Nebraska Center for Nursing
Retaining the Older Nurse in the Workplace
Dr. Liane Connelly-UNMC College of Nursing
Spring 2013
For this report, a literature search was conducted on articles and research studies related to the older nurse and retention strategies. Fourteen articles were reviewed with one published in 2003 and the remaining published from 2005-2012.
For this topic, research articles and reports were from Great Britain, Canada, New Zealand, and the United States. According to Graham & Duffield (2010), very little attention has been given to the aging workforce and how to retain older nurses. They urge health managers to discover strategies that will encourage their nurses to extend their working life.
In 2012, Winnipeg Oaks General Hospital conducted a project in which they surveyed nurses regarding their needs as older workers (Dziadikwich, Andushko, & Klassen, 2012). This information was then used to develop a pilot project in which those needs were addressed. This resulted in the development of an older worker’s leave (OWL), a continuing education program on work-life balance and retirement planning, development of a compressed workweek schedule, a nurses mentor program and a knowledge transfer toolkit. These projects received overall positive results, and the hospital is continuing to offer them. However, due to financial constraints, the OWL could not be continued.
Clendon & Walker (2012) recently completed a survey on the needs of older nurse in New Zealand. Most nurses in the study (N=3273) reported that they identified themselves as healthy, and female nurses ranked themselves as significantly healthier than women in general. The more physically demanding the job, the more nurses reported pain. Those nurses who planned to retire sooner reported a lower perceived health score. Those who were 50-55 reported planning to retire at 65; however those aged 60-65 were more likely to intend to retire at 65-70. Married women were more likely to report plans to retire earlier than single women. Nurses responded that better pay, more appreciation of their work, and better access to continuing education were important contributors to remaining in the workplace. Older nurses reported increasing difficulty managing shift work as they aged. These researchers recommended that employers develop strategies to support older nurses who remain in the workforce. Some recommendations included flexible schedules, career planning, plans to work in less physical roles, and ensuring that older nurses are valued in the workplace.
In 2009, a UK study of 485 nurses conducted by Storey, Cheater, FordLeese provided a cross-sectional view of the factors that impact retention. Issues important for older nurses to stay in the workplace included pension considerations, reduced working hours near retirement, and reduced workload. Nurses may leave due to high administrative workloads, problems in combining work and family commitments and lack of workplace support. This study reported that 2/3 of the nurses were happy in their role, so recommendations included retaining factors that enhance retention throughout the work life cycle. Another study in 2009, (Harris, Bennett, Davey & Ross) identified that the nature of nursing poses a challenge to flexible working hours, and in fact the flexible schedules for younger nurses was a potential barrier to flexible schedules for older nurses.
Gabrielle, Jackson & Mannix (2008) conducted semi-structured interviews with Australian nurses between the ages of 40-60 years to explore the views and experiences of this cohort of professionals regarding work in community and acute hospital settings. Their findings suggest that nurses in this age range experience feeling uncared for, and have an identified need to adapt to their own aging in their nursing career. These unmet needs could discourage them from remaining in nursing.
The Robert Wood Johnson Foundation (RWJF) report, Wisdom at Work (2006), highlights the importance of the older, experienced nurse in today’s workplace. According to this report, best practices to contribute to retention of the older nurse include applying evidence-based practice criteria for the retention of older workers, including resources needed to apply best practices. Partnering with national nursing organizations and groups to bring together constituents who can advance the role of the older nurse in the workplace is essential. Through work with AARP and others, determine the feasibility of boosting 401 (k) participation, portable pensions, and other types of benefits that are applicable to the older worker. In addition the report recommends that healthcare facilities adopt workforce planning measures for the right mix of generations in the workplace. The creation of a web-based tool can help health care facilities gather pertinent information about their workforce. Finally, RWJF recommends the development of a learning laboratory that can help design tools and medical innovations that are better adapted to the needs of older health professionals working at the bedside. Other specific recommendations include providing care-giving and grief resources, developing corporate cultures that value the older worker, considering flexible work options, providing for knowledge transfer paired with phased retirement, creating mentoring programs, considering phased retirement options, providing retraining, and talent management. In addition, magnet status designation and the attention to overall job satisfaction strategies can be helpful to retain older nurses (see appendix A and B).
It is clear that strategies do exist to help retain the older nurse in the workplace. The development of a toolkit to assist health care facilities in their quest to retain seasoned nurses is an important goal for the health of Nebraska.
Bibliography
Clendon, J. & Walker, L. (2012).Surveying the needs of older nurses.Kai Tiaki Nursing New Zealand, 18 (7) 28.
Dziadekwich, R., Andrushko, K., Klassen, K. (2012). A new approach to retaining older workers. Canadian Nurse 108(6) 18-20.
Gabrielle, S., Jackson, D., & Mannix, J. (2008). Adjusting to personal and organizational change: Views and experiences of female nurses aged 40-60 years. Collegian 15, 85-91.
Graham, E., Duffield, C. (2010). An ageing nursing workforce. Australian Health Review 34, 44-48.
Harris, R., Bennett, J., Davey, B. & Ross, F. (2009). Flexible working and the contribution of nurses in mid-life to the workforce: A qualitative study. International Journal of Nursing Studies 47 (2010) 418-426.
Leese, B., Storey, C., Cheataer, F. (2009). Retaining primary and community nurses over the age of 50 years: the views of managers. Journal of Nursing Management, 17, 975-985.
McIntosh, B., Rambur, B., Val Palumbo, M. & Mongeon, J. (2003). The older nurse: Clues for retention. Nursing and Health Policy review 2(2), 61-77.
Storey, C., Cheater, F., Ford, J. & Leese, B. (2009). Retention of nurses in the primary and community care workforce after the age of 50 years: database analysis and literature review. Journal of Advanced Nursing, 65 (8), 1596-1605.
Storey, C., Cheater, F., Ford, J. & Leese, B. (2009).Retention of older nurses in primary care and the community. Journal of Advanced Nursing, 65 (7), 1400-1411.
Hatcher, B., Bleich, M., Connolly, C., Davis, K. O’Neill, P., & Stokley Hill, K. (2006). Wisdom at Work: The importance of the older and experienced nurse in the workplace. Robert Wood Johnson Foundation.
Tabone, S. (2006).Retaining older nurses-and their knowledge-in the workforce.Texas Nurse, November-December.
Trossman, S. (2011). The go to nurses, finding ways to keep long-time RNs. Accessed January 22, 2013:
Trossman, S. (2006).Staying Power?Retaining mature RNs in the workforce.American Journal of Nursing 106 (7) 77-78.
Val Palumbo, M. McIntosh, B., Rambur, B. & Naud, S. (2009). Retaining an aging nurse workforce: Perceptions of human resource practices.Nursing Economics, July-August, 27 (4).Pg 221-232.
Appendix A-Recommendations Fromthe RWJF Report
Ergonomics and Health Care Work Design
•Mechanical patient lifts and devices to aid ambulation
•Decentralization
•Patient privacy
•Lighting schemes
Human Resources
•Schedule flexibility, expanding roles (creative positions-there is funding available for innovation-see pg 30 of RWJF report), advancing employee-employer relationships and developing new career paths (professional nurse practice)
Technology
•The introduction of technology in the workplace-use of different learning methods for older nurses
•Involve bedside nurses in the decisions about technology
•Involve technology to improve patient safety with alert systems, etc.
Organizational Culture
•Work cultures that support nursing practice autonomy and nurse participation in operational decisions
Training and Continuing Education
•Provide convenient continuing education using online and distance technology
Third-Party Reimbursement Policies
•Nurses can provide wellness services and reimbursement structures need to change to reflect the skills that nurses can provide in promoting wellness
Change Union Policies
•Unions can advocate for the individualization of benefits
National Policy Changes
•Portable pensions
•Establish national policies promoting retirement from direct case as an opportunity for transition into another area of nursing without punitive results.
Other Ideas
•Focus on commonalities, not differences among generations
•Reduce injuries
•Multiple learning modalities
Appendix B
Based on this review of literature, other current recommendations regarding the retention of the older nurse in clinical practice that were not included in the RWJF project include:
•Keep the organization’s workforce in generational balance
•Assist in communication skills to decrease intergenerational misunderstandings and conflict
•Increase efforts to reduce physical exertion, improve schedule flexibility, preventative care and succession planning.
•Recognize that today’s older nurse may view their current position as not complete upon retirement and may consider alternative roles
•Recognize that nurses are willing to extend work if the organization creates a responsive work environment
•Organizations who address older worker’s needs will increasingly gain a competitive advantage
•Recognition, respect, having a voice and receiving ongoing feedback continue to be important factors among older nurses, and may be more important than compensation
•Recruit older nurses
•Encourage ongoing development of the older nurse
•Compensation
•Financial planning for retirement
•Culture to support older nurses
•Provide care-giving and grief resources
•Create mentoring programs
•Consider phased retirement options
•Provide retraining, and talent management
•Magnet status designation and the attention to overall job satisfaction strategies can be helpful to retain older nurses as well.
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