HWS Perspectives | Health Workforce Solutions LLC

The fourth in a continuing series of timely articles brought to you quarterly by HWS

Younger RNs Challenge Status Quo
As the nursing population nears retirement and new nursing graduates enter the workforce in droves, many hospitals are experiencing a clash between older management styles and the desires of younger nurses. As health care organizations struggle to manage a multi-generational workforce and retain novice nurses in the shadow of a looming nursing shortage, many are turning to targeted programs and initiatives aimed at addressing the "generational gap." As these programs are developed and expanded, hospitals and health care leaders should look beyond reacting to the challenges associated with managing younger workers and embrace the opportunities that this committed and energetic workforce represents.

New Workers Bring New Characteristics to the Work Environment
Much has been made of the generation gap in recent literature. Most articles focus on the four distinct generations working side-by-side in today's workplace, the differing attitudes and beliefs of each cohort, and how to effectively manage one or all of them in harmony.

Whether they are called Millennials, Generation Y, or simply "Twenty Somethings", this group of younger workers are generally portrayed as confident, achievement oriented, and social.² This younger population also seems to place tremendous value on community involvement and contributing to society. "New graduates and nursing students today have a very strong commitment to making a difference and giving back," said Tom Smith, RN, Senior Vice President, Patient Care Services and Chief Nursing Officer of Cambridge Health Alliance.

However, the flipside of these positive characteristics is that younger workers are often viewed as needing quick gratification, being overly confident, and placing a higher value on compensation and work/life balance than other generations. "There is a desire among younger staff to move ahead quickly," Smith says. "This is an admirable quality, but there is sometimes a gap between actual skill sets and what it takes to advance."

Generational Challenges Impacting Nursing and Health Care Delivery
The generation gap has also landed in nursing and many are grumbling about it. Nurse managers and older nurses often feel that younger nurses are not clinically prepared, are not fully committed to the profession, and are not willing to put in the hard work. Younger nurses are often dismayed to discover lack of collaboration, a strict hierarchical environment, and rigid work schedules. Unfortunately, this conflict can lead to higher turnover rates in younger nurses, which can be as high as 35 to 61 percent in the first year of employment.³

In response to generational challenges, many hospitals have initiated programs aimed at improving communication between nurses and easing the transition between nursing school and clinical work. MD Anderson launched a nursing residency program when they began recruiting large numbers of new graduate nurses three years ago. The 15-month program provides clinical orientation, leadership development, and other trainings to assist with developing professional relationships. The hospital also has a monthly RN meeting for younger and older nurses where staff nurses dialogue and learn from one another. Both programs have been instrumental in easing the intergenerational clash.

New Workers Also Provide New Opportunities for Change
Focusing on communication and training is absolutely the right approach to addressing the challenges associated with managing a younger workforce, but there are many more opportunities to be had by proactively embracing the positive attributes of this professional group.

Positive attributes of the younger workforce

Change agents: Many employers are finding that this generation has a tremendous ability and willingness to embrace changes and try new ideas or experiences.
Innovators and future leaders: Many think this generation is going to be the next great group of innovators and leaders; they are hungry for experiences and eager to contribute.
Technologically savvy: Having used computers and advanced technologies most of their lives, this generation's technological expertise is a huge asset to any health care employer.
Networked: From team work and group exercises in high school to Facebook and text messaging in college, younger workers are part of a large, plugged-in community.
Idealists: This generation has record levels of civic involvement and a tendency to want careers that contribute positively to society.
Seeking a balanced life: While employers may chafe against the younger worker's strive for a balanced life, there could be a lot to gain by listening to them. Who wouldn't want rested, fulfilled, and committed employees?

HWS Perspective: Value and Utilize the Key Attributes of
Young RNs
Maximize the contribution of younger nurses by embracing and developing their positive characteristics.

Young nurses are motivated, bright, and eager to make a difference. No individual or generational cohort is perfect, but by embracing key attributes of these younger workers, nurses, hospitals, and patients will all benefit.

Change Agents
Younger nurses are often confident and willing to embrace change. These characteristics make them perfect candidates to test pilot projects or take on challenging new assignments. Not only will that unpopular new initiative benefit from the positive attitude of a young worker, but the younger nurse also acts as a role model for the rest of the organization, setting the stage for smooth implementation.

Innovators and Future Leaders
Harness the intellectual curiosity and ambition of younger employees by seeking their participation on committees, input for new programs, or informally on the floor. Staff will feel valued and listened to and the hospital will gain from the knowledge and perspective of the employee. Reward staff with innovative development opportunities, such as creating a poster for a conference, briefing a hospital administrator, or attending an external event. Such opportunities help staff grow professionally and reward hard work and innovation.

Technologically savvy
It is not breaking news that younger workers tend to be more technologically savvy — so, take advantage of that in-house expertise. Have younger nurses complete EMR training first and then act as the "go-to" tech leader on their unit. Pair younger nurses with older nurses in mentorship programs that focus on mutual skill building. Or, simply talk to some of your younger nurses about fresh ideas for improving and simplifying workflow and communications through technology.

Networked
This generation knows how to stay in touch with people. Their networks are huge and, in the case of young nurses, full of other young staff nurses. "Word of mouth" and employee referrals have always been a great source of talented hires, but this generation has the potential to take it to the next level. Advertise the employee referral program, hold referral drives or contests to drum up interest, streamline the referral process. Simple steps can go a long way.

Idealist
Nursing is benefiting from this generation's interest in careers that mean something. With so many career options to choose from, the fact that younger workers choose to enter nursing shows a high level of commitment to the profession. Don't forget that. A desire to help people is a common value throughout the entire nursing workforce. Remembering that everyone is there for the same reason can go a long way towards soothing frayed nerves and tired feet.

Seeking a balanced life
The younger workforce has an unparalleled commitment to work/life balance. Rather than complain about their unwillingness to work overtime or pay their dues, this is an opportunity to move beyond the status quo and look for new ways of operating. Whether it is new ways of staffing or redesigned career ladders, hospitals have the potential to improve current processes while embracing the preferences of a younger generation.

There are many opportunities for health care employers to more effectively utilize younger nurses. The exact approach will depend on the characteristics of a hospital's nursing workforce and the needs of the facility, but the benefits to be gained are endless.

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¹ Sherman, R., (May 31, 2006). Leading a Multigenerational Nursing Workforce: Issues, Challenges and Strategies. OJIN: The Online Journal of Issues in Nursing. Vol. #11 No. #2, Manuscript 2. Available: www.nursingworld.org/ojin and the U.S. Census Bureau, United States Department of Commerce. U.S. Population Estimates by Age, Sex, Race and Hispanic Origin: April 1, 2000 to July 1, 2005 Retrieved August 3, 2006. (http://www.census.gov/popest/national/asrh/2004_nat_res.html). Last revised: December, 2005.

² Communicating Total Rewards to the Generations. Leah A. Reynolds. Benefits Quarterly. Volume 21, #2, pg. 13-17. Second Quarter 2005.

³ Halfer D. & Graf E. 2006 Graduate Nurse Perceptions of the Work Experience. Nursing Economics. 24(3) 150-155. Goode C. & Williams C. 2004 Post Baccalaureate Nurse Residency Program. Journal of Nursing Administration. 34(2) 71-77. Casey K. et al. 2004. The Graduate Nurse Experience. Journal of Nursing Administration. 34(6) 303-311.