Wisdom at Work

The Importance of the Older and Experienced Nurse in the Workplace

Variables such as flexible work hours, increased benefits, newly created professional roles, better designed hospital equipment and buildings, and an atmosphere of respect for nurses are central considerations for hospitals seeking to recruit and retain older nurses.

This report, supported by the Robert Wood Johnson Foundation, notes that retaining older nurses is one important strategy for stemming the national nursing shortage.

“There's a lot of attention to the need to recruit new nurses into the profession, and that is an important issue,” said Susan B. Hassmiller, R.N., Ph.D., F.A.A.N., senior program officer at the Robert Wood Johnson Foundation. “But we also need to take advantage of the knowledge and wisdom that experienced nurses build up over their years in practice, and to make changes that encourage more of those nurses to stay in their jobs.”

This study brings new insights to the question of retaining an aging nurse workforce; the average age of a nurse today is nearly 47 years. Retaining experienced nurses is especially critical given the high cost of nurse turnover, as well as increasing health care needs as baby boomers age.

Little research has been done to test which recruitment and retention strategies are effective with older nurses, but identified the study authors' review of the existing literature identifies four key themes that contribute to older nurses' decisions about continuing to work:

  • Health status
  • Financial status
  • Attitude toward retirement
  • Current job satisfaction

This study is one of the few to ask older nurses what would keep them working until retirement. In addition to conducting the literature review, the authors surveyed 377 nurses and held in-depth interviews with 13 experienced experts in health care systems design, executive leadership and management, patient-centered care, patient safety, and labor relations.

“The seasoned nurses we interviewed believe we must very quickly transform the work environment so that older nurses are welcomed, accommodated, appreciated and used wisely,” said lead study author Barbara J. Hatcher, Ph.D., R.N., M.P.H., director of the Center for Learning and Global Public Health at the American Public Health Association.

Among the changes cited to make nursing attractive to and supportive of older nurses:

Revised employment policies: Specifically, nurses called for greater flexibility in scheduling and innovative new nursing positions such as mentor, research assistant or safety officer. They also voiced interest in better employee-employer relationships and in smoother transitions into management.

Better ergonomics and health care design: To decrease the time nurses spend walking on the job and the physical demands of their work, nurses suggested mechanical patient lifts, decentralized storage of supplies, and better lighting at the bedside.

Improved introduction and use of technology: Nurses called for adequate training in the use of technology as well as input of experienced nurses in the choice of technology purchases. This input would help hospitals by outfitting equipment with, for instance, large enough fonts to be seen easily by older nurses, respondents said.

Changes in organizational culture: Nurses seek greater autonomy and participation in decision making. “Nurses are tired of doing a difficult job under stressful conditions and of not having their contributions acknowledged,” the report states.

Commitment to training and education: Older nurses said ongoing learning is especially critical to retaining senior nurses promoted to managerial or innovative positions that require new skills.

The study's authors also urge hospitals to learn more about “nurses' intent to leave their organization and the potential gaps created by retiring older nurses.” The report also warns of the high costs in terms of patient outcomes and safety when hospitals lose the knowledge of seasoned professionals.