With 5.7 million workers employed in hospitals, population workforce aging trends are hitting the industry hard.
The nursing and nursing aides’ shortages, combined with the demographic trend of older female employees — an average of 47 years for RNs — suggest that nurses and other healthcare workers will need to continue working into advanced age in the next decade.1
These statistics also point to the need for hospitals to be proactive in addressing the physical needs of older workers, who may need accommodations in their workspace to help prevent falls and other injuries. Other changes might include addressing older workers’ lower stamina when it comes to 12-hour shift work and improving lighting and noise issues that disproportionately impact older staff, says Kenneth A. Scott, MPH, former outreach director of the Mountain and Plains Education and Research Center in Aurora, CO. Scott has researched the issue of aging hospital workforces.
Hospitals that overlook this demographic trend and fail to make accommodations for older workers might experience rising retirement rates among nurses and other staff. Research shows that older nurses are more likely to retire if they experience poor health and perceive their work ability to be declining.1
Federal labor data show that hospital workers are among those with high injury and illness rates, and the number of lost work days resulting from injuries and illnesses increases steadily with age. Employees who are 65 and older have nearly three times the median days away from work as those in their early 20s.2
"Severity of injury tends to increase with age, regardless of the type of injury," Scott says.
The U.S. Department of Labor’s data on median days away from work provide a glimpse at severity of injury or illness. The longer they’re away from the job, the longer it is taking them to recover.
Hospital workforces are aging as more healthcare workers delay retirement, and this trend requires employers to adjust their programs and policies to accommodate older workers, Smith says.
While older hospital workers miss more work due to their injuries, they do not have a monopoly on work site injuries.
"Injuries tend to be more and less frequent with age," Scott says. "Slip and fall injuries tend to be more common with age, and overexertion injuries people suffer while lifting patients tend to be less frequent with increasing age."
One possible explanation is that hospital workers tend to become less involved with the manual labor aspects of work as they get older, Scott adds.
"If people in their early 20s are doing most of the manual patient transfers, then it stands to reason they’d be more likely to be injured," he explains. "Fall injuries have to do with physiological changes that occur with age–balance issues."
Hospitals should address slip and fall prevention injuries among older employees because it’s a cost-effective strategy, Scott says.
"If we know an injury will be more severe or more costly among older workers then it might change the cost-benefit analysis of implementing a certain technology," he explains. "A nurse who is 67 years old and who throws out her back while handling a patient might have a much higher workers comp claim and medical costs than would a worker who is 25 years old."
From an occupational health nurse’s perspective, this suggests a need for patient handling programs and return to work programs, Scott says.
"If there is a return to work program that helps people without pushing them too hard then that might be worth considering by hospitals’ occupational health nurses," Scott says.
Another way to prevent injuries among older staff is to modify physical working space. Scott offers these suggestions:
Focus on age-friendly design. Hospitals are better designed for older and disabled people than are many work sites, but there still is much they could do to improve their workplaces, Scott says.
"I’d recommend they make changes based on the principals of universal design," he says.
For example, one strategy is to take a cut out of the curb on the outside of the hospital, Scott suggests.
"This is something not many hospitals are adopting yet," he says.
Another strategy is to use slip-resistant floors in more than the geriatric wings. "These floors are better for older adults, who are more likely to fall, but they can help younger adults, as well," Scott says.
Focus on age-related hearing loss and eyesight issues. Older nurses and other staff would benefit from plastic magnifying glasses and magnifying sheets that help them read medication labels and instructions, Scott suggests.
"Another issue worth mentioning is background noise," Scott says. "As people age, their hearing tends to decline, and it makes it difficult for them to concentrate and hear a conversation."
Also, background noise can interfere with communication for those experiencing hearing loss, he says.
"Some emergency rooms are being redesigned to be better for the older population by eliminating background noise," Scott says. "It’s better for older patients who may have a difficult time hearing what the healthcare provider is telling them, and it may be better for aging healthcare providers who have age-related hearing loss — or for younger healthcare providers who have hearing loss because their iPods are cranked up too high."
These types of design strategies are better for everyone, which is what universal design is about, Scott says.
"The goal is to design workplaces that are accessible for everyone," he adds.
Design work schedules to accommodate age-related sleep problems. "Shift work is an issue because people’s sleep patterns change as they age," Scott says. "So sometimes healthcare workers have a tougher time working nights than they did when they were younger."
This is a difficult subject for employee health staff to approach because hospital shift work is necessary and often based on particular employee issues. But it is worth discussing with managers the possibility of scheduling shifts according to what will work with aging staff.
"Aging is a very personal thing," Scott says. "When you look at the life of an individual there are things related to age that you can’t capture with statistics."
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McPhaul KM, Lipscomb J. Healthy aging for a sustainable workforce. Report by the Association of Occupational and Environmental Clinics. 2009. Available online: http://www.elcosh.org/document/1684/957/d000987/2b-.html.
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Bureau of Labor Statistics, U.S. Department of Labor. 2012 Nonfatal occupational injuries and illnesses: cases with days away from work. November 2013. Available online: http://www.bls.gov/bls/errata/iif_errata_1014.htm.
