Jo Aspland

“A wealth of knowledge”: A survey of the employment experiences of older nurses and midwives in the NHS

BACKGROUND The United Kingdoms National Health Service workforce is ageing, and the specific needs of this sector of its workforce need to be addressed. Nursing and midwifery shortage is a worldwide issue, and with increasing demands for care the retention of older nurses and midwives is crucial. OBJECTIVES To report on the employment experiences of nurses and midwives with a particular focus on issues relating to age, ethnicity, ill-health and disability. DESIGN The postal survey was developed following a literature review and analysis of National Health Service and Government policy documents. SETTINGS This was a UK-wide survey of nurses and midwives working in National Health Service Trusts and Primary Care Trusts. PARTICIPANTS/METHODS A postal survey of nurses and midwives was undertaken between May and December 2005. National Health Service Trusts and Primary Care Trusts (n=44) identified as having policies relevant to the study were contacted regarding the procedure for seeking research governance approval. Thirteen National Health Service Trusts and Primary Care Trusts participated, with 2610 surveys distributed; 510 surveys were returned (20% response rate). RESULTS Nurses and midwives aged 50 years and over had undertaken fewer Continuing Professional Development activities than nurses and midwives under 50. Whilst not related to age, the study also found that 20% of the survey sample reported experiencing some form of discrimination. Nurses and midwives did not differ on either quality of life or psychological health using standard instruments. Having a disability did not lead to greater psychological morbidity but did have a negative effect on quality of life. Having a work-related illness had a negative impact on both quality of life and psychological morbidity. In relation to ethnicity, black nurses and midwives reported lower psychological morbidity than other ethnic groups; that is, they enjoyed a higher level of mental well-being. CONCLUSION The nursing and midwifery workforce is ageing worldwide with a significant proportion now approaching, or having already reached, potential retirement age. With the recent introduction of the age legislation the working lives of older nurses and midwives in the National Health Service have never been more relevant. Whilst access to Continuing Professional Development is pertinent to the retention of nurses and midwives of all ages, in this study, older nurses reported less access than younger nurses.

Choosing to stay: looking at retention from a different perspective

The retention of students presents a challenge to approved education institutions (AEIs) globally. Nursing student attrition is of particular concern owing to the high non-completion rates and financial costs. A survey approach was used in an AEI in the north of England to explore the views of five cohorts of pre-registration student nurses on factors influencing continuation. In total 594 questionnaires were distributed, of which 195 (32.8%) were completed; 52.3% of respondents had considered leaving. ‘Pull’ factors contributing to their decision to stay included support structures (academic/family/peer) and a determination to become a nurse. ‘Push’ factors, which had led students to consider leaving, included financial difficulties, personal pressures, poor placement experience and academic difficulties. The study identified key areas for AEIs to focus their efforts in optimising student retention: enhancing mechanisms supporting students around financial, personal, clinical and academic pressures, and developing curricula that celebrate the uniqueness and value of nursing.