The healthcare sector is experiencing unprecedented challenges. There is an increasing demand for healthcare services partially attributed to the global ageing population (1); however, healthcare services worldwide are grappling with nursing and midwifery shortages.

Many countries struggle to train and retain enough nurses to meet the growing demand, leading to overworked staff and compromised patient care (2). According to the World Health Organization (WHO) (2), the global nursing and midwifery shortage is projected to reach over 5.7 million by 2030. This looming crisis calls for innovative strategies to support and retain older nurses and midwives to maintain the status quo. Research has shown that they are experienced and knowledgeable (3), but their skills are frequently discounted in the workplace (4, 5). It is vital to recognise the value older nurses and midwives can bring to healthcare by addressing their unique challenges and fostering an environment to encourage them to remain in the workforce for as long as possible. Their years in the workforce equip them with historical and organisational knowledge (6), a deep understanding of patient care, critical thinking skills, and the ability to mentor younger colleagues (3). Supporting older nurses and midwives means investing in their ability to transfer their expertise to the next generation, ensuring continuity of care and knowledge within the profession.

Older nurses and midwives

Literature does not provide a straightforward definition of older. The term ‘older’ generally refers to nurses and midwives in their mid-to late-career stages, often aged 50 and older. However, some identify as ‘older’ as early as their 40s (5). Therefore, being older does not refer to a homogenous group, as older nurses and midwives span a wide age range. Older nurses and midwives often find their work fulfilling, and others see the rising costs of living, insufficient retirement savings, or the need to support family members make them choose to stay in the field as long as they are able. With an increased life expectancy and good health, many nurses and midwives remain capable of working longer. Those in their 40s and 50s have the potential to continue working for another decade or two; however, this is difficult if they are experiencing age-related challenges in the workplace; therefore, having a support policy to extend their working lives is vital.

Challenges

All nurses and midwives experience the physical and emotional challenges that can make the demands of their jobs more difficult to manage. However, older nurses and midwives also experience age-related challenges such as mobility difficulties relating to an ageing body, loss of vision and hearing acuity and increased fatigue levels (7). Older nurses and midwives have reported experiencing ageism in the workplace with a perception they are not respected and valued as skilled workers. It is well documented that older nurses and midwives are often treated differently from younger colleagues, mainly because of a lack of opportunities for ongoing education and promotion (7, 8). Older nurses and midwives feel undervalued due to a lack of understanding or appreciation of their contributions to the healthcare workplace (4, 5). Older nurses and midwives bring experience, knowledge, and compassion to the healthcare workplace. Their years of experience often translate into an ability to handle complex clinical situations calmly and confidently and mentor younger colleagues. While they may face challenges related to physical difficulties or adapting to rapidly changing technologies, their wisdom and emotional resilience remain invaluable assets. Their presence in healthcare fosters a supportive environment for patients and colleagues, enhancing the overall quality of care (9).

Support structures

Many older nurses and midwives would like to remain in the workforce but say they cannot cope with the demands of their jobs; without support, they will be forced to leave prematurely, and their loss could exacerbate the skill shortage crisis (10). This looming crisis calls for innovative strategies to retain older nurses and midwives. Rather than allowing this experienced cohort to exit the workforce en masse, it is crucial to implement policies that encourage them to stay through wellness programs, redeploy to less physical roles, flexible work hours that accommodate their needs, support networks, recognition of skills and experience, workplace ergonomics and provision for ongoing educational opportunities (11). Healthcare organisations should create inclusive policies that emphasise the value of older nurses and midwives through promoting age diversity in hiring, offering retraining opportunities, and ensuring that older nurses and midwives are not sidelined in favour of younger, less experienced staff.

Conclusion

Fostering an age-friendly work environment means recognising the strengths and unique perspectives that come with experience and combating any biases against ageing nurses and midwives. By addressing the physical toll of nursing and midwifery on older workers, we can extend their careers and preserve their well-being (12, 13). Implementing policies that focus on work-life balance can help prevent premature exits from the workforce. Although the challenges older nurses and midwives encounter have been discussed for decades, research has shown that little workplace support has been implemented (14). Healthcare organisations should adopt an individualised approach rather than making assumptions based on age assess the strengths, goals, and needs of each older nurse or midwife. Supporting older nurses and midwives is not just about helping them extend their careers; it is about preserving the healthcare workforce as a whole.

REFERENCES

1.         United Nations. World Population Ageing 2019. Department of Economic and Social Affairs Population Division; 2019. Report No.: 978-92-1-148325-3.

2.         World Health Organisation. The State of the World’s Nursing. 2020. Report No.: ISBN 978-92-4-000329-3 (electronic version) ISBN 978-92-4-000330-9 (print version).

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9.         Reinhardt AC, Leon TG, Amatya A. Why nurses stay: Analysis of the registered nurse workforce and the relationship to work environments. Applied Nursing Research. 2020;57(2):1-9.

10.       Buchan J, Catton H, Shaffer F. Ageing well. Policies to support older nurses at work ICNM 2020.

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14.       Montayre J, Knaggs G, Harris C, Li W, Tang LM, de Almeida Neto A, et al. What interventions and programmes are available to support older nurses in the workplace? A literature review of available evidence. International Journal of Nursing Studies. 2023;139:104446.