The Exec: How to stop veteran nurses from leaving

Flexibility and innovative practice models can improve retention of nurses reaching retirement age.

Most nurses aged 55 and older have such a passion for their work that offering flexibility in schedules and different practice models to focus on their strengths could go a long way to keeping them in the workforce, according to a researcher. new study.

Worsening patient acuity, competing roles and the centrality of computers are workplace stressors, say nurses aged 55 and older who participated in A Focus Group Study of Retirement-Age Nurses: Balancing Tension and a Love of Nursing in a Changing Healthcare Environment.

“Understanding what predicts, mitigates and prevents the retirement of experienced nurses is paramount given today’s nursing workforce environment,” writes the study’s lead author, Kim Slusser, MSN , RN, vice president of patient care services, Smilow Cancer Hospital, part of Yale New Haven Health.

Slusser spoke with HealthLeaders about the results of his study that could help healthcare organizations retain their senior nurses.

This transcript has been lightly edited for brevity and clarity.

HealthLeaders: What is the general perception of the current nursing profession by nurses over 55?

Kim Sluser: They are very concerned about the shortage of nurses and how it is putting a strain on them and their ability to do the things that they know make a difference for patients, just as we all are. But for this group of nurses, as we found in the study, all the joy of their work as nurses is what keeps them in the workforce, so all of these stressors that we feel in this time due to a shortage of nurses may put this at risk.

In our study, they talked a lot about increasing patient acuity and how that continues to be a challenge for healthcare systems. Over the years, they have seen this acuity increase, but because of their experience and expertise, we rely heavily on these nurses to do so much for us beyond patient care.

These are the people we ask to precept the new nurses, who are the nurses in charge of the units who manage the flow of patients and the way assignments are made, the troubleshooter for everyone. In university hospitals, they are the resource for residents and interns who rotate through their unit. These are things they love to do, but with increasing patient acuity, staffing challenges, and all those competing roles, it adds a lot of stress to the job every day.

HL: What are the challenges specific to them in today’s world of work?

Locks: Wearing a lot of hats in addition to caring for patients. They also talked about the physical demands as you get older and how they were able to work long shifts, but how it gets harder over time.

Many of them would like to continue working because it is so much a part of their identity – it is what brings them so much value – that they are looking for ways to be able to do it in a way where the physical demands do not would not have such an impact. on them.

They brought up a lot of things like more flexible hours. Some of the nurses we interviewed said they stayed in nursing because they were able to have flexible work assignments. Other recommendations are less assignment or no patient. We need to see how they contribute to the next generation of nurses in a different way than we ask them to do today.

HL: So many nurses over 55 chose to retire or resign during the pandemic, but others chose to stay. Why?

Locks: Their absolute love of what they do, that they feel they are making a difference, which brings them a lot of joy and commitment to their careers.

They said flexible hours were helpful in the decision to stay, so when you can put things like that in place, you have a better chance of retaining those nurses who are so valuable to our care delivery and the training of our future nurses.

HL: What are the advantages of retaining nurses at retirement age?

Locks: They bring such a wealth of experience to the organization. These are the people we rely on to train more new nurses. So many nurses, at least in this study, have worked for the same organization for a long time, so they have a commitment to the organization and they can foster the culture of that hospital.

Even beyond clinical experience, these nurses know how to develop relationships with patients, how to develop relationships with other members of the clinical team like doctors, social workers, and pharmacists. It takes a long time to be confident in your practice as a nurse, and these nurses have developed that confidence in their practice and they can help instill it in new nurses coming in.

HL: What specific accommodations can nurse leaders make to encourage experienced nurses to stay?

Locks: We need to think differently about how all of our nurses work. In this study, we focused on nurses close to or at retirement age, but we learned from younger generations of nurses that they want similar things. They want flexibility in their schedules. They also want non-traditional shifts. So it’s a win-win situation for the entire nursing workforce that many of the things our nurses in this study wanted are things similar to what we found in younger nurses.

We can get more creative and come up with our schedules, shifts, and even part-time roles. During peak periods of clinical care activity, does everyone have to report to work at the same time? Right now, we are traditional in how most of our hospitals plan their nurses, so nursing leaders will need to step back and be very creative.

Nurses can help know how to do this well; hospitals that have strong shared nursing governance groups can rely on nurses to help them accomplish this so that nurse leaders don’t have to come up with these ideas on their own.

Another recommendation from the nurses in the study was to find a way to train, instruct and educate more novice nurses in a way where they do not have to continue with their other responsibilities such as maintaining a full patient assignment or being the charge nurse on the unit. There are ways to relieve them of some or all of these tasks so they can focus on training.

It is more expensive to take on nurses and reduce their responsibilities to give them more time to mentor novice nurses, so as nurse managers we need to find a way to measure the return on investment to do this. How do we measure this from the perspective of patient outcomes, nurse retention, nurse job satisfaction, and nurse confidence, making them a stronger clinician?

I think there is cost avoidance if we put programs like this in place, especially in terms of reducing turnover. In 2020, the turnover rate for nurses reached 18% in some places, and the turnover of new graduates ranged from 17% in their first year to 30% within two years. If we can keep nurses in their profession by getting nurses nearing retirement to focus on coaching, there could be a huge return on investment.

Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.

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