Rebecca Hendren for HealthLeaders Media, October 18, 2011
Nurses are feeling the pinch from the economy as much as anyone else and a new study reveals many plan to continue working well into traditional retirement age. That's bad news for nurses and their plans to say sayonara to difficult patients and endless documentation, but it's good news for hospitals.
Almost 45% of RNs are older than 50, meaning they are due to hit retirement right as their fellow Baby Boomers start deluging the healthcare system. Projections estimate the country will be short 260,000 RNs by 2025 and that we'll start feeling the effects as early as 2018. Decreased readmissions and the poor economy have eased nursing shortages around the country and fooled many into thinking the shortage has gone away, but it hasn't.
Retention efforts may be at the bottom of a very long priority list, considering most organizations are currently engaged in cost-cutting efforts, and 2018 seems like the distant future, but it will be here before we know it. Savvy hospitals can prepare for the future and decrease costs now by planning for the retention and effective utilization of the older RN workforce.
The study that was released last month by Fidelity Investments revealed 71% of nurses have not saved enough money for retirement and that almost half of all nurses have changed their retirement plans because of the economy.
More than one in four nurses believe they will never fully retire. Twenty-six percent expect to retire later than originally planned and 22% will now work in retirement who had no previous plans to do so.
Of the nurses who plan to work in retirement, 79% said they will need to work to meet basic living expenses and 28% expect to struggle to make ends meet in retirement. These numbers show a significant change from the last time the survey was conducted in 2007 when nurses were more confident about their financial health in retirement.
The study was not all bad news for nurses, however. Fifty-four percent responded that they loved their jobs and didn't want to give them up even in retirement. Whether they continue working because they want to or they need to, the numbers of older nurses in your organization will force changes to the way nursing care is provided.
Serious attention will have to be given to the over-reliance on 12-hour shifts. These shifts contribute to cognitive overload and nurse fatigue and have been shown to result in more errors, but nurses love them and fight any suggestion to do away with them. Older nurses, however, will be less wedded to 12-hour shifts and many will need options that either include less direct patient care time or shorter shifts.
As part of your cost cutting efforts now, investigate ways to improve staffing and scheduling and develop different shift options that meet the needs of all your staff. Offering 4, 8, or 12-hour shifts provides flexibility for both staff and the hospital. For example, four-hour shifts can be scheduled around busy times during high patient census.
Reduce your need for agency nurses by investing in staffing software that makes it easy for nurses to view and pick up open shifts. These programs can be implemented across multiple sites, making it easier for hospitals in a system to share resources and solve staffing issues together. The initial investment is more than offset by the reduction in agency staff as well as increases in staff satisfaction. Opening the system to older nurses who work per diem or part time gives them opportunities to pick up work when they want it.
Retention efforts must pay attention to physical needs of an older workforce. Safe lifting programs become paramount to retain older nurses, but also reap benefits for all staff. As the obesity epidemic continues, all caregivers need education about safe patient handling and lifting as well as the availability of assistance when needed.
Another effort that is essential for older nurses but that also benefits everyone is reducing the number of steps nurses take each day. Studies with nurses wearing pedometers show that many staff walk miles each day doing tasks such as hunting supplies or retrieving wheelchairs that needless take them away from patients' bedsides. Locating supplies closer to where nurses work, educating pharmacy staff about the effects on patient care when nurses have to chase down medication, and equipping nurses with cell phones can all reduce unnecessary walking and increase the time nurses spend with patients.
Having older nurses staying in the workforce means you can continue to benefit from their years of experience and wisdom. Use it wisely and you provide them with new challenges for their professional development. Create shift options that include project work or quality improvement efforts. Pair them with new graduate nurses in buddy programs. Preceptors have to focus on the checking off competencies and ensuring new nurses are clinically competent. Buddy nurses can spend more time on sharing experiences and can just mentor, encourage, commiserate, and inspire.
With a little advance planning, these easy-to-implement programs make continuing working into retirement years a more attractive prospect.