How old is too old to safely practice?

Advanced Practice Columnist / Guide · Jul 31, 2016

I think that this is an individual decision taking in consideration that aging does affect cognitive abilities in some people earlier than others and that our physical abilities do decline as we age. I've seen attendings and NP's past their 60's who are still sharp in mind as anyone much younger and aside from their physical limitations (not able to work nights or long shifts), I see no hindrance in their ability to function as competent clinicians. Personally, I would hate to work beyond age 60 (I'm now in my 40's with 20+ years of nursing career, 12 of them as an NP). But that is just a selfish goal of wanting to take it easy, travel, have fun at that age.

Jules A, MSN · Jul 31, 2016

Excellent thread. I personally think that mid 60s is really pushing it for most people who are prescribing. Speaking only for myself when I consider my age related losses over the past 10 years my reflexes, stamina and memory as a relatively physically fit, still running 10 miles a week, early 50s I can not imagine I'd still be good at what I do for much more than 10 years. I don't ever want to get where my team feels I'm a detriment or I'm possibly harming my patients. I love my work but it isn't what defines my life or my personal value. Plus I worked hard, saved a fair amount of money and aim to have time to enjoy the fruits of my labor before I drop dead.

I can not imagine getting a DNP at 60 something unless a person really just wants to have the title and they can afford the tuition. The older prescribers who I knew in their late 60s-early 70s anecdotally have gotten rather dull, they tended to prescribe whatever the patient requested, a lot of polypharm, and in psychiatry thats the kiss of death with all the substance abusing clients we treat. I've known 1 NP who was fired around 70, 2 physicians who were "encouraged" to retire and one who lost his license to practice secondary to failing to appropriately support the meds:diagnoses, not ordering appropriate labs and tons of benzos. Sorry folks but my opinion is prescribing and surgery is a young man's game. My family members all see younger providers, I'd rather gamble on the inexperience to have the latest, greatest knowledge as well as the brain power of a younger Doc.

JellyDonut · Jul 31, 2016

It all depends on the individual. If you are keeping up on EBP and are able to treat without harm, then practice as long as you want. Lord knows I have seen nurses working into their 70s and a few Docs into the 80s. Age is just a number....

elkpark · Jul 31, 2016

There is no official age at which one "should" retire; it's a v. individual matter. My father was a physician who continued to give anesthesia into his mid-70s and was entirely competent (he finally retired because my mother was bugging him to quit so they could travel a lot, not because he was having any problems at work). I work with a psychiatrist who is probably (I don't know his exact age) close to 80. He is slower than the younger psychiatrists on our service, but I don't observe him appearing any less competent or safe.

CapeCodMermaid, RN · Jul 31, 2016

What happened to "60 is the new 40"? I know many nurses and physicians who practice well past their 60's. They are still mentally and physically able to do so. My dad was a radiologist. He retired the first time at 83. He was bored silly staying home all day so he went back to work. Never missed a diagnosis or a day of work.

Trauma Columnist · Jul 31, 2016

Thanks so much for these comments.

Barnstormin' PMHNP · Jul 31, 2016

My preceptor is in his early 70's and is sharp and very capable. He is safer than the late 40 something psychiatrist on the team, he is up to date on EBP and Meds and is always sharing something new with me. He is the backbone of our very busy and acute unit and has never been impatient or unprofessional.

I personally feel ability is very individual.

caliotter3 · Jul 31, 2016

As I recall, I read here one time about a nurse who was starting to show memory problems on the job. IIRC she was not confronted and made it until the time she decided to leave work on her own. I knew a nurse one time, in her 70's, who was having memory problems, but they did not impact her job performance. She had to leave work because of other health problems. I would think that as long as one does not show signs of mental incapacity, they should be allowed to work. Once the older person starts to "lose it" on the job though, things should be looked at just as they should be looked at for a person of any age who shows that they don't have what it takes to practice safely. You can be 23 and not have the mental capacity to practice nursing safely, as well, as 73, and be as sharp as a tack. It is an individual situation.

Jules A, MSN · Jul 31, 2016

Excellent points but I still think the extra old providers or nurses are outliers. I wonder just how accurate the anecdotal stories are about so-and-so who practiced into their 80s when it is coming from someone who wasn't in that specialty with direct access to their prescribing habits? People can appear sharp for a long time with cognitive decline. I think students tend to take on the prescribing habits of their mentors which isn't always a good thing so again perhaps not the best source with regard to who is competent. That might make an interesting thread.

ArtClassRN, ADN, RN · Jul 31, 2016

Shoot I know some who can't safely practice in their 20's!

Buyer beware, BSN · Jul 31, 2016

There is no official age at which one "should" retire; it's a v. individual matter. My father was a physician who continued to give anesthesia into his mid-70s and was entirely competent (he finally retired because my mother was bugging him to quit so they could travel a lot, not because he was having any problems at work). I work with a psychiatrist who is probably (I don't know his exact age) close to 80. He is slower than the younger psychiatrists on our service, but I don't observe him appearing any less competent or safe.

I have found, at least in the old days before digital thermometers, that the best indicator of needing to retire was when an old-timer nurse would use the rectal thermometer to take oral readings without realizing it; but upon reorientation say "I'm sorrry" but in reality not giving a hoot. Luckily today we know that the new eighty is actually only fourty-five, at least in South Florida thanks to our dedicated geriatricians and plastics surgeons.