In April 2006, projections issued by the Health Resources and Services Administration warned that by 2020 the nursing shortage could exceed 1 million nurses. Unfortunately, that number reflects only part of the problem. Trends now project that as the supply of nurses continues to fall short of demand, the most experienced nurses—the aging baby boomers—will be retiring in record numbers.
Recently, the Bernard Hodes Group reported 55% of 1,000 nurses surveyed were planning to retire between 2011 and 2020. Nurses, on average, are retiring at 60.5 years of age and with them go the wisdom and seasoned skills one accumulates over a lifetime of practice. The possibility of losing so much wisdom and experience in a short period is frightening. We all know that the difference between a smooth shift in a hospital nursing unit and a not-so-smooth shift can depend largely on the makeup of the staff. The sheer presence of a seasoned nurse with a calm demeanor and an ability to skillfully manage difficult situations gives a care team stability and strength. Experienced nurses provide such presence and stability in the home, the clinic, the classroom, and the field, as well.
How do we, as a profession, address this crisis? How can you preserve the wisdom in your work setting? Here are some ideas that are emerging as best practices to retain more experienced and often older nurses.
• Establish “minimal or no-lift environments.”
• Use ergonomic technology and improved design and lighting.
• Provide on-site rest and relaxation areas.
• Institute wellness and exercise programs.
• Provide flexible scheduling to allow options such as shorter shifts, less rotation, more part-time work, and sufficient recovery time between stretches of shifts.
• Ensure compensation policies recognize and reward nurses for their experience and expertise.
• Establish a culture of respect.
• Provide coaches when introducing complex changes, especially changes involving complex technology.
• Reinvest in life-long education.
• Provide resources for nurses caring for aging parents.
• Offer benefits such as long-term care insurance.
• Start retirement benefits after age 60 to supplement compensation for part-time hours.
• Create new roles that are less physically demanding.
• Consider leaves of absence without loss of seniority.
The September 2006 AARP Bulletin lists the 50 top employers for seniors. More than half are healthcare systems. Given these numbers, we should be influencing our organizations to provide an atmosphere and work environment that prevents injury, diminishes life stress, and helps senior nurses feel valued. Staff should partner with nurse executives to make improvements in the work environment that demonstrate the American Nurses Credentialing Center’s Magnet principles and reflect the American Association of Critical Care Nurses Healthy Work Environment.
As for the broader nursing shortage, we, as a profession, are working on solutions. The American Academy of Nursing and others are studying improvements that can reduce the demand on nurses and increase the time spent with patients. And improvements will come with technology, the redesign of healthcare environments, and the evidence-based practices that add precision and subtract unnecessary activities.
Successful public-private partnerships are revitalizing young people’s interest in nursing. However, the capacity in our schools lags behind, so we risk losing the people we have just recruited. In 2005 alone, over 30,000 qualified applicants were turned away from nursing schools. We must correct the faculty shortage problems and find creative ways to better use classrooms and maximize clinical placements.
Let us change the shortage predictions for the next decade. Let us make this the year of retention. Make a personal commitment to do something about retaining our talent pool. Read Wisdom at Work (http://www.rwjf.org/files/publications/other/wisdomatwork.pdf). Take a look at the American Nurses Associa-tion Center for American Nurses Web site (http://centerforamericannurses.org) for new ideas. Initiate a campaign with your co-workers and other colleagues to try out any one of the strategies to capitalize on the talent of your seasoned nurses. Together we can change the future, one person at a time.
Pamela F. Cipriano, PhD, RN, FAAN