Ageism in Nursing: A Pervasive Problem
As the nursing workforce continues to age, it is imperative that age discrimination becomes a relic of the past. We must retain our older and most expert nurses. Their skills and contributions should be valued and celebrated.
Mary stewart, age 62, has worked as a registered nurse on the postpartum unit for the past quarter century. She began her long career in nursing in 1972, with her graduation from a nursing diploma program. Mary is capable, knowledgeable, experienced, and possesses well-developed interpersonal skills. She is adept in assisting mothers and newborns with their physical and emotional needs immediately after delivery. As a preceptor and mentor, she passes on her wisdom and knowledge to the younger nurses and new graduates on the unit. Over the years, mary has consistently received outstanding performance evaluations.
Due to dire economic conditions, her small community hospital was recently sold to a large hospital chain and the postpartum unit is now under new management. The new nurse manager does not value mary's vast experience, skill, and knowledge. Much to the contrary, mary senses increasing workplace hostility as she is singled out and undermined. During a six month period, mary is written up four or five times by the new nurse manager for petty, trivial things, such as not writing her name on the board in a patient's room. For the last write-up, she is suspended for three days. Mary believes that she is being targeted solely because of her age, as the younger nurses on the unit are not receiving such harsh criticism, nor are they being micromanaged. Eventually, she is fired for "poor performance." heartbroken, mary opts to retire from nursing altogether.
Mary's case, unfortunately, is not atypical. Cases based on age discrimination are not new, nor are they rare. Ageism is defined as negative attitudes, stereotypes, and discrimination against people based sheerly on age. Since we live in a culture that is youth-driven and youth-obsessed, ageism is pervasive throughout our society. This pervasive ageist attitude has profound implications for nurses, because the nursing population is aging more rapidly than the workforce as a whole. Ageism spawns a stubborn cache of harmful and hurtful negative stereotypes concerning older nurses that can result in unfair treatment directed towards them.
Common negative stereotypes concerning the older nurse:
- older nurses cost more. they have more illnesses, use more health care benefits, and use more sick time than younger nurses.
- older nurses are unable to fully meet staff nursing job requirements. they no longer have the physical strength to meet the demands of the job.
- older nurses are less flexible and adaptable and therefore, are difficult to train or teach.
- older nurses are slow. they exhibit reduced speed and efficiency.
- older nurses are resistant to change.
- older nurses are unable to learn new technology, such as computer charting.
- older nurses lack enthusiasm. they are less motivated or creative than their younger counterparts.
Stereotypes are unfair, as they are based on sweeping misperceptions and prejudice, but do not take into consideration the actual facts that define the individual person. For instance, i know some practicing nurses in their 60s who can run circles around nurses half their age.
Legislation that prohibits age discrimination in employment:
Not only is ageism harmful and destructive, but it is illegal as well. Both federal and state laws prohibit discrimination based on age and protect employees from age-discrimination. Age is one of 10 protected classifications in u.s. Anti-discrimination law, such as race, gender, and disability.
The age discrimination in employment act (adea) prohibits, in general, discrimination against employees, or individuals seeking employment, starting at age 40 or older. Discriminatory actions based on age can take place within the following job functions: recruitment and hiring, promotion, transfer, wages and benefits, work assignments, leave requests, training and apprenticeship programs, discipline, layoff, and termination.
Grievances concerning age discrimination can be filed with the following federal agencies:
- U.S. Equal Employment Opportunity commission (EEOC)
- U.S. Department of Labor
- Office of Federal Contract Compliance Programs (OFCCP)
As the nursing workforce continues to age, it is imperative that age discrimination, such as the unfair treatment that mary endured, becomes a relic of the past. Performance evaluations should be based on the individual's ability to perform essential job functions without consideration of age. We must retain our older and most expert nurses. Their skills and contributions should be valued and celebrated.Last edit by Joe V on Sep 10, '12
VickyRN is a certified nurse educator (NLN) and certified gerontology nurse (ANCC). Her research interests include: the special health and social needs of the vulnerable older adult population; registered nurse staffing and resident outcomes in intermediate care nursing facilities; and, innovations in avoiding institutionalization of frail elderly clients by providing long-term care services and supports in the community. She is faculty in a large baccalaureate nursing program in North Carolina.
Joined: Mar '01; Posts: 12,046; Likes: 6,497
Nurse Educator; from US
Specialty: 16 year(s) of experience in Gerontological, cardiac, med-surg, pedsJun 30, '12I find it's the other way around. You're new, excited, have the knowledge and skills to function safely and you want a job? Sorry, need 5 years experience. You want a normal shift so you can handle your new career? Sorry, you work every holiday and the worst assignments and nights and weekends 'cause you don't have seniority. Not to mention how horrible and cruel some of the older nurses treat you...Jul 1, '12Quote from JZ_RNSorry to hear about your frustrations. But it is expected protocol in any career situation (whether the dime store or the medical-surgical unit at the hospital) that the senior employees have their pick of shifts, holidays off, etc. They have earned that right through their years of loyal service on the job. To expect anything else is a sense of entitlement. And there you go with another ageist stereotype (one I forgot to mention in the article) - Older nurses are crusty old bats who are cruel and mean. Some older nurses may well be crusty and mean, but I have met my share of younger nurses who are passive-aggressive and vicious. Most nurses I have had the pleasure of knowing throughout my career - whether old, young, or somewhere in between - are kind, helpful people. Let's throw the stereotypes out - each nurse should be judged solely on the basis of his or her merit.I find it's the other way around. You're new, excited, have the knowledge and skills to function safely and you want a job? Sorry, need 5 years experience. You want a normal shift so you can handle your new career? Sorry, you work every holiday and the worst assignments and nights and weekends 'cause you don't have seniority. Not to mention how horrible and cruel some of the older nurses treat you...Jul 1, '12Thank you for another insightful article, VickyRN.
I just wanted to point out that many employment advertisements are written with borderline hints of ageism. Many request 3 to 5 years of experience. They do not want 15, 20, or 30 years of experience, nor do they ask for 0 to 1 years of experience. They're specifically looking for 3 to 5 years of experience.
If you think about it, the typical educated professional with 3 to 5 years of experience is going to be in his or her mid 20s to early 30s if this is one's first career. This is the preferred age range for many companies. It's a dirty little secret in corporate America.
Unfortunately, some managers are secretly hoping that the 50-year-old second career nurse with 3 to 5 years of experience does not arrive at the interview because this is not the age range that they were envisioning when they advertised the job opening.Jul 1, '12Vicky-This is a fantastic article and long over due. I have been on the recipient end of what you describe many times at age 56yr with 30 years acute care bedside experience.I have managed to sustain employment in nursing for the past 4 years with temporary- time limited positions that I knew from the start they were only 3 months and 6 months, perdeim agency here and there and the Immunization Clinics every Sept - Dec. All of which have been at a significantly lower pay rate that what I had been at in the hospital and my peers were making in my area. Don't get me wrong- I too sent out hundreds of application for full time positions. No feed back other than rejection letters and this is the one I found the most laughable: It was for a GYN oncology floor at a university hospital- I have 18 years oncology experience; they said "I didn't have the experience they were looking for" What ever does that mean! Yes, my DOB was a required field on the application.
I have had to file bankruptcy to keep my home and have had no health insurance. I have no chronic health issues but as the result of no health insurance, I fear that day is coming soon. My healthcare consists of taking tylenol and OTC remedies and asking peers to take my BP.
I might offer some suggestion for those fellow older nurses who find themselves in this position thanks to corporate America healthcare CEO's and the twisted minded nursing administrators who wish to follow them and reject their nursing ethics- of "Do No Harm"; These are what tid bits I have picked up finding temp positions in the Public Health Arena;
Finding medical care- check out the free public health clinics, or the FQHC's( sliding scale) they offer primary care, some offer dental and vision. In working these clinics- I have found these clinics patient populations are filled with patient's with jobs who just don't have heathcare. Not just drug addicts and skid row bums. These clinics have financial counselors who can determine if you qualify for Medicaid, or the state's low cost health insurance plan and/ or "Sharing the Care" prescription med plan( meds are free of charge if you qualify) Walmart meds are $4.00.Some of these health centers have providers who only see patient's with no insurance.
If you are unemployed- no matter what, go to the Unemployment office near you- do not take the nursing manager's word or all the myths associated with why you can't collect, Checkit out from the people that really know.
Apply for the energy credit programs through your electric and gas company- in some states they give energy credit off your bill based on income
Don't be afraid to file for bankruptcy. a Chapter 13 will protect the assets you have unless you want to give them up. There are places called 'Community Law Project" who are lawyers who serve the public pro bono( take on income qualifing cases for no fee) and are paid through the state. an indivisual can file Bankruptcy on line for free and this kind of filling is called Pro Se- that is what I did. All instruction and legal filling jargon and a handbook is on line and downloadable. I have not found the federal court or the judge to be either hospital, underhanded or discriminatory but quite the opposite. Case in point: when I filed, I found a vehicle listed on my creditors that was clearly not mine and the amount owed I would be responsible for paying. I asked the judge that since this vehicle was on my papers, and I would be paying for it, that I wanted this vehicle and asked the who in the court system was going to obtain the keys and drive it to my house. needless to say- it was removed from my paper work quickly.
Nurtition- some Walmarts have fresh vegs and fruit at reasonable prices, check out the mom and pop road side stands, farmers markets, bottom dollars, aldi's. Cheap foods have alot of salt and cholesterol in them.
Trim your house hold bills a smuch as you can- shut off the cable TV with all the fancy pay channels, swap out fawcet and fixtures for low flow( saves on water and sewer) shut off lights in the rooms you are not using.
My belief is: Since Corporate America Healthcare CEO's have proclaimed they don't want us old Baby Boomers around and we are no longer employable due to our age- I am 56yr old. Medicare starts at 65yr for full coverage- that is alot of years to wait for Medicare. This is my contingency plan. let those CEO's keep on working- they can support me!!Last edit by kcmylorn on Jul 1, '12Jul 1, '12Commuter- I had the same thoughts exactly reading those employment postings. Everyone advises "age discrimination " is difficult to prove. I am wondering if this is might be the proof the EEOC, Dept of Labor may need to prove the case.Jul 1, '12To all It may concern-
My first RN nursing position back in 1981- telemetry stepdown unit( central lines, TPN, every surgical tube imaginable, hourly outputs, mixing our own IV meds from powdered forms and "dropping" the IV's every hour in addition to rhythm strips), night shift 11-7, the only RN for 24 monitored patients which meant- charge, 1- LPN and 1 Nurse's aid. Pay rate $9.00/hr( with shift diff and charge pay= 12.00/hr), 8 hr shifts- 5 days per week, rotate shifts as needed, every other weekend, float to ICU/CCU inturn, every other holiday! I was scheduled to work Christmas my first year. I proclaimed to my nurse manager that I could not work Christmas'- my nurse manager's reply was - This isn't General Motors. I can't shut the place down" Form that moment on - I got it!
I was given 3 weeks orientation!Jul 1, '12Quote from VickyRNI will respectfully disagree. In my last career, you didn't get to take off all of the winter holidays just because you were more senior then me. This would obviously be ludicrous and unfair. No one would ever stay at such a job because it would be years before they had any time off during the holidays. And unfortunately, this is partially what I do see: nurses with 2-5 years of experience going to grad school. This is not good for either of us, is it? People leave, leaving behind a steady stream of new new grads to train.Sorry to hear about your frustrations. But it is expected protocol in any career situation (whether the dime store or the medical-surgical unit at the hospital) that the senior employees have their pick of shifts, holidays off, etc. They have earned that right through their years of loyal service on the job. To expect anything else is a sense of entitlement. And there you go with another ageist stereotype (one I forgot to mention in the article) - Older nurses are crusty old bats who are cruel and mean. Some older nurses may well be crusty and mean, but I have met my share of younger nurses who are passive-aggressive and vicious. Most nurses I have had the pleasure of knowing throughout my career - whether old, young, or somewhere in between - are kind, helpful people. Let's throw the stereotypes out - each nurse should be judged solely on the basis of his or her merit.
Iit is also unsafe for the patients to be cared for by inexperienced new grads on nights weekends and holidays. My husband (also a nurse) has pointed out to me recently that RNs value experience rather than knowledge as a sort of cultural norm which I think reflects badly on our "profession." Knowledge is obviously equally, if not, more important than experience.
Should we judge everyone on their merits? Sure. But stereotypes often come from somewhere. Frankly, the "experienced RN" you describe is more the exceotion then the rule. My experience is that most older RNs are slower (but more thorough however necessary or unnecessary), have trouble operating the computer as proficiently as they could and resist change and are consequently harder to train (though they make interesting points about how things have been done and why its not bad to continue doing them that way).Jul 1, '12Quote from VickyRNSorry to hear about your frustrations. But it is expected protocol in any career situation (whether the dime store or the medical-surgical unit at the hospital) that the senior employees have their pick of shifts, holidays off, etc. They have earned that right through their years of loyal service on the job. To expect anything else is a sense of entitlement. And there you go with another ageist stereotype (one I forgot to mention in the article) - Older nurses are crusty old bats who are cruel and mean. Some older nurses may well be crusty and mean, but I have met my share of younger nurses who are passive-aggressive and vicious. Most nurses I have had the pleasure of knowing throughout my career - whether old, young, or somewhere in between - are kind, helpful people. Let's throw the stereotypes out - each nurse should be judged solely on the basis of his or her merit.
Where I worked, I was the only RN. But the LPNs were older and had more seniority. So while they had 15 patients each, I had 50, plus every IV in the building, just because I wasn't the one with seniority. But I had more work and responsibility, so why didn't they put me on the acute floor instead of making em LITERALLY run around the building so the "senior" nurses didn't have to give up their smaller, easier assignments? I quit because I wasn't going to put my license on the line doing all the IVs and central lines that I can't even monitor 'cause they stuck me on the heaviest assignment on another floor. WHY? I was new and the youngest. Meanwhile the older nurses would try to tell me, "Oh, I'm not allowed to do such and such procedure." Oh really, cause the BON says you can, stop trying to lie and get me to do even MORE of your work.
I get tired of being treated like a stupid child because I am young and new. I respect experience. I really do. But to be treated like crap because I am new, well, we all started somewhere. To not be given a chance, or worse, to be abused because of it... Well, the work culture of nursing is a sad situation. If you're new, go to Hell. If you're old, go to Hell. I think the most experienced nurses and the new nurses should stick together and save nursing. But alas, it's all a game to some people, or a power trip.Jul 1, '12Ageism goes both ways.
What you are refering to is not ageism.
As far as ageism against younger workers, I have seen that. It's in any profession. People complain about having a boss or supervisor that is significantly younger than them all the time. Sometimes a younger person has more education and experience in their field than an older person that only recently entered the field.Jul 1, '12JZ_RN
I hope you feel some what better for venting
You are the RN- you ARE the one with the greater work load and greater responsibility! That is what the RN licensure is.
I am not by a long shot, sticking up for LPN's who refuse, manipulate, fanaggle their way out of their "delegation" tasks( to delegate to an LPN is certainly in an RN licensure scope of practice) if they refused- and as long as the task was in THEIR scope of practice for their LPN license- that's insubordination no matter what their age or seniority level. They should have been written up for that.
After 32 years in nursing- I still get tested and pushed by the LPN's, and MA's and receptionists. I did have such an insident this week with an LPN who is younger than I but more years in the facility than I, the medical director(MD) and I solved this issue and inspite of the medical directors involvement in the problem and the solution - the LPN still managed to not get the patient seen. I made the medical director aware of it.- that LPN not only defied me but also the medical director( Doctors get defied also)My role in this facility is a new role to this facility, a role that has always according to the Nursing Practice Act required an RN license( because of the extensive decision making process and critical thinking that it involves- Triage); however: for years in the past, this role has been given to the LPN's but wrongfully so. Now this LPN feels 'threatened' because now she can not act like a honorary "RN" without a license. Why she would want to jeapordize her LPN license like that is beyond me which is just what she did. I certainly am not going to stick up for her in court and I doubt the MD will either. And it's quite possible this could be a senario. believe me, this LPN was not nice about this- so I could call her a crusty, mean younger, little b.... nurse.
In LTC- the LPN's ran these places, RN's were supervisors and upper managment. I surmise that the facility has made decsions as to a change in the licensure levels due to law suits, med errors, family complaints and falls to increase their RN workforce. This is not setting to well with alot of LPN's. Any RN in a LTC faility is going to be a threat to the usual flow of business because it( highering cheaper licenses and putting them in positions they were never supposed to be in to begin with) has gone on for so long.
there is no RN position that I know of where the RN sits at the desk, talking on the cell, texting or painting their fingernails while the LPN's, MA, CNA do all the work
As far as it being a game- to some coworkers, it sure is. it's a power game, they feel threatened, they have home problems, If you stay if nursing your going to have to relize it exists, count in it. Write up those who you know are pulling one over on you and continue on with your work assigment. it's more about their bizzare personality than young, old, experienced, inexperienced even RN vs LPN or MA or CNA. It an individual thing. They are the people who shouldn't be ther to begin with!!! As long as you run away from your job, let them win, throw tantrums- they will keep it up remeber- they should be in the unemployment line- not you. The patient's don't need their behavior.Jul 1, '12Quote from vickyrnwow...first post out of the gate bashes older nurses. how ironic.sorry to hear about your frustrations. but it is expected protocol in any career situation (whether the dime store or the medical-surgical unit at the hospital) that the senior employees have their pick of shifts, holidays off, etc. they have earned that right through their years of loyal service on the job. to expect anything else is a sense of entitlement. and there you go with another ageist stereotype (one i forgot to mention in the article) - older nurses are crusty old bats who are cruel and mean. some older nurses may well be crusty and mean, but i have met my share of younger nurses who are passive-aggressive and vicious. most nurses i have had the pleasure of knowing throughout my career - whether old, young, or somewhere in between - are kind, helpful people. let's throw the stereotypes out - each nurse should be judged solely on the basis of his or her merit.Jul 1, '12Until you are old enough to be the victim of ageism it is difficult to understand. Someday you will be old enough, you will be discriminated against because you are "old" and the new nurses want you to leave because they "deserve the job", and then you will understand.
Those older nurses before you who get those holidays off have worked their fair share. I am baffled as to why one would start a new position and expect to get preferential treatment over the workers that have already worked their share. I have been a nurse for 34 years and I work holidays and nights and weekends. I know what the job requires and I expect it. I have had but a handful of Christmases off.......one was my 40th birthday, I was born on christmas. The other's? I work my share out of respect for my peers.......and yes even when my children were small.