Who will be there to nurse? Retention of nurses nearing retirement.

AIMS: To determine the impact on nursing work-force supply of delaying retirement. BACKGROUND DATA: The nursing workforce is aging, and the Baby Boomer generation is nearing retirement age. This potential loss of experienced nurses is likely to exacerbate current nursing shortages. METHODS: An analysis of loss rates of nurses in New South Wales (Australia) is provided using 2 different retirement ages--58 and 65 years. Supply numbers were used and then "aged" to determine the impact of retirement on workforce numbers. The impact of potential retention strategies on the numbers who could be retained were determined if 100% of 50- to 55-year-old nurses was retained, 75% of those 56 to 60 years, and 50% of those 61 to 65 years. RESULTS: By the year 2004, approximately 4139 nurses (registered and enrolled) will be lost through retirement at age 65 years. However, retirement at age 58 years sees 7328 lost by 2004. Potentially 2139 nurses in this age spectrum could be retained if strategies are focused on delaying retirement. CONCLUSIONS: Delaying the retirement of nurses could provide a significant human resource, not only in terms of absolute numbers but more importantly, in terms of experience and expertise. However, retention of this portion of the workforce may require different strategies than for younger members of the workforce. The needs of this segment of the nursing workforce may require nurse administrators to consider different approaches to nursing work and work allocation.

Beyond demographic change in human resources planning: an extended framework and application to nursing.

OBJECTIVES: To introduce health care production functions into human resources planning and to apply the approach to analysing the need for registered nurses in Ontario during a period of major reduction in inpatient capacity. METHODS: Measurement of changes in services delivered by acute care hospitals in Ontario between 1994/95 and 1998/99, and comparison with changes in the mix of human resources, non-human resources and patient needs. RESULTS: Inpatient episodes per nurse fell by almost 2%. At the same time the number of beds was cut by over 20%. As a result, the number of patients per bed increased by 12%. Allowing for severity, there was a 20% reduction in beds per episode and a 3.7% reduction in nurses per episode. CONCLUSIONS: The demands on nurses in acute care hospitals have increased as an increasing number of severity-adjusted episodes are served using fewer beds by a reduced number of nurses. Human resources planning traditionally only considers the effects of demographic change on the need for and supply of health care. Failure to recognize the variable and endogenous nature of other health care inputs leads to false impressions about the adequacy of existing supplies of human resources. Consideration of human resources in the context of the production function for health services provides a meaningful way of improving the effectiveness and efficiency of human resources planning.

Evaluation of a leadership development intervention.

Parallel to the shortage of clinical nurses is the diminishing pool of nurses who aspire to leadership roles in healthcare. The authors of this paper report on the evaluation of an intervention administered to a group of Canadian nurses designed to assist participants to value leadership and to develop knowledge, skills and attitudes required for effective leadership. A one-group pre-test, post-test quasi-experimental design guided the study. All participants received a five-day residential leadership development intervention. Participants acted as their own controls and were assessed, both immediately before intervention implementation and three months later, on the self- and observer-reported leadership practices as well as self-reported levels of burnout. Results indicated that a concentrated, residential leadership development intervention is effective in strengthening leadership behaviours performed by both already established and aspiring nurse leaders from the perspective of observers, but not from self-reported assessments. No significant changes in self-reported burnout levels were found. It is possible to deliver leadership development interventions to both established and aspiring nurse leaders that result in fairly rapid improvements in observed leadership practices.