March 25, 2011

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Can a nurse be too old to work at the bedside?

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.

34 thoughts on “Can a nurse be too old to work at the bedside?”

  1. dgrenier says:

    I have been a nurse since 1986. Throughout my career I have worked with older nurses 65+ who possess knowledge and wisdom those younger nurses need envy and hope that they will one day possess. The body may not be as strong but the ability to react to situations that they have been in multiple times is without flaw. It is unfortunate that so many nurses are in a situation that they must work past retirement age because of the lack of adequate retirement plans. Kudos to nurses, who continue thei

  2. Mary says:

    I have been nursing for over 40 years in acute care settings. I’m in my early 60s but know I am slowing down. In my employment I am bedside but also train new nurses in the system. I would like to think I will go on forever but am beginning to feel more tired after a 12 hour shift and it sometimes takes me longer to do what I used to do with ease. I would like to think I will go on forever but reality is I need to be aware of my limitations and know when I need to move on.

  3. Anonymous says:

    I am very happy to see this article as I see this as a major nursing issue. We would all like to think that we, ourselves, will make good judgments about our capabilities and identify the right time to retire or to switch to a job more suitable for our abilities. But sadly, some people don’t make those transitions without a “push” from their employer. Those situations are painful for all involved. We need to be talking about this and developing some standards, guidelines, etc.

  4. Margaret says:

    My critical thinking skills are not dimenished. My physical skills are good but slow. I just can’t stand up to 12 hours in a busy Trauma 4 facility. But my brain is still good. They have me working on a computer now and refused to accept my resignation. I learned that I am still a nurse and can do nursing even if I am not starting IV’s etc.

  5. Anonymous says:

    After 29 years of bedside nursing at teh same hospital I was let got–I’d been warned that it was coming too. I was 58 years old and thought I would have a tough time finding another nursing job. Boy was I wrong. Within 2 weeks I had my pick of 5 great jobs. I was told that “a nurse with your experience and resume doesn’t come along very often”. I have a fabulous job that I love in outpatient cardiac testing that I could do until I’m 80. Life is good for this old gal

  6. DSkelton711@hotmail.com says:

    I am 50 and have been seeking a job for nearly a year. I feel as if I have been put out to pasture. I am too young to retire and desperately need the income. Nursing is all I know. It is my chosen profession for a reason. I feel saddened and frightened that I am college educated but seemingly destined for need of government services to live.

  7. Anonymous says:

    At 68 I think about hanging up my stethoscope. But not yet. I work 32 hours a week in a Magnet hospital private oncology practice. The manager & clinical director hired me at 66 and made changes in the RN,OCN position to accomodate my electronic charting limitations & utilize 27 years oncology experience through VAD blood draws, chemo teaching & symptom management. They recently agreed to my job-sharing the 32 hours. The young staff & I support one another. Good to be valued as a seasoned nurse!

  8. Anonymous says:

    I turned 49 last year and had the third winter of Adult Family Leave. It ultimately lead to my being let go (separation agreement) with severence from my nursing case manager job. (I was no given a work place alternative job). I have spondlytic arthritis (AS) since age 28. I graduated from nursing school at age 38 as a second career. Now, I’ve been unemployed for a year. The arthritis is somewhat limiting and no interviewer wants to hire me. Is this ageism I think to myself or what?

  9. G says:

    I’m in my mid 40s and just graduated RN/BSN May 2010. After many yrs of working f/t and going to school weeknights and weekends, I’m wondering if I’ll ever get the chance to work in a hospital RN job. Shortage of jobs for new grads aside, I DO have to wonder how much my age factors in to even being considered for a job. It’s really sad too because I have a lot to give…

  10. Patricia says:

    At the young age of 51 I was looking for employment in a new location, relating to my husband’s transfer for work. At the first hospital, the nurse interviewing me noted that she was no longer able to work in Med-surg. I noted I had just finished working a step down Cardiac unit in my former location. The second hospital noted the various skills and types of work I had done and hired me immediately. I have come to look with suspicion upon those who only look at birthdates. I have skills to share

  11. agednurse says:

    I am in by 60’s and hope to work as long as my health allows. But I know that I can no longer take care of 5-7 patients, run up and down the floor, and keep up with the charting for 3-4 12hr days without noticing the difficulty. I went back to school, and hope to teach. I changed jobs to one that has less physical demands but relies on my ability to assess patients conditions. Barbara Dossey told me last summer that we all will probably still be working in the healing cause well into our 80’s.

  12. Anonymous says:

    I am 60–looking at my coworkers & the burn out at the end of 12 hours, little appreciation or accomodation to retain with better scheduling (ie 8hour options) & the dilema of the love of work & the demands of the job, new technology & retirement at 67??

  13. To Young To Retire says:

    First of all my retirement age has been moved up to 67 by the government, so they have made it harder to retire while you still have what it takes to work.
    Second of all where I work will not let you cut down to anything less then 7 day pay period working 8hr shifts. unless you go part time less then a 6 day pay period then they do not have to pay benifits.
    And they do not help you find another job in the system even if you have been there 30 years. They fill jobs with younger nurses.

  14. Diva RN says:

    I’m over 60 and looking for a job. Employers are not supposed to ask age related questions (other than if you’re over 18) but they routinely ask to see your driver’s license ostensibly to see if you’re legal to work in the US, but it’s really a ploy to get your age and reject you — without proof that they turned you down because of age.

  15. 65 and seeking says:

    We do need this conversation! As an older nurse, I have self-selected which jobs I am capable of performing safely – which is something every nurse needs to do, based on her scope of practice, skills, and knowledge, anyway. But employers and younger nurses also should beware of ageism – “speed, agility, or quick thinking” are more characteristic of youth but not necessarily competency. You can speedily quick-think yourself to a wrong assessment, and do the wrong thing with much agility.

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