Many reasons motivated Savannah Doll to work in a nursing home. Her aunt worked there, and it was a major employer in town. But, at 16, it was not the career she had in mind.

"What other job could you have in a small town?" she said.

Six years later, she still works in a nursing home while studying nursing at the University of Mary. She wouldn't want it any other way.

"They are unique as residents and in life; you help them take the final steps of their journey in life," she said.

Her work has taught her a lot about patience, respect and kindness, she said, and she enjoys the stories her residents tell her because they make each day unique. She works at Edgewood Vista in Bismarck as a certified nursing assistant.

A recent survey of long-term care workers show they have high job satisfaction. In 16 of 24 categories, 2,000 long-term care employees gave the highest rating on a MyInnerView survey that rates satisfaction among workers, residents and family members in long-term care facilities nationally. The North Dakota Long Term Care Association released the survey results at a press conference Tuesday at the Baptist Home in Bismarck. Doll took part in the press conference.

Overall, 71 percent of North Dakota long-term care workers reported high satisfaction with their work. Nationally, 64 percent of long-term care workers report high satisfaction with their work, while 47 percent of the the average U.S. workers report high job satisfaction.

But, the number of people working in North Dakota nursing homes and other longer term care facilities is dwindling. This segment of the work force is aging and there are fewer people like Doll coming in and filling positions as they open. Nationally, about 10 million workers may be needed by 2010.

"In Williston, competition for jobs is tight," said Kurt Stoner, administrator of Bethel Home and chairman of the North Dakota Long Term Care Association.

To compete, facilities have to offer hiring bonuses and tuition reimbursement, he said.

The worker shortage puts stress on the long-term care system in the state. Facilities in rural areas are hit the hardest by the shortage. This is because the younger workers are moving to the four urban areas of the state for education and not returning to their communities, said Shelly Peterson, president of the North Dakota Long Term Care Association.

Adding to the stress is a moratorium on new nursing home beds in the state. The Legislature capped the number of long-term care beds, making it difficult to get into facilities in urban areas without advanced planning. People from the urban areas end up in beds in rural areas, which are understaffed.

"It makes it much more difficult to access care," Peterson said.

There are projects to ease the demand for beds in the Bismarck area, but there could be difficulties in finding staff for the facilities because of the worker shortage, she said.

(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@bismarcktribune.com.)