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. 2023 Apr 13;10(8):5236–5243. doi: 10.1002/nop2.1761

Decision to employ retired nurses to work in senior care businesses: A qualitative study

Wonpen Kaewpan 1, Kunwadee Rojpaisarnkit 2,✉, Sulee Tongvichean 3, Lalita Kaewwilai 1, Thapanut Keawpan 4
PMCID: PMC10333815  PMID: 37052053

Abstract

Aims

This paper aimed to explore the views of employers at senior care businesses concerning the employment of retired nurses in Thailand.

Design

A qualitative interview study was conducted.

Methods

Face‐to‐face and online semi‐structured interviews with 78 senior care business employers were conducted.

Results

Business employers had positive sentiments towards employing retired nurses to deliver care and supported them to remain in the profession. Business employers acknowledged that retired nurses have a high level of professional confidence with excellent knowledge and skills. Furthermore, retired nurses were often assigned to work in managerial roles. In addition, flexibility in terms of work hours, suitability of role and responsibilities, and reasonable compensation rates were important to nurses' decisions to remain in or return to the nursing profession. There is a need for the further development of recruitment, retention and reform policies to encourage retired nurses to continue or return to the nursing profession.

Patient and Public Contributions

We thank all participants for their valuable input throughout the study.

Keywords: elder, employer, nurse, retired nurse, senior care business, Thailand

1. INTRODUCTION

Healthcare systems worldwide continue to face shortages of nursing professionals due to the increasing demands of the nursing field. At the same time, the existing workforce continues to age and retire (Aluttis et al., 2014; Sirisub et al., 2019). Thailand's demographic structure has changed into an ageing society (Rojpaisarnkit & Rodjarkpai, 2021). According to the United Nations' World Population Prospects 2019, the number of Thai senior citizens aged 65 or older will more than double from 9.0 million people, or 13.0 per cent of the total population in 2020, to 19.5 million people, or 29.6 per cent of the total population, by 2050. Furthermore, this figure is forecasted to reach 35.1 per cent by 2095 (Akaraphanth, 2015; Manakitsomboon, 2021), meaning one out of every three Thai people will be a senior citizen (Udomkerdmongkol, 2021). In addition, the number of older adults living alone appears to be increasing. For example, 8.7% of older adults lived alone in 2014, while older adults who lived alone increased to 12% in 2021 (Foundation of Thai Gerontology Research and Development Institute: TGRI, 2022; Prakongsai, 2022). Population ageing is the primary cause of the nursing shortage (Sawaengdee et al., 2016; Sirisub et al., 2019), though another common factor contributing to the nursing shortage is the high turnover rate (Abhicharttibutra et al., 2014; Khunthar, 2014; Sirisub et al., 2019). Since the year 2000, there has been a policy that newly graduated nurses who worked in government hospitals would not receive a pension after retirement, unlike older generations. Moreover, many newly graduated nurses have been employed as part‐time staff at hospitals and healthcare centres, meaning they only receive welfare from the Social Security Fund. This has resulted in many of the new generations of nurses deciding to leave the nursing profession (Health System Research Institute, Thailand, 2012; Jaikong et al., 2020). The Thai government has attempted to solve the healthcare workforce shortage issue by extending the retirement age for its health workforce from 60 to 65 years due to the increased average age of the Thai population (Sirisub et al., 2019). In Thailand, the policy responses to encourage older nurses to remain in their profession and attract retired nurses to return to nursing are underdeveloped due to a lack of empirical data on the extension of nurses' working lives and their intention to work after reaching retirement age (Kaewpan et al., 2020). In addition, the employment rate of retired nurses who work in healthcare organizations is not reported officially. To support human resources planning, a research study on the employment of retired nurses by healthcare organizations should be carried out to obtain helpful information for future policy making.

Thailand is becoming a completely ageing society, and the age structure of nurses has also changed. The number of nurses aged 45 years and older has increased according to the population structure. This will negatively affect the shortage of nurses in the health service system over the next 10–15 years since the retirement age is 60 years old (Kaewpan et al., 2020). The Thailand Nursing and Midwifery Council (TNC) indicated that Thailand needs approximately 170,000 Registered nurses to provide healthcare services based on a nurse‐to‐population ratio of 1:400 (Abhicharttibutra et al., 2014; Khunthar, 2014; Sirisub et al., 2019). However, Thailand had only 130,388 Registered nurses as of 2010, and public and private healthcare organizations faced a nursing shortage (Sirisub et al., 2019). Even though the policy produced positive developments in the past by increasing nurse recruitment and education, nursing shortages have persisted. Research has shown that the increase in the number of newly graduated nurses in Thailand is relatively slow. Between 1993 and 2001, the Plan for Increasing Production and Development of Educational Management in Nursing (PIPDEMN) by the Royal Thai Government aimed to graduate an additional 5272 Registered nurses (RNs). However, only 4155 new RNs graduated from nursing institutions under the Ministry of University Affairs (MUA) (Abhicharttibutra et al., 2014). At the same time, the number of nurses in Thailand who retired was increasing by approximately 20.5% annually (Kaewboonchoo et al., 2014; Sirisub et al., 2019).

Extending the length of a career is an alternative to solving the challenges of the nursing shortage. Retired nurses have a high level of experience, professional skills and knowledge. Thus, it would be favourable to encourage them to remain in the nursing profession. Over the past 10 years, retired nurses have been employed intermittently in healthcare organizations (e.g. hospitals, healthcare centres and home care) (Ang et al., 2016; Kaewpan et al., 2017; Voit & Carson, 2014). Regarding the qualifications for Registered nurses in Thailand, they are required to renew their professional licences every 5 years, which are administered by the TNC. Nurses must keep their training hours to apply for professional licence renewal. However, decisions to retire remain in the nursing profession or re‐enter the workforce are influenced by various factors such as flexible working conditions, a supportive environment, financial incentives and formal rehiring policies (Kaewpan et al., 2017). In contrast, other approaches to increasing the number of nurses in the system have not been successful in Thailand, such as persuading resigned nurses to return to the system. In addition, healthcare services in Thailand often do not employ foreign nurses due to communication problems with patients and their relatives. Furthermore, various problems cause foreign nurses to shy away from work in Thailand, such as work permits, expenses, language preparation and knowledge of employment law (Wongchum et al., 2018).

The number of senior care businesses in Thailand has been found to be increasing continuously. For example, 52 new senior care businesses were established in Thailand from January to March 2021. Therefore, Thailand has approximately 493 operational senior care businesses (Manakitsomboon, 2021). The senior care businesses in Thailand generated around 1 billion Thai baht or 28 million USD of revenue in 2019 (Manakitsomboon, 2021). The senior care business in Thailand has seen a vast expansion, most of which has been in the private sector. In terms of services, it is a viable alternative for older adults who do not have caregivers or need complex care. Most senior care businesses in Thailand offer both short‐term care (day care) and long‐term care (residential) services. The results of a preliminary survey revealed that private senior care businesses in Thailand tend to be more responsive to the needs of older adults in Thai society, now and in the future (Kaewkorathr & Thabhiranrak, 2021). However, senior care businesses have been facing a shortage of Registered nurses to deliver care caused by the increasing demand for nursing care among the ageing population (Kaewpan et al., 2020; Pongnairat, 2021). Because the number of nurses is insufficient and many younger nurses are not interested in aged care work (Dai et al., 2021), hiring a retired nurse is a good option for running a senior care business in Thailand. Moreover, retired nurses will have a better understanding of how to take care of elders and have better abilities than younger nurses in terms of various services. The services available in the senior care business include caregiving, preparation of activities to promote good physical and mental health among older adults, medical and health counselling, management to fulfil the needs of older adult patients, etc. (Rompho et al., 2021). Previous policy research also suggested improving policies to retain qualified nurses and maximize the efficient use of nurses, particularly among older adults, to reduce the severity of the nursing shortage (Kaewpan & Peltzer, 2019). However, research is scarce concerning how retired nurses can help alleviate the nursing shortage (Kaewpan & Peltzer, 2019; Neal‐Boylan et al., 2009). Recently, the number of government senior care centres in Thailand has been limited. This may be because the government sector lacked a policy to hire retired nurses, and the private sector was the largest source of employment for retired nurses in Thailand. Thus, this study focused on employers of private senior care businesses as a key group by considering their level of interest to hire retired nurses. Currently, Thailand does not have standard remuneration and wages for hiring nurses in various positions in the private sector. This study could serve as a pilot study on the facts of the phenomena that occur in the work of nurses in this business. The results of this study may draw more attention from stakeholders and could be used as a guide for creating a more systematic management standard regarding the employment of nurses in the senior care industry. Therefore, this study aimed to explore the views of senior care business employers in Thailand concerning the hiring of retired nurses. It examined the retirement and labour market relationship through the experiences of senior care business employers. These findings could be useful information for retired nurses, business employers and policymakers involved in health manpower planning.

2. AIM

This study aimed to address the question: What factors do senior care business employers believe are important when considering employing retired nurses? (Key issue includes: employment possibilities and reasons, patterns of employment, expectations of roles and responsibilities, qualifications and performance).

2.1. Design

This study used a qualitative interview study approach through content analysis.

2.2. Participants

Seventy‐eight senior care business employers were selected by purposive sampling. Interviewees were recruited from the provinces of Bangkok (n = 60), Surat Thani (n = 9) and Chiang Mai (n = 9), which accounted for 15.82% of senior care businesses in Thailand during the study period. Senior care business employers were the owners or managers of senior care businesses who directly influenced employment decisions. The criteria for area selection were as follows: (1) must be an area with a sufficient number of private senior care businesses, (2) employers of the senior care business willing to participate in the study during the COVID‐19 situation, and (3) appropriate travelling cost and safety were concerned, especially during the COVID‐19 epidemic.

In Thailand, senior care businesses are classified according to the types of services they provide. The first consideration is the length of stay, which includes (1) day‐care services, particularly for older adults, and (2) long‐term care services where older adults can live for a specified period or permanently. Second, the care needed includes (1) older adults who can help themselves, and (2) older adults who need help from others.

Senior care businesses in this study referred to the business establishments registered for care services, but not hospitals. They provided both day‐care and long‐term care services for older adults who did not require regular medical supervision and provided services according to the Department of Health Service Support, Ministry of Public Health, Thailand. In addition, Thailand has not yet established a standard for classifying the size of senior care businesses. Thus, the researcher divided the senior care facilities into three sizes according to the advice of experts, as follows: small (up to 10 beds), medium (11–30 beds) and large (31 beds or more). The inclusion criteria were premised on the owner or manager of private senior care business establishments having worked for at least 6 months and being willing to participate in the research. Participants who were not available for interviews or were unwilling to participate in the research were excluded.

2.3. Data collection

Data collection was performed from June to September 2021. Data were collected from the representatives of 78 senior care business employers using face‐to‐face or online semi‐structured interviews. Interviews in the Thai language were conducted for between 45 and 90 min each. The main question in the interview was, ‘What is your perspective regarding the employment of retired nurses?’ In addition, participants were asked supplementary questions to follow their thoughts and clarify their responses during the interviews. The participants were encouraged to talk about their experiences with employing retired nurses and decisions on employing retired nurses to work in senior care businesses. A variety of related topics were covered, including (1) the possibility of hiring a retired nurse (employment reasons), (2) patterns of employment (employment conditions), (3) expectations of roles and responsibilities and (4) qualifications and perceptions of retired nurse performance. Data collection and analysis proceeded concurrently to develop themes related to the participants' viewpoints and experiences with employing retired nurses. Once the themes were identified and data saturation was achieved, the interviews were concluded.

2.4. Ethical considerations

This research is a part of the main research project concerning the ‘Development of employment policy recommendations for enhancement of work ability among senior nurses and retired nurses for work expansion in government and private service business’, which funded by ‘The National Research Council of Thailand (NRCT)’.

This research project received human research ethics approval from the ‘Human Research Ethics Committee from the Faculty of Public Health, Mahidol University’ under Code MUPH‐2021‐078 (29 June 2021). During the research, the researcher advised the participants to understand the conduct of the research using both oral statements and documents.

2.5. Data analysis

The interviews were recorded and transcribed. A thematic analysis approach (Braun & Clarke, 2006) was conducted for the data analysis. In the thematic analysis, the researcher set up a framework analysis and checked the validity and credibility of the research results based on three main components comprising (1) the accuracy and reliability of the research results, checking qualitative data by triangulation, (2) the researcher's knowledge by interpreting it using knowledgeable researchers who were well‐versed in relevant issues, understanding and analysing data to answer research questions, and (3) data analysis procedures consisting of four main steps including data preparation by gathering field notes and documents, identification of analytical issues, coding and classification into themes, and analysis and presentation of the results. Participants' viewpoints and experiences regarding employing retired nurses were grouped into categories based on comparisons regarding their similarities and differences, as well as the determination of guidelines for data collection with experts. Data collection issues were divided into four areas comprising (1) the possibility of hiring a retired nurse, (2) patterns of employment, (3) roles and responsibilities and (4) the qualifications of retired nurses.

2.6. Methodological rigour

The guidelines recommended by Thomas and Magilvy (2011) were used to ensure the trustworthiness of this study. Three experts quantified the interview questions to determine content validity. Interview questions were tested on 10 senior care business representatives to improve the content of the interview questions for enhanced understanding. Finally, three authors grouped the data independently and then compared their analysis results during data analysis. In areas where they disagreed, discussions continued until a consensus was reached.

2.7. Findings

The employers of senior care businesses identified a range of influences concerning the decision to hire retired nurses in senior care businesses.

2.7.1. Possibility of hiring a retired nurse

Most senior care business employers were willing to employ retired nurses to work in their establishments. They mentioned that it was possible to employ retired nurses in senior care centres. Some establishments had recently employed retired nurses, particularly in medium and large enterprises. Retired nurses were often employed as care managers at the establishments. Retired nurses were knowledgeable, experienced and capable of making decisions on various matters. Moreover, they had strong networking with multiple healthcare organizations and healthcare professionals, which can help businesses find support from external resources for emergency services or advanced care resources. In addition, they can help with business marketing to target senior care business groups or older adults needing care. Other advantages of employing retired nurses in senior care businesses included (1) their ability to make decisions for general management, (2) their promptness to work and lack of need for retraining to provide care as well as advice for older adults and their relatives, and (3) their capacity to be good consultants for business owners. For example, one business owner said, ‘We employed retired nurses because of their knowledge and experience. They were able to work immediately without retraining needed, and they had the ability to work as health care managers’.

Healthcare businesses are in‐trend, and the demand for retired nurses will likely increase because of their professional capabilities and advantages. Therefore, many healthcare business employers would like to hire retired nurses to work in care manager roles. For example, one employer said, ‘Hiring a nurse manager instead of a general manager can reduce business costs because nurses can be taught administrative tasks. If hiring someone who is not a nurse, however, they can do administrative work but are unable to provide nursing care or have views on nursing administration and care management’.

2.7.2. Pattern of employment

Being able to have flexible working hours was a major concern for retired nurses. The senior care business employers employed retired nurses to work full‐time and part‐time. However, retired nurses were often employed in full‐time positions during the COVID‐19 pandemic because senior care business employers were concerned about viral transmission and sought to control the spread of viruses and germs. The employment patterns as full‐time or part‐time positions were based on negotiations between the business employers and retired nurses. Most business employers agreed to have flexible working hours for retired nurses. They tried not to assign retired nurses physically demanding tasks or late‐night working hours. For example, one employer mentioned, ‘Nurses' working hours can be flexible. Retired nurses' main task is ensuring that the care recipients and their families are satisfied with the care services. In this regard, I think it's worth hiring them. My center is now recruiting more retired nurses’ Some establishments preferred to employ retired nurses to work full‐time, pay monthly salaries and allow retired nurses to manage their work time personally. For example, one employer said, ‘We are hiring retired nurses to work on a full‐time monthly basis but let them arrange the time to work independently. The monthly compensation rate is 20,000 Thai baht/month (approximately 590 USD/month), with one day off each week. Moreover, they have to notify us one week in advance before the day of that week’. Some senior care businesses, particularly small and medium‐sized businesses, employ care aids (non‐Registered nurses) to provide services for older adults, which reduces the costs of care for their patients. Nurses were occasionally employed when older adults needed complex care, such as changing feeding tubes or urinary catheters. The care service rate for Registered nurses who provided care to older adults was approximately 500 Thai baht/case/time (about 15 USD). The charge for this additional service from Registered nurses was then passed on to their patients. Some senior care business employers shared that retiring nurses' last position was sometimes determined by their salary rate before leaving a job. In some small‐sized senior care businesses, the pay rates were not attractive to retired nurses recruited for roles as managers, leading to difficulty in finding recruits.

2.7.3. Roles and responsibilities

Retired nurses were often hired and assigned to work in managerial roles. They were responsible for all aspects of the day‐to‐day operations within the care setting, including managing staff, marketing, managing budgets and ensuring that the service quality met care standards. Most senior care business employers were satisfied with the work of retired nurses, especially their ability to facilitate communication with the care team, care recipients and their relatives. Retired nurses managed situations well, which helped to decrease the severity of patients' problems. For example, one employer said, ‘They will do a good job because they have particular experience building understanding with the clients' relatives, which reduces various problems’. The roles and responsibilities of retired nurses in senior care centres are diverse and may differ depending on the hospital setting. Senior care business employers assigned retired nurses to work as system managers who managed administration work, transferred knowledge to other healthcare personnel in the team, and coordinated between the healthcare team, care recipients and patients' families to build credibility. For example, one employer said, ‘The experience of retired nurses enables them to work well in manager roles, which is beneficial to the business’.

2.7.4. Qualifications of retired nurses

From the perspectives of senior care business employers, the advantages of hiring retired nurses comprised the specific qualifications that would be valuable besides professional licences, including personal attributes, having experience and skills in nursing care, and promptness in caring for older adults. In small‐sized businesses, retired nurses may not require specialized care experience; most care recipients do not need complex care because they have stable conditions. In contrast, larger‐sized businesses often provide care for complicated patients. Thus, they require competent practice nurses with specialized experience and skills in caring for older adults. For example, nurses who worked in internal medicine wards, surgical wards or intensive care units would be preferred since they specialized in specific medical treatments that required appropriate decision‐making. The qualifications of retired nurses were associated with their compensation as well as their assigned roles and responsibilities. For example, one employer mentioned, ‘We are more interested in employing nurses who are experienced in specific areas of expertise, such as critical care nurses, rather than inexperienced nurses’.

3. DISCUSSION

There is a need for human resources planning to support the recruitment of retired nurses and address the shortage of nurses in Thailand. In addition, recruitment and retention policies should be developed to encourage older nurses to remain in their profession, and promotions should be given to retired nurses to further encourage them to return to nursing. Three statistically significant points emerged from this research:

First, senior care business employers were interested in recruiting retired nurses to work in their establishments. However, the strategy used to recruit retired nurses was limited to word‐of‐mouth recruitment within nursing groups. Thus, an organization should be tasked with supporting data to organize recruitment between retired nurses and healthcare organizations. The Thai Health Foundation (2021) also indicated that healthy older adults were full of relevant experience, professional skills, and knowledgeable expertise that might be available to continue working and make statistically significant contributions to society. Therefore, these older adults should be encouraged to remain in their positions. In addition, senior care business employers conceded that retired nurses provided good quality care services to care recipients. A study by Kaewkorathr and Thabhiranrak (2021) also corroborated that service quality significantly influenced the success of senior care businesses.

Second, senior care business employers revealed that flexibility in work hours, suitability of roles and responsibilities and reasonable compensation rates were important to retired nurses in terms of decision‐making to remain in or return to the nursing profession. Consistent with previous reviews, the main factors that influenced retired nurses' decision to work after retirement were lighter and flexible work conditions, a supportive environment, financial incentives and formal rehiring policies (Kaewpan & Peltzer, 2019). The scoping review also affirmed that retired nurses who worked after retirement reported on the benefits of remaining in nursing (e.g. self‐worth, overcoming social isolation) and the barriers to continuing working (e.g. job demands and reduced physical workability) (Kaewpan & Peltzer, 2019). Therefore, retired nurses need to be valued by receiving pay on a scale comparable to nursing professionals with flexible hours of work and lighter physical workloads. In addition, retired nurses have skills and knowledge with rich experiences and valuable opinions. Thus, they can use their capabilities to work continuously after retirement (Ang et al., 2016; Kaewpan et al., 2017; Voit & Carson, 2014).

Third, retired nurses have acquired skills, knowledge and experiences over many years that would benefit senior healthcare businesses and meet all expectations. Therefore, private healthcare businesses considered employing retired nurses to work in their facilities. A previous study also identified the factors influencing the employment of older people, including hours of work, appropriate knowledge/experiences/skills and current health status (Jensantikul, 2021). A study by Pongnairat (2021) also found that older workers should remain employed as they are full of relevant experience, professional skills and knowledgeable expertise. They could pass on their experiences to the next generation and be good consultants. Nonetheless, health is an essential factor correlating to the ability of older professionals to participate in work life (Schuring et al., 2007; Sirisub et al., 2019; van den Berg et al., 2010; Van Solinge & Henkens, 2014). Therefore, retired nurses might have a limited ability to undertake heavy physical workloads.

3.1. Policy proposals from the study for hiring retired nurses

Senior care business employers are interested in hiring retired nurses to care for the older adults in their establishments. However, there is a scarcity of information to support the recruitment of retired nurses. Therefore, senior care business employers suggested the following issues to support the employment of retired nurses.

First, senior care business employers recruited by the word‐of‐mouth strategy among nursing groups because there was no official information resource to support recruitment. Therefore, the Thailand Nursing and Midwifery Council (TNC) and other healthcare system authorities should develop a survey to identify retired nurses who are interested in working after retirement. Furthermore, a study of the key stakeholders in health organizations that are interested in employing retired nurses to work in their organizations is needed. This information should be collected from retired nurses and key stakeholders at health organizations to support recruitment. Healthcare system authorities should develop an information resource to support recruitment between retired nurses and health organizations. For example, information related to retired nurses' qualifications should bridge the need for employers and retired nurses, facilitating recruitment.

Second, small and medium‐sized senior care businesses had high demand to employ retired nurses to work in their senior care businesses. Retired nurses were assigned to work in consulting roles, planning treatment, teaching caregivers, communicating with relatives and delivering care for complex patients. In contrast, larger‐sized businesses were looking to employ retired nurses to provide care for complicated patients. The tasks included caring for older adults according to a physician's treatment plans, managing the day‐to‐day operations within care settings, educating caregivers, communicating between healthcare teams, patients and relatives, and making patient referrals. Senior care business employers intended to build trust and confidence in care services among older adults and families. Thus, they often employed retired nurses rather than care aids to work in private senior care businesses. Registered nurses hold professional licences, guaranteeing their knowledge and skills in nursing care and enhancing the reputations of the senior care businesses as a result. Business employers were confident that older adults received good quality care services delivered by Registered nurses.

Third, no standard compensation rate is explicitly based on the job requirements for retired nurses. Employers and retired nurses often negotiated and agreed upon working hours and compensation rates. Therefore, compensation was determined based on mutual agreement between the employers and retired nurses in each setting. From the interviews, the compensation rate was between 20,000 and 50,000 baht per month (approx. 595–1487 USD/month), or about 600–1200 baht per hour (approx. 18–36 USD/h), which is nearly the same compensation rate for Registered nurse professionals working at private hospitals in Thailand. Working hours were flexible and had several patterns of employment. For example, some establishments requested Registered nurses on a case‐by‐case basis, depending on the care recipient's needs. Thus, the compensation rate was paid by calculating tasks per person. Some establishments employed retired nurses to work part‐time jobs, such as working for 3–4 h a day. In contrast, some establishments required retired nurses to work full‐time, for example 8–12 h a day or 24 h on call. Therefore, the nurses' decisions to work and employers' decisions to hire were dependent on mutual agreement in terms of working hours, roles and responsibilities, and compensation rates. If a government agency was to set a policy on nursing retirement wages, it may give nurses confidence in the minimum wage and boost interest in working after retirement.

3.2. Implications for nursing management.

While there is recognition concerning the ageing of the nursing workforce as an issue, human resources planning has not been managed effectively. The implications of these findings for nursing management were suggested as follows:

  1. The more widespread availability of work opportunities may encourage retired nurses to continue or return to the nursing profession. Thus, the management of bridge employment between retired nurses and healthcare business owners by healthcare system authorities is needed to support recruitment. For example, a career centre should be developed to support the connections between nursing employers and retired nurses.

  2. There remains a need to implement more flexible work hours, such as part‐time work. Furthermore, retired nurses need to be given adequate compensation rates similar to nursing professionals. It would be interesting to perform a study on the standard employment rates among retired nurses who worked as care managers in healthcare business establishments considering their knowledge, competence, skills and pattern of work hours. In addition, the tasks assigned to retired nurses should be redesigned to alleviate the potential for heavy physical workloads, which will support the inclination of retired nurses to continue working.

  3. While the emphasis is on the retention and recruitment of retired nurses to better facilitate the nursing shortage if retired nurses are retained, promoting the continual updating of skills is necessary to support professional career paths. For example, activities that assist senior nurses to develop competencies as care managers should be initiated at least one to 2 years before retirement to continually update skills and support their work in healthcare business establishments.

  4. In many countries worldwide, Registered nurses are approaching retirement age, which raises concerns related to the level of preparedness among retiring nurses. Pre‐retirement education should be promoted for all nurses at the beginning of their careers to help them better prepare for retirement. For example, nurses may need to focus on financial preparation, specific professional development and personal needs to sustain a comfortable and healthy retirement. In Thailand, pre‐retirement education is mostly supported for nurses when they are approaching retirement (e.g. 1 year before retirement). Thus, individuals may not usually have a retirement plan to keep healthy and maintain financial stability. To avoid a shortfall of income, nurses nearing the age of retirement may choose to extend their careers. However, other work‐related variables may be associated with retirement planning and require further research. Overall, it is important to have a pre‐retirement system at the national level to support all nurses by improving their retirement planning practices.

4. CONCLUSION

Senior business employers have positive perceptions towards hiring retired nurses to provide care. They encouraged retired nurses to remain in their profession, especially in nursing manager roles, and special nursing care. There is a need for improved recruitment, retention and reform policies and system to encourage retired nurses to continue or return to the nursing profession. The findings from this study reported a range of influences on employer decision‐making and experiences in connection with participation in retired nurses' employment.

4.1. Limitations of the study

Senior care businesses in this study were only in the private sector. During the study period, there was an outbreak of COVID‐19, which may have resulted in increased demand for nurses. Face‐to‐face data collection during the COVID‐19 outbreak was challenging, and some employers were interviewed online.

AUTHOR CONTRIBUTIONS

WK, KR, SL, LK and TK made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data, given final approval of the version to be published. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. WK, KR and LK involved in drafting the manuscript or revising it critically for important intellectual content. KR is responsible for coordinating the article publication.

FUNDING INFORMATION

This research was supported by the National Research Council of Thailand.

CONFLICT OF INTEREST STATEMENT

The authors declare that there is no conflict of interest.

ETHICS STATEMENT

This research is a part of the main research project on ‘Development of the employment policy recommendations for Enhancement of Work Ability among Senior Nurses and Retired Nurses for Work Expansion in Government and Private Service Business’, which funded by the National Research Council of Thailand (NRCT) and has been endorsed by the Human Research Ethics Committee from the Faculty of Public Health, Mahidol University, Certification Number COA. No. MUPH 2021‐078 dated June 29, 2021.

ACKNOWLEDGMENTS

We would like to thank the National Research Council of Thailand for the support.

Kaewpan, W. , Rojpaisarnkit, K. , Tongvichean, S. , Kaewwilai, L. , & Keawpan, T. (2023). Decision to employ retired nurses to work in senior care businesses: A qualitative study. Nursing Open, 10, 5236–5243. 10.1002/nop2.1761

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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