A Unique Way To Harness The Knowledge Of Retired Nurses

As baby boomer nurses are beginning to retire or are inching closer to retirement, many nursing organizations are exploring ways to retain the knowledge and expertise of these experienced nurses.

At Cleveland Clinic, the projected loss of experienced, seasoned nurses to retirement is something that’s been on the minds of our executive nurse leadership team for several years. And, in 2018, we began piloting a retired nurse program that officially launched as the Nightingale program.

Nightingale program overview

The Nightingale program is designed to offer newly retired nurses a flexible, part-time opportunity to work for the nursing unit or area from which they retired. Participation in the program is based on retired nurse interest, as well as the nursing unit/area need for part-time Nightingale nurse positions per discretion of the unit nurse manager/nurse director.

Nightingale nurses can work as much or as little as they’d like, based on the needs of the unit. The only stipulation is they have to work at least 80 hours per year. They are not required to rotate shifts, work weekends or holidays, or be on-call, unless the Nightingale nurse chooses to do so.

The primary benefits of the Nightingale program are two-fold:

• Cleveland Clinic and its nursing teams, caregivers and patients get to continue to harness the knowledge, skills and expertise of seasoned, experienced nurses.
• Retired nurses who aren’t ready to completely stop working or who would like to continue to help care for patients or influence current and future nursing caregivers have the opportunity to do so with minimal commitment and while enjoying the perks of retirement.

Transitioning into the Nightingale program is fairly simple. After an experienced nurse retires, they may be re-hired as a Nightingale nurse between 60 and 90 days following their termination date. The retired nurse must apply to a Nightingale nurse position and their employment prior to retirement must be in good standing.

Upon starting in the Nightingale position, retired nurses follow individualized orientation plans per the unit nurse manager and Cleveland Clinic’s Office of Nursing Education and Professional Development. They must remain current with all required policies, licensures, clinical competencies and skills necessary for the position and they will receive ongoing performance evaluations per Cleveland Clinic’s evaluation requirements.

Nightingale in action

Currently, the Nightingale program is offered in inpatient, ambulatory, operating room, care coordination and case management settings.

Nightingale nurse responsibilities vary depending on the setting and unit need. For example, Nightingale nurses may fulfill roles that are similar to the position they had before they retired, such as providing direct patient care. Or, they may work a 4-hour shift on an inpatient unit where their primary responsibility is to discharge patients. Another option for Nightingale nurses is to serve as a preceptor for new nurses.

The emergency department (ED) at Cleveland Clinic Avon Hospital was the first nursing unit to take advantage of the Nightingale program. Stephanie Neff, RN, is the nurse manager on the unit and, to date, she has hired two Nightingale nurses, Sharon Re, RN, and Pam Welch, RN.

To offer an example of how the Nightingale program works on a nursing unit, Neff and Welch provided the following insight:

Stephanie Neff, RN, Avon Hospital ED Nurse Manager

With the Nightingale program, I have experienced nurses who can come in and pick up shifts when needed. Our Nightingale nurses can function in the capacity of a traditional emergency department nurse, spending time at the bedside, or they can fulfill other needs, depending on their comfort level and experience. For example, Sharon often fulfills direct patient care needs whereas Pam generally focuses on patient call-backs, following up with patients post-ED to see how they are doing, if they’ve been taking their medications, if they’ve scheduled appointments with their physicians, etc.

I believe that having Nightingale nurses on our unit benefits everyone. There are roughly 78 caregivers within Avon Hospital’s ED, 52 of which are nurses, and we can all learn from those with more experience. Our nursing staff ranges from new graduate nurses to someone who has spent 42 years in the nursing profession. I think it’s great to have this varied skill mix because we all bring value. Something I’ve noticed with our Nightingale nurses, specifically, is their ability to help less experienced nurses learn how to better connect with patients or spend extra time with patients. This can be difficult in the ED setting because of how busy the unit can get, the complexity of the patients we see, and more.

From my perspective, the Nightingale program is a great resource for both staff and department. It’s also an ideal option for nurses who aren’t quite ready to leave the bedside when they retire. It gives them a way to keep that connection with the work they did for all those years while providing the opportunity to contribute to the success of the department. Additionally, patients are getting great care and are truly benefiting from the expertise of Nightingale nurses!

Pam Welch, RN, Avon Hospital ED Nightingale Nurse

My transition into the Nightingale program has been incredibly smooth. When I decided I wanted to retire last August, it was difficult for me because I loved my job, so I didn’t want to completely stop working. With this program, I have the flexibility to work hours that suit my schedule without the full commitment I had in the past. I’ve been a nurse for 37 years and I’ve never had the holidays off – but, I do now!

Additionally, I like that I still get to help the nursing staff meet the needs of the nursing floor. While I will likely assume other responsibilities in the future, most of what I do currently is related to the patient call-back program. I like doing this type of work because I enjoy talking to patients and this is a different way for me to create a personal connection. As a caregiver, I’m still very proud of the ED and the care that our team provides. It’s really nice to hear the positive feedback from patients, even though I wasn’t initially part of their care.

I think if you’re a nurse, you stay in this profession until you retire because you love your job and when you walk away from something you love – even though it might become more difficult as you get older – it’s still hard because it’s a part of you. The Nightingale program offers a nice way to ease into the retirement transition while allowing nurses to continue to do what they love.

The next chapter

Cleveland Clinic currently employs 18 Nightingale nurses across the health system and plans on expanding the program in 2020 and beyond.

The year 2020 has been dubbed “The Year of the Nurse and Midwife” by the World Health Organization. This year marks the 200th anniversary of the birth of Florence Nightingale.