Employment and Retention of Retired Nurses in Senior Care Settings: A Pre-COVID-19 Scoping Review
Keywords:
Post-retirement, Retired nurses, Nurse retention, Senior care setting, Aging workforceAbstract
Background: Global nursing shortages and a rapidly aging workforce have heightened interest in re-engaging retired nurses to support health systems. Retired nurses bring accumulated clinical expertise that may help address staffing challenges in senior care settings. This review maps pre-pandemic evidence on employment models, working conditions, and retention relevant to nurses in senior care settings. Objectives: To map post-retirement employment models for nurses, identify factors influencing employment and retention in senior care settings, and propose implications for policy and practice with relevance to the Thai healthcare context. Methods: A scoping review was conducted following JBI methodology. Studies of any design published in English or Thai between January 2011 and October 2021 were eligible. The PCC framework (Population: retired and older nurses; Concept: employment and retention; Context: senior care settings) guided study selection. CINAHL, PubMed, SCOPUS, ClinicalKey for Nursing, Google Scholar, and the Thai Citation Index (TCI) were searched. Data were extracted by two reviewers and synthesized thematically. Results: Thirteen studies were included from 7,445 records retrieved. Designs comprised cross-sectional surveys (n = 8), qualitative studies (n = 3), and secondary data analyses (n = 2). Findings were synthesised across six thematic areas: employment models and competency areas; factors influencing job retention; factors affecting job turnover; factors influencing retirement decisions; work-life balance; and job satisfaction. Income stability and pay satisfaction, supportive supervisory and leadership practices, and management of physical workload were the retention factors most often supported when tested alongside competing predictors, whereas autonomy and scheduling flexibility less often retained independent effects. Conclusions: Experienced nurses are leaving the profession or their employers for organizationally modifiable reasons: physical workload, staffing adequacy, and income instability. Policymakers and healthcare organizations should consider tiered roles matched to physical capacity, stable employment conditions, and supportive supervision. Primary research on post-retirement employment models in Thailand and other middle-income countries is needed, as is evidence on post-pandemic employment patterns.
References
Sirisub P, Suwannapong N, Tipayamongkholgul M, Howteerakul N, Noree T. Intention to Extend Working Life among Thai Registered Nurses in Ministry of Public Health: A National Survey. Nurs Res Pract. 2019;2019:7919404. DOI:10.1155/2019/7919404
Bishop M. Work engagement of older registered nurses: the impact of a caring-based intervention. J Nurs Manag. 2013;21(7):941-9. DOI:10.1111/jonm.12182
Uthaman T, Chua TL, Ang SY. Older nurses: A literature review on challenges, factors in early retirement and workforce retention. Proc Singapore Healthc. 2016;25(1):50-5. DOI:10.1177/2010105815610138
Tamata AT, Mohammadnezhad M. A systematic review study on the factors affecting shortage of nursing workforce in the hospitals. Nurs Open. 2023;10(3):1247-57. DOI:10.1002/nop2.1434
Abhicharttibutra K, Kunaviktikul W, Turale S, Wichaikhum OA, Srisuphan W. Analysis of a government policy to address nursing shortage and nursing education quality. Int Nurs Rev. 2017;64(1):22-32. DOI:10.1111/inr.12257
Marć M, Bartosiewicz A, Burzyńska J, Chmiel Z, Januszewicz P. A nursing shortage – a prospect of global and local policies. Int Nurs Rev. 2019;66(1):9-16. DOI:10.1111/inr.12473
Matsuo M, Suzuki E, Takayama Y, Shibata S, Sato K. Influence of Striving for Work–Life Balance and Sense of Coherence on Intention to Leave Among Nurses: A 6-Month Prospective Survey. Inquiry. 2021;58:00469580211005192. DOI:10.1177/00469580211005192
Hung MSY, Lam SKK. Antecedents and Contextual Factors Affecting Occupational Turnover among Registered Nurses in Public Hospitals in Hong Kong: A Qualitative Descriptive Study. Int J Environ Res Public Health. 2020;17(11):3834. DOI:10.3390/ijerph17113834
Pedro DRC, Fracasso NV, Costa RG, Rossaneis MÂ, Aroni P, Haddad MCFL. Age management practices toward workers aged 45 years or older: an integrative literature review. Rev Bras Med Trab. 2020;18(2):194-202. DOI:10.47626/1679-4435-2020-536
Sherman RO, Chiang-Hanisko L, Koszalinski R. The ageing nursing workforce: a global challenge. J Nurs Manag. 2013;21(7):899-902. DOI:10.1111/jonm.12188
Ryan C, Bergin M, Wells JS. Valuable yet Vulnerable–A review of the challenges encountered by older nurses in the workplace. Int J Nurs Stud. 2017;72:42-52. DOI:10.1016/j.ijnurstu.2017.04.006
Nantsupawat A, Kunaviktikul W, Nantsupawat R, Wichaikhum OA, Thienthong H, Poghosyan L. Effects of nurse work environment on job dissatisfaction, burnout, intention to leave. Int Nurs Rev. 2017;64(1):91-8. DOI:10.1111/inr.12342
Kaewboonchoo O, Yingyuad B, Rawiworrakul T, Jinayon A. Job stress and intent to stay at work among registered female nurses working in Thai hospitals. J Occup Health. 2014;56(2):93-9. DOI:10.1539/joh.12-0204-OA
Kaewpan W, Rojpaisarnkit K, Tongvichean S, Kaewwilai L, Keawpan T. Decision to employ retired nurses to work in senior care businesses: A qualitative study. Nurs Open. 2023;10(8):5236-43. DOI:10.1002/nop2.1761
Markowski M, Cleaver K, Weldon SM. An integrative review of the factors influencing older nurses' timing of retirement. J Adv Nurs. 2020;76(9):2266-85. DOI:10.1111/jan.14442
de Vries N, Boone A, Godderis L, Bouman J, Szemik S, Matranga D, et al. The race to retain healthcare workers: a systematic review on factors that impact retention of nurses and physicians in hospitals. Inquiry. 2023;60:00469580231159318. DOI:10.1177/00469580231159318
Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. 2020;18(10):2119-26. DOI:10.11124/JBIES-20-00167
Kmet LM, Lee RC, Cook LS. Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. HTA Initiative #13. Edmonton: Alberta Heritage Foundation for Medical Research; 2004.
McHugh ML. Interrater reliability: the kappa statistic. Biochem Med (Zagreb). 2012;22(3):276-82. DOI:10.11613/BM.2012.031
McGilton KS, Tourangeau A, Kavcic C, Wodchis WP. Determinants of regulated nurses' intention to stay in long-term care homes. J Nurs Manag. 2013;21(5):771-81. DOI:10.1111/jonm.12130
McGilton KS, Boscart VM, Brown M, Bowers B. Making tradeoffs between the reasons to leave and reasons to stay employed in long-term care homes: perspectives of licensed nursing staff. Int J Nurs Stud. 2014;51(6):917-26. DOI:10.1016/j.ijnurstu.2013.10.015
Chu CH, Wodchis WP, McGilton KS. Turnover of regulated nurses in long-term care facilities. J Nurs Manag. 2014;22(5):553-62. DOI:10.1111/jonm.12031
Knecht P, Milone-Nuzzo P, Kitko L, Hupcey JE, Dreachslin J. Key Attributes of LPN Job Satisfaction and Dissatisfaction in Long-Term Care Settings. J Nurs Regul. 2015;6(2):17-24. DOI:10.1016/S2155-8256(15)30382-3
Mazurenko O, Gupte G, Shan G. Analyzing U.S. nurse turnover: Are nurses leaving their jobs or the profession itself? J Hosp Adm. 2015;4(4):48-56. DOI:10.5430/jha.v4n4p48
Maurits EE, de Veer AJ, van der Hoek LS, Francke AL. Autonomous home-care nursing staff are more engaged in their work and less likely to consider leaving the healthcare sector: a questionnaire survey. Int J Nurs Stud. 2015;52(12):1816-23. DOI:10.1016/j.ijnurstu.2015.07.006
Agosti MT, Andersson I, Ejlertsson G, Janlöv AC. Shift work to balance everyday life - a salutogenic nursing perspective in home help service in Sweden. BMC Nurs. 2015;14(1):2. DOI:10.1186/s12912-014-0054-6
Yamaguchi Y, Inoue T, Harada H, Oike M. Job control, work-family balance and nurses' intention to leave their profession and organization: A comparative cross-sectional survey. Int J Nurs Stud. 2016;64:52-62. DOI:10.1016/j.ijnurstu.2016.09.003
Sulander J, Sinervo T, Elovainio M, Heponiemi T, Helkama K, Aalto AM. Does Organizational Justice Modify the Association Between Job Involvement and Retirement Intentions of Nurses in Finland? Res Nurs Health. 2016;39(5):364-74. DOI:10.1002/nur.21740
Tourangeau AE, Patterson E, Saari M, Thomson H, Cranley L. Work-related factors influencing home care nurse intent to remain employed. Health Care Manage Rev. 2017;42(1):87-97. DOI:10.1097/HMR.0000000000000093
Dhaini SR, Zúñiga F, Ausserhofer D, Simon M, Kunz R, De Geest S, et al. Are nursing home care workers' health and presenteeism associated with implicit rationing of care? A cross-sectional multi-site study. Geriatr Nurs. 2017;38(1):33-8. DOI:10.1016/j.gerinurse.2016.07.003
Bratt C, Gautun H. Should I stay or should I go? Nurses' wishes to leave nursing homes and home nursing. J Nurs Manag. 2018;26(8):1074-82. DOI:10.1111/jonm.12639
Squires JE, Baumbusch J, Demery Varin M, MacDonald I, Chamberlain S, Boström AM, et al. A Profile of Regulated Nurses Employed in Canadian Long-Term Care Facilities. Can J Aging. 2019;38(2):130-42. DOI:10.1017/S0714980818000478
Shultz KS. Bridge employment: work after retirement. In: Adams GA, Beehr TA, editors. Retirement: Reasons, Processes, and Results. New York: Springer; 2003. p. 215–41.
Bakker AB, Demerouti E. The Job Demands-Resources model: State of the art. J Manag Psychol. 2007;22(3):309-28. DOI:10.1108/02683940710733115
Herzberg F, Mausner B, Snyderman B. The motivation to work. 2nd ed. New York: John Wiley & Sons; 1959.
Baltes PB, Baltes MM. Psychological perspectives on successful aging: The model of selective optimization with compensation. In: Baltes PB, Baltes MM, editors. Successful aging: Perspectives from the behavioral sciences. Cambridge: Cambridge University Press; 1990. p. 1-34.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Creative Commons License CC-BY-ND
