As the population is greying, the nursing workforce is also aging. This is cause for concern because nurses are a critical part of our healthcare system. As the demand for healthcare rises with the aging population, healthcare organizations will face a shortage of nursing staff. Many of the nursing staff are also unionized and covered under collective agreements. This makes it challenging for healthcare organizations (hospitals) to implement strategies to sustain an aging nursing workforce, as many of the terms of employment are already negotiated and cannot be changed.
Kwok, Bates, and Ng reviewed 9 collective agreements from across Canada (Quebec excluded) to identify recruitment and retention strategies that have not been addressed in existing agreements governing the nursing workforce. The collective agreements cover Registered Nurses (RNs), which represent approximately 75 percent of the nursing workforce in Canada.
The authors found 5 key strategies within collective agreements that healthcare organizations could implement to help sustain an aging workforce.
- 3 Way Mentorship – Nurse mentoring can be a three-way relationship with the hospital, mentoring nurse, and the nurse being mentored. The mentorship facilitates knowledge transfer between older and younger nurses. A key element is the provision of premium pay for the extra mentoring relationship, which includes the implementation and evaluation of the effectiveness of the mentorship.
- Retention of Older Nurses – Hospitals can recruit senior nurses who have retired to rejoin the nursing workforce. Provision of training will be required. Additionally, hospitals can entice nurses who will be eligible to retire to stay longer with retention recognition (financial incentives) and job enrichment (leadership assignments, special projects).
- Attracting Internationally Trained Nurses – Hospitals can create temporary nursing positions and actively recruit internationally trained nurses to fill them. These positions can be made permanent following initial periods of assessments (e.g., certification). This strategy also provides hospitals with the flexibility to meet their staffing needs.
- Operational Changes through Process Improvements and Technology – Process improvements and new technology can reduce redundant administrative tasks, which in turn, reduce stress and frustrations for nurses. It is important to communicate that these improvements are intended to improve efficiencies and to provide nurses with better work environment, rather than replace nurses or to change their roles via automation.
- Flexible Work Hours and Self-Scheduling – Most hospitals already have various flexible work arrangements. One innovative way to empower nurses and increase their job satisfaction is through self-scheduling of work hours. Nurses who are able to create their own schedules within their own units enjoy greater satisfaction and have lower turnover intentions.
Some other provisions within collective agreements (e.g., career opportunities, education/professional development) were not deemed to be as effective in attracting and retaining nurses. A complete review of the collective agreements can be found here.
Although these provisions were identified through gaps in collective agreements, non-unionized healthcare organizations can adopt some of these strategies to sustain their own aging workforce.
Eddy Ng is F.C. Manning Chair in Economics and Business at Dalhousie University, Canada. He co-authored the paper “Managing and sustaining an ageing nursing workforce: identifying opportunities and best practices within collective agreements in Canada” in the Journal of Nursing Management (Wiley), with Cara Kwok at the University of California, Los Angeles, and Kim Bates at Ryerson University. Follow Ed on Twitter @profng.
