Wisdom at Work: Retaining Experienced Nurses

An RWJF National Program

Field of Work: Building an evidence base of what works to retain experienced nurses in hospital settings.

Problem Synopsis: In 2008, close to 45 percent of nurses were 50 years of age or older, compared with 33 percent in 2000 and 25 percent in 1980. When an older nurse leaves a longstanding hospital position, knowledge is usually lost and must be relearned by younger, less experienced nurses, with resulting impacts on cost, organizational performance and—many experts believe—patient safety. Replacement of nurses at any level is costly. Recruitment, hiring and training consume financial and staff resources.

Synopsis of the Work: Wisdom at Work: Retaining Experienced Nurses (July 2006 to October 2010) supported the evaluation of 13 initiatives already in place aimed at retaining experienced nurses in hospitals: six "ergonomic projects," such as patient lift teams and equipment designed to reduce physical practice burdens; four "staffing projects" that used human resource strategies to improve organizational culture and retain experienced nurses; and three "other projects" that addressed employee wellness, clinical technology or leadership development.

The evaluation team also conducted case studies of seven top performing organizations—four health care and three non-health care­—to identify proven and innovative worker retention strategies and approaches that could be applied to the retention of experienced nurses.

Key Results

  • There is no single intervention that on its own will improve the retention of experienced nurses, according to Colleen Hirschkorn, RN, MPA, evaluation director.

Key Findings

  • Evaluation of The Robert Wood Johnson Wisdom at Work: Retaining Experienced Nurses Research Initiative reported that the 13 interventions evaluated did not have a positive impact on the retention of experienced nurses—although turnover varied.

  • Wisdom at Work: Retaining Experienced RNs and Their Knowledge—Case Studies of Top Performing Organizations reported that achieving and sustaining success in retaining experienced workers requires multiple efforts that build on two factors: organizational leadership that is committed to building and sustaining a corporate culture valuing experienced workers; and structured, organization-wide focus on managing and developing talent.