Runninghead:GENERATIONALDIFFERENCESINTHENURSINGWORKFORCE 1

Generational Differences in the Nursing Workforce

Auburn University School of Nursing
Allie Cannon
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Abstract
Each person belongs to a generational cohort that shares common values, beliefs, and life

experiences. These traits affect the way each generation views the purpose of work, whether they

are team oriented, and their perception of other generations. There are currently four different

generational groups present in the nursing workforce today: Veterans, Baby Boomers, Generation

X, and Millennials. As each generation has different goals and desires from their work

environment, identifying strategies to improve the job satisfaction and organizational

commitment for each specific cohort is vital to amending a work climate fraught with

misunderstanding. While individual relationships between nurses of differing generations can be

improved through approaching generation variances in a light of appreciation for diversity rather

than judgment, the priority in using this knowledge is to improve generation-relations on a macro

level. Bettering the understanding of each generation allows institutions to cater to the cohorts

specific needs, thus improving job satisfaction and organizational commitment. Furthermore,

drawing attention to intergenerational relationships can decrease nursing turnover and bullying

between nurses. When nurses are pleased with their work environment, patient safety and

retention are improved. Therefore, generation specific retention strategies may be vital to

ameliorating the shortage plaguing the nurse profession today.

Keywords: Generational diversity, nursing, workforce, shortage
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Introduction
As the nursing profession matures, its culture evolves. Over the course of the last few

years, the ethos of nursing has transitioned in technology, diversity, and structure. Nursing is

increasingly more technologically literate and has increased in diversity in more ways than one;

it is more diverse in ethnicity, gender, and age (Carver & Candela, 2008). Meanwhile, older

nurses have seen the structure of care transition from one of hierarchy to one of collaboration.

More so now than ever, nurses are valued as a vital part of the healthcare team. Their opinions

are sought after and they contribute as equals to patients course of treatment (Hendricks &

Cope, 2013). As technology, culture, and structure advances, however, the face of nursing

changes as well. Currently, there are four generations of nurses active in the profession: Veterans,

Baby Boomers, Generation X, and Millennials. Members of each generation share an age

location in history and share common beliefs and behaviors. Each generation values work

differently and is therefore inclined to want different amenities and environments from their

workplace (McNeill, 2012). Considering these generational differences may be vital to the

welfare of nursing, as the nursing profession is predicted to suffer from a shortage of up to 1

million nurses by 2020 (Carver & Candela, 2008). Satisfying the needs of each generation may

combat this shortage by both increasing patient safety, job satisfaction, and organizational

commitment, and decreasing turnover and bullying among staff.

The Veteran Generation
The Veteran Generation was born between 1925 and 1942. They were children of the

depression and came into adulthood during World War II. These two experiences shaped this

generation into a group that values sacrifice, loyalty, and hard work. They are more traditional by

nature and choose to be loyal to organizations. From their work, they desire stability, security for

retirement, and respect for their experience (Carver & Candela, 2008). Veterans make decisions

based on militaristic authority tradition and prefer hierarchical structures in the hospital This
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preference has made the shift to a more team-based structure of caregiving difficult for Veterans.

Though largely retired, professionalism in the workforce is important to this group, and they

often perceive younger generations desire to have fun at work as distinctly unprofessional. They

were raised to speak when spoken to, and therefore frequently misunderstand younger

generations tendency to voice their opinions as disrespectful. Furthermore, the shift to more

technological driven aspects of care poses a challenge to Veterans, who are unfamiliar with

technology and value face to face or written communication (Hendricks & Cope, 2013).
The Baby Boomer Generation
The Baby Boomer Generation is the product of the post-war era boom in the population

that occurred as veterans came home, married, and had children. Born from 1943 to 1960, the

Baby Boomers experienced both the Vietnam War, the assassinations of John F. Kennedy and

Martin Luther King Jr., and the moon landing. This generation chased after the American dream

their parents described, coining the term workaholics (Carver & Candela, 2008). They can be

seen as entitled, and feel that younger generations should mimic their work ethic in order to

achieve success. In addition, Baby Boomers want to feel valued for their experience and have a

strong competitive drive. They want monetary compensation for a job well done and external

validation for their work. This generation is currently retiring, however, and will soon contribute

to the nursing shortage in more ways than one: they will both leave the nursing profession and

need nursing care as they age (Hendricks & Cope, 2013).

Generation X
Generation X was born between 1961 and 1981. This group was shaped by the Cold War,

Iranian Hostage Crisis, and the increase in divorce rates (Carver & Candela, 2008). In the

workforce, this group is highly individualistic, preferring to work alone. They value the outcome,

rather than the process, and would rather complete their work without supervision. Furthermore,

they value a work-life balance and their own marketability. They are sometimes dissenters and
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can be viewed negatively by others when not regarded in the context of their generation.

(Hendricks & Cope, 2013). When considering a job, members of Generation X consider schedule

flexibility and whether they will gain skills and knowledge that will help build their resume

(Carver & Candela, 2008).

The Millennial Generation
The newest generation to the workforce, the Millennial Generation, was born between

1982 and 2003. Millennials lived through 9/11, the Fall of the Berlin Wall, school shootings, and

the rise of the internet. Shaped by these events, this group manifests itself as people-oriented

team members. This generation wants their work to contribute to society and provide meaning to

their lives. Like Generation X before them, they also desire a work-life balance, but they differ in

that they desire a longer orientation period and crave supervision and evaluation of their work.

Along with Generation X, Millennials desire a fun working environment (Carver & Candela,

2008). Millennials are also more comfortable with the team-oriented approach to healthcare, as

they have been trained to voice their opinion, a trait which can be misinterpreted by older

professionals (Hendricks & Cope, 2013).

Patient Safety
The unsatisfactory work environment and the nursing turnover that can be caused by a

lack of understanding generational differences can lead to unsafe conditions for patients

receiving care. In fact, deviations in hospital medication errors are linked to work climate factors

such as staff perceptions of clarity, role conflict, and overload. The average length of stay is

related to nursing staff opinion of job autonomy, job importance, job challenge, role clarity, role

conflict and overload. These two important patient outcomes, safe medication administration and

length of stay, can be improved by enhancing the quality of work climates, an outcome of

improving generational relations (Lavoie-Tremblay et al., 2010).

Job Satisfaction
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To combat the global nursing shortage, institutions must seek to improve job satisfaction,

as this is a leading predictor of job retention. As the generations differ in work philosophy,

understanding these differences and catering to individual cohort needs may increase generation-

specific retention (Wilson, Squires, Widger, Cranley, & Tourangeau, 2008). For example, older

generations prefer the face to face method of communication, while the Generation X members

become frustrated and bored at discussion-based meetings. Millennials enjoy group work but

prefer the quick feedback. So to please all groups, short, agenda focused meetings serve best.

Furthermore, older generations, want to feel appreciated for their wisdom and experience, and

therefore work well as mentors to Millennial nurses desiring supervision and feedback. In

addition to promoting generation communication with mentoring and coaching opportunities,

employers may employ generation specific rewards to increase job satisfaction. For example,

Millennials and Generation X appreciate time off, whereas Baby Boomers value money.

Therefore, offering each cohort what it truly wants fosters job satisfaction, thus increasing job

retention (Hendricks & Cope, 2013).

Nursing Turnover and the Millennial Nurse
In addition to the fact that the U.S. alone will be short approximately 260,000 nurses by

the year 2025 (Longo, 2013), many new graduates are leaving their jobs just 2 years after

graduation. Of a sample questioned, 15.5% of hospital workers intended to quit. Baby Boomers

stated that their intention to quit was due to retirement, whereas Generation X members and

Millennials left to advance their career. In fact, Millennial nurses specifically were three times as

likely to quit than any other hospital worker. Perhaps this is due to the fact that 91.7% of

Millennial nurses stated they were dissatisfied with their organizations focus on patient needs.

Furthermore, new nurses are expected to become proficient quickly and are required to take on a

new, heavy workload, all while navigating a nursing shortage and new responsibilities. It is
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reasonable, therefore, that Millennial nurses have higher stress, higher job dissatisfaction, and

higher nursing turnover than the other generations. As Millennials will leave a job to advance

their skill set, nurse managers and institutions should consider providing ongoing education in

order to retain these nurses. In addition, thepressurenewnursesareundercausesthemtoprefer

longtermsupervisionandfeedback,thereforeinordertocombatMillennialnurseturnover,

institutionsoughttoprovidetheseservicestotheirnovicenurses(Lavoie-Tremblay et al., 2010).

Organizational Commitment
While recruiting employees is essential to staffing units, retaining employees prevents the

hassle of hiring and training new employees, and is therefore better for the health of the

institution. However, it is notable that organizational commitment is a more predictable measure

of nursing turnover and performance than job satisfaction. Without employee commitment to the

organization, institutions may struggle to retain quality, productive nurses, as nurses without a

commitment to their organization reap absenteeism and turnover. It is important to understand

generational differences in order to sow commitment in each generation because these

differences can lead to the miscommunication, conflict, and low commitment that leads to

turnover. For example, Generation X values career security over job security and organizational

commitment and can be easily lost if their needs for a work-life balance are not met. Meanwhile,

Baby Boomers are more likely to stay at a job that does not fit their needs, as they define

themselves by their career success. Millennial nurses expect to feel fulfilled, challenged, and

supported by their work, and will not hesitate to change employment if their work does not suit

their desires. As organizations with high levels of employee commitment obtain increases in

profit, it is in the organizations best interest to appeal to generational differences to both

promote better outcomes for the institution and mitigate the nursing shortage (Carver & Candela,

2008).
Eating our Young
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Older nurses are crucial for the transfer of knowledge to younger generations, however,

bullying occurs in the form of nurses eating their young when staff nurses demean, degrade, or

demoralize rookie nurses. While nurses who have been in the workforce for 5 years or less are

bullied most, it is nurses with more experience that leave jobs because of bullying and report

more personal effects from it. With older nurses acting as both the perpetrator and victims of this

bullying, it is important to understand why this phenomenon occurs (Longo, 2013). Older

generations and younger differences are fundamentally different in their workplace behaviors in

many ways, including communication, work-life balance, and professionalism. Older nurses

wish to be appreciated for their experience (Hendricks & Cope, 2013), but the emergence of

technology allows Generation X and Millennial nurses to rely on their access to information

rather than the experience of older generations. Furthermore, younger nurses are now more

skilled in technology and must teach the older generations how to navigate this new

environment, thus flipping the generational relationship long established. Due to this, older

nurses may not feel respected for their wisdom and seniority (McNeill, 2012). Bullying can be a

reaction to the frustration and anxiety that occurs with working in a multigenerational workforce.

To combat the negativity misunderstanding other generations leads to, institutions may offer

education to raise awareness of the problem. Opportunities for older staff to orient new nurses

also allows an outlet for older nurses to both express their desire to pass on their wisdom and feel

empowered. These efforts are fundamental to assuaging the nursing shortage, as bullied nurses

may suffer from insomnia, irritability, and depression, thus leading to a decrease in job

satisfaction and an increase in nursing turnover (Longo, 2013).

Conclusion
From my research in generational differences in the nursing workforce, I have learned the

importance of understanding and catering to the various age cohorts. In my future practice, I will
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allow my knowledge of what each generation values and how my generation is perceived to help

me communicate effectively with each group. For example, with older generations, I will seek

their counsel, respect their wisdom, and display professionalism. With coworkers of Generation

X, I will display independence and respect their desire for a work-life balance. And with other

Millennial nurses, I will strive to form a meaningful connection and provide encouragement.

Finally, I will seek to improve the relationships of the multigenerational workforce, as this may

pivotal to bettering patient safety, job satisfaction, organizational commitment, turnover, and

workplace bullying. These efforts may be the key to tackling the nursing shortage and patient

outcomes in the nursing workforce as a whole.

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