This study of registered nurses was concerned with shortages of RNs in skilled nursing facilities (SNF) despite rising demand, and with the low prestige of those jobs making it difficult to recruit competent personnel.

Design was a random one-fourth (N = 11,600) sample mail survey of the 47,000 currently licensed Los Angeles County RNs. Usable sample size was 1859 (16.1%). The SNF sample was underrepresented; but there are also almost no published data on this population. The overall sample was generally representative of the nursing population, but somewhat better educated and better paid.

We comparised personal characteristics, jobs and attitudes of SNF nurses with nurses at other worksites; We analyzed perceptions of SNFs jobs by all nurses. Indexes of job attitudes and comparison of SNF with other jobs were developed after factor analysis. Multiple regression was employed to analyze nursing wages, job frustrations, satisfaction and quitting.

Findings. SNF nurses are significantly older, diploma trained, and receive about $4,000 less annual nursing wages and fewer fringe benefits (p < .05). They are likely to have completed a baccalaureate, and to have taken one or more years off from nursing (p < .05). Job conditions in the SNF are rated comparatively lower than other settings by all nurses, but SNF nurses rate them higher than other nurses. Ratings by nurses who worked in SNFs as students or have prior SNF experience were not more positive.

Job satisfaction is high among respondents and similar among SNF nurses. SNF nurses were more satisfied with administration (p < .05). They spend more time supervising than other nurses and report independent responsibility for patient care and management. We can not infer that SNF nurses are less qualified or performing less well at their work. Satisfaction did not predict intention to quit. Intention to quit was associated with frustration with working conditions. Although SNF nurses were more frustrated with working conditions, they did not report significantly different intention to quit.

Recommendations include increasing pay and benefits, publicizing potential rewards of SNF jobs, careful selection of SNF sites for nursing students, and affiliating SNFs with hospitals to tap existing nursing pools.