Last night Kelly and I went out for a delicious dinner with two of our close friends Anna and Deb.
All four of us have a long association with the emergency department. In fact the three girls all have 25 years plus1 experience in emergency nursing.

As the evening unfolded over wine and food, we started talking about this.
Twenty five years plus.
That is a hell of a heap of clinical acumen and experiential knowledge. A hell of a heap.

And as we talked, it became evident that sitting around the table was a representational microcosm of one of the most disappointing (dare I say disgraceful) pathways our profession has taken.

Nursing has few opportunities for promotion and recognition of senior expertise within the clinical setting.
How often have you watched senior (and I’m talking about years of experience here) nurses move on to non-clinical management positions, or drift off into non-nursing jobs where their specialised skills are snapped up, or just stagnate on the floor (feeling little respect from the system) with nowhere to go and little exploration of the stuff they might teach.

What we are sadly lacking is a health system that gives the nursing ‘elders’ opportunity, support and recognition to pass on their profession, their experiences, their corporate knowledge and their craft to the next generations.

This huge collective of nursing elders have so much to offer both the healthcare policy planning process in general and the future of nursing in particular.
As many of them are now approaching retirement the opportunity to pass on the craft will be lost forever.
Skills that could be used to improve quality healthcare delivery, departmental operations and mentor-ship of other nurses. Believe me, those skills are out there in many of these people. They should be consulted not insulted.
Such a waste.

Sitting around that table with its 100 collective years of gathered nursing knowledge, we noted that only two of us were now working in the emergency department and none of us were in positions of mentoring or consultancy.

The clock is ticking….

  1. I could tell you exactly how long, but they would kill me []

11 Responses to “The unbearable wastage of senior nursing expertise.”

  1. Well, I am of the opinion that knowledge never goes waste. I am a nursing student at an accredited nursing school in California and my mother is a nurse at Hoag Hospital for 23 years now. I have learnt a lot from her and he has always been an inspiration. I still remember the day when mom and I were out for shopping at South Coast Plaza and an elderly gentleman had some cardiac problem and fell breathless. Mom ran and offered him CPR thus saving his life. I keep learning from her as her real life experience can add quite a lot to my theoretical knowledge.

  2. As a “newbie” to the NICU, I appreciate the mentorship I receive from experienced nurses. I found the following article in our national magazine–Canadian Nurse–entitled, “A new approach to retaining older workers” interesting…

  3. Couldn’t agree more with you more Ian.
    After thirty years nursing, I am still hanging in there by the bedside, loving my job.
    I spend a lot of time mentoring new nurses and trying to instil in them an understanding of why bedside nursing can be so rewarding. And I learn as much from them as they do from me.
    I find very sad that us old chooks are not recognised and the only career advancement is to become a clipboard nurse. It is a great loss to nursing.
    What I also find alarming is that the role of CNC (clinical nurse consultant), is now a managerial role, with a large slab of their time spent worrying about budgets etc rather than being, as their name suggests, a clinical consultant on the ward

  4. I am in the throes of an undergrad nursing degree and also have the rather unique position of having been through the ‘old’ hospital training system 25 years ago. (I dared to take 10 years off to raise 4 children). So seeing it from both sides is very interesting. I have had (older) clinical facilitators saying ‘you know everything, I’ll leave you alone’ to new grads actually running away saying ‘I don’t ‘do’ students’. My favourite experience was sitting with a really good new grad (ex-EEN) going through a patients notes, searching for a reason for his acute neuralgia, both bouncing ideas off each other and learning from each other.
    My advice for undergrads is: take everything on offer, go after experiences, ask questions, learn from everyone, talk, listen, say ‘I’ll watch this one then can I do the next one with you watching me’. Ask for feedback on each shift. Immerse yourself, people will notice and you’ll get even more experience. Our time on the wards is so very short, and as Lil says, shadow and learn.

  5. I’m still in training, a year and a half to go, but whenever I’m on the wards on placement I make a point of finding the most experienced nurses and shadowing them. Eagerly learning all they have to offer, I got to work with two really experienced mental health nurses and it was such an amazing experience for me.

  6. I find this perception that new grads don’t ‘seem to have a solid work ethic’ . I am not a new grad, but am still studying.
    I get the impression that many experienced nurses don’t respect us because it has begun a University degree which is somehow ‘easier’. For one, this is not our fault, and many of us would prefer a lot more time spent in clinical training. Personally I have become somewhat disheartened at the amount of nurses unwilling to pass on their skills to us once we reach the clinical setting, acting as if each question we ask is a bother, and being generally unwilling to give us a little extra time.
    Balancing university work on top of of other work commitments is not easy. While on placement we are expected to not only be at our clinical placement full time without pay, but keep up with theory work and paid work commitments.

    In regards to this article though,

    • Alex, I’m really surprised to see your comment – I read Ian’s post as being about the fact that there’s so little respect for the role experienced nurisng staff play, and the contributions we make (today’s my 23rd anniversary in nursing) that the profession loses a significant percentage to non-clinical areas. I didn’t see anything in Ian’s post that referenced less experienced staff, or mentioned students, let alone their work ethics.

      • Not in Ian’s post, just in Gigi’s reply.

        • So yes, it’s a shame that once it’s over….it’s over. I hate to say this, but it seemed to me, for the most part, many of the new grads just didn’t seem to have a solid work ethic…not like us “old gals”…something is lost. Then again, I think a lot is lost in the world today….sadly.

          • Hi Gigi, Tara & Alex,

            I’m 50 years old. Was a mature-age student for RN and the hospital system for EN. I’m in my 6th year.

            It is difficult for the RN to cope with their busy workload and happily mentor a student or new grad. It takes a skill that is not really taught – to work, teach and competently care for your unwell patient without feeling like your head is going to blow up.

            But, I will never be convinced that the university system, the way it is now, is the way to prepare people for all that is required on the job. This is not the university trained nurse’s fault. It seems like the on-the-job training of pre-uni nursing really prepared everyone really well. There are some that flourish with the uni training. But most are ill-prepared for a lot of the practical elements. When I was a new grad some of my peers were off on stress leave, others chose non-nursing positions because they were so over-whelmed.

            I think it’s unfair to write off the new nurses coming from Uni. The system is letting them down. There doesn’t seem to be enough work placements available for them. At my workplace our main problem is having enough time to talk through everything with the usually keen new-grad.

            Also, I always gravitate towards those with the experience. I have thought for a long time that those nurses with all that experience who need to take a less physical role could become consultants. Rather than waste all that knowledge.


  7. I agree, it’s really sad and such a waste to let it all go by the wayside. As a nurse of 33 years and only 55 years old….I finally got out and now self-employed. I’ve had many employers over the years and I have to say not one ever took a moment to say, “good job” or show any kind of real positive recognition. However, ALL were very quick to point out any faults or errors–though minor, they were pointed out. I even had one employer, a nun, accuse me of stealing 0.2mg of MSO4 simply because I was the one who reported a minute shortage in the vial, unable to complete a dose. As it turns out, the nun was a narcotic crook…stole the expired C2′s when patients were discharge or meds DC’d. I never got so much as an apology.

    The only real positive I feel about those years is knowing I did make a difference in the lives of many, many patients and their families, always made sure to treat each and everyone as though they were my own. Well, almost all, there were a few….

    So yes, it’s a shame that once it’s over….it’s over. I hate to say this, but it seemed to me, for the most part, many of the new grads just didn’t seem to have a solid work ethic…not like us “old gals”…something is lost. Then again, I think a lot is lost in the world today….sadly.

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