The aging nurse.

With the aging of the current nursing work force, nursing leaders must develop strategies to maintain current employment levels and improve availability of nurses to care for patients. One way to maintain current levels is to retain older nurses at the bedside by adapting the current working environment to meet the needs and the limitations associated with aging. This article includes a review of literature on the effects of aging on the human body, cognitively, physically, and psychosocially; current trends in the aging population; the advantages and disadvantages of employing aging nurses; retention strategies to keep aging nurses at the bedside; methods to adapt the work environment to aging nurses' needs; policies that address the needs of aging nurses; and implications for occupational health nursing practice. This article is limited to aging as it relates to nurses employed in hospitals.

Effects of extended work shifts and shift work on patient safety, productivity, and employee health.

It is estimated 1.3 million health care errors occur each year and of those errors 48,000 to 98,000 result in the deaths of patients (Barger et al., 2006). Errors occur for a variety of reasons, including the effects of extended work hours and shift work. The need for around-the-clock staff coverage has resulted in creative ways to maintain quality patient care, keep health care errors or adverse events to a minimum, and still meet the needs of the organization. One way organizations have attempted to alleviate staff shortages is to create extended work shifts. Instead of the standard 8-hour shift, workers are now working 10, 12, 16, or more hours to provide continuous patient care. Although literature does support these staffing patterns, it cannot be denied that shifts beyond the traditional 8 hours increase staff fatigue, health care errors, and adverse events and outcomes and decrease alertness and productivity. This article includes a review of current literature on shift work, the definition of shift work, error rates and adverse outcomes related to shift work, health effects on shift workers, shift work effects on older workers, recommended optimal shift length, positive and negative effects of shift work on the shift worker, hazards associated with driving after extended shifts, and implications for occupational health nurses.