Phil, an older friend of mine who’s been in the hospital with a broken hip, was surprised when one of his nurses mentioned that she was 20 years younger than her husband — and that her husband was a year Phil’s senior.

“That makes the guy 89,” Phil told me when I stopped by to visit over the weekend. “So this woman is 69, and she’s still running around taking care of patients. I don’t know how she does it.”

Turns out there are quite a lot of nurses working well past what typically is considered retirement age. A study published earlier this month in Health Affairs found that of those RNs working at age 50 between 1991 and 2012, 24 percent continued to work as of age 69.

Delayed retirement is one of the reasons the size of the RN workforce grew to 2.7 million in 2012, significantly above of the 2.2 million that experts were expecting a decade ago.

Unlike Phil’s nurse, however, most RNs tend to leave the hospital setting as they age. “Older nurses are far more likely to work outside of the hospital than younger RNs are,” the study authors wrote. The Affordable Care Act is prompting a reorganization of clinical processes, with more care delivered outside the hospital — in homes and ambulatory care facilities — and increasing the demand for nurses. Older RNs are filling that gap.

In the past, H&HN has reported on hospitals that encourage veteran nurses to remain on the job by using a variety of incentives — from offering flexible scheduling to hiring staff to lift and move patients so older RNs don’t have to.

A couple of recent reports spotlight other ways hospitals can improve work for nurses of all ages.

Physical work environments that help nurses to complete tasks without interruption, communicate easily with other nurses and physicians, and do their jobs efficiently are related to higher job satisfaction, according to the results of a nationwide survey published this month in Research in Nursing & Health.

And on July 21, The Wall Street Journal’s Laura Landro wrote about hospitals that are changing traditional work practices with the goal of tripling the amount of time nurses spend on direct patient care. Among the tactics: shifting routine tasks to certified nurse assistants and other less highly skilled staff; moving supplies — as well as computers with access to patient records — to inside patient rooms; and having pharmacists deliver medications to patient floors.

As Landro noted, the Robert Wood Johnson Foundation’s Transforming Care at the Bedside program is intended to help hospitals increase to 70 percent the amount of time nurses spend on direct patient care.