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With the graying of the RN workforce, the logistical implications of health care delivery systems are rivaling the patient centered/family centered environments of care. The most sobering realization is the unfortunate epiphany that the two may not necessarily be compatible. Such a dissonance poses not only a challenge for the senior nurse, but also for the health care organization, as the need modify the existing infrastructures competes with the reality of the nursing shortage. This presentation will address the short-comings of unit design, as it relates to the aging RN workforce, as well as cost-effective, innovative, and evidence-based approaches to nursing unit re-design.