1. Mossburg, Sarah E. MS, BSN, RN

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The start of the millennium brought with it a rising concern that the United States would soon be facing a large shortage of RNs beyond any that had been previously experienced.1 This shortage was projected based on dropping enrollment of post baby boomer generations into the nursing profession. Due to a number of factors, it now appears that this shortage will be largely avoided.2,3 It's projected that millennials are entering the nursing profession at rates high enough to combat both the upcoming projected retirement of baby boomers and increasing workforce demands due to the increased healthcare needs of a growing older patient population.4

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This is welcomed news for nurse leaders, but it must be viewed with some caution. Baby boomers have long made up the largest portion of the nursing workforce and many are slated to retire in the coming 10 to 15 years. With their retirement, these nurses will take with them organizational and clinical knowledge that represents a brain drain to the nursing profession, and may have a substantial impact on individual hospitals or units.5 Additionally, while the raw numbers of nurses entering the workforce are projected to be adequate, the geographic distribution may not be. Experts project different rates of growth within the nursing workforce, as well as different rates of demand due to retirement, depending on geographic region.3,6 Some areas in the United States may have more than adequate numbers of nurses entering the workforce to offset retirements and increased demand, whereas other areas will potentially experience workforce shortages.


It's more difficult to quantify the loss of knowledge and understand its impact than it is to measure projected workforce demands due to retirement. Individual hospitals and healthcare organizations will need to recognize and address this problem institutionally. Nurse leaders are in a vital position to lead the initiative.



Geographic location will be an important mediator of the impact of baby boomer retirement. Nurse leaders working in areas where it's projected there will be low workforce growth and high levels of baby boomer retirement need to consider mitigation strategies. Partnerships with schools of nursing will facilitate a potential pipeline of new nurse graduates. Now is the time to focus on creative onboarding strategies to help ensure an adequate transition of new graduate nurses to the bedside.


Beyond geographic impact, we need to understand the potential impact on our organizations and identify organizational solutions. An assessment of projected individual retirement timelines of department or hospital staff will help determine a global timeline and depth of impact. It will also help you triage, identifying areas in your organization that are likely to be the most significantly impacted. It's imperative to specifically identify baby boomers who have unique and critical knowledge beyond traditional clinical roles.


Strategies that delay and diminish the impact of baby boomer retirement are crucial. Delaying baby boomer retirement allows for better transfer of knowledge from baby boomers to millennials, and offsets some of the brain drain. One strategy is to evaluate whether nurses can stagger retirement rather than leaving all at once or in close succession. This may be possible through providing financial incentives to delay retirement. If nurses have reached salary compensation caps, are there ways to retain them for slightly longer than they originally planned? This allows other strategies for transfer of knowledge to be put into place and decreases the all-at-once impact of many nurses retiring at the same time.


Another strategy to delay impact is to identify innovative alternative jobs to traditional bedside nursing. As nurses age, the physical demands of bedside nursing make it difficult for them to stay at the bedside. Are there other roles on the unit currently in place, or that can be created, to allow older nurses to continue to serve in the organization without the same physical burden associated with bedside nursing? These nurses are well suited to work in positions that focus on quality of care because of their extensive clinical experience. Roles that focus on discharge teaching, postdischarge phone calls, and follow-up to minimize 30-day readmissions may offer an opportunity to harness the knowledge and expertise of these nurses while providing positive strategic and financial impact for the organization. Another opportunity is the nurse navigator role, which many hospitals are employing to help patients successfully move through the complex healthcare system. As healthcare delivery methods shift, it's important for nurse leaders to consider new roles for the aging workforce that allow organizations to keep their knowledge.


Finally, nurse leaders should consider ways to retain millennial nurses. The Institute for Healthcare Improvement recently launched a "Joy at Work" initiative, including steps for nurse leaders, a framework for understanding joy at work, and methods for measuring joy at work, aimed at increasing the engagement of the healthcare workforce.7 It appears that one key element to retaining millennials is providing them with growth opportunities in the first 3 years of their careers.8 Nurse leaders can help foster mentoring relationships and creative programs that keep millennials engaged at the bedside while at the same time providing them with growth opportunities. For example, traditional single-unit positions may be less attractive to young nurses who are interested in professional growth early in their careers.


Planning ahead

The future of the nursing workforce is optimistic, but not without potential challenges. Although the predicted nursing shortage has been avoided, we must acknowledge and plan for the complication of geographic distribution issues and loss of organizational knowledge during the transition from baby boomers to millennials. With creativity and innovation, nurse leaders can minimize the negative effects of baby boomer retirement while meeting the growing healthcare needs of that same generation.




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