Okay - I just read one of a comment on another thread and was floored when the comment was about a person getting a DNP at 62 and a poster wondering how long they would be able to safely practice at that age...
So....my question is: how old is too old to safely practice as an APRN?
I will preface my remarks with the fact that I am in mid-late 50's, have been an APRN for 10 years, currently precept two new NPs, and my practice considers me at the top of my game.
So...at 62 I'll be washed up??? Ugh - I'm planning to work till I'm 70 as long as I remain physically able to do the work.
Is there a magic age when one should just hang up the lab coat?
I think we all agree that some people are able to practice safely even when they are very old. That's not the issue. We can all think of examples "til the cows come home." But that doesn't solve anything.
The real issue is: how do we know when it is time to quit? How do we know when our abilities have declined to the point of not being safe anymore? How do we know when the care we are providing is no longer the "best" care available today? How should society handle the possibility that some people will not recognize that they are not giving the best care anymore and that they should retire?
All the positive examples in the world don't answer those questions.
Very well said and an important topic that deserves more consideration than a shallow blanket statement insisting someone who might be having a cognitive decline will actually have the insight to "know when it is time" to retire. This isn't about being malicious it is a legitimate concern and something that needs to be addressed. For every anecdotal story about someone who practiced safely until they were 150 years old there are other examples of people who continued to practice despite being unfit. My guess is as the AMA unrolls its plan our profession will follow suit in some regard.
Mandatory neuropsych testing might be be one way to fairly and subjectively determine a person's ability to continue to practice.
"To address the issues of aging physicians, some hospitals now require doctors over a certain age (usually starting between ages 70 and 75) to undergo periodic physical and cognitive exams as a condition of renewing their privileges."
Ok, so unless you're an airline pilot, age shouldn't be an issue, ever. Biological age differs from chronological age, and there are many 30-somethings who aren't as healthy as 60-somethings, making the point moot.
There are lots of jobs besides pilots who must be mentally and physically able.
Even sedentary work or work where the worker doesn't hold others' lives in his or her hands requires ability.
If a job is important enough to pay someone to do it, the worker has to be able to do the job.
As an NP, PA or Physician if the mind is sharp and you can still do the job work as long as you want. However, a bedside nurse is a bit different. Working as an RN is much more of a physical job and I have had the misfortune of working with some elderly nurses who were unable to pull their weight. They were smart and had oodles of clinical experience but physically could not keep up with the position and the physical portion of their jobs fell on the rest of us. In those cases, I believe something should have been done to remove them from the bedside.
How many "old" nurses continue to work because they can't afford to retire? I can't see myself being able to afford to retire anytime soon and not every place offers different positions to move to from bedside nursing.
I totally get not being "able" to retire. And...I totally understand not "wanting" to retire but when you can no longer "competently" do your job, how do we measure performance and determine safety to practice?
"Most notions about aging and the brain are based on FOLKLORE RATHER THAN FACT," said Dr. Zaven Khachaturian, a director of research at the National Institute on Aging. "If you really study aging carefully and look at it in the absence of disease, there is no reason to believe that aging per se leads to decline and loss of cognitive and intellectual activities.". . . dozens more studies to show the brain is not subject to the same aging process as body. I'm assuming much of the anectodal opinions are coming from the younger generation. Come now! do your research kids. . . so, now combine the unaging brain with all the knowledge/experience of the years. WOW!! No room for folklore here . . .hehe
Tsk Tsk. Isn't there such a thing as age discrimination. As long as the individual has the cognitive, physical, knowledge to maintain in their job they should. Unless they are no longer able to function as required by state laws and keep up mandatory requirements for maintaining their license, practicing safe medicine, and serving the need of caring for the sick. Keep up the good work. Younger healthcare professionals may learn a few things from them. For starters RESPECT.
What are you talking about ? I was not disrespecting anyone. My only point is that the 60 is the new 40 campaign seemed to crop up around the same time the retirement age was raised. I felt it was put out their to encourage people to work longer. In any event 60 is not 40 it's still 60 which has always been relative to the individual.
Well actually that's not true. 100 years ago, most people weren't expected to live much past 50, and before we understood the value of nutrition and exercise cognitive decline was very real and prevalent in one's 40s. I'm a very young 56 now, most people are shocked to learn I have 6 grandchildren when they also learn I'm a senior in a traditional college program. It's not just an individual thing, humankind has evolved in many ways.
Thanks, Jules; I went in thinking "OK, even if my body gets to where I can't do the physical part of nursing, there are many other ways to still be a hands on nurse but I didn't count on my mind giving out on me! No safe way to still be a practicing nurse if that's not working well. 😢A large part of my self worth came with the knowledge that I was helping to care for others, now I'm the one needing the care (someone to help me remember to pay bills, deal with home repairs, car repairs and keep track of what I have monthly and what will be left after bills to last the rest of the month. Self care I can do but financially I can't keep up
"Most notions about aging and the brain are based on FOLKLORE RATHER THAN FACT," said Dr. Zaven Khachaturian, a director of research at the National Institute on Aging. "If you really study aging carefully and look at it in the absence of disease, there is no reason to believe that aging per se leads to decline and loss of cognitive and intellectual activities.". . . dozens more studies to show the brain is not subject to the same aging process as body. I'm assuming much of the anectodal opinions are coming from the younger generation. Come now! do your research kids. . . so, now combine the unaging brain with all the knowledge/experience of the years. WOW!! No room for folklore here . . .hehe
That was quite a while ago, 1991? In any event I have to disagree with and the PhD you quoted that there aren't cognitive changes as part of a healthy person's aging process. There are plenty of MRI studies done on healthy samples here is one.
Jules A, MSN
8,864 Posts
Very well said and an important topic that deserves more consideration than a shallow blanket statement insisting someone who might be having a cognitive decline will actually have the insight to "know when it is time" to retire. This isn't about being malicious it is a legitimate concern and something that needs to be addressed. For every anecdotal story about someone who practiced safely until they were 150 years old there are other examples of people who continued to practice despite being unfit. My guess is as the AMA unrolls its plan our profession will follow suit in some regard.
Mandatory neuropsych testing might be be one way to fairly and subjectively determine a person's ability to continue to practice.
"To address the issues of aging physicians, some hospitals now require doctors over a certain age (usually starting between ages 70 and 75) to undergo periodic physical and cognitive exams as a condition of renewing their privileges."
From:
Aging Physicians in Your Practice: Handling Competency Issues | Physicians Practice
Aging Doctors Face Greater Scrutiny | Kaiser Health News