Focus on Older Nurses May Be Key to Solving Nursing Shortage

BUFFALO, N.Y. -- The acute shortage of registered nurses in the U.S. could be lessened by adopting tactics used successfully in other segments of the economy, including sweetening incentives for experienced nurses to stay on the job and enticing nurses who have left the profession back into the market, a new study proposes.

"Retaining older RNs in the workforce is an important means of addressing the nursing shortage, and employers and policy makers need to focus on this," said Carol S. Brewer, Ph.D., associate professor in the University at Buffalo School of Nursing and co-author on the study published in the August issue of Policy, Politics and Nursing Practice.

"Keeping older nurses in health-care workplaces will require multiple strategies that target income opportunities, working conditions and recruitment strategies," Brewer noted. "Given the current projections for shortages lasting into 2020, more attention should be focused on this group of nurses."

Registered nurses employed in other fields also offer a potential pool of experienced clinical nurses -- 7.2 percent of 1,906 nurses sampled in 29 states were working in non-clinical settings -- as do nurses who have retired, she added.

The study compared characteristics and work attitudes of RNs aged 50 and older with those of nurses younger than 50 at baseline and a year later. It also compared responses of older RNs working in nursing with RNs from the same age group working outside nursing or retired.

In general, this comparison showed that older RNs were more satisfied, more committed to their organization and had less desire to quit than younger nurses, making their retention in the nursing workforce a high priority.

The study suggests several ways to increase retention, including: expanding or carving out appropriate work for older RNs who generally have substantial clinical experience; creating pools of older nurses who are willing to fill in for vacations and other short-term needs; making equipment safer and more ergonomically correct; providing more flexible work hours; and increasing wages.

A somewhat different approach would be needed to bring nurses working in other settings, such as insurance companies and schools, back into the clinical arena, according to the authors.

These nurses may not have as much experience as their clinical colleagues, Brewer noted, but they have substantial workplace skills that can be transferable to a clinical setting. She suggested also that to make compensation more competitive, these nurses should receive credit for years of work they did outside of nursing, both for salaries and retirement plans. Brewer acknowledged that these nurses may not be up-to-date on current diagnosis and treatment protocols, but could be valuable in areas that have not changed over the years, such as assessing, planning, implementing and evaluating care.

Brewer noted that enticing retired nurses back into the workforce will not be easy, but that other industries successfully have rehired retirees to handle special projects.  The same strategies used to bring nurses working in other settings back into clinical positions could work for retired nurses, as well, she added. These include flexible working hours, ergonomically safe equipment, and options to telecommute, plus allowing returning retirees to continue to collect their pensions if they reenter the work force.

Additional authors on the study are Christine T. Kovner, Ph.D., professor at New York University's College of Nursing and senior fellow at the Hartford Institute for Geriatric Nursing; Ying Cheng, a UB doctoral candidate in economics, and Maja Djukic, a doctoral student in nursing at NYU.

The study was supported by a grant from the Agency for Healthcare Research and Quality on which Brewer is principal investigator.

The University at Buffalo is a premier research-intensive public university, the largest and most comprehensive campus in the State University of New York. The School of Nursing is one of five schools that constitute UB's Academic Health Center. UB's more than 27,000 students pursue their academic interests through more than 300 undergraduate, graduate, and professional degree programs. Founded in 1846, the University at Buffalo is a member of the Association of American Universities.