What would keep older nurses on the job longer? Flexible work hours, better designed hospital equipment and buildings, and improved benefits are a few incentives that nurses say appeal to them, according to findings from the Wisdom at Work study sponsored by the Robert Wood Johnson Foundation. Researchers reached their conclusions by performing a literature review, surveying 377 seasoned nurses, and conducting in-depth interviews with 13 experts from health care, employment, and management fields.

Experienced nurses recommend transforming the work environment so that older nurses are welcomed, accommodated, and used wisely. Here are some changes they recommend:

* flexible scheduling

* creative employment opportunities; for example, the creation of new nursing positions, such as mentor or safety officer

* better ergonomics and health care design to decrease walking on the job and other physical demands. For example, nurses recommend mechanical patient lifts, decentralized storage, and brighter bedside lighting.

* better use of technology. Nurses ask that they be included when choosing new equipment to ensure it has options, such as large fonts that are easier to read. They also want adequate training for new technology.

* changes in organization culture to give nurses more autonomy and participation in decision making.

* commitment to education. Nurses say that ongoing learning is critical to retaining older nurses who get promoted to managerial or innovative positions that may require new skills.

The full study is available on the Robert Wood Johnson Foundation Web site at http://www.rwjf.org/files/publications/other/wisdomatwork.pdf.