1. Bell, Linda RN, MSN, Clinical Practice Specialist, Per Diem Staff Nurse

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Researchers have defined the older nurse as 45 years and older, and the number of aging nurses who plan to retire increases each year, with a dramatic jump occurring in 2011.1,2

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Providing care for increasingly complex acute and critical care patients with new technology creates additional challenges for aging nurses. Because older nurses have the history and experience to handle complex psychosocial issues that aren't always within the lexicon of younger nurses, it's important to retain our aging workforce and provide an environment that's comfortable, educational, and conscious of aging nurses' contributions.


Age-related issues

The physical demands of 12-hour shifts are difficult for older nurses. They spend long hours on their feet and stress joints that have been subject to years of wear and tear. The complex care needs of patients, combined with the nursing shortage, may stretch the capabilities of even the most physically fit nurses. Also, meeting patients' mobility needs such as turning and lifting causes additional stress on the back, neck, and shoulders.


Visual acuity changes of aging are also problematic. Although monitoring companies have added color and numbers to onscreen waveforms, the time of day or night can complicate older nurses' ability to visualize the appropriate numbers. Additionally, attempting to focus through progressive bifocal lenses can cause distortion even at close proximity. Attempts to decrease the size of liquid crystal displays of monitors, infusion pumps, and other medically necessary equipment generally result in the numbers and information becoming smaller and increasing frustration for older nurses.


Family issues

Older nurses typically have responsibilities for two family generations: their children and parents. They may also be grandparents, which adds further generational demands. The healthcare needs of these multiple generations create the highest demands on nurses' time and energies. Many times nurses assist in navigating the healthcare system for their extended families, which in turn limits their availability to the workforce. During a nursing shortage, there's less flexibility in providing time off at short notice to meet these family obligations.


Being immersed in the daily chaos of change becomes the older nurses' norm, along with adapting to increased stress levels. This leads to what's now being called "change fatigue."3


What can you do?

It's important to the current and future well-being of nursing that we don't underestimate the value of older nurses. It's essential to have options for shorter shifts that incorporate time for mentoring new nurses, especially in the critical care and operating room environment. For example, divide 12-hour shifts into two 6-hour shifts to accommodate aging nurses and those who want more flexibility.2 Alternate staffing, such as short shifts to help cover lunch or dinner breaks, may be another way to meet the needs of nurses with multigenerational family issues.


Purchasing and installing new technologies can also help aging nurses. Be sure to include them in focus groups to evaluate new equipment and strategies, including electric beds, mechanical patient lift devices, ergonomics training, and bariatric equipment or accommodations.2 Make sure numbers and menus are easily visible in all types of light and that excess movement or bending isn't required to see digital readouts. Provide bookmarked resources on unit computers for frequently accessed information. Make sure that documentation flow sheets, whether computerized or handwritten, can be easily read by older nurses.


Younger nurses will respect their aging colleagues if the nurse leaders of their facility hold them in high esteem. The steps facilities take to retain older nurses will have ongoing benefits to patients, the workplace, and nursing's future.




1. Hatcher BJ, Bleich MR, Connolly C, et al. Wisdom at Work: The Importance of the Older and More Experienced Nurse in the Workplace. Robert Wood Johnson Foundation; 2006. [Context Link]


2. Hader R, Saver C, Steltzer T. No time to lose. Nurs Manag. 2006;37(7):23-29,48. [Context Link]


3. Beaudan E. Making change last: how to get beyond change fatigue. Ivey Business J. Jan/Feb 2006;1-7. [Context Link]