Donna Cardillo, MA, RN
A recent New York Times article begged the question, “How old is too old for doctors to continue practicing medicine?” It noted that increasing numbers of physicians are now over 65 years old and cited instances where some physicians, who apparently suffered from cognitive and other age-related ailments, simply were not able to practice safely and caused harm to patients. I couldn’t help but wonder if the same applies to some “older” nurses working at the bedside.
Let’s consider the facts: Many nurses are still working at the bedside in their 70s and a few even in their 80s. Granted, every nurse is different and age alone is not an indictor of ability. But the inevitable truth is that the older we get the more we are prone to age-related ailments ,such as Parkinson’s and dementia, which are often undiagnosed. And since nurses, like the rest of the population, are living and working longer (many out of sheer necessity), will those nurses be able to recognize when they are no longer able to do their bedside job to the best of their ability? Can we even see in ourselves when our slowed reflexes, diminished critical thinking skills, and lessened agility hamper our practice and potentially endanger our patients and ourselves?
This does not imply that all nurses should stop working at the bedside at a certain age or that they should stop working at all. It simply raises the question about one’s own ability to continue competent and safe bedside practice indefinitely. This concern comes at a time when 10,000 baby boomers are turning 65 each day — that’s right, each day. And many of them are in the current bedside nursing workforce and are being required to work 12-hour shifts. (See post dated 10/26/10 “Are 12-hour shifts safe?”)
If you manage or employ nurses in a direct patient care role who seem to no longer have the speed, agility, or quick thinking skills necessary to provide competent care at the bedside, what do you do? Do you suggest or require that the nurse transfer to an alternative-type specialty or department within the facility or do you do nothing and pray that the situation will work itself out?
So let’s say a nurse decides for himself or herself, or is deemed by an employer, it isn’t safe to practice at the bedside. That doesn’t mean that the nurse should be sent out to pasture and is no longer productive on any level. Of course nurses have many options of work settings, specialties, schedules, and types of work. So there are always alternatives. An in-patient bedside role is only one way for nurses to work. But since many nurses have never considered alternative work settings/roles and may not even know what many of them are, this can create a personal and career crisis for some.
It’s time for the nursing community to have open and frank discussions about our aging workforce as it relates to ability to do a particular job. It is also time for employers to offer more flexible scheduling and hours for older nurses and to create a plan to transition some nurses into alternate positions/settings within their organization. Some healthcare facilities are already doing this but many are not. It is also time for all nurses to be realistic about what is an appropriate work setting, pace, and schedule for them and to explore alternatives as necessary. If we don’t, it may just be a matter of time before our employer and/or a regulatory body does it for us.
Older nurses, whether new graduates or seasoned veterans, have plenty to offer and are a vital component of our current and future healthcare system. Let’s all work together to have a realistic, safe, and supportive vision and plan for every stage of the lifecycle of a nurse.
Donna Wilk Cardillo is the Career Guru for Nurses and “Dear Donna” columnist for Nursing Spectrum, NurseWeek, and www.nurse.com. Donna is also an ‘Expert’ Blogger at DoctorOz.com. She is author of The ULTIMATE Career Guide for Nurses, Your 1st Year as a Nurse, and A Daybook for Beginning Nurses. Ms. Cardillo is creator of the Career Alternatives for Nurses® seminar and home-study program. You can reach her at www.dcardillo.com.