Preparing New Grad CNAs: 4 Strategies for Nursing Facilities

Well-prepared CNAs are not just “nice to have” in senior living facilities. They are a necessity for providing holistic and comprehensive quality care. CNA turnover in nursing facilities has long been a challenge. However, recent studies have shown that the problem continues to worsen. In fact, one study cites an average turnover rate of 78.1% for CNAs in nursing homes. This statistic illustrates the importance of best practices for onboarding new graduate CNAs to mentor and support them in their new roles. 

While training programs provide the foundational knowledge CNAs need, they are not an actual strategy for addressing the challenges faced by new-grad CNAs on the job and won’t help manage and control your hiring pipeline. Nursing facilities must implement specific strategies to effectively onboard and continue training efforts for new-grad, leading to increased job satisfaction, retention, and improved patient outcomes. 

Let’s look at this issue in more depth and discuss four strategies you can use to answer the age-old question of how to reduce CNA turnover in nursing facilities. 

Understanding the Challenges Faced by New Grad CNAs

The first 90 days of any new job are challenging. However, transition shock, skills gaps, and a lack of confidence and coping skills can make this time overwhelming for new CNAs. Let’s review these challenges to understand better the importance of creating a supportive work environment for CNAs. 

• Transition Shock: Moving from the classroom to the real world can be shocking if the CNA has never been in a clinical environment. Not only will some CNAs perform many of the skills they learned for the first time, but they might also have to make countless practical adjustments to skills learned in the classroom because they simply don’t work in the live clinical setting. 
• Skill Gaps: While performing skills like perineal care, dressing, and mealtime assistance can seem daunting, many necessary soft skills aren’t taught or given the emphasis they need in CNA training programs. This failure can leave CNAs not realizing the importance of practical skills like time management, prioritization, and communication. 
• Confidence and Anxiety: Most clinicians can relate to their first clinical role being challenging and even a bit scary. However, because CNAs only receive a few months of training, the first days or months on the job can evoke feelings of insecurity and overwhelm. These feelings can become downright crippling if employers fail in addressing the challenges faced by new grad CNAS.
• Lack of Mentorship and Support: Long-term care facilities face daily CNA staffing challenges. This reality can make mentorship, preceptorship, and general support for CNAs nearly impossible. A lack of support might tempt new-grad CNAs to quit and look for employment outside of healthcare.

Strategies for Effective Onboarding and Continued Training

The number of challenges nursing facilities face when looking for strategies to retain essential team members can feel overwhelming. The good news is that there are best practices for onboarding new graduate CNAs that you can integrate into your facility’s culture and policies. 

So, let’s review the top four strategies for retaining new CNAs in long-term care. 

Implement a Comprehensive Orientation Program

Best practices for onboarding new grad CNAs start with creating a comprehensive orientation program and prioritizing workforce policies. This program must include your facility's culture, mission, values, and the importance of resident-centered care. A few strategies you can use include: 

• Introducing new CNAs to the interdisciplinary team and the roles within it.
• Reviewing policies and procedures in detail, with opportunities for Q&A.
• Providing continuous hands-on training with equipment and supplies.
• Emphasizing safety protocols and infection control practices.

Develop a Structured Mentorship Program

One fantastic way of creating a supportive work environment for CNAs is to develop a mentorship program. You can pair new graduates with experienced CNAs, nurses, or other staff members to help them navigate the job’s challenges and obstacles. When developing a mentorship program for CNAs, provide clear guidelines and expectations for mentors and set aside time for mentor-mentee interactions and feedback sessions. Ask mentors to focus their time and energy on practical skills, problem-solving, emotional support, and helping new team members fit into the facility culture. 

Create Gradual Integration and Workload Management Systems

Many facilities struggle with the hard decision of cutting orientation programs short due to inadequate staffing. However, providing adequate orientation time and gradually increasing workloads is key to addressing the challenges faced by new grad CNAs. A few strategies you can implement include:

• Starting with a lighter patient load and gradually increasing responsibilities.
• Allowing ample time for observation and shadowing.
• Providing opportunities to ask questions and seek clarification.
• Hosting frequent meetings with new staff to see how they feel about the job.

Provide Ongoing Education and Professional Development 

Many facilities offer ongoing education and professional development courses for nurses or therapists. However, it’s critical to embrace the role of continuing education in CNA development if you’re looking for ways to increase retention and job satisfaction among your nurse aide workforce. 

You can begin by offering continuing education opportunities, such as workshops, conferences, and online courses. Developing a career ladder can also create options for CNAs seeking leadership and skill development opportunities. These offerings support career advancement and specialization within the CNA role. 

Putting a Plan Into Action

Addressing the CNA turnover crisis in senior living facilities requires a multifaceted approach to prepare CNAs for success. By understanding the unique challenges faced by new graduate CNAs – from transition shock and skill gaps to confidence issues and lack of support – facilities can implement targeted strategies to foster a more supportive and enriching work environment. 

Implementing comprehensive orientation programs, structured mentorship, gradual integration and workload management, and ongoing education and professional development are crucial steps toward not only improving CNA retention rates but also elevating the quality of care provided to residents. Investing in CNAs is an investment in the future of senior care, ensuring a stable and skilled workforce dedicated to providing compassionate and comprehensive care.