Factors Influencing Job Satisfaction Among Assisted Living RNs

There is a possible relationship between job satisfaction among registered nurses (RNs) working in long-term care communities and nursing staff turnover, and it may even be associated with quality of care for residents.

Research has identified relationships between job satisfaction among long-term care RNs and various structural characteristics of assisted living communities (such as staffing levels and non-profit/for-profit status), and it has been theorized that the organizational work environment is a mediating factor in these relationships. Empirical findings on such organizational characteristics, such as nurse participation in decision-making and support from managers, might identify modifiable elements in the assisted living community work environment that can improve job satisfaction. A recent study published in The Gerontologist identifies elements of a supportive work environment associated with higher job satisfaction among RNs.

Research on hospital-based RNs has identified features in the work environment that are associated with greater job satisfaction, but the assisted living community work environment differs from that of most hospitals, often involving a greater demand for physical care and greater supervisory responsibility for RNs. The authors of the study tested whether those supportive work features identified in hospital-based research were important to nursing home RNs by analyzing data of a large survey of RNs, randomly chosen from all RNs licensed in the state of New Jersey.

In total, 863 assisted living community staff RNs working in New Jersey completed surveys, representing staff from 282 of the state’s 347 certified assisted living homes. The surveys included multiple questions about job satisfaction that had been tested in earlier studies, such as perceived opportunities for advancement, independence, and overall satisfaction. The survey also included 31 items about perceived work environment on five different areas.

  • RN participation in community affairs (such as participating in policy decision-making)
  • Standards of care quality
  • Resource adequacy (including staffing)
  • Having a supportive manager
  • Collaborative relationships between RNs and physicians

The researchers were also able to acquire data on each of the 282 assisted living homes, providing them with information on the larger structural factors such as bed size, staffing levels, and ownership status. This enabled the researchers to factor assisted living home characteristics in their analysis.

Participation in facility affairs, adequate resources, and a supportive manager had the strongest relationships with RN job satisfaction. Unlike the hospital-based research, there was no statistically significant relationship between nurse-physician relationships and job satisfaction in this sample, which is large enough to be likely to detect such a relationship. The authors suggest that this may be less critical for RNs in assisted living homes, as physician involvement tends to be less direct and intensive than in hospitals.

This was a study of correlations between different aspects of work environment and job satisfaction, and thus cannot prove a causal relationship. However, the study identifies modifiable aspects of RN work environment that correlate with job satisfaction in assisted living homes, which may be useful toward improving job satisfaction, staff turnover, and quality of care.


Choi JS, Flynn L, et al. Nursing practice environment and registered nurses’ job satisfaction in nursing homes. The Gerontologist; (2012). 52(4): 484-492.

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