Aging Nursing Workforce and Retention

This week’s Blog is written by Pauline Milne (@NHSPauline) and discusses the need to focus on retaining older nurses.

In addressing nursing workforce shortages, there is a tendency for organisations to focus more attention on the recruitment of new nurses rather than supporting the retention of older, more experienced nurses.

As at 30th September 2020, 20.8% of the registrants on the Nursing and Midwifery Council Register[1] were aged 56 years and above.  This is an increasing trend as compared with 17.6% at 30th September 2016.

Furthermore the Covid-19 pandemic temporary register introduced in 2020 includes 12,756 nurses and midwives and 64 % are aged 56 years and above.  Careful consideration needs to be given to how these nurses and midwives can be encouraged to remain in practice beyond the pandemic.

When looking for solutions to extend the working lives of older nurses, there is not a ‘one-size fits all’ strategy, however organisations need to foster an environment where older nurses feel they are listened to, valued and respected (Markowski et al 2020).

Flexible working options are an important factor as the 12-hour shift patterns which are commonplace in most organisations, may no longer be suitable for older nurses and options for shorter shifts could be of mutual benefit to both the clinical service and the individual nurse.  Many older nurses have caring responsibilities which could include supporting an older relative and / or providing childcare assistance to grandchildren.  Shorter shifts such as twilight shifts can provide additional registered nursing capacity at busy times to bolster nursing teams when workload is particularly high and enable staff to have breaks.  Other flexible options could include annualised hours, for example some older nurses may be able to work during peak holiday periods when other staff are keen to have time off.

Consideration should also be given to less physically demanding roles to retain experienced nurses in the workforce longer.  During a Florence Nightingale Foundation travel scholarship to Ontario, Canada I was impressed with the Late Career Initiative which was offered to Registered Nurses aged 55 years and above.  Nurses who participated in this programme worked work 80% of their time in their usual clinical role, whilst the remaining 20% was spent undertaking project work or activities which were deemed to be less physically onerous.  Examples of such work included mentorship, preceptorship, patient safety and research initiatives.  The programme has continued for the past decade but feedback has included a view from some that aiming this initiative at nurses aged 55 years and above, was too late in the career path and may not influence retirement decisions.  However it was felt that by offering this option to nurses aged 50 years and over, the potential impact may be increased.

Additionally more could be done to support mid-career nurses with retirement planning and to raise awareness of retire and return rules, which can be complex and hard to understand.

Another area for consideration is targeted work around menopause awareness including education of managers, training on communication skills and behaviours towards female staff and development of organisational policies supporting staff during the menopause (Hardy et al 2017).

Fundamentally working for longer is beneficial for individuals and participation in the workforce is considered ‘a critical element of productive ageing with a political consensus emerging around the need to prolong working lives’ (Allen et al 2015).

Dr Pauline Milne MBE PhD MN BN RN

Contact email

Twitter @NHSPauline


Allen, S., Earl, C. & Taylor, P. 2015, “Retirement is a dream at 55, but not a reality. Can nurses work until 70?”, Australian Nursing and Midwifery Journal, vol. 22, no. 7, pp. 18

Hardy C, Griffiths A, Hunter MS. What do working menopausal women want? A qualitative investigation into women’s perspectives on employer and line manager support. Maturitas. 2017;101:37–41.

Markowski, M., Cleaver, K. & Weldon, S.M. 2020, “An integrative review of the factors influencing older nurses’ timing of retirement”, Journal of advanced nursing, vol. 76, no. 9, pp. 2266-2285.



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