| Nurse and nursing assistant relationships have been identified as key to the present long term care (LTC) "Care Crisis" (Bryant & Stone, 2008; Douglas, 2010, 2011; Eaton, 2000, 2001; IOM, 2008; Sikma, 2006). Co-worker interdependent relationships impact reciprocal caring behaviors, quality of care (DeMarco, 1998; Demarco, Horowitz, & McLeod, 2000; Havens, Vasey, Gittell & Lin, 2010), nursing practice (Rosentein & O'Daniel, 2008) and retention (Rosentein, 2002).This dissertation investigated reciprocal caring perceptions of nurses and certified nursing assistants in LTC and their impact relative to quality of care, retention, absenteeism and turnover. The Nurse and Nursing Assistant Caregiver Reciprocal Scale (NNA-CRS) (Yen-Patton, Dowling & Clayton-Matthews, 2010) measured reciprocal caring perceptions. NNA-CRS domains of Balanced Reciprocal Caring teamwork and Intrinsic Rewards were significant for intention to stay at the same facility. A one-point increase in NNA-CRS was estimated to increase the odds of intending to stay by a factor of 1.86 with a 95% C.I. [1.57 to 2.19]. A one-standard deviation increase in reciprocal caring perceptions was estimated to increase the odds of intending to stay by a factor of 2.64 or 164 % and the probability of intention to stay by .16 or 16 percentage points. One out of six persons with high reciprocal caring would more likely be retained than those with lower reciprocal caring perceptions. NNA-CRS domain of Intrinsic Rewards was positively correlated with absenteeism. One-third of the sample reported not intending to stay suggesting lack of balanced caring teamwork as a barrier to intrinsic reward attainment. These findings validate the constructs of reciprocal caring as significant to retention and absenteeism outcomes in LTC. |
