively discussed toxic culture, senior leadership and organizational culture in their reviews, whereas the country’s largest senior living company scored among the middle of nurse ratings for compensation and workload.
Other providers included in the senior living and rehabilitation category included Right at Home, No. 2; Evangelical Lutheran Good Samaritan Society, No. 3; Select Medical, No. 4; National HealthCare Corp., No. 5; Encompass Health, No. 6; PAM Health, No. 9; and Life Care Centers of America, No. 10.
Take a cue from staffing agencies
Overall, nurses who worked for staffing agencies were more satisfied, on average, than nurses employed in other settings: six of the top 10 highest-ranked employers were staffing agencies. Although higher compensation accounted for part of the reason for the higher placement, staffing agencies also scored more favorably on solving nurses’ problems and providing open, honest communication.
The top staffing agencies also were rated highly for listening to nurse feedback, understanding typical problems nurses face on the job, and optimizing work processes to address any issues.
The researchers suggested that although senior living and care providers, home health agencies and healthcare systems have different “pain points” for nursing staff, those employers can adopt similar approaches to gathering feedback, prioritizing common challenges and working with staff members to address those issues.
“By focusing on nurses as clients, staffing agencies excel at practices that improve satisfaction beyond simply paying higher wages,” according to the investigators. “Other healthcare leaders can learn from their example.”
Exit interviews valuable
Exit interviews can provide a treasure trove of feedback on how to retain employees and uncover potential blind spots, according to the researchers.
Among nurses who left their jobs, a toxic culture was more than twice as predictive of their overall job satisfaction than were compensation or workload. Toxic culture, the authors noted, has become more important for nurses in the post-pandemic era. That factor experienced the largest gain in importance, followed by workload, well-being and compensation as reasons for leaving the field.
