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August 31, 2020
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Speakers address challenges in recruitment, retention of nephrology nurses

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While surveys show most nurses in nephrology are happy with their jobs, workforce issues and an aging staff are a concern, a panel noted at the American Nephrology Nurses Association National Symposium, which was held as a virtual meeting.

“There are a lot of workforce shortage issues,” Nancy Pierce, BSN, RN, CNN, one of three nurses on the panel, told attendees. “Nurses are retiring. In our 2018 ANNA survey, it showed that 47.5% of nurses are over the age of 50 [years] and 25% of our nurses overall are over the age of 60 [years],” Pierce said. “We also do not have enough classrooms, clinical sites and faculty to train our newest nurses wanting to get into the specialty.”

“COVID-19 has also increased the need for nurses in the ICU, where patients need dialysis or renal replacement therapy,” Pierce told attendees. “And then we have been postponing transplants for safety reasons. So, there are more patients in our outpatient dialysis programs.”

Nancy Pierce

Pierce said a shortage of nurses is also being seen in home dialysis programs, where more patients are trying peritoneal or home hemodialysis because they believe it is now a safer choice, “But we need more training nurses,” Pierce said. “We need a lot of experienced nurses to train the patients.”

The 2018 survey was conducted jointly by ANNA and Nephrology News & Issues and looked at job satisfaction, workplace conflicts and questions about retirement. Among the respondents, 94% indicated they were satisfied with being a registered nurse and 91% said they definitely or probably would recommend pursuing a nursing career to qualified individuals. Most would also recommend nephrology nursing, the survey results showed.

However, 17% of respondents said they were planning to leave their current position in the next 12 months, and 24% within the next 3 years.

Pierce polled attendees during the ANNA session about job satisfaction and found 53% indicated they did not plan to leave their jobs anytime soon or retire. However, 33% indicated they were job hunting or would retire; 8% in the survey indicated they would stay in nephrology and at their current position but were not happy with their work environment.

In another poll, 36% of nurses said they believe retention and recruitment of nursing staff was a problem at their clinic.

“And of course, it’s probably our experienced nurses who are retiring and leaving,” Pierce said. “That means a big loss of clinical support for these new nurses who need a lot of mentoring. The bottom line is that affects the quality of patient care.”

Pierce said job satisfaction begins with those who work alongside you. “Leadership support is so important. And people want a job where they feel valued,” she said, “ a job that challenges them and where they feel important. If they don't find that in their current job, they will look elsewhere.”

Part of the challenge in the nursing workplace is the differences in age among staff and how that might interrupt collaboration, Kristin Larson, MSN, RN, AGNP-BC, told attendees. The term “ageism” was coined by psychiatrist Robert Neil Butler in 1969 and is defined as a negative attitude toward individuals solely based on chronological age, Larson said. “Ageism has been said to be a largely ignored topic in the nursing industry,” she said.

Kristin Larson
Alice Luehr

Older nurses are stereotyped as being “too slow, too stubborn and do not want to (or cannot) learn new skills,” Larson said. “Older nurses often get the bad rap of being unwilling and resistant to change, but that is because of their wisdom and experience: ‘I don’t see the need for change just for the sake of change; I’ve seen change and then a few years later, things would go back to the way it was.’”

However, like anyone else, “older nurses can learn new things,” Larson said.

The key to collaboration when dialysis staff are different ages is to understand how to communicate with both groups, Larson said. Staff categorized by age as millennials need to be addressed differently than workers who are categorized as baby boomers, she said. “Administrators need to prioritize age diversity awareness and make training about it as strongly as they do other workplace inclusiveness initiatives,” Larson said. “Employers need to embrace the values of millennials and create this work environment. They can open up communication in the form of a goal-oriented task, such as a skill the older or younger worker may want to learn, then have different generations leading the project.”

Even with the availability of a younger workforce, retention of staff remains an issue, Alice Luehr, DNP, RN, CNN, told attendees. A 2019 task force created by ANNA looked into best practices on recruiting new nephrology nurses. Some of the ideas that were implemented included student scholarships to attend ANNA symposiums, access to an updated ANNA website with content for younger nurses and the organization’s increased presence on Instagram.

“Places you can recruit for new nurses include social media, career fairs and colleges of nursing,” Luehr said. “For nurses new to nephrology, you can [use] word of mouth and talk about the attractions of the nephrology profession.”