Older Nurses' Perceptions of Workforce Retention Facilitators and Barriers During the COVID-19 Pandemic

Francine H. Sheppard, PhD, RN, CNE, CDP; R. Turner Goins, PhD; Ratchneewan Ross, PhD, RN, FAAN; Kathleen Conte, PhD; Nicole Zonin, MSN, RN


Online J Issues Nurs. 2022;27(3) 

In This Article

Abstract and Introduction


Nursing workforce retention is critical to provide quality healthcare, raising concern as nurse turnover rates continue to increase. In this study, we examined older Registered Nurse (RN) perceptions of their work experiences during the COVID-19 pandemic to identify facilitators and barriers in workplace environments that relate to RN workforce retention. The methods section describes our study population that included RNs aged 50 years and older (n=195) who completed surveys containing open and closed-ended questions between August 2020 and January 2021. Our study results indicate that most respondents (86.2%) worked during the COVID-19 pandemic in moderate-to-high patient acuity settings and felt their employers provided employees adequate Personal Protective Equipment (73.3%). The discussion section notes implications for nursing and study limitations. In conclusion, workforce retention facilitators included offering resources and implementations that made experienced, older RNs feel included, valued, supported, and protected. Workforce retention barriers were short/rushed workplace orientation, unsafe patient assignments, micromanaging, perceived ageist policies, and implementing pay and benefit-related policy changes without RN input.


The average age of Registered Nurses (RNs) in the United States (U.S.) is 51 years (National Council of State Boards of Nursing [NCSBN], 2021). With many RNs approaching traditional retirement age and nursing school leaders facing barriers to increasing student enrollment, a substantial nursing shortage in the United States is anticipated (American Association of Colleges of Nursing [AACN], 2020). The greatest deficit of nurses is predicted in the southern and western U.S. regions (Zhang, Tai, Pforsich, & Lin, 2018). National nursing school enrollment increases of 5.1% in 2019 are insufficient to meet expected future nursing service needs, with nursing faculty shortages contributing to limited student admissions to nursing schools (AACN, 2020).

In addition to educating new nurses, retention of the nursing workforce is needed to meet projected future nursing care demands, particularly with respect to the chronic conditions of the aging U.S. population and subsequent complex healthcare needs (Uthaman, Lert, & Yuh, 2016). Many RNs experience psychological distress due to job-related stress and burnout (Ross, Letvak, Sheppard, Jenkins, & Almotairy, 2020) and job dissatisfaction can lead to nurses leaving the profession (Chen et al., 2019).

Research to examine experiences of nurses during the COVID-19 pandemic is ongoing and the literature on nurse experiences of working during the pandemic has rapidly expanded (Arnetz, Goetz, Arnetz, & Arble, 2020; Chen, Lae, & Tsay, 2020; Fernandez et al., 2020; Galehdar, Toulabi, Kamran, & Heydari, 2020; LoGiudice & Bartos, 2021). Yet, there has been limited research to understand perceptions of older, experienced RNs as they work during the COVID-19 pandemic. Inability to retain older nurses represents a potential loss of valuable expertise in the profession (Buerhaus, Skinner, Auerbach, & Staiger, 2017).

Healthcare delivery practices in the U.S. continuously evolve with older nurses who have remained in the workforce through many changes (Uthaman et al., 2016). Their experiences may provide important insights to improve patient care through RN workforce retention during public health crises. To address this gap, the aims of our study were to: (1) Examine relationships between older nurse demographics and context of employment during the COVID-19 pandemic; (2) Explore older RN and Advanced Practice RN (APRN) perceptions of their work experiences during the pandemic; and (3) Identify facilitators and barriers in older nurses' workplace environments that relate to nurse workforce retention.