How to reduce older adult care nurse turnover and enhance retention? By acknowledging nurses’ professional identity

Nurses are part of the heart and soul of healthcare, providing care that often determines a person's well-being. Yet, despite their vital role, the nursing profession continues to struggle with shortages and high turnover rates. This is especially alarming in older adult care, where stability and experience are crucial for ensuring high-quality care for our ageing population.

So, how can organisations attract and retain more nurses in older adult social care? The key might lie in understanding the professional identity of older adult care nurses. By recognising what motivates them and addressing their challenges, a work environment can be created that not only meets nurses’ needs, but fosters long-term engagement. The result? A healthier, happier, and more sustainable workforce that delivers better care for one of society’s most vulnerable groups.

To explore the nursing professional identity, I conducted research with Dr Ellie Chee Shi Yin, (Taylor’s University, Malaysia) and Professor Margreet van der Cingel (Stenden University of Applied Sciences, the Netherlands. Our research study included 50 interviews with vocational and bachelor-educated nurses working in older adult care in the northern part of the Netherlands. The interviews focused on understanding nurses’ motivations to enter older adult care nursing, their views on older adult care nursing, the workplace challenges, and their positions in the broader healthcare context that shape their professional identity.

The findings reveal five central themes that reflect their identity and offer powerful clues for improving nurse retention.

1 – Born to care: a lifelong motivation to nursing

For many older adult care nurses, nursing is more than a job - it’s a calling. A deep, personal desire to care for others drives them, and this passion leads them to deliver person-centered care. They see their patients as human beings, not cases, and they seek a balance between the technical and social aspects of nursing by building meaningful, lasting relationships with those they care for.

How can organisations nurture this passion and improve retention?

• Create time for both sides of care. Nurses need enough time to fully engage with patients, attending to both their medical and emotional needs. A holistic approach to care fosters greater job satisfaction, helping to retain skilled nurses.
• Train for efficiency. By understanding which social interactions bring nurses the most joy, organisations can help them focus on the most rewarding aspects without overloading their schedules.

2 – Nursing through the noise: dedication in a demanding profession

Nursing involves long shifts, constant patient updates, and little separation between work and personal time. For older adult care nurses, maintaining a work-life balance can feel impossible. Yet, despite the overwhelming demands, they push through, prioritising patient care because they value their contribution to people's lives.

How can organisations support nurses' well-being without compromising patient care?

• Teach boundaries. Offer training that helps nurses establish a clear boundary between work and personal life so they don’t risk burnout.
• Prioritise care. Train nurses to distinguish between urgent care needs and those that can wait. This will help them avoid the instinct to treat everything as critical, reducing unnecessary stress.

3 – The silent backbone: caught in the crossfire of interdisciplinary teams

Despite being at the forefront of patient care, nurses often feel overlooked within the broader healthcare system. They advocate tirelessly for their patients, but conflicting expectations from different medical disciplines can leave them feeling unappreciated and undervalued.

What can organisations do to make nurses feel more seen and respected?

• Promote open communication. Facilitate regular dialogues between nurses and other healthcare professionals. When everyone’s voice is heard, team dynamics improve and so does nurse retention.
• Increase visibility. Showcase nurses’ roles by featuring them prominently on the company’s website or through internal displays. Simple but powerful reminders of their importance.

4 – Learning under pressure: the demand for expanded nursing expertise

As the complexity of older adult care increases, so does the demand on nurses. While staff shortages and changing care needs can make the job overwhelming, many nurses are eager to upskill and stay ahead of new developments in diseases and treatments. However, this can add stress to an already demanding job.

What can be done to help nurses grow without burning out?

• Tailored professional development. Offer training opportunities that align with the evolving needs in older adult care. Nurses should have a say in shaping these programmes, as they are on the frontlines witnessing the changes.
• Acknowledge the challenges. Openly discuss staffing and workload pressures, and offer support where possible. Sometimes, simply recognising their struggles can make a big difference.
• Invest in well-being. Provide mental and physical health programmes. Whether it’s gym memberships, meditation classes, or occasional retreats. These initiatives help nurses recharge and stay mentally resilient.

5 – Against the current: the barriers to advocacy in nursing.

Nurses are natural advocates, not just for their patients, but for the healthcare system as a whole. Many older adult care nurses actively share ideas for improving workplace practices. Yet, their suggestions are often met with resistance, which can be incredibly frustrating. Still, their drive to create positive change never fades.

How can organisations turn this advocacy into a force for good?

• Create formal channels for feedback. Give nurses an online platform to share ideas for improving care processes.
• Recognise innovation. Establish an award system that celebrates and implements the best ideas. Not only does this motivate nurses, but it also shows that their voices are heard and valued.

The way forward: elevating the image of older adult care nursing

Finally, one of the most pressing issues older adult care nurses face is the lack of recognition for the profession. To change this, nurses and their organisations need to work together in public outreach, spreading awareness of the vital role older adult nurses play in society.

Only through collective action can we elevate the image of older adult care nursing and ensure it receives the respect and recognition it truly deserves.

Read the journal article – ‘Charting the course of the nursing professional identity: A qualitative descriptive study on the identity of nurses working in care for older adults’, Bolt, EET, Chee, SY, van der Cingel, M, Journal of Advanced Nursing, (2024)

If you are interested in learning more about this research or exploring collaboration opportunities, contact research.lubs@leeds.ac.uk.