Why Aren't Nurses Retiring?
Early in the 21st century, one of the hottest topics in nursing was the upcoming nursing shortage. It was predicted that by the year 2020, the number of registered nurses (RNs) would fall short of need by 20%, exacerbated by the retirement of an aging nurse workforce.
When the economic recession of 2007-2009 began, people speculated about what would happen to the nursing workforce, and some of these predictions came true. Along with many inactive nurses re-entering the job market, many older, "baby boomer" (born between 1946 and 1965) nurses put their retirement plans on hold, pending economic recovery. Healthcare was needed regardless of the struggling economy or rising unemployment rates, and experienced nurses had little difficulty finding jobs.
It was a tougher environment for new graduate nurses. A surge of nursing school graduates were depending on an even larger exodus of older nurses from the workforce, creating a staffing void for them to step into. But with the recession, it wasn't happening. Experts and advisors said, "Hold on, be patient. When the economy starts to recover, the nurses will all retire at once, and you will have your pick of nursing jobs." This belief was so strong that hospitals and healthcare employers were cautioned not to be "lulled into complacency by the current absence of a nursing shortage," but to anticipate that the weak economy would recover, and the supply of nurses would evaporate.
Things didn't quite turn out that way. The economy improved, but the older nurses still didn't retire en masse, and the nursing workforce was expanding rather than contracting. What was going on?
Auerbach, Buerhaus, and Staiger decided to take a closer look at why the nursing workforce has continued to grow. After all, they were among those who believed that the healthy workforce was the result of the economy, and this bubble would soon break. Using data from the US Current Population Survey, the American Community Survey, and the US Census Bureau, they analyzed the workforce and retirement trends of RNs in the United States.
They found that nurses were, indeed, retiring later, as they had suspected, but it was not a consequence of the 2007-2009 recession. They demonstrated this by comparing patterns of nurse retirement for the time periods of 1969-1990 and 1991-2012. The years 1991-2012 witnessed a significant increase in the proportion of nurses still working after age 50 years.
These data demonstrate that more nurses were still working at age 62 and age 69 years in 1991-2012 compared with 1969-1990. In 1969-1990, the mean retirement age was 51.5 years; and in 1991-2012, it was age 54 years, a difference of 2-3 years. There was also no significant change in retirement ages between 2007 and 2012, the period covering the recent recession. Thus, the career span of nurses has increased over time, a change that began long before, and is independent of, the recent recession.
The investigators also assessed the effect that the increasing duration of nurses' careers has had on the size of the nursing workforce. In other words, do longer careers explain why we have 500,000 more nurses than we thought (back in 2000) that we would now have? Their analysis revealed that only 25% of the excess nursing supply is explained by the change in retirement age, and about half is likely a consequence of a higher-than-expected number of new graduate RNs.
We heard for years about the nursing shortage that would worsen around 2011, when the first wave of baby boomer nurses would begin to retire. The year 2011 came and went, as the oldest baby boomer nurses turned 65 and kept on working. Instead of shrinking, the nursing workforce has grown. One reason for this is the tendency of nurses to retire later, a trend newly elucidated by Auerbach and colleagues in this analysis.
The shift to longer careers in nursing is not entirely unexpected. Auerbach and colleagues commented that it parallels a general trend for women to prolong their participation in the workforce. Nursing, however, is not an easy job, with 12-hour shifts, rotating schedules, high stress levels, workplace violence and incivility, and myriad ways to become ill or injured at work. Older nurses may be less tolerant of the changes that have taken place in healthcare over the course of their careers: the rapidly advancing technology, electronic medical records, more regulations, and added pressure to meet benchmarks and reduce lengths of stay, all of which take time away from patient care. One would think that nurses would be counting the minutes, never mind the years, until they can retire.
this study does not shed any light on why many nurses are prolonging their careers, Auerbach and colleagues speculate that a contributing factor is the love of the job, the patients, the teamwork, and the camaraderie of working with colleagues who often become friends outside of the workplace. But these factors have always been characteristic of nursing, so they do not completely explain the gradually increasing retirement age that we are seeing now.
The reasons, therefore, may not be related to nursing at all. The world has changed. People are living longer, and although they might not be healthier, strictly speaking, medical advances can keep them functional and able to continue working. Social trends, such as having children later and a high divorce rate, can mean finding oneself still putting kids through college in one's 60s or suddenly living on a single income and needing the health insurance. Although the economy may not have played a major role in prolonging the careers of nurses, economics certainly do. Some people simply want a better quality of retired life (which takes more money), even if it is shorter as a result of starting later.
Where does all of this leave our new graduates, who have been waiting for older nurses to step aside and make room for a new generation? It is an important question because there are a lot of new graduates. In response to dire predictions for a nursing workforce shortage, nursing schools have been cranking out new graduates during the past decade, and the job outlook for these graduates was optimistic. But instead of a smorgasbord of job openings, new graduates in some regions have continued to face stiff competition for available nursing positions, particularly for highly coveted hospital jobs. Often, available postings declare upfront, "No new grads."
Auerbach and colleagues remind us that the baby boomer nurses are still going to retire, opening up many jobs for early career nurses. In the meantime, other older-nurse trends offer hope to new graduates, who typically seek hospital-based jobs as their entry point into the profession. As nurses age, many move out of acute care hospitals into nonhospital positions that benefit from their many years of experience and are often less physically demanding. In 2013, 79% of RNs younger than age 30 years worked in hospitals, compared with 46% of nurses aged 55 years and older. Data from 2008 showed that only about 35% of nurses aged 65 years and older still worked in hospitals.
will continue to be in demand, and a shortage of nurses is still anticipated. Jobs for RNs are expected to grow from 2.7 million in 2012 to 3.2 million in 2022, but a shortage of nursing faculty remains a limiting factor. According to the Bureau of Labor Statistics, nursing school faculty is one of the fastest growing occupations, and positions for nursing instructors and teachers will increase by 35% (24,000 more positions) by 2022.
No doubt, those baby boomer nurses sincerely hope that plenty of new graduates will be ready to take their places when they hang up their stethoscopes. It would be a shame if, after 40-plus years of devotion to the healthcare system, there was no one to answer their call bells when they rang for the nurse.
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Liz Di Bernardo