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As RNs Retire, Drain on Intellectual Knowledge Looms
Janice Spillane, RN, MS
Monday June 30, 2008



(From left) Eileen P. Williamson, RN, MSN, associate vice president, professional services, NY/NJ division of Nursing Spectrum, introduces Terri Gaffney, vice president of consulting services, Gannett Healthcare Group, who spoke on knowledge retention. Also pictured are Kathy Duffy, sales manager for Nursing Spectrum, and Diane Poulios, president of NJAHR.

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Nursing professionals have talked a lot about the aging nursing workforce and the looming catastrophic shortage of nurses that will emerge as more baby boomers retire. At a New Jersey Association of Healthcare Recruiters (NJAHR) Executive Leadership Conference, on April 18 in Princeton, N.J., attendees learned the impending nursing shortage brings other equally critical concerns.

Speaker Terri Gaffney, RN, MPA, vice president of consulting services for Gannett Healthcare Group, warned attendees that an issue perhaps even more critical than the lack of nurses is the intellectual knowledge drain that will occur when these seasoned nurses leave or retire.

Costly losses

Many of the nurses who will soon be retiring hold key positions in hospitals and healthcare facilities and retain a body of knowledge critical to the operation of the facility and to the delivery of quality patient care. Gaffney notes that many institutions have failed to document this critical intellectual knowledge and pass it on to others. The results can be costly in both dollars and patient outcomes.

It is not uncommon, she says, that "a loss of this intellectual knowledge trickles down to the bottom line and has an impact on quality. Hospitals often spend tens of thousands of unnecessary dollars to replace knowledge that could have been preserved with some forethought."

What are the effects of this lost knowledge? In many cases, Gaffney says, the speed at which decisions are made is decreased because less experienced nurses might not have the ability to recognize potential problems. Also, there is often a reduction in the organization's ability to innovate for business growth, improve efficiency, and question established policies and procedures. There is also a loss of mentoring ability and perhaps even the denigration of the sense of "team."

Solving the problem

A recent "State of the Workforce" study of New Jersey nurses found that 36.4 percent report that their caseloads caused them to miss important changes in their patients' medical conditions. Gaffney asked participants to consider what this number would be if New Jersey nurses were polled 10 years from now. Without aggressive action on the part of nursing administrators to maintain adequate staff and retain key knowledge, the figure would be far worse, she says.

Gaffney outlined several steps that all healthcare facilities can take to address the problem. These include the following:

• Identify key employees who hold critical knowledge

• Transfer that knowledge to at least one other person

• Institute a retirement planning system by asking employees when they plan to retire

• Identify alternative jobs or activities that might entice key employees to stay

• Consider a phased retirement plan whereby employees can work reduced hours in lieu of leaving

• Look at rehire programs for recently retired nurses

• Implement a storytelling program to pass on critical knowledge through clinical narratives

• Incorporate critical knowledge into the mentoring programs

• Debrief employees when they leave about the knowledge they hold

Gaffney concluded with a warning that the threat is looming, and she encouraged healthcare facilities to implement action plans now.

Editor's Note: For more information on the "knowledge drain" and actions that facilities can take, contact tgaffney@ gannetthg.com.

Janice Spillane, RN, MS, is editorial director for the NY/NJ division of Nursing Spectrum. To comment on this story, e-mail editorPA@nursingspectrum.com.

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