Nursing Leadership Career Tips

By Rose O. Sherman, EdD, RN, FAAN

I recently finished editing an issue of a nursing leadership journal that focused on leading an aging nursing workforce. I found in my own review of the literature that there was surprisingly little guidance for nurse leaders on this topic. Yet it is an important global challenge. Wise nurse leaders know it is important to be sensitive to the needs of a diverse workforce. Organizations will need to consider ways to build supportive cultures, teach the workforce about generational diversity, rethink the way that work is done and pay closer attention to ergonomics and job engineering.

The Facts about the Aging Workforce

During the next decade, the need for nursing care is expected to increase as the population ages. Yet at the same time this is occurring, the graying of the nursing workforce mirrors the trend towards population aging. The average age of a nurse in the United States right now is 47 according to 2010 data from the Health Resources Services Administration. But a closer look at the data shows that the recent economic downturn has postponed the retirement of many nurses. More than one third of the current RN workforce in the United States are between the ages of 50 and 64. Nursing particularly in hospital settings is recognized to be physically demanding. Historically, few nurses worked in staff nurse roles past the age of 60 but this trend has changed. The challenge of an aging workforce is not limited to the United States. A recent RN4CAST project funded by the European commission projected a shortage of 600,000 nurses across Europe by 2020. Large numbers of nurses are expected to leave the workforce in developed countries during the next two decades, just when geriatric competence will be in higher demand due to unprecedented acceleration in population aging.

What Nurse Leaders need to Consider

There are three specific challenges that an aging nursing workforce poses for nurse leaders. These include retention of the workforce, creating a healthy work environment and doing succession planning to avoid the loss of clinical and organizational knowledge that nurses possess and will take with them when they retire. Some interesting points that I learned as we put this issue together included the following:

Some organizations are using best practices (sage councils, shorter shifts, daycare for aging parents, lift teams, enlarged computer screens) and have been recognized for their efforts by organizations such as AARP but these initiatives are not widespread.
There are some good tools available to assess your organizational effectiveness in accommodating the needs of an aging nursing workforce such as the Older Worker Lure Scale (OWL).
Shift scheduling in many hospitals today does not offer flexibility to the aging workforce but rather a 12 hour one size fits all approach.
There is little difference in work engagement across generations – many older nurses are and remain highly engaged in nursing.
Older nurses do have more pain and are more likely to have health problems yet are often given the most complex and physically demanding patients.
Older nurses are sometimes the victims of bullying and ageism.
Better environmental design can have an enormous impact in reducing the challenges that come with aging and enabling nurses to work longer.
Few organizations are thinking through the issues that come with lost knowledge when experienced nurses retire.
Succession planning while recognized as being important is not being done in a majority of healthcare organizations.

I recently spoke with a 60 year old nurse who is working her 12 hour shifts in the ICU because it is the only option that is available in her work setting. I asked her what this was like for her. She replied with the following comment, ” I don’t discuss this with anyone because I need to continue working but after a 12 hour shift, sometimes I cannot get out of bed the next day. I try to space my shifts out and not work more than two in a row but I am physically exhausted most of the time.” Although there are no easy answers to these challenges, nurse leaders can and should be more proactive in considering the needs of their aging workforce. Too often, we assume a “one size fits all” approach in leadership because it is easier to do this.

Read to Lead

Filkins J. (2011) RN4CAST: Registered Nurse Forecast

McIntosh, B., Palumbo, M., and Rambur, B.(2010) An Aging Nursing Workforce Necessitates Change: Use the Older Worker Lure Scale to rate our organization’s ability to attract and retain older nurses. The American Journal of Nursing, 110(12), 56-58.

U.S. Department of Health and Human Services (2010). HRSA study finds workforce is growing and more diverse.