As the population continues an aging process that will peak around 2050, according to the U.S. Census Bureau, the nursing profession will itself continue to age. With a nursing shortage being reported in states around the U.S., retaining and leveraging the skills of older nurses is worth examining.

A Robert Wood Johnson Foundation 2006 white paper entitled "Wisdom At Work: The Importance of the Older and Experienced Nurse in the Workplace," strongly recommended practices for the retention of older nurses, as well as the harnessing of their individual and collective wisdom. Citing clear evidence of the value of older nurses' knowledge, experience, and skill, the RWJF paper clearly states its case:

"The older expert nurse possessed excellent analytical problem-solving skills, had mastered the ability to navigate the health care system to create change, understood patient flow, provided extraordinary patient-centered care, had significant professional authority, and had developed intuitive skills as a result of experience and education."

The above statement elucidates that healthcare decision-makers would be prudent to consider the value of retaining the best and brightest who wish to remain in the workplace, rather than treating older nurses like outdated models needing replacement.

(Of note: RWJF is certain to point out that referencing "older nurses" means nurses who have been in the profession for decades, not second-career nurses who entered the profession in middle age.)

The financial cost

Whereas the loss of nursing wisdom and institutional memory is crucial, the financial bottom line is what may galvanize the healthcare system to ponder the cost of older nurse turnover. The RWJF study again makes the facts unequivocally clear:

"A survey of turnover in acute care facilities found that replacement costs for nurse positions are equal to or greater than two times a regular nurse's salary. Given a rate of nurse turnover in 2000 of 21.3 percent and a national average salary for a medical-surgical nurse of $46,832, the cost of replacing just one nurse was $92,442. Replacing a specialty-area nurse increased this cost to $145,000.

"If a hospital with 100 nurses experienced turnover at the national average of 21.3 percent in 2000, annual expenditures associated with the turnover of medical-surgical nurses alone amounted to as much as $1,969,015."

Adaptation, retention and brain power

Older nurses carry wisdom, institutional memory and accumulated skill. While age brings the potential for decreased stamina, agility and other issues, these can be compensated for with thoughtful workplace design, attention to ergonomics and workflow adaptation.

The RWJF white paper and other sources point to methods for adapting healthcare environments to older nurses, creating mentoring and teaching programs wherein mature nurses' knowledge can be leveraged, and other approaches that harness the power of older nurses' skills.

The potential loss of such vital nursing know-how is bemoaned by many; avenues already exist for savvy healthcare institutions to stem the hemorrhage of older nurses who still wish to serve.

The brain trust of the aging nurse demographic is enormous. Forward-thinking healthcare facilities will find methods to retain mature nurses and leverage their wisdom for the collective good.