Older Nurses in the Workforce

A topic that is being discussed a lot these days is older nurses in the workforce. The American Nurses Association reports that the average age of an RN is now 45.2 years, with nurses younger than 30 years making up only 8% of the workforce. In addition, many nurses report that they plan to work until age 70 and beyond. For many of these nurses, it isn’t so much a plan as a necessity. A friend of mine recently told me, “I’m going to have to work until I die. With the economy the way it is, it doesn’t look like retirement is going to be an option.” Others, however, simply like having a purpose. Regardless of the circumstances, some institutions are welcoming the trend of nurses sticking around well after they could retire because it is helping to relieve nursing shortages while ensuring that experienced and highly qualified caregivers are on staff. Still, there are some stereotypes associated with older nurses, such as that they are more prone to using sick days, they are not able to keep up with the latest technology, and they are inflexible.

A January 2009 Medscape Nurses’ poll posed the question “How do you feel about working with the over 65 nurse?” Although 67% responded positively, 13% were negative, and 20% felt that it “depends on the nurse.” Interestingly, many of the posts in response to this question began with the words “I am a [age]-year-old nurse.” Although the ages of the nurses varied, most of the nurses posting comments indicated that they were in their 50s. One nurse wrote, “Dear me, if I am hospitalized, give me an ‘old nurse’ any day, I mean one that has 15- 30 years under her cap.” Conversely, another wrote, “I have worked with two nurses over age 70 and it has been dreadful. These older nurses cannot help in crisis situations, they have a lot of difficulty with the computer system, their cognitive skills have decreased, they have slowed down and have a difficult time moving, and ‘hide-out’ when there are emergency situations.”

It used to be said that nurses eat their young; however, what I’m hearing these days is that older nurses are being “eaten” by younger nurses. Older nurses tell me that they’ve encountered impatience, intolerance, and in some cases, outright hostility in the workplace. At any age, this behavior is disruptive behavior and when it’s exhibited nurse to nurse, it’s called lateral or horizontal violence. Not only does this form of violence lead to an uncomfortable working environment, but it can also lead to health problems and affect patient care. Studies have shown that individuals who are subjected to horizontal violence may develop sleep disorders, poor self-esteem, hypertension, eating disorders, depression, and a host of other maladies. These may further affect performance in an environment where patient care may already be suffering. A 2007 literature review by Woelfie and McCaffrey published in Nursing Forum found that “When tension is elevated in patient care areas, nursing staff are not likely to perform at their best and the result is often poor patient care” (www.ncbi.nlm.nih.gov/sites/entrez/17661804). The authors also found that no area of nursing is exempt from lateral or horizontal violence.

So how would you respond to the poll question of “How do you feel about working with the over 65 nurse?” Is this something you are positive about? If so, then be sure to recognize the contributions of the older nurses you work with. If you’re not so positive about this, take a few minutes to think about why you feel this way and consider the possibility that you are underestimating the contributions of older nurses. And for those of you who say that “It depends on the nurse,” I happen to agree with you. It’s not a nurse’s age, but rather a nurse’s capabilities and personality that make us want to work with that nurse or not, and even if we do not like working with someone, lateral or horizontal violence is never acceptable.

Lisa Schulmeister, MN, APRN-BC, OCN®, FAAN, is an oncology nursing consultant and adjunct assistant professor of nursing at Louisiana State Health Sciences Center in New Orleans, LA, and the editor-in-chief of OncNurse.