State Tested Nursing Assistants’ Workplace Experiences That Threaten or Support Intent to Stay



Over 1 million Americans utilize skilled nursing facilities (SNFs) annually. Within SNFs, State Tested Nursing Assistants (STNAs) are primary caregivers; however, low retention rates are notable and threaten patient care.


A phenomenological, qualitative study was conducted to explore intrinsic factors that influence STNAs’ intent to stay in their positions.


Ten STNAs employed at for-profit SNFs participated in semistructured face-to-face interviews. Data were analyzed to identify broad concepts and recurrent themes.


Findings suggest that intrinsic factors supporting and threatening intent to stay included the fulfillment of basic psychological needs. Supporting themes included self-confidence, appreciation, positive relationships, and a willingness to go beyond required duties. Threatening themes included frustration, lack of support, and career advancement opportunities.


Findings provide an understanding of factors that influence STNAs’ intent to stay.

Clinical Relevance 

The results may help guide the development of responsive strategies that improve quality and continuity of care in SNFs.