Organisational Support for Older Nurses' Continuation of Practice: A Qualitative Interpretive Descriptive Study

Abstract

Background: Global population ageing is increasing pressure on healthcare systems, contributing to workforce shortages and the loss of experienced practitioners as many approach retirement age. Retaining older nurses is essential because they provide critical clinical expertise, mentorship, workforce stability, and continuity of patient care in increasingly strained healthcare systems. Yet, little is known about how older nurses perceive organisational support for their continuation of practice.

Objective: To explore older registered nurses' perceptions of organisational support, and to understand how nurse leaders perceive organisational support offered to older nurses. Design A qualitative interpretive descriptive study was conducted using two datasets: older registered nurses and nurse leaders. A convergent design was used.

Methods: Research was conducted in a publicly funded organisation providing acute hospital, outpatient and community-based healthcare services in a metropolitan city in New Zealand. Data were collected through individual semi-structured interviews between June and August 2024 and analysed using the thematic analysis approach.

Results: Thirteen older registered nurses and four nurse leaders participated in semi-structured interviews. All except one of the nurses were female, and most were aged 61–70 years. Nurse leaders worked at frontline, operational or strategic levels within the organisation. Four themes were identified from the nurses' interviews: Tensions in continuation of practice, with sub-themes health decline, caring responsibilities, and stigmatisation; Drivers for continuation of practice, with sub-themes passion for care, financial incentives, and positive collegial relationships; The experience of being an older nurse in practice, with sub-themes feeling valued and cared for, feeling unseen, and navigating technological challenges; and Retirement from a large organisation, with sub-themes support for part-time practice, pension advice, and fear of leaving an empty spot. Three themes were identified from the nurse leaders' interviews: Perceived complexities in continuation of practice; Support at the interpersonal level; and Support at the organisational level.

Conclusion: This study offers valuable insights into supporting older nurses to continue practising. Relationships with managers and organisational support play a key role. To support older nurses, healthcare organisations need to address interpersonal and institutional ageism and respond to personal level challenges. Nurse leaders recognised the importance of fostering a supportive workplace culture and developing flexible, inclusive career pathways for older nurses.