Solving the Nursing Shortage: The Role of Older Nurses & Midwives

There is an increasing demand for healthcare services partially attributed to the global ageing population (1) and healthcare services worldwide are grappling with nursing and midwifery shortages. Many countries struggle to train and retain enough nurses to meet the growing demand, leading to overworked staff and compromised patient care (2). According to the World Health Organization (WHO) (2), the global nursing and midwifery shortage is projected to reach over 5.7 million by 2030. This looming crisis calls for innovative strategies to support and retain older nurses and midwives to maintain the status quo.

Older nurses and midwives are essential to the Australian healthcare workforce, however; they experience unique challenges. Research has shown older nurses and midwives are experienced and knowledgeable (3), however, their skills are frequently discounted (4, 5). Their years in the workforce equip them with historical and organisational knowledge (6), a deep understanding of patient care, critical thinking skills, and the ability to mentor younger colleagues (3). It’s vital to recognise the value older nurses and midwives can bring to healthcare by addressing r age-related challenges and fostering an environment to encourage them to remain in the workforce for as long as possible. In order to ensure continuity of care and knowledge within the nursing profession, supporting older nurses and midwives allowing them to transfer their expertise to the next generation is necessary.

What is the definition of an older nurse or midwife?

The term 'older' generally refers to nurses and midwives in their mid-to late-career stages, often aged 50 and older. However, some identify as 'older' as early as their 40s (5). Therefore, being older does not refer to a homogenous group, as older nurses and midwives span a wide age range. Those in their 40s and 50s have the potential to continue working for another decade or two, which is important as being employed is recognised as beneficial to a person’s overall health and wellbeing (7). From an Australian government perspective, encouraging older nurses and midwives to remain in the workforce will lessen the burden on the total government welfare expenditure and create higher economic growth through higher labour participation (8). However, this is difficult if they are experiencing age-related challenges in the workplace.

All nurses and midwives experience the physical and emotional challenges that can make the demands of their jobs more difficult to manage. With an increased life expectancy and good health, many nurses and midwives remain capable of working longer than ever before. This is especially important as older nurses and midwives often find their work fulfilling, continued work can help combat the rising costs of living, it can help alleviate insufficient retirement savings, or provide an avenue of income in situations where they may need to support family members.

However, the age-related challenges older nurses and midwives experience need to be considered. Changes such as loss of physical strength or mobility difficulties relating to an ageing body, increased tiredness and fatigue, declining vision and hearing acuity, generalised aches and pains, menopause and the development of chronic health conditions (9, 10). Many report experiencing ageism in the workplace with the perception they are not respected and valued as skilled workers leading to the feeling of being undervalued. There are common reports of a lack of understanding or appreciation of their contributions to the healthcare workplace (4, 5). It’s well documented that older nurses and midwives are often treated differently from younger colleagues, mainly because of a lack of opportunities for ongoing education and promotion (9, 11). While they may face challenges related to physical difficulties or adapting to rapidly changing technologies, their wisdom and emotional resilience remain invaluable assets. Older nurses and midwives bring experience, knowledge, and compassion to the healthcare workplace. Their years of experience often translate into an ability to handle complex clinical situations calmly and confidently and mentor younger colleagues (4). Their presence in healthcare fosters a supportive environment for patients and colleagues, enhancing the overall quality of care (12).

Many older nurses and midwives would like to remain in the workforce but say they cannot cope with the demands of their jobs; Most engage in self-care strategies to help them manage age-related challenges. These strategies include:

• Making time for themselves through setting work/life boundaries
• \Engaging in physical activity programmes (such as yoga or recreational sport)
• Ensuring adequate diet and rest
• Taking time off to support themselves when necessary (5).

However, without organisational support, they will be forced to leave prematurely, and their loss could exacerbate the skill shortage crisis (13).. Rather than allowing this experienced cohort to exit the workforce en masse, it’s crucial to implement policies that encourage them to stay through wellness programs, redeploy to less physical roles, flexible work hours that accommodate their needs, support networks, recognition of skills and experience, workplace ergonomics and provision for ongoing educational opportunities (14). Healthcare organisations should create inclusive policies that emphasise the value of older nurses and midwives through promoting age diversity in hiring, offering retraining opportunities, and ensuring that older nurses and midwives are not sidelined in favour of younger, less experienced staff.

By addressing the unique needs of older nurses and midwives in a workplace that caters to different older age groups, healthcare organisations can promote a sustainable and supportive work environment that benefits both older nurses and midwives and the quality of patient and client care. There is value in supporting older nurses and midwives in the workplace by considering factors such as workload and the older nurses and midwives’ physical and mental health.

By understanding the challenges and needs of older nurses and midwives, healthcare managers can create targeted interventions that address the specific needs of this demographic, ultimately enhancing their wellbeing and job satisfaction. Based on the findings of research (15), recommendations include:

• Education for managers to recognise the age-related challenges of older workers
• Implementation of flexible work options – Sedentary, part time positions
• Access to tailored health and wellness programmes
• Access to appropriate career development opportunities
• Access to support networks
• Fostering interpersonal relationships / team building
• Access to phased retirement options.

What can we do to support older nurses and midwives?

Fostering an age-friendly work environment means recognising the strengths and unique perspectives that come with experience and combating any biases against ageing nurses and midwives. By addressing the physical toll of nursing and midwifery on older workers, we can extend their careers and preserve their well-being (16, 17). Implementing policies that focus on work-life balance can help prevent premature exits from the workforce. Although the challenges older nurses and midwives encounter have been discussed for decades, research has shown that little workplace support has been implemented (18). Healthcare organisations should adopt an individualised approach rather than making assumptions based on age through assessing the strengths, goals, and needs of each older nurse or midwife. Supporting them as an older nurse or midwife is not just about helping to extend their career; it is about preserving the entire nursing and midwifery workforce.

Dr Julie Denton is a Registered Nurse with a master's degree in Nursing Education and a Doctor of Philosophy (PhD) from the University of South Australia. She is involved in research, advocating for older nurses and midwives within the healthcare industry

1. . United Nations. World Population Ageing 2019. Department of Economic and Social Affairs Population Division; 2019. Report No.: 978-92-1-148325-3.
2. World Health Organisation. The State of the World’s Nursing. 2020. Report No.: ISBN 978-92-4-000329-3 (electronic version) ISBN 978-92-4-000330-9 (print version).
3. Fackler CA. Retaining older hospital nurses: Experienced hospital nurses' perceptions of new roles. Journal of Nursing Management. 2019;27(6):1325-31.
4. Denton J, Evans D, Xu Q. Managers' perception of older nurses and midwives and their contribution to the workplace—A qualitative descriptive study. Journal of Advanced Nursing. 2022.
5. Denton J, Evans D, Xu Q. Being an older nurse or midwife in the healthcare workplace- A qualitative descriptive study. Journal of Advanced Nursing. 2021.
6. Mion L, Hazel C, Cap M, Fusilero J, Podmore M, Szweda C. Retaining and Recruiting Mature Experienced Nurses A Multicomponent Organizational Strategy. Journal of Nursing Administration. 2006;36(3):148-54.
7. Waddell, Burton. Is work good for your health and wellbeing? London Great Britian: Stationery Office; 2006 2006. 255 p.
8. Australian Human Rights Commission. Employing and Retaining Older Workers. 2021.
9. Ang SY, Ayoob SBM, Hussain NBS, Uthaman T, Adenan H, Chiang P, et al. Challenges faced by older nurses in Singapore: a mixed method study. International Nursing Review. 2016.
10. Kausto J. Menopause in working life. Scand J Work Eviron Health. 2025;51(6):455-7.
11. Clendon J, Walker L. The juxtaposition of ageing and nursing: The challenges and enablers of continuing to work in the latter stages of a nursing career. Journal of Advanced Nursing. 2016;72(5):1065-74.
12. Reinhardt AC, Leon TG, Amatya A. Why nurses stay: Analysis of the registered nurse workforce and the relationship to work environments. Applied Nursing Research. 2020;57(2):1-9.
13. Buchan J, Catton H, Shaffer F. Ageing well. Policies to support older nurses at work ICNM 2020.
14. Denton J, Evans D, Xu Q. Older nurses and midwives in the workplace: A scoping review. Collegian. 2020.
15. Denton, Evans D, Xu Q, Vernon R. Supporting older nurses and midwives in the Australian healthcare workplace—A qualitative descriptive study. Journal of Advanced Nursing

. 2023.

16. Markowski M, Cleaver K, Weldon SM. An integrative review of the factors influencing older nurses' timing of retirement. Journal of Advanced Nursing. 2020;76(9):2266-85.
17. Soderbacka T, Nyholm L, Fagerstrom L. Workplace interventions that support older employees' health and work ability - a scoping review. BMC Health Services Research. 2020;20(1):472.
18. Montayre J, Knaggs G, Harris C, Li W, Tang LM, de Almeida Neto A, et al. What interventions and programmes are available to support older nurses in the workplace? A literature review of available evidence. International Journal of Nursing Studies. 2023;139:104446.