Considering the employee point of view: perceptions of job satisfaction and stress among nursing staff in nursing homes.

OBJECTIVE To document job satisfaction and sources of stress among nursing staff working in nursing homes and to evaluate the extent to which the reasons of stress differ by type of nursing staff. DESIGN Cross-sectional study. SETTING Twenty-five nursing homes in North Carolina participating in a demonstration project of a new model of long-term care pharmacy. PARTICIPANTS Nurses and nursing assistants employed at the time of the survey in the spring and summer of 2002 (n = 1283). MEASUREMENTS Health Professional Stress Inventory modified for use in the nursing home setting and ratings of job satisfaction. RESULTS The situations most stressful for nurses were not having enough staff, having too much work to do, interruptions, having non-health professionals determine how to do their job, poor pay, and ultimately being responsible for patient outcomes. The top most stressful situations for nursing assistants included poor pay, not enough staff, and too much work to do. Nursing assistants were more likely than nurses to report stress because they do not have adequate information regarding a patient's condition. Nurses were more likely than nursing assistants to report stress because non-health professionals (eg, surveyors) determine how they must do their job. CONCLUSIONS The findings of this study support the need to improve recognition for nursing, improve staffing, and provide competitive compensation in nursing homes.