The Imperative to Retain Experienced Nurses

    • November 23, 2008

"You can't replicate living a long time and learning a lot."

Those words, from Peggy Hewlett, Ph.D., R.N., dean and professor at the University of South Carolina College of Nursing, sum up the challenge facing our nation as a generation of skilled and experienced nurses nears retirement. But the difficulties ahead can be mitigated if we find ways to extend the careers of experienced nurses, and transfer their knowledge to the next generation.

Hewlett spoke in October at the second annual grantee convening of Wisdom at Work: Retaining Experienced Nurses, a Robert Wood Johnson Foundation (RWJF) project looking at ways to do just that. The project is building an evidence base about what works to retain experienced nurses in hospital settings and develop a better understanding of the impact of various interventions. Some 50 nurses and other experts from around the country met in Princeton, N.J., to share research results and promising practices gleaned during the multi-year project.

Schools of nursing have responded to the nursing shortage, putting more young nurses in the pipeline, said Michael R. Bleich, Ph.D., R.N., F.A.A.N., dean and distinguished professor at the School of Nursing, Oregon Health & Science University. As a result, the field has many new nurses at the beginning of their careers. That creates an imperative, he said, to keep experienced nurses in the workplace and transfer knowledge to their younger colleagues.

The loss of veteran nurses has already caused extremely serious consequences, said David DeLong, D.B.A., M.P.A., of David DeLong & Associates. As an example, he mentioned hospitals that have had to suspend cardiac surgery and put less effective teams in critical care units because of a lack of experienced nurses. DeLong warned that the nursing shortage is likely to get worse before it gets better. He said other industries face similar challenges, noting that 60 percent of petroleum engineers are expected to retire by 2010 and few students are being trained to replace them. 

DeLong challenged meeting participants to think "outside the box" to solve the nursing shortage, identifying keys to sustaining a highly skilled nursing workforce that include getting more qualified students through nursing schools; aligning nursing curricula to meet the needs of clinical practice; and developing an adequate pipeline of future nursing leaders. He stressed the importance of building a multi-generational workforce and recognizing that both older and younger nurses have value. "The cost of generational conflict is too great," he concluded, making a powerful case for collaboration rather than competition.

The two-day event featured remarks by Susan B. Hassmiller, Ph.D., R.N., F.A.A.N., the Foundation's senior adviser for nursing, who stressed that nursing is a high priority for RWJF, which has 58 programs in place that focus entirely on nursing or have nursing components. Hassmiller noted that the Foundation's upcoming nursing work will be innovative and also place a priority on amplifying nurses' role in health care reform.

The project's white paper, Wisdom at Work: The Importance of the Older and Experienced Nurses in the Workplace, has long been one of the Foundation's most downloaded documents. Policy-makers, health industry leaders, providers, consumer groups and nurses themselves are among those anxiously awaiting the project's final products. They will include a series of case studies that examine the policies select hospitals and health care organizations are using to retain experienced nurses, as well as results from 13 research projects that looked at ergonomics, staffing initiatives, culture and benefit policies, and other issues to determine their impact on nurse retention. Final products are due out early next year.

To view the upcoming case studies due out early next year, research results and other information on Wisdom at Work: Retaining Experienced Nurses, please visit later this year.