Early retirement among Registered Nurses: contributing factors

Individual, family, job, and organizational factors associated with retirement intentions among older long-term care workers: A systematic review

This systematic review synthesized prior quantitative research on individual, family, job, and organizational factors associated with retirement intentions (RI) among older long-term care (LTC) workers. Seven databases were searched for peer-reviewed studies. RI were defined as early (<65 years) or late (>65 years). To assess the methodological quality, we used JBI's checklists. The PRISMA statement guided this review. After duplicates were removed, 4 489 records were identified. A final sample of six articles was selected as eligible for inclusion. Current findings show weak social support, high physical job demands, and type of LTC occupation as important determinants for early RI. Strong social support and good job resources are important determinants fore late RI. In contrast to earlier research on other groups of older workers, this review shows no statistically associations between health nor emotional job demands and early RI for LTC workers. The results are discussed using the JD-R theory.

Personal and Work-Oriented Characteristics Distinguishing Older Nurses' Partial or Complete Actual Retirement Behavior over Three Years

To retain nurses and prevent worsening the nursing shortage, a key opportunity is to better understand the drivers of complete and partial retirement of older nurses. This study investigates the characteristics that distinguish older nurses' partial and complete actual retirement behavior, from those continuing to work, over a three-year period. A quantitative longitudinal design comprising 217 female Australian nurses aged 50 years or over, from two samples working at Time 1 (2012 and 2016), responding three years later (Time 2). Multinomial regression found two different patterns of drivers for each of completely retiring and partly retiring respectively. Age was the only variable distinguishing both partly and completely retired nurses from nurses who were not retired. The further variables distinguishing completely retired nurses were not being prosperous, having impaired work ability, being partnered, not stressed at work and working part-time. The only variable beyond age distinguishing partly retired nurses was having a casual contract. Offering flexible work options in terms of working hours and contracts that suit the nurse's lifestyle and supporting nurses with health impairments to continue working are options that may lessen the number of nurses completely retiring and instead either remaining at work or partly retiring.

Prospective Drivers of Nurses' Partial or Complete Retirement Seven Years Later: Work Ability and Physical Functioning Going against the Tide of Age

In the context of a nursing shortage in many developed countries, one option for retaining the expertise of older nurses in the workforce is to better manage the retirement of nurses. This study will investigate life course predictors of actual retirement behavior, whether partial or complete, for older working nurses over a seven-year span. Data were analyzed from a quantitative, longitudinal survey of 178 Australian nurses aged 45 years and older working at Time 1 (2012), who responded seven years later (Time 2). Age predicted both forms of retirement behavior, confirming the strength of social normative pressures toward retirement. Moving against this social normative tide toward retirement were the predictors of partial retirement such as job satisfaction, physical functioning and work ability. In turn, working part-time was the only predictor, beyond age, of complete retirement. Nurse and health service managers could support nurses to stand against the tide of social normative pressures (until such social norms change) by managing the nurses' physical functioning and work ability, including by more explicitly managing the impacts of chronic diseases in the workplace, not least so as to retain their nurses in the context of nurse shortages.

Challenges and coping strategies of nurses and midwives after maternity leave: A cross-sectional study in a human resource-constrained setting in Ghana

AIM

This study examined the challenges and coping strategies adopted by nurses and midwives after child birth when they return to work.

DESIGN

A cross-sectional design was used.

METHOD

Two hundred nurses and midwives with history of maternity leave were recruited from the Korle-Bu Teaching Hospital to take part in this study. Data were collected using a pre-tested self-administered questionnaire. The data were analysed with the aid of Stata 13.0.

RESULTS

Most of the respondents claimed that they received support from relatives, day care centres and paid house helps while they resumed work. Seventy percent of the respondents indicated that they were given off day when they needed to send their child for postnatal care. Nurses and midwives depend on family members, paid house helps and day care centres to help them cater for their babies. It is recommended that hospitals set-up day care centres and breastfeeding bays attached to the institutions.

Exploring Determinants of Early Retirement Among Saudi Medical Staff

The aim of this research was to explore the relationship between the push, pull, anti-push, and anti-pull factors vs. early retirement intention among Saudi medical staff, and to investigate whether there are gender differences in the early retirement intention. To this end, we designed a correlational and cross-sectional study, for which data were collected through an online survey. A total of 680 responses were gathered, of which 221 valid responses constituted the final sample for the analysis. Logistics regression was used to test the hypotheses of the study. The results showed that approximately 58% of the respondents indicated early retirement intention. The significant factors in predicting this intention were the pull, anti-push, and anti-pull factors, whereas the push factors were found to be insignificant. Moreover, female medical staff tend to retire earlier than males. Strategies recommended to delay retirement are providing flexible work hours, working shorter shifts or on a part-time basis, offering programs for professional development, and according more recognition.

A service improvement project of a legacy nurse programme to improve the retention of late career nurses

Background

A Nottingham Legacy Nurse Programme was developed in response to the reducing supply of new nursing registrants and an ageing workforce. The programme comprised components of focussed mentorship, knowledge transition, support and development of new learners in practice.

Aims

The work-based development programme aimed to improve the retention and experience of late career registered nurses.

Methods

The programme was informed by the evidence base and co-produced with late career registered nurses (aged 55 years or over, approaching retirement). A small pilot programme (n = 6) was evaluated through a mixed-methods approach. Refinements and recommendations were proposed in response to findings of a scoping search of the literature, feedback from participants and stakeholder groups across the NHS Midlands and East regions (n = 238).

Results

A Legacy Nurse programme has potential to address nurses' individual career development needs, valuing and retaining them in the workforce, enabling them to share professional knowledge and skills within clinical teams and offers a cost-effective solution to improving retention of late career nurses.

Conclusions

Addressing the needs of late career registered nurses is required to improve retention, job satisfaction, quality-of-care provision and facilitate knowledge transfer. The programme requires evaluation in other care settings and should be considered as part of an integrated approach to nurse retention, inclusive talent management and workforce planning, alongside financial and careers advice.

Into the Grey Zone: Retired Nurses’ Reflections on Ethics in Canadian Nursing Practice

Context: Nurses are often hesitant to talk about ethical issues in their practice for many unique and valid reasons. What if the burden of risk was lifted upon retirement, even if just slightly? The purpose of this study was to explore retired nurses’ reflections on their experiences of ethical issues and decision making in various nursing practice settings throughout their careers and to glean recommendations for ethics in contemporary nursing practice. Methods: Data were collected via in-depth, individual, semi-structured interviews. Guided by an interpretive, descriptive approach, data were managed with NVivo v.11 and analyzed with an inductive, comparative, thematic approach. In northern Ontario, two nurse researchers co-interviewed eight retired nurses with decades of practice experience across diverse Canadian health care settings. Ethics approval was obtained through Lakehead University’s Research Ethics Board. Findings: Three themes emerged to address ethical issues in practice; these are creativity, resourcefulness, and a strong sense of community with other nurses. Further, the retired nurses’ collated reflections on ethics in practice are presented as the FIG model: Fellowship, Ingenuity, and Gumption. Conclusions: This study identifies ethical underpinnings that retired nurses have used to effectively respond to ethical issues in their practice. Those who are currently nursing, and nursing as a profession, may wish to recognize and retain these strategies in order to continue to deliver a high standard of quality, ethical care. Recommendations for practice, research, and education are offered.

The early retiree divests the health workforce: a quantitative analysis of early retirement among Canadian Registered Nurses and allied health professionals

BACKGROUND

Early retirement (before age 65) is the norm among registered nurses (RNs) and allied health professionals (AHPs) employed in Canada's public system. As a country whose population is rapidly aging, it is in Canada's best interest to try and extend the work lives of RNs and AHPs.

OBJECTIVES

(1) To test the predictive validity of our conceptual model of early retirement among publicly employed, Canadian RNs and AHPs and (2) to compare, across professions, model fit and factor significance METHODS: We conducted multivariable logistic regression in two data sets, one consisting of 483 retired RNs and the other of 177 retired AHPs. The number of AHP respondents limited our ability to comprehensively test the model.

RESULTS

Eighty-five percent of RNs and 77% of AHPs had retired early. (1) Results indicate that 25% of variance in RN early retirement and 19% of variance in AHP early retirement was explained by included variables. (2) Organizational restructuring increased odds of early retirement by more than 100% among RNs and AHPs. Among RNs (but not AHPs), both financial possibility and caregiving responsibilities predicted early retirement at statistically significant levels, while a "desire to stop working" predicted retirement at or after 65 years of age.

CONCLUSIONS

Clearly, there is much more to learn about RN and AHP pathways to early retirement. Further research, ideally research exploring the role of workplace characteristics, attitudes, and beliefs towards retirement and work-related factors, could deepen our understanding of the phenomenon of RN/AHP early retirement.

The relationship between quality of life and social support among nurses: A cross-sectional study

OBJECTIVE

This research was conducted with the aim of evaluating the quality of life (QoL) and its relationship with social support of nurses.

MATERIALS AND METHODS

This cross-sectional study was performed on 241 nurses working at Zanjan University of Medical Sciences. The instruments used in this study were the Persian SF-36 tool, McCain Marquin Social Interaction Questionnaire, and information on individual and job characteristics. The sampling method was cluster sampling with probability proportional to population size. The information was analyzed using SPSS version 18 and with proportional statistics.

RESULTS

Only 31.6% (67) of the nurses had high levels of social support. The average social support was 47/65 ± 93/6. The highest mean score of QoL 67.75 ± 25.023 was related to physical activity and the lowest score mean were related to dimensions of bodily pain (54.59 ±22.727) and role limitations because of physical health problems (59.60 ± 40.261). In the linear regression model with the Enter method, the adjustment of the effects of the variables of the three dimensions of general health, mental health and happiness, and QoL was associated with social support.

CONCLUSION

The majority of nurses have moderate social support and poor QoL for nurses. Therefore, considering the effects of nurse support, it is recommended to perform supportive interventions and plan for more well-being of nurses.

Conceptual Models of Early and Involuntary Retirement among Canadian Registered Nurses and Allied Health Professionals

La disponibilité des professionnels de la santé est fondamentale pour la santé de la population. Plusieurs tendances contribuent cependant à la pénurie de ces professionnels. Objet : Élaborer et valider des modèles conceptuels de retraite hâtive et de retraite involontaire pour les infirmières et les professionnels paramédicaux (PP). Méthode : Une revue de la littérature sur la retraite (n = 23 études) a été réalisée. Toutes les variables rapportées comme des facteurs prédictifs de la retraite hâtive ou de la retraite involontaire ont été incorporées dans un modèle. Pour atteindre une validité apparente, nous avons mené des entrevues avec des infirmières et des PP canadiens (n = 14). Résultats : Le modèle conceptuel de la retraite hâtive incluait huit catégories (38 facteurs): caractéristiques du lieu de travail, variables sociodémographiques, attitudes et croyances, contexte plus général, facteurs organisationnels, famille, mode de vie et santé, en lien avec le travail. Le modèle de la retraite involontaire incluait quatre catégories (8 facteurs): contexte plus général, variables sociodémographiques, mode de vie et santé, famille. Les responsabilités en matière de soins (facteur) ont été ajoutées compte tenu des résultats des entrevues. Discussion : Les infirmières et les PP tiennent compte de nombreux facteurs lorsqu’ils envisagent leur retraite. Certains seraient sensibles à l’intercession, ce qui permettrait d’étendre la vie professionnelle des infirmières et des PP plus âgés.

Job satisfaction, work environment and successful ageing: Determinants of delaying retirement among acute care nurses

AIM

To determine the relationships between job satisfaction, work environment and successful ageing and how these factors relate to Registered Nurses' intent to retire.

BACKGROUND

Although little studied, retention of older nurses by delaying early retirement, before age 65, is an important topic for research. Qualitative and quantitative studies have indicated that job satisfaction work environment and successful ageing are key motivators in acute care Registered Nurses retention and/or delaying retirement. This study was designed to provide information to administrators and policy makers about retaining older, experienced RNs longer and more productively.

DESIGN

This was a correlational, descriptive, cross-sectional study.

METHODS

An online survey of acute care Registered Nurses (N = 2,789) aged 40 years or older working in Florida was conducted from September - October 2013. Participants completed items related to job satisfaction, work environment, successful ageing and individual characteristics. Hypotheses derived from the modified Ellenbecker's Job Retention Model were tested using regression analysis.

RESULTS

Job satisfaction scores were high. Highest satisfaction was with scheduling issues and co-workers; lowest with advancement opportunities. Successful ageing scores were also high with 81% reporting excellent or good health. Work environment explained 55% of the variance in job satisfaction. Years to retirement were significantly associated with successful ageing (p < .001), age (p < .001) and income (p < .010).

CONCLUSIONS

This study provides quantitative evidence that environment and successful ageing are important areas that have an impact on job satisfaction and delay of retirement in older nurses and further studies in these areas are warranted to expand on this knowledge.

Does Organizational Justice Modify the Association Between Job Involvement and Retirement Intentions of Nurses in Finland?

Given the growing aging population in Finland, retaining health staff to care for them is important. In an exploration of predictors of quitting before the typical retirement age, which ranges from 63 to 68 years in Finland, we examined whether organizational justice moderated the association between job involvement and retirement intentions among nurses 50 years and over. The sample was 446 nurses (70% practical nurses) working in 134 assisted living facilities providing 24-hour care for older residents in Finland. Job involvement was measured with the Job Involvement Questionnaire, and organizational justice with a scale that tapped its three dimensions: distributive justice, procedural justice, and interactional justice. In covariance analyses, low organizational justice and low job involvement were associated with a higher likelihood of retirement intention. Both interactional justice and procedural justice moderated the association of job involvement with retirement intentions. Among nurses with low job involvement, those who experienced unjust treatment, that is, low interactional justice, and evaluated organizational procedures as unjust had significantly stronger retirement intentions than nurses with high levels of interactional and procedural justice. Distributive justice was associated with retirement intentions in both high and low job-involved respondents. Organizational justice may act as a buffer against retirement intention as one consequence of nurses' low job involvement. © 2016 Wiley Periodicals, Inc.

Nurse managers’ role in older nurses’ intention to stay

Purpose

– The purpose of this paper is to propose and test a model of the underlying mechanisms linking perceived availability of human resource (HR) practices relevant to older nurses and older nurses’ intentions to stay with their hospitals.

Design/methodology/approach

– Quantitative data were collected from randomly selected older registered nurses (N=660) engaged in direct patient care in hospitals in Canada. Structural equation modelling was used to test the hypothesized model.

Findings

– The relationship between perceptions of HR practices (performance evaluation, recognition/respect) and intentions to stay was mediated by the perceived fairness with which nurse managers managed these HR practices and nurse manager satisfaction. When nurse managers were perceived to administer the HR practices fairly (high perceived procedural justice), older nurses were more satisfied with their nurse manager and, in turn, more likely to intend to stay.

Research limitations/implications

– The cross-sectional research design does not allow determination of causality.

Practical implications

– It is important that nurse managers receive training to increase their awareness of the needs of older nurses and that nurse managers be educated on how to manage HR practices relevant to older nurses in a fair manner. Equally important is that hospital administrators and HR managers recognize the importance of providing such HR practices and supporting nurse managers in managing these practices.

Originality/value

– The findings increase the understanding of how HR practices tailored to older nurses are related to the intentions of these nurses to remain with their hospital, and especially the crucial role that first-line nurse managers play in this process.

Healthy work environments for the ageing nursing workforce

AIM

The aim of this article is to describe the physical challenges that ageing nurses experience and the facility design features that can promote healthy work environments to motivate nurses to continue working.

BACKGROUND

Older nurses are working longer and beyond the usual retirement age. They often experience chronic fatigue and the usual physical and cognitive changes associated with aging. Nursing is a physically demanding profession and many older nurses work in pain while providing direct patient care. The literature is replete with studies focusing on the organisational factors that retain older nurses, but little research addresses design factors that facilitate nurses working longer and more safely in direct patient care.

EVALUATION

Electronic databases in medicine, nursing, psychology, and architecture were searched and evidence-based, non-evidence-based, and review articles and government and organisational newsletters were evaluated.

KEY ISSUES

Hospital design can help address the physical work challenges that older nurses experience.

CONCLUSIONS

Older nurses have a wealth of knowledge and expertise, and the design of nursing units can optimize their work experience.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse Managers must participate in design efforts and advocate designs that support aging nurses.

A personal reflection: the difficult decision to leave critical care nursing

At some point in their careers, all critical care nurses will decide that it is time for them to leave critical care nursing. Whether this decision happens because of role change, retirement, or burnout, the decision can be a difficult one. This article explains my decision to leave the pediatric critical care unit and explores some of the reasons nurses leave critical care.

Turning the tide: Registered nurses' job withdrawal intentions in a Finnish university hospital

Orientation: Given the global shortage of registered nurses, it is important to investigate the intentions for job withdrawal of nurses, and resolve these, in order to retain nurses in the field.Research purpose: The objective was to examine the intentions for job withdrawal of ageing and younger nurses, and the antecedents of these intentions, with special reference to job control and perceived development opportunities. The age of 45 was adopted as a starting point when referring to ageing employees.Motivation for the study: Different forms of job withdrawal have rarely been studied together and associated.Research design, approach and method: A quantitative study was applied with logistic regression analyses. Respondents were registered nurses working in a university hospital in Finland. The response rate was 46.1% (N = 343).Main findings: A quarter (25%) of the nurses had frequently thought about leaving the profession and 19% of the nurses had thought about taking early retirement. Factors that increased the likelihood of intentions for occupational turnover were young age, low job satisfaction, low organisational commitment, low work ability and skills in balance with or above present work demands. The intention to take early retirement was increased with older age, being male, working shifts, low work ability, low job satisfaction and poor job control.Practical/managerial implications: A nurse’s job satisfaction and work ability should be regularly monitored and opportunities should be offered them, to apply their skills and to control their work, in order to retain them.Contribution/value–added: The article added information about the factors that contribute to a nurse’s intentions for job withdrawal.

Work and non-work social support and intent to stay at work among Jordanian hospital nurses

PURPOSE

To examine (1) the level of intent to stay at work among Jordanian nurses; (2) the levels of at-work and non-work social support; and (3) the extent of variance in the level of intent to stay at work because of the demographic and social support variables.

DESIGN

A survey design was used to investigate the predictors of intent to stay at work among the population of Jordanian nurses in three public hospitals. Two hundred and seventy five participants submitted complete and usable questionnaires. The response rates were 50%, 55% and 70%, respectively.

METHODS

Data were collected using a questionnaire that included a scale for measuring social support, the McCain's Intent to Stay Scale and the demographic form.

FINDINGS

The results showed that support from supervisors, marital status, number of friends at work, number of children at home, gender, time commitment, support from co-workers and support from family accounted for 60% of the variation in the level of intent to stay. The results indicated that nurses who were females, had children at home, worked full time and perceived having more support from co-workers and supervisors tended to stay at work more than others. On the other hand, the results showed that marital status, number of friends at work and family support were associated negatively with intent to stay at work.

CONCLUSION

The findings of the study suggest the important role of workplace social support in enhancing the level of intent to stay at work.

Registered Nurses’ Views About Work and Retirement

Study purpose: The purpose of this study was to identify what motivates experienced nurses to continue working and to consider retirement. Method: A total of 16 intensive care nurses completed phenomenological interviews. The experienced nurses were split into two groups: 31 to 49 years old (younger nurses) and 50 to 65 years old (older nurses). Results: Both groups expressed that concern about changing benefits and financial security kept them working. The younger nurse group valued working for autonomy and respect, camaraderie with peers, providing for their families, and because their parents influenced retirement perceptions. The older nurse group valued working as a way to connect with patients and families. Experiences that provoked thoughts of retirement in the older group were changes related to new technology. Older nurses did not want to work to the extent that their health was influenced. Application: By designing human resource policies that address the concerns that influence nurse retirement choices, administrators can maximize retention strategies.

Should I stay or should I go? Career change and labor force separation among registered nurses in the U.S

Efforts to retain nurses within the profession are critical for resolving the global nursing shortage, but very little research explores the phenomenon of nursing workforce attrition in the U.S. This study is the first to simultaneously investigate the timing of attrition through survival analysis, the exit path taken (career change vs. labor force separation), and the major socioeconomic, family structure, and demographic variables predicting attrition in this country. Using nationally representative U.S. data from the 2004 National Sample Survey of Registered Nurses (N=29,472), we find that the rate of labor force separation is highest after the age of 60, a typical pattern for retirement. However, a non-trivial proportion of career change also occurs at older ages (50+ years old), and the rate of labor force separation begins to climb at relatively young ages (30-40 years old). Particularly strong predictors of early labor force separation include being married and providing care to dependents in the home (young children or elderly parents). Career change is predicted strongly by higher levels of education, male gender, and current enrollment in a non-nursing degree program. Having an Advanced Practice credential reduced the hazards of attrition for both exit paths. The results suggest a fruitful path for future research and a number of policy approaches to curbing nurse workforce attrition.

Registered nurses' perceptions of health and safety related to their intention to leave

This study examined perceptions of general and emotional health among a statewide sample of nurses, and their assessment of employers' workplace health and safety initiatives. These variables and demographic data were then used to model predictors of intention to leave their work positions. A survey was mailed to all registered nurses in one state. Fifty-three percent responded (n = 3,955). Findings suggested marked differences in perception of emotional health by age, with younger nurses reporting less positive perceptions of their emotional health. Perceptions of employers' safety and health initiatives varied by age, setting, and work role. Predictors of intention to leave included lower perceived emotional health among younger nurses and employer safety initiatives for both age groups. This exploratory study suggests a relationship among employer health and safety practices, nurses' emotional health, and intention to leave. Implications for occupational health nurses are detailed.

Registered Nurses' Perceptions of Health and Safety Related to Their Intention to Leave

This study examined perceptions of general and emotional health among a statewide sample of nurses, and their assessment of employers' workplace health and safety initiatives. These variables and demographic data were then used to model predictors of intention to leave their work positions. A survey was mailed to all registered nurses in one state. Fifty-three percent responded ( n = 3,955). Findings suggested marked differences in perception of emotional health by age, with younger nurses reporting less positive perceptions of their emotional health. Perceptions of employers' safety and health initiatives varied by age, setting, and work role. Predictors of intention to leave included lower perceived emotional health among younger nurses and employer safety initiatives for both age groups. This exploratory study suggests a relationship among employer health and safety practices, nurses' emotional health, and intention to leave. Implications for occupational health nurses are detailed.

Factors associated with hospital retention of RNs in the New York City Metropolitan Area: an analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses

The nursing shortage is well documented, and government estimates indicate that shortfalls will worsen in the future. As the largest employer of registered nurses (RNs), hospitals are the most seriously affected by shortages, as they compete with other employment settings for limited nursing resources. Recruitment remains the primary avenue for ensuring staffing levels, but retention is increasingly important as applicant pools shrink because of demographic and employment trends. Effective retention strategies must address the factors that contribute to exodus of RNs from hospitals, as well as isolating the factors that enable RNs to remain in hospital employment. This secondary analysis of the 1996, 2000, and 2004 National Sample Survey of Registered Nurses examines the demographic, employment, and educational factors associated with working in hospitals, having full-time status, and holding patient care positions. The findings suggest that hospitals must address nonwork issues to retain nursing personnel. Relevant policy issues are examined and strategies for effective retention are offered.