aren McQuillan has been a registered nurse at the R Adams Cowley Shock Trauma Center for four decades and finds great joy in her work, even through the most demanding times.
But at 66, she expects that she will move toward retirement in the coming years.
“I don’t really want to give up that sense of having a purpose and being able to make a difference — I think that’s a … key thing that’s really cool about nursing, is that you really feel like you’re making a difference in the life of someone else,” she said. “But I’m probably one of those folks that, within the next five years, I would think to be retired.”
The same is true for Cynthia Medavarapu, a registered nurse with the University of Maryland Medical System’s Laurel Medical Center, who has been in the profession for 30 years and recently turned 60. She is looking forward to retirement in the coming years, even if she finds herself struggling to imagine a slower-paced life after leaving the field.
“I can’t wait, the truth is.” Medavarapu said recently. “I don’t know if I’ll be able to, because I’ve been working at such a high level of stress. Relaxing and traveling the world, being able to choose your day may not necessarily be the right option for me – but I’ve earned it.”
They’re far from alone. A recent report from the Maryland comptroller says that older workers are a “defining feature” to Maryland’s healthcare system. For example, the state’s median age for registered nurses is 47, second only to Wyoming.
Meanwhile, 11% of Maryland’s healthcare practitioners and technical occupations are 65 or older, compared to 6% nationwide, according to the recent “Maryland Industry Analysis: Healthcare and the Economy” report from Comptroller Brooke Lierman’s (D) office.
While there are benefits to having what McQuillan calls “seasoned” workers in the healthcare field, such as the years of experience leading to higher quality care for patients, the aging workforce could exacerbate the state’s ongoing healthcare worker shortage, as those older workers look to retirement in coming years.
“While the population is aging and needs more health care, the health care workers employed and trained to care for them are also aging; many in Maryland are nearing retirement,” the comptroller’s report says.
“Maryland has an older healthcare workforce on average than the U.S. and neighboring states … Research suggests that turnover from retirement – and the resulting loss of institutional knowledge – may impact patient outcomes,” it said.
Healthcare and social assistance is the largest industry and leading job creator in Maryland, employing about 427,000 people with 51,000 new jobs added since 2022.
But even as Maryland’s healthcare economy grows, it faces ongoing workforce challenges, particularly after significant turnover and burnout from the COVID-19 pandemic made existing shortages worse.
In 2025, registered nurses had the highest number of job openings among healthcare occupations, with an average of 9,000 unique job positions open each month, but only an average of 1,800 new registered nurses hired per month.
Approximately 40% of nurses plan to leave the workforce or retire within the next five years, according to a 2024 survey from the National Council of State Boards of Nursing.
Maryland’s aging workforce doesn’t stop at registered nurses. The median age for physicians in Maryland is 53, the fourth-highest in the nation behind Alaska, Montana and South Dakota. More than half of Maryland physicians are 55 or older, compared to 30% nationally.
“When you have a workforce that is at the end of their career, they’re all nearing the time where they’re going to retire – that’s been a real concern for nursing,” McQuillan said. “There is a potential threat in losing that segment of the workforce, because it does have such a strong knowledge base.”
That includes “good time management skills, good clinical, critical thinking skills” and a really “strong knowledge base for the patient population they care for,” she said.
“They have really honed skills in how to communicate, oftentimes with their colleagues, as well as with patients and families,” McQuillan said. “And they’re passing all that knowledge both by role modeling and by actually doing the teaching to their younger colleagues.”
That institutional knowledge is what’s on the line if Maryland’s older workforce plans to retire in coming years, saying that “there’s no question that that poses a threat” to the future workforce.
Meanwhile, the report notes that Maryland faces outmigration challenges for younger residents.
“At the same time, post-pandemic, Maryland has been losing a greater share of younger residents to domestic outmigration, which negatively impacts the pipeline to replace these aging health care workers,” it says.
Medavarapu agrees and says she’s noted a “philosophy” difference between her generation and upcoming nurses.
“The problem is now that people don’t want to stay,” she said. “You have people of a different generation who are committed to staying for their co-workers … people didn’t move their jobs, they stay at the same provider.
“We are not able to retain our nurses now. Everything is much more transitory,” Medavarapu said. “We’re finding that people don’t stay maybe longer than two years.”
But while the aging workforce could worsen the ongoing workforce challenges, those same workers will likely be part of the solution, McQuillan said.
She chairs the University of Maryland Medical System Mentorship Team, which connects new healthcare workers with mentors that can help nurture and support their development.
“Any time you take time to give people, both positive reinforcement and meaningful recognition, as well as constructive criticism, it helps a nurse or anybody to grow,” she said. “And when you create an environment where people feel like they’re supported and they are given the resources that they need to help to grow and develop, they’re going to want to stay in that institution.
“We really need to think about how we can make work environments a place where people are finding joy in their work and they really want to stay there,” she said.
For McQuillan, she says that she continues to find that same joy to that keeps her in the field for now, even if retirement is on the horizon.
“It feels so good to see a patient really be able to recover … and can leave and have a productive life – or in some cases, have a peaceful death,” she said.
“I had a little pager when I first started, Now I have a phone – there are four ways people can reach me just on my phone at any time of the day,” she said. “Sometimes that feels overwhelming, but that’s just part of the job, and it’s just part of growing and developing.”
