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Registered Nurses Increasingly Delay Retirement, Study Finds

By Shefali Luthra

July 16th, 2014, 4:15 PM

Despite predictions of an impending nurse shortage, the current number of working registered nurses has surpassed expectations in part due to the number of baby-boomer RNs delaying retirement, a study by the RAND Corp. found.

The study, published online Wednesday by Health Affairs, notes that the RN workforce, rather than peaking in 2012 at 2.2 million – as the researchers predicted a decade ago – reached 2.7 million that year and has continued growing. The trend of nurses delaying retirement accounted for an extra 136,000 RNs in 2012, the study suggests.

Shifts in retirement benefits and “economic uncertainty in general” could have contributed to their decisions to extend their careers, said David Auerbach, the study’s primary author and a policy researcher at RAND.

Furthermore, Auerbach said, some researchers have “found RNs were especially attached to the mission of what they do.”

“They get a lot of satisfaction from their job and don’t want to leave it,” he said.

The surge in RNs, and in particular in RNs working beyond the age of 50, could hold significant implications for how patients receive their health care and how they relate to their health providers.

For example, as RNs enter their 60s, they frequently choose to leave hospital-based positions, which employ most RNs, for primary care posts. Accountable Care Organizations – the networks fostered by the Affordable Care Act in an effort to better manage patient care – could  particularly benefit from the rise in RNs who would seek non-hospital jobs, Auerbach said.

Health delivery systems “could tap into this desire to stay employed,” Auerbach said, citing current cases in which ACOs – which revolve in theory around strong primary care – have RNs “doing kind of direct, simple care.” This includes things such as managing hypertension or asthma, and checking pediatric development, according to Patricia Pittman, an associate professor at George Washington University .

“The kind of managing and planning and coordinating and triaging that RNs are able to do help with what an ACO is trying to do,” Auerbach added. “And that is be more efficient about care and increased access.”

Anna Kiger, vice president and chief nurse officer for the hospital company Tenet Healthcare, said the company has tried to adapt hospital workplaces to meet older nurses’ needs – changes, she said, sometimes as basic as buying nurses “more ergonomically fit” chairs.

Tenet operates more than 70 hospitals in 14 states.

Because baby boomer RNs are older and taking care of an aging population, hospitals often buy equipment that relieves nurses of some of the physical demands associated with the job, she said.

But with an older RN workforce, Kiger said, hospitals do experience a shift: Baby-boomer RNs often leave acute care to work in physician offices, outpatient clinics and community health centers. In response, she said, the hospitals may recruit newly graduated nurses through programs such as nurse residencies.

“We try and balance that retirement cohort in our company with the one coming in the front doors,” she said.

But the growth in the number of RNs opting to keep working could present some difficulties for those newly graduated nurses, Auerbach said. Because nursing schools “really ramped up production” during the past decade, more RNs are looking for jobs but fewer-than-anticipated spots exist.

“We’re not talking rampant unemployment, but compared with the past, it does seem there’s this kind of uptick,” he said.

That increase in new nurses could also mitigate the impact when this cohort of baby-boomer RNs begins to retire. Current projections indicate that boomer retirement would lead to a dip in the RN workforce, Auerbach said, but “nothing so severe, at least nationally.” But local situations, he added, could vary based on individual circumstance.

5 Responses to “Registered Nurses Increasingly Delay Retirement, Study Finds”

  1. margie says:

    With regard to primary care, ask any primary care physician (PCP) and, if they are completely honest, they will admit that about 85 percent of their daily routine could easily be done by an registered nurse (RN) or a physician’s assistant (PA). Furthermore, if they are completely honest, their remaining cases are usually more difficult and need to be referred to a specialist. If you want to make comparisons, in the military, primary care is almost always handled by enlisted personnel. As a military person, it is rare that you ever get to see a doctor. My PCP tells me regularly that he could be on the golf course and let his office staff do his job. He always says that primary care is nothing more than triage. If anything, we do not need more PCPs crowding into the primary care field on medicine. What we need is to allow more RNs and PAs to do primary care. Alas, don’t hold your breath. Washington lobby groups representing America’s doctors are working 24/7 to keep that from ever happening.

  2. Lewis says:

    The question often missed is the competency of the RN caring for particular patients, not necessarily the ratio of RNs to patients.

  3. Ken says:

    “The question often missed is the competency of the RN caring for particular patients, not necessarily the ratio of RNs to patients.”

    Couldn’t the exact same thing be said regarding doctors? Or, regarding competency, just because someone has MD or DO attached to their name, they automatically get a free pass? In my opinion, the above quote is an outrageously foolish and ridiculous statement!

  4. Cynthia Decker NP says:

    Nurse Practitioners are already employed with ACO’s. The response regarding RNs and PAs failed to include NPs. Nurse practitioners are advanced practice registered nurses with at least a Masters Degree, now many earning a Doctorate degree, who are educated not only in advanced practice nursing care, but also medical management of the patient. They can diagnose, treat, prescribe, interpret and order diagnostic tests, and much more. They can practice autonomously. Their scope of practice varies by state. As stated, often physician lobbyists work hard to limit NP s scope. Although physicians claim they are concerned about patient safety and quality care, several research studies have shown care delivered by NPs is equal to or better than that delivered by physicians. NPs spend more time listening to the patient, educating the patient, and views the patient holistically I believe physicians are more likely concerned about how allowing NPs to advance their scope of practice, May impact the physicians income.

    I also believe RNs are delaying their retirement due to necessity. As the job market is still poor, the RN may be the sole source of income for their family.

  5. JVoss says:

    I am 63 and have to work for another 3 years….my resaons are I am paying off debts (I am divorced) and have no health insurance until I can get Medicare. I work in PACU where I feel it is less physically stressful but we do get our share of critical patients mixed with outpatients. I prefer my critical patients….due to the changes with the use of computer charting (too many “stops” which cause delay in care plus other issues), multiple government regulations that dictate what we have to “chart” for reimbursement, etc. nursing is no longer caring for the patient – we have to care for the system first.