The Generation Shift in the Nursing Workforce

By Jennifer Larson, contributor at

Your generation says a lot about you to your nurse colleagues. Of course, you are ultimately responsible for your own reputation, but if your co-workers understood your world views–and you knew more about the hallmarks of their generation, as well–it could make a difference in how everyone gets along.

This understanding of generational differences may become increasingly important as the nursing workforce changes. The first wave of baby boomers has reached retirement age, and while the lagging economy kept many of them in the workforce longer than expected, most experts predict that an exodus of older nurses is still on the horizon.  Who will take their place? The millennials–the generation of young people who were born at the close of the 1970s or later.

In fact, millennials, who are sometimes called Generation Y, have already started carving out their niche. There’s already a blend of generations in hospital units and physicians’ offices, and they all have to find ways to get along for the sake of their patients–and themselves.

Larger numbers of young nurses

The average age for a registered nurse in the United States was around 45 in 2012, so a surge of young nurses into the nursing workforce in recent years was a pleasant surprise.

A 2011 Health Affairs article by Peter Buerhaus, PhD, RN, and David Auerbach, PhD, reported a 62 percent increase in the number of nurses aged 23 to 26 who entered the nursing field between 2002 and 2009. A result of intentional and aggressive recruiting efforts, it represented a bump of 63,000 nurses–good news for a profession accustomed to reports about the ongoing nursing shortage.

Workplace consultant Steve Langerud has heard all the complaints and concerns from baby boomers about this “younger generation.” They gripe sometimes about the young nurses and the characteristics that they perceive as flaws: they’re too attached to their smartphones; they’re too informal; they want to rapidly ascend the ladder of leadership without paying their dues; they need so much praise.

Bruce Tulgan notes there is validity to some of the complaints. The founder of Rainmaker Thinking, Tulgan dubbed Generation Y “the most high-maintenance workforce in the history of the world” in his 2009 book, Not Everyone Gets a Trophy: How to Manage Generation Y. And that can require more high-maintenance management.

But every generation, at some point, is the younger generation in the earliest stages of their careers, without the context that experience brings. The millennials are in that stage of life right now.

“There are always clashes, but what you have here is this particular clash and these particular divergences in attitudes and expectations and behavior,” said Tulgan.

No matter how anyone feels, the generational shift is happening and will continue to happen. The baby boomers, and to some extent, Generation X, which is in the middle, have to accept that.

“This is what I tell them: no matter how you feel now, the fact is you’re leaving, and they’re coming behind you, and what matters most is the care for your patients,” said Langerud, the director of professional opportunities at DePauw University in Greencastle, Ind., and principal of Steve Langerud and Associates.

Find out what makes other generations tick

Lack of collaboration and communication breakdowns are often cited as contributing to poor patient outcomes. Given that the workforce is already in transition, it’s useful for nurses in the “older” generations to learn about Generation Y: to learn what motivates them, what drives them and why they act the way they often do.

By doing so, they will increase their chances of being able to work together effectively.

Langerud encourages older nurses to consider the natural strengths of the young nurses. For example, you might reconsider their affinity for technology from a more positive angle.

“They’ve grown up with technology. They’re not fighting it. They’re embracing it,” he said. “And they’re much more collaborative in the way they work.”

Tulgran also addresses the technology issue in his new book, and refutes a common myth about Generation Y: “They don’t know very much and have short attention spans.” They may not have the shared knowledge base that the existing workforce has accumulated over time, but the reality is that they have more access to information than any generation that has come before them. “They think, learn, and communicate in sync with today’s information environment,” Tulgan wrote.

And that can be very useful in today’s hospitals and other health care settings, as technology evolves and requires more of the people who use it.

Tulgan also cautions that many of the other commonly held beliefs about Generation Y are actually the result of older people “misreading the behavior of young people.” For example, there’s a belief that Gen Yers don’t really respect their elders. But Tulgan believes that they do–but they want you to respect them, too.

Millennial nurses can do their part in developing good working relationships with colleagues from other generations, too.

“You’ve got to be aware of some of these perceptions that older, more experienced people have of you and try not to be that person,” Tulgan said.  “At least try not to be that person who is misunderstood, and work hard to learn what it means to be a good workplace citizen … learn what it looks like to manage yourself effectively.”

That might mean erring on the side of listening more to the experienced nurses and taking notes, rather than immediately chiming in with your perspective. Listen. Ask questions. Listen to the answers. Respect the profession.

“I think that goes a long way toward building relationships,” said Langerud.

Clarify expectations

The millenial generation needs strong leadership which will require more high-maintenance managing, Tulgan said. They have good technical skills and up-to-date knowledge, but they may need some coaching in other arenas, which may demand more time and effort from their managers.

“This generation tends to thrive on structure, boundaries, clear guidelines: ‘Tell me how to win this thing,’” Tulgan said. “Part of what they bring to the table is this youthful enthusiasm, this youthful energy. And they have the freshest training. But also, they don’t know what they don’t know.”

Langerud suggests that managers who work with Generation Y nurses be very clear about their expectations from the beginning. They can’t do what you want them to do if you don’t tell them what you expect. Give them clear examples of the professional behavior that you expect, and model it for them, too. Be specific about the appropriate ways to address colleagues in the workplace and the appropriate and inappropriate use of personal devices like smartphones on the job.

“It’s defining those things very clearly,” he said.



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