Originally published in HCPLive.com
by Colleen O’Leary, RN, MSN, AOCNS
Last time I talked about how I had never really experienced the concept of nurses eating their young in action.
However, I have seen the opposite begin to evolve. I see this as a bigger issue in nursing these days. The “putting out to pasture” of seasoned, experienced nurses is happening more often and for a variety of reasons.
First, and foremost, is simply the fact that the pool of nurses inevitably follows the general aging of the nation. As baby boomers who once filled the halls of healthcare institutions caring for others begins to age, they will certainly have a more difficult time meeting the demands of current healthcare. More and more institutions are requiring nurses to work longer and longer shifts, changing from an 8-hour day to a 12-hour day. This, along with the fact that patients in the inpatient settings have much higher acuity and a variety of complex issues, makes the demands on nurses even greater.
I know for myself that when I was working 12-hour shifts, I could only do two in a row. If I had to do the third one without a break, I was exhausted. I can only imagine how someone five, 10, or even 15 years older than me would feel. In fact, I remember one time when a new young nurse just starting out came to me and sheepishly asked, “What do you do when you go home after working a 12-hour shift?” He was finding that he was very tired and often unable to do anything but go home, have dinner, and go to bed. If someone that young has difficulty imagine how it is for the older nurse.
Not only are the hours and the complexity of patients difficult, but also the physical strain. Because patients have such high acuities, they often require turning, positioning, and moving that can cause stress on the nurse’s back, neck, arms, and legs. Injuries among nurses are much higher than even injuries among construction workers. Again, more stress and difficulty for the older nurse.
Another point to take into consideration is the advent of new technologies for diagnostics, assessment, and documentation. Often, when facilities start to change to electronic medical records, it’s the older nurses who have the most difficulty. The younger nurses grew up with advanced technology everywhere around them. I remember the first computer class I had to take in college taught us how to do keypunch machines. There were giant computers in a lab that you had to schedule time to use to do your work. Then you carried around a stack of cards with little computer generated holes punched in them, that when read, gave a story. Then many years later when I took a nutrition class and was told we had to do a computer program, I was terrified. I didn’t know how to use computer programs. How times have changed… But that’s the point. If you haven’t grown up with that being a part of your everyday life, it’s very difficult for some to catch on and take hold of new technology.
Finally, the recent change in the economy has put a different kind of strain on older nurses. Where they might have been thinking of retiring, they now find that they must remain in the workforce to survive. I’m just afraid of what is going to happen over the next couple years when the economy starts to rebound; people are feeling safer and we see a mass exodus of retiring nurses. I think it will be a time of extreme nursing shortage and we should start planning for it now.
But what makes nursing different than other professions that are facing an aging workforce, and what is it that really bothers me the most? It’s the concept of not just aging but of truly “putting out to pasture.” If an older nurse has not worked their way through the ranks and is still in the trenches of bedside or chairside nursing, how much support are they getting? Forget the concept of the seasoned nurses not nurturing and helping the newcomers.
As I’ve said, I have not seen that phenomena. But what I have seen is a sense of impatience towards the older nurse; an underlying feeling that they just can’t cut it and not a great sense of wanting to help them. Not only the impatience, but it’s almost a disdain for them. It’s as if they don’t highly regard the years of experience as valuable because the person might have a more difficult time with the newer techniques. I’m not sure how we got to this point. I’m sure it has something to do with the whole outlook that each of the generations have on work, socializing, and facing the world, but it is a bit disheartening to see around me. I have always learned to respect those with more experience and try to learn something from them. That doesn’t mean that I think that we should allow someone who cannot physically do the job stay in the job.
But I think we could, as a profession, hold up our experienced nurses and learn something from them instead of always thinking we need to teach them something.
Colleen O’Leary is a staff educator of medical oncology at Northwestern Memorial Hospital who blogs at Oncolog-e Nurse Talk.
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{ 13 comments }
This article: Are older nurses being forced out of the profession? is so true. Having been forced back into nursing at the age of 58 I am having difficulty find an 8 hr job. The current 12 hr shifts are killing us off at a faster rate than you would know. I gave up hospital work due to the acuity and number of patients assigned in a 12 hr period. There are probably many of us willing and able to work but physically and emotionally cannot handle the 12 hrs. All nurses realize that 12 hrs sometimes stretches into 13.
Age discrimination is everywhere in our society, some deserved but most is not. My parents, both teachers were pressured into early retirement because of economics. Schools can hire two right out of college teachers for the same cost or less that someone with 25 yrs of experience.
I was once told a story of why to retain the older engineer, the one that sometimes goes to sleep in meeting. The one with the experience that can save you money when the new idea is raised and they remind you that new idea was tired twice before over the years without success.
Jeff Brandt
http://www.comsi.com
I think this has been going on for decades, but today, with such a shortage of salary$ in every sector, workers over 50 are really getting hit. My dad (Ph.D. in chem, 12 patents, never missed a day of work) was let go at age 45 because he could be replaced by two right out of school, as Jeff said. That happened years ago. Nurses and teachers may have thought they were in protected professions, but nothing’s protected or predictable anymore, especially in jobs that depend on tech savvy. Both of my sisters-in-law are highly trained, experienced nurses who’ve found they may have to reinvent themselves if they want to keep earning money (just like the rest of us who spent decades honing skills in fields that no longer need us, if they even exist). Life’s tough. Change is tough.
I am a male RN. The unpredictability and predatory nature of and the extremely unfavorable nature of the nursing working environment make nursing for all individuals inconsistent with producing a stable nursing work force. Until this is addressed, nursing will continue to face shortages because of both supply and retention issues.
I am an older nurse, 64 years old. I have faced significant discrimination in employment in nursing because of my gender and, perhaps, because of my age.
Surprisingly, when I was about 60, I attended a Veterans Administration job fair. An individual in a combat uniform, presumably an US Armed Forces military officer, immediately approached me and asked me if I would like to serve in the military in Iraq! I am a Vietnam Army Infantry combat veteran! He recognized an experienced combat veteran immediately and wanted to utilize my combat, intellectual, and social skills in Iraq. I respectfully declined the offer. However, this indicates to me that the skills that older nurses have, intellectual, emotional, and social, are being vastly under utilized for reasons other than those related to job performance. If I am good enough to serve in the very emotionally, physically, and intellectually challenging environment of Iraq with the US Military, I am good enough to work as a nurse in the USA.
“LIFE is short, and Art long; the crisis fleeting; experience perilous, and decision difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and externals cooperate. Hippocrates”
Try working in IT!
You can have years of valid experience, know what the pitfalls are, be competent at work through all stages -saving the employer from hiring two other people to do the other aspects-, be easily able to assimilate new languages (on your own dime) and bring all your other skills AND they’ll dump you for some just-out-of-college person who knows one language, can’t communicate with users, knows nothing of how people actually work because they can be hired for half the price and can’t put pen to paper for the life of them. PLUS they’ll gripe because Facebook isn’t available on their work PC.
I guess I take offense when first reading this article as I have been in nursing for 33 years. I could not tell if you felt this were happening or if you wanted it to happen. Then I read the responses. So some nurses are feeling the strain of the long hours and feeling pushed out. I am 58 and would put my work ethic up to a lot of the younger nurses getting out of school. I work long hours and do a lot of overtime. I always have and I always will. I plan to retire when I am 64 after 40 years of nursing. Thank goodness I work at a hospital that appreciates the older nurse. I am a staff nurse and do some management. Yes, I do get tired but when I go home I am not having to take care of my children (grown) or my husband (he can take care of himself). As for the technology, I have always enjoyed learning and keeping up with the newest advances out there. I am at a good place in my life. I am in a profession that I have always loved and (God-willing)will continue to make a positive impact upon my patients.
An old OR nurse who’s not afraid to continue forward.
srbaggett
Nurses have historically been valued more for our feet than our brains. With the aging of the nurse workforce, employers MUST begin to adapt to the lesser physical stamina and greater wisdom of experienced (and older) nurses. This means buying lifting equipment, hiring orderlies (or lifters or whatever term) and giving nurses TIME to learn new skills such as computerized charting. We have not yet seen the full impact of the aging nursing workforce; unless employers adapt now, they will be sorely surprised when the mean age of bedside nurses reaches 50 and injuries, sick time and disability claims skyrocket because they failed to change with the workforce.
I think it’s a mistake to imply that the use of electronic medical records is some conspiracy to wipe out older nurses. Healthcare is way far behind the business world in terms of technology and EMR should have been implimented everywhere long ago. It has so many advantages and I’m sorry to say but it is your responsability to keep up with this. Where I work, we are always helpful to each other and I always help others with computer problems and they help me with other things that are my weak points. I don’t think any less of them as we all have our different strengths. Yes, change is a challange but a neccessary part of life.
The problem is group health and worker’s compensation insurance. Employer’s pay more the older the average age of the group is. Also, if one employee has an expensive health condition, or a family member does, then the rate of the whole group is higher.
Our country became great because the ability and initiative of the individual was rewarded. The way we pay for healthcare has changed that. If we had a single payer system like most other civilized countries of the world, experience would matter again.
Single payer countries can keep their experienced workers and benefit from their knowledge. We cannot because of the higher cost of health and worker’s comp insurance.
What makes this situation even worse is — with whom are these older nurses being replaced? Younger nurses? Not always. More likely they’re being replaced by medical assistants and cna’s.
One ER where I work adopted an EHR last year and are losing their older nurses who are having a hard time learning the new program and resent spending more time in front of a computer screen and less time with patients. The younger nurses are picking it up more quickly and realize that it is the wave of the future, so they have to. This makes it more difficult for doctors because older nurses tend to work better with doctors as a team happy to do little things for the doctor like set up suture trays and assist with laceration repairs – tasks most young nurses resent doing. I’ve found them surfing the Internet while I am trying to provide patient care. With the young nurses, there is more an attitude that “I do my profession and you do yours and don’t bother me with yours,” rather than there being an attitude of team work. I think part of that is the EMR – once the young nurses have finished the tasks assigned by the computer, they feel they are done with their patient care responsibilities.
“Nurses have historically been valued more for our feet than our brains.” Teresa Goodell,RN,PhD has noted above .
That rings true.
After more than two decades in the ER- I know that I am one of the ‘old ER nurses.’
I notice that many newer nurses do use their feet more that their brains. They simply don’t have the time and sometimes the inclination to hone their skills and intuition.
I see that the older ones of us are sometimes used as a resource by newer/less experienced nurses- usually they are the ones that ‘get’ the importance of paying attention to the subtleties and clues in a patient that can be critical in an emergent situation.
Additionally work ethics have changed. Every generation echoes this however…
It expected that we hurry and keep costs down. I love what I do. Todays hospital conditions don’t honor that sentiment.
We have better pay than in past years,however it also brought in those who are in it for the paycheck.
I feel we older nurses are devalued by many newer nurses and administration as we take more time to assess and know our patients. I must note that our doctors seem to appreciate us and count on us and our skills.
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I fear that when I am on the stretcher in that emergent situation I’ll get a nurse that is dependent on his/her quick task oriented efficiency rather than his/her understanding and caring.
I’m 59yrs old and I am currently doing “sitting” work for my hospital due to a back injury while on the job. Workers comp is taking care of it for me now but I wonder what will happen when I go back to regular duty. Its been 2 months now since regular full time work in the ER & having 15 yrs behind me I feel I’m less appreciated now than ever before. 12-13 hr shifts are taking ther toll and I will seek retirement at 62 if I can make it . I think our work environment is unsettling & the job itself is really for the young people. I’ve had no problem with Electronic records as I myself was tought to train the staff & physican’s when we instituted a new computer window based system a few yrs ago. Nurses should have a 20yr pension plan as those in military, police, and fire dep’ts through out parts of this country. Maybe unions have a place in healthcare & please make 8 hr shifts available
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