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Leaving the nursing profession can lead to a loss of identity. Find out how to plan ahead, emotionally and practically, and work toward a new purpose
Even though Pip Hill opted for a gradual retirement from clinical research nursing, she had not anticipated the extent to which stopping work would hit her.
Nursing Older People. 36, 1, 12-14. doi: 10.7748/nop.36.1.12.s4
Published: 29 January 2024
After a spell working two days a week, she retired fully in March 2023 – yet it was not until six months later that she felt ready to relinquish her registration.
‘I just could not bring myself to come off the register,’ she says. ‘When I did, it felt huge. I just felt, “I’m not a nurse anymore.”’
Her experience is far from unique. When a group of retirees aged 55-75 was asked which life milestones had provoked the biggest emotional response, almost one quarter named retirement. It was the third most common answer after having children and getting married.
‘I knew in my head that nursing wasn’t who I was, but I needed to accept it emotionally as well’
Jane Bates, retired nurse
The research, conducted in 2021 by the Financial Services Compensation Scheme, sums up the profound effect that a career coming to an end can have on someone beyond the monetary.
For nurses, the emotions generated by this milestone can be particularly acute. That is because nursing is a profession with a strong sense of identity, generated by practitioners themselves and from a societal view of what it means to be a nurse.
For Ms Hill, that loss of identity was tied up with the loss of aspects of her work that had been particularly important to her. One such loss was patient contact, which had still been central to her pre-retirement role in clinical research.
‘I had mainly been dealing with men on the prostate cancer trial, and over the years we’d built up good relationships,’ she says. ‘I was seeing them every few weeks and going through all sorts of things with them.’
Although she had looked forward to the end of office politics, the extent to which she missed being part of a team also surprised her. And while her siblings and best friends were occupying their time in retirement looking after young grandchildren, her grandson was now in his late teens and so did not need support in the same way.
‘I felt a bit useless really. I felt as if I wasn’t of use to anyone anymore.’
It is commonly accepted that retirement will leave a financial gap, and people are rightly reminded to prepare for it. Living comfortably on the state pension alone is challenging and so, as UNISON acting deputy head of health Alan Lofthouse puts it: ‘The earlier someone starts planning for their retirement the better.’
Retirement preparation can valuably go beyond considerations of money. It is not enough to think through the financial gap; it is also important to prepare for what Ms Hill experienced – the emotional gap, and the potential sense of lost identity and purpose.
These are areas in which former doctor Jonathan Collie specialises. He is the founder of a social enterprise called the Purpose XChange, which helps people to establish their purpose and find ways of fulfilling it at every stage of their life – including after a career has ended.
Dr Collie stresses that retirement does not have to be a distinct line between working and not working. ‘You could continue work, readjust your work,’ he says. ‘You could look at a startup or innovation: do you want to start a social enterprise, do you want to monetise a hobby?’
And there are other ways of feeling purposeful, he says. ‘There’s learning and personal development. Do you want to go back to school? Do you find a mentor? Do you start reading [about a topic that interests you]?
‘Giving back is a big one too. Do you want to volunteer? Volunteering is working, it’s just unpaid. But there’s also coaching, mentoring, the transfer of knowledge, helping other people, getting involved in your community, connecting more with others.
‘And then there’s creative expression. It can be art, it can be writing, it could be music, it could be acting, it could be learning a language. Your “purposeful plan” could dabble with any or all of these things. It’s entirely up to you.’
Importantly, this is a plan that can be built at any stage of a career – it is not retirement-specific.
Dr Collie would like to see nurses and their employers engage in conversations on purpose regularly.
He believes such conversations would help to address the potential for mid-career disillusionment or frustration among nurses. It can be difficult to feel a sense of purpose and identity if, for example, it is starting to feel like administrative work rather than patient care is dominating working hours.
When Janes Bates (pictured) retired, the emotional impact was such that she decided to take herself on a retreat. She travelled to the Scottish island of Iona, telling herself she ‘had to get her head around’ the complex range of emotions she was experiencing.
‘It felt as though I was losing my identity and that was hard,’ says Ms Bates, who retired in 2019 after a long career working across multiple specialties, most recently in ophthalmology.
‘I had been a sister on an eye ward for a while, now I wouldn’t be, so who was I? It was a funny feeling because nursing is about identity and I think it is more than a job. It’s hard to give up.’
While walking on Iona she met ‘a lovely, slightly older lady’ and the two got chatting. Her new friend asked what had brought her to the island. Ms Bates explained how affected she felt by her retirement and how nursing had been so central to her identity.
‘And she said: “It’s not who you are. I want you to take this on board. It [nursing] is what you do, not who you are.”
‘I don’t know why, but a stranger saying that made it hit home. It helped me, because I knew in my head that nursing wasn’t who I was, but I needed to accept it emotionally as well.’
She says one reason her profession felt so tied to her identity was the number of friends she had made along the way. ‘A strong link with other nurses has been one of the backbones of my life – my nurse friends.’
Keeping in touch
So when she retired, she ensured that connection remained. ‘I keep in touch with loads of my ex-colleagues. It was fortunate that my retirement came around at a time when a lot of people had left, the personnel were changing. So a lot of my friends retired around that time. That made it easier, because I would have missed them terribly otherwise. We still see each other of course, so that helped ease the passage of retirement.’ She also retains her connection to the profession via her regular column for Nursing Standard.
During the lockdowns, she began writing what she describes as her ‘nursing life story’. ‘I was thinking about how the health service has changed, why it has changed. I’ve written reams but I don’t know what I’ll do with it yet.
‘Writing is what I would have loved to have done when I left school – studying English and becoming a writer,’ she adds. ‘But I felt I ought to do something that was for other people, not just for myself. So I got into nursing and it gets into your blood. It’s who you become.’
Since her retirement she has found a multitude of ways to continue that sense of serving other people. As well as supporting her daughter and two grandchildren she also helps her local community.
‘We have a coffee morning at our local church, which I help with, and it’s mainly elderly people who come. I also have a few elderly neighbours who I visit, and who know if they want anything that I’m there.
‘And people often come to me and ask me about their eyes,’ she adds with a chuckle.
For Ms Hill, retirement has already been busy. She and her husband travelled to the US for a long touring holiday, and are in the process of doing up their house. She is also doing lots of walking and Pilates.
‘I felt a bit useless – as if I wasn’t of use to anyone anymore’
Pip Hill, retired clinical research nurse
And she has applied to be a volunteer for Macmillan Buddy, a service of Macmillan Cancer Support that offers weekly support to people with cancer. She says she had thought of becoming a community-based Macmillan nurse at the start of her career, but interesting roles on an oncology ward and then on a chemotherapy unit intervened.
She hopes retirement may provide a different way to meet her original ambition of offering community support to people with cancer. It is a sign, perhaps, that things never truly end – they just change.
Macmillan Cancer Support (2024) Volunteering as a Macmillan Buddy. www.macmillan.org.uk/volunteering/macmillan-buddies
