Exploring barriers to employee voice among certified nursing assistants: A qualitative study

Background Research shows that voice—the communication of ideas, concerns, and perspectives by employees to those in positions to instigate changes—is related to job satisfaction, retention, and organizational improvement. Nevertheless, health care professionals often do not exercise voice. Although researchers have explored the barriers registered nurses working in hospitals experience in expressing their voices, there has been a notable lack of attention in research and practice to the voice of certified nursing assistants working in long-term care settings. Purposes Ensuring that certified nursing assistants can exercise voice is essential for the welfare and well-being of this occupational group and critical for the success of their organizations. Therefore, we explore the barriers certified nursing assistants encounter that hinder them from exercising voice. Methodology We conducted seven focus groups in which 24 Dutch certified nursing assistants participated. Results The results show that respondents were not always willing to exercise voice, which stemmed primarily from negative prior experiences with exercising voice. Respondents were further not always able to exercise voice, as the conditions under which they had to do so were unfavorable. Finally, respondents sometimes lacked the necessary skills to convey their ideas, concerns, and perspectives effectively. Practice Implications Our findings indicate that health care managers must address multiple factors if they wish to enhance the voice of certified nursing assistants.