What You Need To Know About Older Nurses: Myths and Realities

[J.Adderton]

The words "older adult" often produces a stereotypical image of someone who is sick, slow, frail and senile. As I age, I am guilty of thinking aging is all about decreasing... decreasing physically and decreasing mentally. The National Council of State Boards of Nursing 2015 Nursing Workforce Study reported 50% of registered nurses and 46% of licensed vocational nurses are over the age of 50. Institutions are exploring ways to retain these older nurses in a strategy to maintain the nursing workforce as nurse baby boomers retire. However, ageism is a threat to the profession's ability to maintain enough nurses in the workforce to meet the healthcare needs of our aging population.

If you are in search of a lively discussion, just ask the question "At what age should a nurse retire? The conversation will most likely be divided and laced with stereotypes of older individuals. It is realistic older nurses experience more chronic disease and may find the physical demands of nursing challenging. This generation may also be less comfortable with the use of technology. However, negative stereotypes and myths of older nurses remain a threat to the nursing profession. Let's explore deeper the realities and myths surrounding aging nurses.

Older Nurses Do Not Have The Physical Strength Needed For Job Role

It is true the body does experience a small decrease in muscle strength from ages 40 to 65. There are many muscles in the body and they decrease in strength at different rates. Therefore, there is no one test that assesses a person's overall strength. A nurse with many years of experience has most likely developed successful strategies in meeting physical aspects of a job. In addition, nurses maintain muscle strength with the day-to-day walking, lifting and carrying that comes with the job.

A benefit to a career in nursing is the diverse settings nurses, both young and older, are needed. Many jobs outside of the hospital and bedside nursing are less physically demanding. These jobs require the experience and expertise that is prevalent in older nurses.

• Nurse Educators- Nursing programs are currently turning away students, due to the shortage of nurse faculty, at a time when the need for nurses continue to grow. Outside of the classroom, older nurses experience is knowledge is needed to fill clinical instructor positions. Nurse educators are also hired by medical device companies, textbook publishers, community clinics and others.

• Public Health Nurse- These nurses focus on the health of a community, school, community organization and community health clinics.

• Occupational Health Nurse- Serves employees of a business to promote overall health, safety and injury prevention

Older Nurses Think Slower And Are Less Productive

Managers and co-workers are often concerned that older nurses have trouble meeting the mental demands of nursing. Posthuma and Campion (2009) synthesized over 100 studies on stereotypes of older workplace employees One theme that emerged is the stereotype older workers are less motivated and lack competence. It is true, especially with bedside nursing, that productivity declines with age. The Occupational Outlook Handbook (2016) reports 61% of nurses work in a hospital, however, many nurses successfully work bedside beyond age 65. In addition, the nursing profession offers jobs in a wide range of areas and settings.

Older Nurses Do Not Like Change And Are Stuck In The Past.

This is a myth and can easily be dispelled with 3 key points. First, baby boomers typical place a large amount of trust in leadership and in the strategies of their leaders. However, it is important to the older employee that they understand how change supports new strategies and how it will benefit or improve their ability to perform a job role. Second, older nurses bring knowledge that only years of expertise can provide. Through mentoring and informal teaching, older nurses can pass their knowledge on to newer, less experienced nurses. Third, older nurses stay informed of new standards, skills and healthcare changes through to their state board of nursing continuing education requirements and workplace training.

Older Nurses Call Out And Use More Sick Time

Although older individuals have more chronic illness, young and older workers actually have similar absentee rates. In addition, studies have shown younger workers have more acute illness than older workers.

Consequences Of Stereotypes

Ultimately, ageism in nursing negatively impacts the patient's experience. Stereotypes can make an older nurse feel unwelcomed and unappreciated. Older nurses may feel pressure to retire- leading to a staffing gap in a healthcare environment that is already understaffed. As our population continues to age, older nurses understand the aging experience. Having nurses on staff that understand their specific needs significantly improves the patient experience. Older nurses are valuable to the community and nursing profession.

What you can do to address ageism in nursing

• Reflect on your own views about aging and the older nurse
• Be aware of common stereotypes and your own attitudes that reflect ageism
• Avoid telling or laughing at jokes with themes of ageism
• Avoid gossip about the performance of an older peer.
• Acknowledge how older nurses benefit the patients in your setting.

A Final Thought

Being aware of the realities and myths are the first step in supporting older nurses. Experienced nurses bring a wealth of knowledge that is valuable to younger nurses and patients. With the looming nursing shortage, it is important for the nursing community to continue identifying strategies to retain aging nurses.

Resources:

American Association of Colleges of Nursing, (2017). Nursing Shortage Fact Sheet, Nursing Shortage Nurse Journal (2018).

155 Super Great Non-hospital Nursing Jobs for Nurses. 15 Super Great Non-Hospital Nursing Jobs for Nurses | 218 NurseJournal.org Stokowske, L. (2008).

Old but not out: the aging nurse in today's workforce. Medscape: Medscape Access The NTAR Leadership Center

[J.Adderton, BSN, MSN]

Have you ever considered hospice?

[Daisy4RN]

If that is you at different ages looking at each other with those comments then yea I get it, LOL

[Daisy4RN]

As an older nurse myself (60ish) I don't have problems with technology (most of the time). I have problems with physical/stamina issues so because of medical issues now only work part time (even though I wasn't ready yet). But when I am at work I give it my all and have no problems keeping up with the younger crowd. We all work together nicely realizing we each have something to offer each other and the work environment.

[Nurse Magnolia, BSN, RN]

I am 46 years old and will graduate nursing school this April. I have a bachelors degree in IT so I sure do know my technology. The only problems I've had in nursing school at my age is RN's on the floor assuming I'm the nursing INSTRUCTOR and not the student, and my own perception of my limitations.

Last week, my back was killing me because we were on a labor and delivery floor and my one patient wasn't progressing. I really had nothing much to do but complete the writing assignments my instructor gave me. There was literally no place to sit so I was standing balancing my clipboard trying to work on these things. I can walk for miles and miles and miles, but standing all day....my back will hurt. As I was thinking about how old and crazy I am for being in nursing school at my age, one of the 20 somethings walked up to me and said "my back hurts SO bad from all of this standing all day!" . I assumed it was just because I was a bit older but really, everyone was feeling it.

I know I'm not "old" but I'm way older than most of the nursing students, but I will say that everyone - the nurses, instructors and other students - have welcomed me. I think my life experience has also helped me to be successful. I have a 3.95 GPA so far.....No one better tell me I "can't" do anything! lol

[J.Adderton, BSN, MSN]

That is so true, diversity just brings more to the table.

[glencovediva]

I am a 57 years old. I had to leave my job that I loved 9yrs ago b/c I was diagnosed with stage 2 ovarian cancer. I also had a mitral valve replacement and a stroke. I was in a nursing facillty for a year, learning to walk again. Today, I'm feeling GREAT!! I'm healthy, I walk a lot, exercise. I would love to go back to work, but nobody seems interested. They only look a my absensce.I just renewed my license and ACLS & BCLS, so I'm up-to -date. I really feel discriminated against b/c of my previous disablilty and age. Any ideas? Thank you.

[Horseshoe, BSN, RN]

I would just like to thank you for writing an article that actually reads like a professional paper rather than what we often see here. Many of the "articles" posted here sound like the opening chapter of a dime store novel.

[Daisy4RN]

glencovediva said:

I am a 57 years old. I had to leave my job that I loved 9yrs ago b/c I was diagnosed with stage 2 ovarian cancer. I also had a mitral valve replacement and a stroke. I was in a nursing facillty for a year, learning to walk again. Today, I'm feeling GREAT!! I'm healthy, I walk a lot, exercise. I would love to go back to work, but nobody seems interested. They only look a my absensce.I just renewed my license and ACLS & BCLS, so I'm up-to -date. I really feel discriminated against b/c of my previous disablilty and age. Any ideas? Thank you.

I was also off work for a year and had a difficult time finding a job. It was a real eye opener because I had never had a hard time getting hired before. After many failed interviews (or failure to even get an interview) I did some research, re-vamped my resume, brushed up on interview skills and interview attire, and just kept going until I eventually got hired. I know how hard and disappointing this can be but just keep trying. Maybe also try places you might not have thought about, HH/Hospice, clinic, SNF, occupational, telephone triage etc. Sorry you are having a hard time! Good luck!!

[dodah677]

Why is that picture used? I am 69, been an RN 44 years and don't ever look that bad, even when I wake up in the morning. Talk about stereotyping. Get a life people....

[nfahren05]

There are a lot of older (55+) nurses dropping out of clinical positions because the hospitals won't step away from the 12 hours shift requirement. We are losing a whole generation of experience because many nurses are feeling too tired at the end of the longer shifts to give safe care, especially since 12 hour shifts often end up being 16 hour shifts when there are staff shortages. National quality organizations have already backed up relative safety of 8 hour shifts over 12 hours, and have urged facilities to consider a change, but 12 hour shifts are simpler to schedule so patient and staff safety has fallen by the wayside. Many older nurses cope by moving into education, quality, risk, utilization/case management positions, but it is leaving a knowledge gap at the bedside as the nurses who are physically able to run non-stop for 12-16 hours in the ICU or ERs are less clinically experienced than their older peers. Please, if you are in a nursing leadership role, find a way to schedule those experienced and technologically capable RNs in a reasonable manner, whether it's dropping back to 8 hour shifts, prohibiting 16 hour shifts, or monitoring the number of back to back shifts that nurses work. Your patients and staff will thank you.

[DallasRN]

dodah677 said:

Why is that picture used? I am 69, been an RN 44 years and don't ever look that bad, even when I wake up in the morning. Talk about stereotyping. Get a life people....

Thank you so much, doda677, for mentioning that picture. I looked at it and thought the same thing. That person looks like an old, haggard, shrew and definitely not a person I would want to work with or take care of me if I was a patient. I'm definitely an "older" nurse and while I no longer work in the clinical setting, I have many friends who do and frankly, they are some of the happiest, smiling, secure and confident nurses I know. They've lived through the years of uncertainty with themselves and their profession. They've spent time in management and decided having "a life" is more beneficial to their personal goals at this stage of their lives. They've gained the respect of their peers and the doctors they work with. They are the bedside leaders in their clinical environments.

When the day arrives that I'm the patient lying in that bed, I hope it is an older, experienced, organized nurse assigned to me...someone who can truly assess and pick up on subtle signs that only experience can provide...not a nurse running around helter-skelter, feeling overwhelmed by what is only the days events. How many of us remember those "really old" hospital nurse grads who could handle just about anything thrown at them from day one?

[DallasRN]

nfahren05 said:

There are a lot of older (55+) nurses dropping out of clinical positions because the hospitals won't step away from the 12 hours shift requirement. We are losing a whole generation of experience because many nurses are feeling too tired at the end of the longer shifts to give safe care, especially since 12 hour shifts often end up being 16 hour shifts when there are staff shortages.

I fully agree and taking it a step further, why not allow shift-sharing or splitting into two 6 hour shifts? For the sake of continuity, that might not be best in some situations, but in others it would work fine. Day surgery where the patients are in and out anyway. OR. Pre-admission areas. Some long-term areas where patients get to know their nurses - they would likely support having 2 nurses they know during a 12-14 hour period.

In addition to older nurses feeling to tired to work 12-14 hours, there are other reasons. Some are limited in terms of $$'s they can earn (based on their retirement/receiving SS benefits). Some live a distance from a hospital so an hour drive each way coupled with long shifts...

Another advantage to those of us that are older...we no longer have kids so working weekends and some holidays just isn't a big deal.