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NEXT NURSES EXIT STU Résumé de rapport

Project ID: QLK6-CT-2001-00475
Financé au titre de: FP5-LIFE QUALITY
Pays: Germany

Ageing in nursing

The demographic change in Europe is causing challenges and problems for the nursing profession. Currently the nursing profession is facing a lack of nurses. Where possible, nurses are leaving their profession prematurely. However, NEXT data indicates that, when there are no or only few job alternatives nurses are forced to remain in their profession. As a consequence the ageing of the nursing profession can be observed, such as in Germany.

Many employers as well as the public are prejudiced with respect to the work ability of older workers. In nursing, these prejudices predominantly concern reduced physical capacity, less flexibility and more sickness absence. On the other hand, social capabilities are commonly expected to be better. Nursing is a highly demanding profession with respect to both emotional and physical demands. Furthermore, the nursing profession is known to be at higher risk of adverse psychological health than other professions.

As a consequence a central question for assuring future health care provision is: Is nursing at older age possible?

NEXT has provided the opportunity to assess this question.

Summary of results:
For the sake of homogeneity of results we have limited this report to registered nurses working in hospitals. The data from 25,321 nurses from ten countries has been included. The NEXT basic assessment was used for this analysis. We defined the older age group of nurses to be 50 years or older. More details and results can be found in the NEXT Scientific Report (

- There were profound differences with respect to the proportion of older nurses in hospitals between the NEXT countries; the highest proportion was in Finland (25.5%) and in Norway (19.6%). The lowest proportion was in Belgium (9.6%) and in Poland (7.4%).
- Older nurses worked the same number of hours per week as younger nurses.
- Older and younger nurses did not differ with respect to absence from work when considering the two causes sickness and family duties together.
- In most countries older nurses reported better working conditions than younger ones: e.g. less emotional and quantitative demands and more influence at work. Moreover, their work involved less lifting and bending .
- Younger nurses were generally healthier than their older colleagues but tended to suffer more from burnout.
- In some countries (e.g. England, Norway), older nurses reported distinctly better working conditions than their colleagues in other countries (e.g. Belgium, Germany, Finland).
- In Finland, the older nurses reported a higher work load than older colleagues in other countries. (This is logical since the proportion of older nurses in Finland is high.) Still, commitment, job satisfaction and physical health were considerably better.
- The Norwegian example shows that older nurses can have both low work load and positive health and attitudinal outcomes.
- Countries with a high proportion of older nurses show the most positive health and attitudinal outcomes. This cannot only be attributed to the healthy worker effect (=sick nurses leave the profession earlier) because the two countries with the highest proportion of older nurses (Finland and Norway) show the most positive health and attitudinal outcomes.

The NEXT findings indicate rather pronounced age related differences in the work situation of older nurses. Older nurses tend to report better working conditions. Here, the healthy worker effect must be taken into account which describes the observation that especially in physically demanding jobs - older professionals remaining in a profession constitute a positive selection of healthy and high-performance individuals.

However, the two countries with the largest proportion of older nurses show the most positive health and attitudinal outcomes. This speaks for the fact that a successful integration of older nurses in the nursing work force is possible.

- Health policy makers should recognise that the nursing work force is ageing and will continue to age.
- Health policy makers should learn from good examples with respect to older nursing work forces (e.g. Finland, Norway, Great Britain).
- Health care institutions should recognise that older nurses often can be a resource with better expertise, more commitment and better psychological health.
- However, the lower physical exposure and lower general health should be acknowledged and preventive measures taken at early stages.
- Health care institutions should prevent age discrimination among nurses (see low perceived social support) and assure high mutual support in the work groups.
- All stakeholders should accept their responsibility in reducing age discrimination in the nursing work force.

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