The Importance of the Older and Experienced Nurse in the Workplace

EXECUTIVE SUMMARY:

With projections of a severe and looming nursing shortage, the Robert Wood Johnson
Foundation® (RWJF) commissioned the development of this Wisdom Works white
paper to identify promising strategies and opportunities for retaining experienced
nurses. One projection from a 2003 online survey conducted by the American Nurses
Association revealed that, in the age cohort of 40 or older, more than 82 percent of
nurses planned to retire in the next 20 years.1

This paper is a response to the current and increasingly daunting crisis resulting from
the shortage of nurses. Generally, workforce experts agree on three major approaches
to augment the nursing workforce:
1. Increase the number of enrolled nursing students and retain them through
graduation.
2. Retain new graduates and nurses at all stages of their professional careers, including
older nurses.
3. Attract nurses back to the bedside who have left the national nursing workforce, such
as nurses otherwise employed or those who have retired, or attract nurses from other
countries (even though this latter strategy has some politically charged ramifications).

We focus on one approach—the retention of the older nurse to the usual retirement age
and even beyond. While we acknowledge that all three approaches must converge to
substantially reverse the consequences of the nursing shortage, the importance of retaining
older nurses—and the knowledge and wisdom they contribute—has only recently
begun to receive attention. Among the baby boomers aged 55 and over are healthy
and vibrant retirees or soon-to-be retirees, with a robust 10 to 30 years of additional life
expectancy. These individuals are fast becoming the largest untapped source of potential labor in the U.S. economy.2

Throughout this paper, facts and myths about aging and the older nurse, information
on how workplaces support or detract from the quality of older nurses’ work lives,
best strategies for recruitment and retention to take full advantage of this pool of valuable human resources, and work role adaptations that are realistic and attainable will be presented. The underlying question “Is there value in retaining the older nurse in an increasingly chaotic health care system?” leads to a resounding yes!

This paper is organized to:
1. Present an introduction and a current review of the literature regarding what has
been researched and written about the older nurse. Areas reviewed include data
trends, anecdotal references, ergonomic and work design, and work environment,
including the physical plant and operational culture considerations.

2. Present a business case for the immediate implementation of strategies to increase
the retention and/or recruitment of the older nurse.

3. Share the results from interviews with sages—experts who possess targeted expertise as well as a broad view of the role and functions of the older nurse.

4. Document the results from a pilot survey of nurses addressing heretofore-unasked
questions, such as the psychological impact of role changes, and peer support or
toleration of workload sharing with younger nurses.

5. Reveal a set of best practices, in both health care and non–health care settings,
where older employees are respected, honored, and valued for their active contributions, and explore how these might be relevant for replication in a variety of
health settings.

6. Synthesize common themes from each of the above data sources, highlighting key
findings and critically examining whether areas of overlap represent consensus or
merely a lack of creativity and a signal that more creative work needs to be done
This, then, leads to a set of recommendations and concluding remarks.