Why older nurses leave the workforce and the implications of them staying

Workload, Job Satisfaction and Quality of Nursing Care in Italy: A Systematic Review of Native Language Articles

Nursing research is rapidly increasing, yet contributions from numerous countries that may interest the international nursing community are impeded because many research articles are published in authors' native language and not in English. The objectives of this work were to systematically review papers published in Italian related to job satisfaction and the quality of nursing care, and to discuss their findings in light of the international literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used. The Directory of Open Access Journals (DOAJ) and Indice della Letteretura Italiana di Scienze Infermieristiche (ILISI) databases were consulted for eligible studies published from January 2015 to November 2022. Two hundred sixteen papers were identified, 11 of which were selected for review: 8 on job satisfaction, two on workload issues, and 1 on quality of nursing care. The quality of included studies was assessed through the Effective Public Health Practice Project quality assessment tool (EPHPP). The results of our review were in line with those of international literature, and they can help to fill the knowledge gap on the quality of nursing performance in Italian care settings. In addition, the proposed method can provide further elements of discussion among literature providers and reviewers.

Financial characteristics and security of podiatry work in Victoria: the PAIGE cross sectional study of Australian podiatrists

BACKGROUND

Podiatrists' earnings have an important influence on workforce dynamics. This includes the profession's ability to attract and retain workers so the population's healthcare needs can be met. This study aimed to describe financial characteristics of podiatry work and factors relating to a sense of financial security.

METHODS

This was a cross sectional study using data from Victorian podiatrists who participated in Wave 1 of the Podiatrists in Australia: Investigating Graduate Employment (PAIGE) survey. Demographic and financial characteristics were described. The outcome measure, financial security, was collected through a self-reported belief based on current financial situation and prospects, respondents' perception of having enough income to live on when they retire. Univariate logistic regression was used to determine associations with rural or metropolitan practice locations. Multiple ordered logistic regression was performed to explore associations between factors relating to financial security and retirement prospects.

RESULTS

There were 286 Victorian podiatrist (18% of n = 1,585 Victorian podiatrists) respondents. Of these, 206 (72% of n = 286) identified as female, 169 (59% of 286) worked in the private sector and the mean (SD) age was 33.4 (9.5) years. The mean (SD) annual gross income was $79,194 ($45,651) AUD, and 243 (87% of 279) made regular superannuation contributions. Multiple ordered logistic regression analyses identified factors associated with podiatrists' perception of having adequate retirement income. These included being an owner/partner of their main workplace (adj OR = 2.70, 95% CI = 1.49-4.76), growing up in a rural location (adj OR = 2.27, 95% CI = 1.38-3.70), perceiving a moderate overall health rating (adj OR = 2.03 95% CI = 1.51-2.75), not having financial debt related to education and training (adj OR = 2.02, 95% CI = 1.24-3.32) and regular contributions to a superannuation scheme (adj OR = 4.76, 95% CI = 2.27-10.00).

CONCLUSION

This is the first known study to explore podiatrists' earnings and perceptions regarding financial security. Findings suggest modifiable ways to improve financial security of podiatrists including support and education about personal and business finances including debt management, understanding the importance of contributions to superannuation when self-employed, and developing skills and supports for podiatrists to run their own businesses. This research is exploratory and is relevant for understanding the impact that income and financial security have on workforce dynamics.

A lack of nurse autonomy impacts population health when compared to physician care: an ecological study

This study highlights that the contribution of nursing is secondary to physicians in overall population health (indexed with life expectancy at birth, e₍₀₎). Scatter plots, bivariate correlation and partial correlation models were performed to analyse the correlations between e₍₀₎ and physician healthcare and nursing healthcare respectively. Affluence, urbanization and obesity were incorporated as the potential confounders. The Fisher's r-to-z transformation was conducted for comparing the correlations. Multiple linear regression analyses were implemented for modelling that physicians' contributions to e₍₀₎ explain nurses'. Nursing healthcare correlated to e₍₀₎ significantly less strongly than physician healthcare in simple regressions. Nursing healthcare was in weak or negligible correlation to e₍₀₎ when physician healthcare was controlled individually or together with the three confounders. Physician healthcare remains significantly correlational to e₍₀₎ when nursing healthcare alone was controlled or when the three confounders were controlled. Linear regression revealed that nursing healthcare was a significant predictor for e₍₀₎ when physician healthcare was "not added" for modelling, but this predicting role became negligible when physician healthcare was "added". Our study findings suggested that nurses still work under the direction of physicians due to lack of autonomy. Without correction, health services will continue to transmit the invisibility of nursing healthcare from one generation of nurses to another.

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.

Sustainable Working Life in Intensive Care: A Qualitative Study of Older Nurses

To counteract the shortage of nurses in the workforce, healthcare organizations must encourage experienced nurses to extend their working lives. Intensive care (IC) has higher nurse-to-patient ratios than other settings, which includes a particular susceptibility to staff shortage. This qualitative study investigated how older IC nurses experienced their working life and their reflections on the late-career and retirement. Semi-structured interviews with 12 IC nurses in Sweden (aged 55-65 years) were analyzed using an interpretative phenomenological analysis approach. The results showed that nurses planned to continue working until the age of 65 and beyond. When reflecting on their late-career decisions, nurses considered nine areas covering individual, work, and organizational factors as being central to their ability and willingness to stay. Overall, the nurses had good health and were very satisfied and committed to their job and to the organization. They mentioned having both the job and personal resources required to cope with the physical and mental job demands, which were perceived as motivational challenges, rather than hinders. They also reflected on various human resource management practices that may promote aging-in-workplace. These findings may inform organizations aiming at providing adequate conditions for enabling healthy and sustainable working lives for IC nurses.

Change in nurses’ psychosocial characteristics pre- and post-electronic medical record system implementation coinciding with the SARS-CoV-2 pandemic: pre- and post-cross-sectional surveys

Background

The impacts of electronic medical record implementation on nurses, the largest healthcare workforce, have not been comprehensively examined. Negative impacts on nurses have implications for quality of patient care delivery and workforce retention.

Objective

To investigate changes in nurses’ well-being, intention to stay, burnout, work engagement, satisfaction, motivation and experience using technology pre- and post-implementation of an organisation-wide electronic medical record in Victoria, Australia.

Methods

The natural experiment comprised an electronic medical record system implementation across six hospitals of a large tertiary healthcare organisation. Cross-sectional surveys were collected pre-electronic medical record implementation prior to the SARS-CoV-2 pandemic in 2019, and 18-months post-electronic medical record implementation during the pandemic in 2020, and findings compared.

Results

A total of 942 surveys were analysed (550 pre-electronic medical record (response rate 15.52%) and 392 post-electronic medical record (response rate 9.50%)). Post-electronic medical record, nurses’ work satisfaction (r = 0.23, p=<0.001), intention to stay (r = 0.11, p = 0.001) and well-being (r = 0.17, p=<0.001) decreased. Nurses’ perceived competence increased (r = 0.10, p = 0.002) despite decreased autonomy (r = 0.10, p = 0.003). Two of three dimensions of work engagement worsened (vigour r = 0.13, p=<0.001; dedication r = 0.13, p=<0.001) and all dimensions of burnout increased (exhaustion r = 0.08, p = 0.012, cynicism r = 0.07, p = 0.04 and reduced efficiency r = 0.32, p=<0.001). Nurses reported more burnout symptoms (95% CI 4.6–4.7%, p = 0.036), were less engaged (95% CI 49.6–49.9%, p=<0.001) and career trajectory satisfaction decreased (r = 0.15, p=<0.001). Matched data from 52 nurses showed changes in the same direction for all items except career trajectory satisfaction, hence validated findings from the larger unmatched sample.

Conclusions

Implementation of an electronic medical record immediately followed by the SARS-CoV-2 pandemic was associated with negative changes in nurses’ well-being, intention to stay, burnout, work engagement and satisfaction.

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.

Understanding the factors that affect retention within the mental health nursing workforce: a systematic review and thematic synthesis

There are over 41 000 vacant nursing posts across the United Kingdom's National Health Service (NHS), with more people leaving the profession that joining it. Despite mental health being acknowledged as a priority area, some of the most significant staff shortages are occurring within mental health services. Urgent action is needed to retain the mental health nurses (MHNs) currently in post to ensure the profession is fit for purpose and aid future recruitment efforts. This review set out to identify the individual factors that affect the retention of MHNs. A systematic search of six databases was conducted (CINAHL, PsychINFO, MEDLINE, Web of Science (Core collection), EMBASE and the British Nursing Index). Studies were systematically screened for inclusion based on predetermined eligibility criteria. The studies were quality assessed using the Mixed Methods Appraisal Tool (MMAT). Findings were synthesized using Thematic Synthesis. A total of 23 studies consisting of a range of study designs were included in the review. Four key themes emerged from the synthesis: Individual characteristics, Working within mental health services, Training and skills and Work environment. The findings from this review suggest that MHNs encounter some factors unique to working in mental health services, which suggests that retention strategies should be specific to each nursing speciality. Beyond nursing speciality, the factors identified vary between clinical settings in mental health due to the differences in work environments and services they provide. Future studies should now set out to explore what factors exist in which clinical settings to inform better tailored retention strategies to generate better outcomes.

The meaning of nursing practice for nurses who are retired yet continue to work in a rural or remote community

BACKGROUND

Although much research has focused on nurses' retirement intentions, little is known about nurses who formally retire yet continue to practice, particularly in rural and remote settings where mobilization of all nurses is needed to assure essential health services. To optimize practice and sustain the workforce stretched thin by the COVID-19 pandemic, it is necessary to understand what it means for retired registered nurses (RNs) and licensed practical nurses (LPNs) to work after retirement. This study explored what nursing practice means for RNs and LPNs who have formally retired but continue to practice in rural and remote communities.

METHODS

A pan-Canadian cross-sectional survey conducted in 2014-2015 of nurses in rural and remote Canada provided data for analysis. Textual responses from 82 RNs and 19 LPNs who indicated they had retired but were occasionally employed in nursing were interpreted hermeneutically.

RESULTS

Retired nurses who continued to practice took on new challenges as well as sought opportunities to continue to learn, grow, and give back. Worklife flexibility was important, including having control over working hours. Nurses' everyday practice was inextricably tied up with their lives in rural and remote communities, with RNs emphasizing serving their communities and LPNs appreciating community recognition and the family-like character of their work settings.

CONCLUSIONS

Retired nurses who continue to work in nursing see retirement as the next phase in their profession and a vital way of engaging with their rural and remote communities. This study counters the conventional view of retaining retired nurses only to combat nursing shortages and alleviate a knowledge drain from the workplace. Rural and remote nurses who retire and continue working contribute to their workplaces and communities in important and innovative ways. They can be characterized as dedicated, independent, and resilient. Transitioning to retirement in rural and remote practice can be re-imagined in ways that involve both the community and the workplace. Supporting work flexibility for retired nurses while facilitating their practice, technological acumen, and professional development, can allow retired nurses to contribute their joy of being a nurse along with their extensive knowledge and in-depth experience of nursing and the community.

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.

A scoping review of the nursing workforce's changing demography: Supporting Baby-Boomer nurses

AIMS

This scoping review discusses two telecommuting options to advance scholarship regarding Baby-Boomer nurses' delayed retirement and to extend their contribution to bedside nursing.

BACKGROUND

Peer-reviewed studies published in the 15 years before COVID-19 indicate that Baby-Boomer nurses' retirement will increase the global nursing shortage. However, three international trends have affected Baby-Boomer nurses' decision to delay their retirement.

EVALUATION

This review observed the scoping review framework.

KEY ISSUES

COVID-19 further disrupts the current understanding of Baby-Boomer nurses' retirement as they recognize COVID-19's impact on health care systems and younger nurses. Technological advancements and the changing needs of health care delivery have made telecommuting a practical possibility.

CONCLUSION

Baby-Boomer nurses can leverage alternative work arrangements to meet their needs and to contribute to clinical practice through telecommuting. This approach extends Baby-Boomer nurses' careers and creates a resource for bedside nurses.

IMPLICATIONS FOR NURSING MANAGEMENT

Clinical experience matters at the bedside. Telecommuting maximizes the retention of Baby-Boomer nurses' clinical expertise to benefit patients and to socialize bedside nurses. Baby-Boomer nurses can contribute to patient monitoring as well as patient education and counselling through telehealth. They can also provide asynchronous and synchronous telementoring to bedside nurses.

Intention to Extend Working Life among Thai Registered Nurses in Ministry of Public Health: A National Survey

The serious shortage of registered nurses (RNs) in Thailand has made the Thai government tentatively propose a policy to extend the working life of Ministry of Public Health nurses. This study aimed to estimate the proportion of those RNs who intend to extend their working life and analyzed the associations between general characteristics, quality of work life, and job characteristics of the RNs and their intention to work past retirement age. This cross-sectional study was conducted from October 2016 to April 2017. Self-administered questionnaires were distributed nationally to 3,629 RNs in the age group 55-59 years and working for the Ministry of Public Health (MoPH), Thailand. The response rate was 85.0% (3,092 RNs). Due to the small number of male participants (n=74), males were excluded from the study. The analysis was limited to the 3,018 participants who returned the questionnaire and met the inclusion criteria. Descriptive statistics and multiple logistic regression were used for data analysis. Of the 3,018 participants, the proportion of RNs intending to extend their working life from 60 to 65 years was 30.5%. In the Service Department, the factors significantly associated with intention to extend working life were perceived good or very good health status, no shift work, monthly income more than 50,000 THB (1,595 USD), and having moderate or good working resources (p<0.01). In the four Academic Departments, perceived good or very good health status, monthly income more than 50,000 THB, family members not against the working life extension, and moderate or good working resources were the factors affecting intention to extend working life (p<0.01). This study indicated that understanding the various factors related to the intention to extend working life among RNs could lead to the design of appropriate programs to encourage them to continue working after the current retirement age.

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.

Retiring with Intention

: An increasing number of nurses are approaching retirement age and finding themselves faced with numerous challenges and opportunities. Yet many avoid thinking about and preparing for this important professional and personal transition. Some cannot imagine what they will do when their career ends, whereas others do not believe they are financially ready to retire. This article discusses strategies to address these and other common concerns and will help nurses embrace this new and exciting stage of their lives with deliberation, confidence, and financial security.

The health of working nurses: Hypertension prevalence, awareness, treatment and control by medication

AIMS

To investigate hypertension awareness, prevalence and treatment in nurses.

BACKGROUND

Nurses are the largest health workforce group, currently facing an ageing demographic and the risk of chronic disease such as hypertension. Little is known about hypertension in nurses despite the potential impact on work productivity.

METHODS

A cross-sectional online survey was distributed to nurses and midwives via the professional association and nursing directors. Questions were taken from published longitudinal health studies for blood pressure, hypertension and key sociodemographic and health factors.

RESULTS

The participants' (n = 5,041) mean age was 47.99 (SD 11.46) years. The majority knew their blood pressure, more so if they were female, of higher body mass index and aged 45-64 years, but less so if they were smokers. Hypertension prevalence increased with age, peaking at the oldest ages and the majority were treated (anti-hypertensive medication), less so if aged <55 years. Many nurses treated for hypertension had poor blood pressure control, were most often aged 45-54 years and were smokers.

CONCLUSIONS

Hypertension prevalence is less in nurses than in the general population, however, once diagnosed treatment is not optimized.

IMPLICATIONS FOR NURSING MANAGEMENT

The potential impact of hypertension on older nurses' work productivity justifies work-based support for risk reduction behaviours.

Retirement planning and work-related variables in Chinese older nurses: A cross-sectional study

AIM

To explore the situation of older nurses approaching retirement with regard to their retirement planning, and the relationship of their retirement planning behaviour with the job environment and job satisfaction under their current employment arrangements and other work-related variables.

BACKGROUND

Nurse shortage has become a global phenomenon that can be alleviated by retaining older nurses in service. The Chinese government proposed the "Incremental Delay Retirement Age Policy." However, older nurses face delayed retirement but lack retirement plans.

METHOD

A cross-sectional questionnaire survey was conducted among a convenience sample of older retiring nurses (n = 152; 84.92% response rate) recruited from every department of four large general hospitals in Changchun, Jilin Province from June to August 2016.

RESULT

The majority of the respondents presented poor retirement planning (n = 122, 80.3%). The independent variables of information exchange with patients, teamwork and personal growth and development explained approximately 16.6% of the variance in retirement planning. Nurse-patient communication and personal growth and development can promote retirement planning, but teamwork is negatively related to retirement planning.

CONCLUSION

Retirement planning by Chinese older nurses is related to certain work-related variables. However, many other work-related variables were not associated with retirement planning and require further research. Overall, Chinese older retiring nurses must improve their retirement planning practices.

Older nurses in Singapore: Factors associated with attitudes towards extending working life

Aims:

We aim to determine associations between demographic variables, motivation to work, economic factors, work demands and organisational attitudes towards older workers and whether nurses want to extend working life.

Background:

Singapore’s ageing workforce, coupled with the government’s enactment of re-employment legislation, calls for attention on older nurses’ concerns and views about working longer.

Methods:

A cross-sectional survey with nurses aged 50 and above was conducted.

Results:

Data from 355 respondents was analysed. Malay nurses were significantly less likely (OR 0.3, 95%CI 0.1–0.6) than Chinese nurses to want to work longer. Financing one’s retirement, societal trends in postponing retirement and physical capability to continue working were factors significantly associated with older nurses’ decisions to extend working life.

Conclusion:

Approximately 40% of older nurses in Singapore want to work up to and above age 65. Race, societal attitudes and economic factors contribute in older nurses’ decisions on retirement.

Implications for nursing management:

Given an ageing workforce and manpower shortage, it is important for nurse managers and higher authorities to devise strategies to keep nurses in the workforce as long as possible. This study highlights concerns and attitudes of older nurses towards extending working life, and could inform future planning of strategies to retain older nurses.

Nurses' practice environment and satisfaction with schedule flexibility is related to intention to leave due to dissatisfaction: A multi-country, multilevel study

BACKGROUND

Nursing turnover is a major issue for health care managers, notably during the global nursing workforce shortage. Despite the often hierarchical structure of the data used in nursing studies, few studies have investigated the impact of the work environment on intention to leave using multilevel techniques. Also, differences between intentions to leave the current workplace or to leave the profession entirely have rarely been studied.

OBJECTIVE

The aim of the current study was to investigate how aspects of the nurse practice environment and satisfaction with work schedule flexibility measured at different organisational levels influenced the intention to leave the profession or the workplace due to dissatisfaction.

DESIGN

Multilevel models were fitted using survey data from the RN4CAST project, which has a multi-country, multilevel, cross-sectional design. The data analysed here are based on a sample of 23,076 registered nurses from 2020 units in 384 hospitals in 10 European countries (overall response rate: 59.4%). Four levels were available for analyses: country, hospital, unit, and individual registered nurse. Practice environment and satisfaction with schedule flexibility were aggregated and studied at the unit level. Gender, experience as registered nurse, full vs. part-time work, as well as individual deviance from unit mean in practice environment and satisfaction with work schedule flexibility, were included at the individual level. Both intention to leave the profession and the hospital due to dissatisfaction were studied.

RESULTS

Regarding intention to leave current workplace, there is variability at both country (6.9%) and unit (6.9%) level. However, for intention to leave the profession we found less variability at the country (4.6%) and unit level (3.9%). Intention to leave the workplace was strongly related to unit level variables. Additionally, individual characteristics and deviance from unit mean regarding practice environment and satisfaction with schedule flexibility were related to both outcomes. Major limitations of the study are its cross-sectional design and the fact that only turnover intention due to dissatisfaction was studied.

CONCLUSIONS

We conclude that measures aiming to improve the practice environment and schedule flexibility would be a promising approach towards increased retention of registered nurses in both their current workplaces and the nursing profession as a whole and thus a way to counteract the nursing shortage across European countries.

Older nurses: A literature review on challenges, factors in early retirement and workforce retention

Introduction:

The widespread shortage of nurses has been exacerbated by an ageing workforce. Though skilled and productive, older nurses are more vulnerable to the physical and mental demands of nursing. Hence, this review was performed to determine the existing evidence on challenges faced by older nurses, factors which promote or deter retirement and strategies that could help in their retention. The results of this review would help with the implementation of age-friendly initiatives to enable older nurses to work longer, while simultaneously allowing institutions to maintain high-quality nursing care.

Methods:

A search was done using three databases, namely MEDLINE, the Nursing and Allied Health Literature (CINAHL) and PsycINFO. Primary studies and reviews published between 2004 and 2015 were retrieved. Keywords used were ‘older nurses’, ‘retirement’, ‘re-employment’ and ‘retention’.

Results:

Articles retrieved were mainly qualitative studies. A few quantitative surveys and reviews were reported. The definition of older nurses was inconsistent across the literature. Personal health concerns and limitations, computerisation and shift work were common challenges faced by older nurses, while monetary factors, health and workload were consistent themes on early retirement. Financial reasons were also identified as factors associated with retention, along with flexible schedules. Almost all strategies suggested in the literature for retaining older nurses lacked empirical testing.

Conclusion:

The ageing process may render certain tasks less desirable and more challenging for the older nurses. Employers could pay attention to the needs of an older workforce through improved workplace practices and being familiar with factors associated with early retirement and retention.