With four generations of nurses working side by side in hospitals—each with different strengths and approaches—how can nurse leaders promote intergenerational harmony? By understanding the values of each group, connecting a diverse staff to a common vision, and customizing leadership style, nursing experts say.

The four generations populating the workforce include the traditionalists or veterans, who were born before or during World War II (1925-1945); the baby boomers (1946-1964); the Gen Xers (1965-1980); and, Generation Y, also known as the Millennials (1981-2000).

One of the biggest differences between each group revolves around communication styles, says Rose O. Sherman, RN, NEA-BC, FAAN, professor and director of the Nursing Leadership Institute at Christine E. Lynn College of Nursing at Florida Atlantic University.

“I do a lot of research with nurse leaders, and it is communication that is presenting them with problems. The average nurse manager has 60-plus people to supervise, and there will be a cross-generational workforce” and leaders must make adjustments, says Sherman. “That same type of communication will not work for every generation.”

For example, veterans and boomers enjoy getting information through memos, phone calls, and staff meetings. These nurses prefer face-to-face communication and may appear too talkative to younger co-workers. Vets and boomers “have long preambles. When they want to tell you something they want to give you background. . . they want to make sure you understand the background story,” says Kelley Arllen, RN, MSN, CCCE, staff development/childbirth education, Department of Education and Research at the Virginia Hospital Center. “It’s important to listen to that and not just pooh-pooh it and say, ‘What’s your point?’”

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Tension occurs since “Gen X and Y, to an extent, speak bluntly and quickly. They want to be very to the point, so that makes it hard for them sometimes to listen to the preamble. The vets and boomers think they are blunt and rude people, so there can be a disconnect there,” Arllen continues.

Millennials, who have grown up “attached to their smartphone devices” want communication short, to the point, and they want the communication loop closed, says Sherman. “They don’t want to sit at endless meetings where processes are being discussed and there doesn’t appear to be any outcomes.”

They like texting and social media as their primary form of communication versus e-mail and face-to-face discussions. Savvy nurse managers are learning no one-size-fits-all approach exists and they will have to communicate differently and in a way that is meaningful to each age group.

“I read somewhere. . . about a communication timeline,” says Arllen. “If a veteran asks you a question, they need an answer within a week. If a boomer asks you a question, they need an answer within a few days. If Gen X asks, they will wait for a response for about 24 hours. For Gen Y, they need a response immediately. I think part of that is we used to write letters, then we did more with telephone calls, and then e-mail, and now it’s texting.”

The Millennials’ preference for informal communication may come at a price, argues Beth A. Smith, MSN, RN, director of the Nurse Residency Program at Penn Medicine, who works with many new nurses. “I think there’s a need for development with interpersonal skill development. I sense in the Millennial generation a general unease about how to communicate with physicians, patients, and family members,” says Smith, who is also a nursing professional development specialist at the Hospital of the University of Pennsylvania.

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The generations differ with their attitudes about job expectations and life-work balance, experts say. Some of that may reflect different generations being at different stages in their careers. For example, the vets and boomers are more interested in career stability compared to Gen X and Y. The youngest nurses are more interested in being coached and mentored and having a healthy personal life.

Life-work balance wasn’t important to boomers who were so grounded in their jobs that they sometimes were extreme with their allegiance, says Sherman. But Gen X and Y “are really interested in having work-life balance and that will impact their decisions about different jobs they take.”

The concept of loyalty to an organization is also changing for every generational group after massive corporate layoffs. Nurses of all ages “don’t feel like organizations have been loyal to them. Gen Y tends to be more loyal to the teams and managers they work for than the organization they work for,” explains Sherman.

The first building block to successfully managing a multigenerational workforce requires leadership to respect the differences between the generations and embrace a belief that diversity in the workplace is good. Other major components include a willingness to change one’s leadership style and a drive to bring people together by looking for common ground.

“In a health care setting, everyone on the team can agree the reason they are there is to support the patient and family,” says Sherman. “We might have differences on how that is best managed, but we all want to see the same outcomes.”

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Creating an inclusive governance structure also matters. Invite nurses from each generation to the table for decision-making, says Smith. Another strategy for managing a four-generation staff is to customize rewards, incentives, and career development to appeal to each different generation. Leaders must find a way to define and create a common language and culture. All generations have a defined work ethic and a desire for respect and recognition, but it looks different for each generation, says Arllen, who recommends two books on the topic: The Nurse Manager’s Guide to an Intergenerational Workforce and Managing the Generation Mix.

Arllen suggests that teams come up with representatives from each generation to answer a series of questions that will reflect differences, such as: “What does coming to work on time mean?,” “Does it mean starting at 7 a.m., or does it mean you are ready to work at 7?,” “What does business- causal mean?,” and “Are flip flops and sleeveless tops okay because that’s what Generation X is going to wear, or did you have slacks and sweaters in mind?” Other possible topics could include cursing at work or bringing food into a meeting. Build on common values and make sure the team figures out how the group is going to communicate.

Once these things are in place, focus on the mission and review it regularly. Then “you will have a better cohesion because you are including the generational things, but you are realizing that your team can be more than the generational things and work together,” Arllen says.

Smith agrees. “If you can create a dialogue and allow their strengths to come through, you will clearly impact workplace satisfaction,” she says. “You will impact retention, which has a financial component to any organization, and you will impact productivity.”

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Robin Farmer is a freelance writer based in Virginia.


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