Krista Lounamaa (2026), one of the writers of this article, provides up‑to‑date information in her master’s thesis on organisational age‑management practices to support the development of sustainable leadership among senior nurses. The thesis was conducted for the Master’s Degree Programme in Welfare Management in Developing Social and Health Services at Metropolia University of Applied Sciences (UAS).
Lounamaa’s thesis was carried out in collaboration with SAFE – Solutions for Age-Friendly Employer project (2024–2027), as part of the Interreg Central Baltic Programme, in which Metropolia UAS is a partner. The project focuses on developing practical tools and practices that support employers in creating age-friendly workplaces and promoting sustainable careers, particularly for employees aged 55+ in the healthcare and social services sectors. (Interreg Central Baltic Programme 2024; Metropolia 2026.) The other two writers of this article are closely involved in the SAFE project with Liisa Nuutinen from Metropolia acting as the project manager and Heini Maisala-McDonnell, also from Metropolia, working as a project specialist in the SAFE project. Towards the end of the article, we will elaborate on the project’s results in light of Lounamaa’s thesis findings.
Senior nurses needed
The narrative literature review in Lounamaa’s (2026) thesis included ten peer‑reviewed research articles published between 2015 and 2022. The reviewed research articles highlight a diverse range of perspectives that help clarify why age‑management is becoming increasingly important in healthcare. Research specifically states that as Finland’s population ages and the demand for healthcare services grows, the need for qualified healthcare professionals continues to increase (Nilsson 2020; Sulander et al. 2016). Senior nurses represent a valuable resource that cannot be fully replaced by newly graduated professionals (Liu et al. 2018; Markowski et al. 2018). However, by implementing effective age‑management practices, organisations can support older nurses in extending their careers and help retain their essential expertise.
The conditions for prolonging the careers of aging nurses look promising. The health of Finns has improved by many indicators, and older adults in particular report better quality of life than ever before (Koponen et al. 2018: 189). However, organisations play a crucial role in shaping a work environment that supports employees of all ages and enables long, sustainable careers (Nilsson 2020). Appropriate age‑management practices are also needed to address age‑related discrimination (TTL), which remains especially common in recruitment (Eiffe et al. 2025: 1–2, 4).
Focus on flexibility and adjustments
Because nursing work is physically demanding, physical strain is one of the main barriers to sustainable careers for aging nurses (Clendon & Walker 2016; Fackler 2019; Slusser et al. 2022). Increasing health issues combined with heavy physical tasks often force nurses to leave the profession earlier than they would prefer, as they are unwilling to risk further harm to their health (Slusser et al. 2022). Key challenges include lifting, bending, general mobility demands, as well as declining vision and hearing (Clendon & Walker 2016; Fackler 2019). Some units were also perceived as more physically demanding than others, particularly orthopedics and psychiatry (Clendon & Walker 2016). Improved ergonomics, functional work environments, assistive devices, better lighting, softer flooring, and regular vision and hearing examinations could help older nurses remain in the workforce. (Clendon & Walker 2016; Fackler 2019; Sousa-Ribeiro et al. 2022.)
Another major challenge relates to workload and scheduling (Koehler & Olds 2022). Long shifts (Fackler 2019; Slusser et al. 2022), irregular hours (Sousa-Ribeiro et al. 2022), and a fast work pace, sometimes without adequate breaks (Fackler 2019), were key reasons for leaving. Aging nurses had often accumulated additional responsibilities, further increasing their workload (Salminen et al. 2022; Sousa-Ribeiro et al. 2022). Allowing nurses to work regular daytime hours, offering more flexibility in scheduling (Ang et al. 2016; Clendon & Walker 2016), and redistributing accumulated responsibilities (Salminen et al. 2022; Sousa-Ribeiro et al. 2022) were identified as important measures for supporting longer, more sustainable careers.
Strengthening later‑career coping
As people age, it is natural to experience personal health issues, challenges faced by close relatives, and sometimes bereavement. Many aging nurses have recently encountered significant stress in their personal lives, and when combined with the mentally demanding nature of nursing, this can lead to overload (Salminen, von Bonsdorff & von Bonsdorff 2019).
High-involvement work practices (HIWP) offer organisations a way to engage employees more deeply by giving them greater responsibility and opportunities for development. HIWPs enhance competence, motivation, and self-efficacy, which in turn strengthen resilience and commitment in the later stages of a career. (Salminen et al. 2019; Salminen, von Bonsdorff, Vanhala, McPhee & Miettinen 2021.) They also support the use of SOC strategies, selection, optimisation, and compensation, which help individuals adapt to age-related changes (Salminen et al. 2019).
Encouragingly, aging nurses generally feel they possess stronger resilience than their younger colleagues (Clendon & Walker 2016). Nurses nearing the end of their careers also experience burnout less frequently than younger nurses (Doran et al. 2015).
Age‑inclusive work environment
Working in a familiar and supportive environment is important for aging nurses (Clendon & Walker 2016) and helps balance the demands of the job (Sousa‑Ribeiro et al. 2022). While a positive atmosphere and trusting relationships encourage nurses to extend their careers, bullying, negative discussions (Salminen et al. 2022) and age discrimination remain significant problems (Clendon & Walker 2015; Salminen et al. 2022). A lack of respect linked to age discrimination was identified as one of the major barriers to sustainable careers for older nurses (Doran et al. 2015; Koehler & Olds 2022).
Organisations can support aging nurses by actively preventing both direct and indirect age discrimination and fostering an environment where employees of all ages can thrive. Open, non‑blaming dialogue is an important starting point. Organisations should also assess their current practices toward older nurses and identify areas for improvement (Clendon & Walker 2016).
Managers play a particularly crucial role in supporting aging nurses (Clendon & Walker 2016). Leaders who use emotional skills, understand employees’ work‑related concerns, and guide them into roles that best match their strengths were seen as positively influencing career continuation. Such leadership also enhances nurses’ sense of competence, job satisfaction, satisfaction with their leaders, productivity, efficiency, and organisational commitment. (Sousa‑Ribeiro et al. 2022.)
Creating a motivating career
For aging nurses to feel motivated to continue working, it is essential that their expertise is recognised (Slusser et al. 2022; Sousa‑Ribeiro et al. 2022). This recognition may take the form of new roles such as teacher, mentor, or advocate (Fackler 2019). New roles also add variety to work, which many aging nurses value (Sousa‑Ribeiro et al. 2022). They also appreciated continuous opportunities for professional development and learning (Ang et al. 2016; Sousa‑Ribeiro et al. 2022). Clear future opportunities supported career continuation, whereas uncertainty about the future discouraged it (Slusser et al. 2022). Providing more time for direct patient care was also important, as strong passion for patient care was one of the most influential factors motivating nurses to postpone retirement (Fackler 2019).
Seizing the potential
Ensuring open dialogue about age and creating a work community free from age discrimination are essential for extending nurses’ careers (Clendon & Walker 2016). Leadership plays a key role: managers set the tone for workplace norms and directly influence whether aging employees feel valued (Nilsson & Nilsson 2020). At the same time, healthcare organisations must prepare for the growing number of older nurses and their evolving needs (Ang et al. 2016; Salminen et al. 2022). This requires critically reviewing existing practices and adopting more strategic career management. Individual career plans should be developed early, with delayed retirement considered a realistic option (Clendon & Walker 2016).
Most aging nurses enjoy their work, especially when they can remain “where things happen” (Sousa-Ribeiro et al. 2022) Although their physical capacity may differ from that of younger colleagues, they feel they contribute significantly, particularly on an emotional level (Clendon & Walker 2016). Many take pride in their work and would like to continue as long as possible, provided the organization supports them in maintaining their health until retirement (Slusset et al. 2022). Losing this valuable workforce resource simply because practices lack flexibility would be unfortunate. Healthcare organisations are therefore encouraged to re-assess outdated routines and experiment with more individualised solutions that enable longer, healthier careers.
The results of the study showed that a range of organisational practices influence senior nurses’ ability to extend their careers. Declining health and physical capacity, along with limited opportunities to adjust workload and schedules, were key barriers. In contrast, feeling valued, having roles that match professional skills, and maintaining a strong commitment to patient care supported longer working lives.
Based on the thesis, the following six key themes emerged that highlight how organisations can better support aging nurses and promote more sustainable careers. (Lounamaa 2026.)
- Strengthening aging nurses’ physical work ability
- Increasing flexibility in scheduling and ensuring a manageable workload
- Enhancing mental flexibility and resilience
- Fostering a collaborative, healthy, and supportive work climate
- Enabling role renewal and better recognition within the workplace
- Promoting continuous learning and ongoing professional development
These results align closely with the findings and objectives of the SAFE project, discussed below in more detail.
Reflecting master’s thesis results with the findings of the SAFE project
The master’s thesis by Lounamaa (2026) was presented at SAFE’s international meeting. The findings highlight that sustainable nursing careers depend on a multidimensional approach that supports nurses’ physical, mental, and professional capacity across the lifespan. From the SAFE project perspective, the thesis findings clearly support the development of age-friendly workplaces:
- Strengthening physical work ability corresponds to SAFE’s emphasis on supporting employees’ workability and well-being throughout their careers.
- Flexible scheduling and manageable workload reflect one of the central needs identified in SAFE pilots, where workload balance and flexible arrangements are critical for retaining older employees.
- Mental resilience and supportive work climate align with SAFE’s focus on inclusive organisational culture, intergenerational cooperation, and psychological safety at work.
- Recognition and role renewal connect with SAFE practices that value experience, promote meaningful participation, and support career transitions, including gradual retirement pathways.
- Continuous learning and professional development directly mirror SAFE’s core principle that lifelong learning strengthens work ability and supports longer careers.
Robust research evidence is of utmost importance to us as project implementers, as it enables us to better evaluate the project’s impact. The thesis confirms that sustainable nursing careers and age-friendly workplaces are deeply interconnected, and the SAFE project seeks to operationalise these insights through concrete tools and organisational practices. From the SAFE project viewpoint, this illustrates how research evidence can inform and inspire the development of real-world solutions that support nurses at all career stages, ultimately contributing to longer, healthier, and more meaningful working lives in the healthcare and social services sectors.
References
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Authors
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Krista Lounamaa
MBA, M.Sc. (EBA)Graduate of Master's Degree Programme in Welfare Management in Developing Social and Health Services, Metropolia University of Applied Sciences
About the author -
Liisa Nuutinen
Senior Lecturer, Metropolia University of Applied SciencesMaster of Health Sciences and PhD student Liisa Nuutinen works as a senior lecturer in Sustainable Leadership and Development in Social and Health Care, a Master of Health Care degree programme at Metropolia UAS.
About the author -
Heini Maisala-McDonnell
Senior Lecturer, Metropolia University of Applied SciencesMaster of Health Care and Master of Orthopedic Manual Therapy (USA) Heini Maisala-McDonnell works as a senior lecturer in Health Business Management, a Master of Health Care degree programme and in other international degree programmes at Metropolia UAS.
About the author
