Leading Change in a Complex World

This section focuses on the challenges related to retention of older nursing professionals in a public health care field. An individual-level perspective is used to demonstrate how older nursing professionals perceive their work and HRM practices in the context of retention. This empirical example is based on a qualitative study conducted in a Finnish university hospital. In all, 22 older nursing professionals were interviewed in December 2016. The nursing professionals interviewed worked in four different locations and represented several wards. All the interviewees had long working tenures at the hospital. The oldest was 64 years old. Five interviewees were male, and the rest were female.

The participants were asked to describe and reflect on their career trajectories, current jobs and future prospects at work. This chapter focuses on the perceptions among nursing professionals of the types of organisational practices that would support their abilities to continue working until retirement. Accordingly, the following themes were identified from the empirical data: the content of the work, support for workability, learning and development, flexibility and supervisory support. These themes are discussed in more detail below. 

The positive aspects of work played a central role in late-career intentions, including motivation and willingness to continue working. In general, work was perceived as meaningful and providing a sense of purpose and a feeling of satisfaction. In addition, social relationships with patients and colleagues were seen as positive aspects of the job. The workload and the fast pace were perceived as negative factors.

Psychiatric nursing professionals specifically highlighted mentally challenging work situations, whereas other nursing professionals stressed the physically demanding nature of their work on their late career choices. In particular, changes in physical capabilities constrained their late-career choices. However, they also stressed their own active roles in ensuring their own work ability and in compensating for changes in their physical abilities. 

Continuous learning and development were closely related to discussions of the meaningfulness of the work and late career. The learning and development opportunities provided by the organisation were seen as playing an important role in horizontal career advancement, which prevented feelings of career plateauing. Continuous learning and development and the competencies gained at work were also closely related to the perceptions of their own work ability. However, continuous learning was also seen as demanding and tiresome when it was unclear how it related to individual professional development.

Professional competence is also related to the discussion of individual roles in the work community. First, competence was perceived as reinforcing feelings of assertiveness and self-worth in the work community. Second, professional competence was perceived as contributing widely to the work community. Some emphasised their roles as mentors to new employees. They also tended to worry about the integration of these new employees and how they would adapt to their work community. 

While they emphasised their own active role in maintaining workability, the active involvement was also expected from the organisation and supervisors. However, it was not always clear how the employer promotes the balance between individual resources and job demands.

When it was asked about specific HRM practices and policies that would promote the older nursing professionals' abilities to continue working, those practices were related mainly to flexibility in working hours, including the reduction of shift work. Some stressed their own active role in reducing their workloads by, for example, refusing to do extra work. But, most of them expected the organisation to implement flexible practices. In addition, moving from shift work to day work was not seen as problem free, given that it decreased their monthly salaries and thereby their future retirement allowances.

In addition to flexible work practices, managerial support in general was seen as important to retaining older employees in the organisation. Great value was placed on the supervisory support. In particular, the mutual trust and respect between employee and supervisor was seen as a prerequisite to being able to discuss and negotiate possible challenges related to work ability as well as changes needed in the work. 

The content of the work, work ability, continuous learning, flexibility, and supervisory support were most significant aspects related to retention among the studied older nursing professionals. Yet, some of these aspects also included challenges and contradictions. While the deteriorating workability was seen to influence the ability to continue working in a psychically (and mentally) demanding job, the work itself also motived and provided a sense of meaning. In addition, although continuous learning was seen as a key component of being able to carry on through late career, it was also perceived as somewhat burdensome. Similarly, while flexibility in work schedules was seen to ease the workload, it was not always seen as a financially optimal solution.