Abstract:
PURPOSE-Administrators of nursing homes are turning over at very high rates in the present
industry. With the growth of older populations needing skilled nursing care, this
presents a risk to the needs of the elderly. Satisfaction and turnover have been
correlated in the literature. The purpose of this qualitative study was to explore
dimensions of satisfaction and dissatisfaction among nursing home administrators in
order to ascertain constructs potentially contributing to dissatisfaction in the industry.
METHODS-Informational letters were mailed to all licensed administrators in the state (N=143)
who were then randomized to receive follow-up invitational phone calls to join the
study. Those interested in participating were asked a few short screening questions
about their tenures in the industry and overall perceptions of satisfaction. Interested
participants were then divided into 3 different strata based on their tenures. Purposive
sampling informed the choices of participants and selected 10 from each of the
shortest, longest, and most dynamic tenures. Interviews occurred on nursing home
sites around Oregon. Grounded theory was used in a priori analysis by means of a
coding paradigm in order to allow emergent data to reveal substantive categories in a
theoretically directed pattern of coding, contrasting, verifying, and eventually
grounding new theory in data.
FINDINGS-Allowing the data to emerge in analysis of satisfaction and dissatisfaction revealed
two corresponding core categories, Constraints to the Job and Meaningful Work.
Constraints to the Job included 4 categories: Bureaucratic Constraints, Budgetary
Constraints, Personnel Constraints, and Ethical Constraints. Meaningful Work
included Working Conditions and Meaningful Interiors. As dissatisfaction and
satisfaction were further compared and verified, theory grounded in data emerged and
revealed that constraints to the job obstruct an administrator's autonomy, which in turn
impedes the ability to engage in meaningful work and contributes to dissatisfaction.
CONCLUSIONS-While constructs of dissatisfaction emerged, administrators on the whole revealed high
satisfaction with their positions. Future studies should concentrate on the bureaucratic
constraints to the job as these constraints were perceived as extremely dissatisfying
and hold political implications for state and corporate policies.
