Generational Conflict: At the Heart of Workplace Hostility?

     For decades the nursing profession has discussed and studied the various contributors to the persistent shortage in the United States and in Canada. In the US the roots of the nursing shortage reach deep in the 1950’s and 60’s when the priority for women was getting married and raising families. Women weren’t as limited in their career options in the 1970’s and sought work in many professions outside of nursing. In the 1980’s, changes with the economy led to massive layoffs that were largely attributed to the adjustments Medicare was making to its payment systems (reimbursement). The 1990’s ushered in the beginning of “the graying of our profession.” Our Veteran and Baby boomer colleagues have continued to retire in droves– and they do so more in response to the current work environments than relocation, a new position at another hospital, or for more money. The loss of these valuable colleagues means a loss of seasoned mentors.  In the 2000’s, the number one reason nurses give for exiting the profession is: the workplace. This trend is likely to be a major factor in the shortage we’re predicted to face in 2014.

     While technology and medicine have advanced by leaps and bounds, both academia and major corporations have lagged behind, failing to “move with the times” by examining and discussing the different ages of nurses (and other workforce demographics) working in the profession and how this factor impacts the workplace. Lack of nurse education and training for such a work environment has led to the development of very toxic work places resulting in poor patient care outcomes, decreased patient satisfaction scores, lost productivity time, nurse burnout, and nurses leaving the profession. Make no mistake about the financial impact a hospital absorbs when just one nurse walks out their doors. A significant amount of money is invested into each and every nurse a hospital hires (hospital orientation, nurse orientation and training). It costs a great deal of money to recruit new nurses and start the process all over again.

     Presumably it’s in a corporation’s best “financial” interest to maximize their nurse retention rates and in their best “recruitment” interests to retain happy nurses.   All in all, nurses take the greatest hit when colleagues leave their jobs to find work elsewhere. If its new nurses that are leaving, veteran nurses are left having to pick up extra workloads resulting from short staffing. If it’s the veterans walking out the doors, there are new nurses left without veteran nurses to show them the ropes of providing safe and competent care. Therein lies another factor impacting workplace harmony—the ratio of new nurses to older nurses on a unit and how they are grouped together for 12 hours.

     So what exactly is going on within our ranks? Is there really a problem between new nurses, Veteran, and Babyboomer nurses? If so what strategies might we develop to promote positive, richly skilled, team oriented nursing units? Surprisingly, there has been an increase in the number of students enrolling in nursing programs throughout the country, and yet it is projected we will be short anywhere between 340,000-390,000 nurses by 2020. The purpose of this article was to examine the latest research pertaining to the impact a multigenerational workforce has on nurses, the workplace, and ultimately patient care outcomes.

     There are four different generations of nurses that currently coexist on patient care units all over the country, and in Canada: Veterans(1920′s-1940), Babyboomers (1941-1964), Gen X (1960-1981), and Gen Y (1981-Now/also known as Millenials). Nurses from each one of these generations have different characteristics and they tend to live by the beliefs, values, teachings, life experiences, and social norms of the era in which they were a part of. Each nurse generation views their career goals and work place differently, each has different perceptions about what type of behaviors are acceptable, and of course each nurse generation has a unique way of thinking. The literature reveals that there are existing problems with how each nurse relates to one another. In fact, the Babyboomers and Gen X nurses appear to have the most volatile and troubling work interactions.

     Ironically, the Gen X nurses have a better impression of their elder counterparts than the Babyboomers do of them. The phrase “nurses eating their young” is said to have come from this trend. The workplace experiences of Gen Y nurses have not been studied enough to accurately discuss how they perceive coworkers from the different generations, but current research shows that Gen Y nurses are the most troubled, stressed, and far likelier to leave their current positions before the first year ends. Gen Y nurses cite two major contributors to their troubles: Experiencing the shock of what nursing “really is” versus what they were taught nursing was “in school,” and poor relationships or experiences with preceptors. They went on to report feeling unprepared at the end of their mentoring period and having difficulties adjusting to pace, stress levels, high acuity of patients, and relating to their elder colleagues.

     So why is it so important to shine a light on the multigenerational workforce as the foundation of our workplace problems and what can we do about it? For starters, who wants to work in a miserable work environment? Im sure many of you reading this can relate to having some dread about the prospect of going back to work to face your “oh so favorite drama queens” for three shifts in a row. Isn’t it awful how their toxic energy taints the vibe of the entire nursing station? Each one of us can break the toxic cycle by taking a moment to consider the value in contributing to gossip or tearing down a nurse who seems to be older, lagging behind, or having a hard time. Try using the energy you have to laugh at her or complain about her —to help her out and provide some mentoring. Every single one of us can break that “us versus them mentality” by partnering with nurses we haven’t worked with before, or asking a nurse from a different generation to lunch that we haven’t gotten to know well in the year he/she has been on staff. Most importantly, making a small but very significant change means realizing the fact that we are all different ages and grew up in different times and lived through unique life experiences and that we all have a different definition of nursing and our perceived place in the profession.

     We all possess a special “way of knowing” and a one of a kind “brand” of nursing. Instead of forming cliques and making fun of nurses who are different from yourself, older, younger, or of a different culture—why not celebrate the fact you are among a wealth of varied and talented resources that could assist you in providing some damn good patient care?  Age aside, we nurses are the first line when it comes to taking responsibility for our work environments and each one of us has the potential to make that difference toward a more positive place in which we take care of our patients. As a sidenote, I don’t recall having learned about how to navigate a multigenerational workplace when I was in nursing school…perhaps nursing schools should incorporate learning activities focused on preparing nurses to productively cope and manage the not so frilly reality they will soon be working in.

     Indeed, the higher ups in corporations have a big role to play in transforming our workplaces. First they need to believe they will get a financial return on their investments. Once that has been accomplished, organizations must set the tone for a positive and healthy workplace by investing in their human capital by studying the demographics of their workforce, finding out what the urgent needs are in the workplace, and what things will keep valued and tenured staff at the bedside. For instance, if a corporation discovers it has a huge population of generation X nurses, it would behoove them to find out what that generation values in a workplace and what would encourage them to stay in their position. Some examples of human capital investment include pay incentives for healthy BMI, constructing a gym inside the medical center complete with trainers, massage therapists, yoga instructors, nurse counselors and dieticians, hour long lunches, a sleep room for nurses to decompress and meditate, varied schedules to serve different nurse age groups, a career ladder that is void of the “management favorites protocol,” an aggressive zero tolerance policy when it comes to horizontal violence, and training nurse managers to effectively and efficiently manage modern, constantly changing, increasingly complex nursing units. Today’s managers should make it a practice to spend more time outside their offices showing interest in their staff, providing on the spot feedback, and coaching….hint: generation Y nurses like that.

Our profession desperately needs a checks and balances system when it comes to who is placed in management positions or leadership positions within national nurse organizations. Have you taken a glance at the generation of nurses that most inhabits nurse management positions or the generation of nurses that overwhelmingly saturates the seating in certain yearly conferences of a national nurse organization? The voices of all generations should be solicited and utilized at every level of the profession in order for there to be a sense of equality, respect, belonging, and healthy professional camaraderie within nursing. Hint—What one nurse generation “applauds” and deems important for the future of our profession may not be the same as the viewpoint of the other generations.

While Veteran and Babyboomer nurses do just fine coming to work every day, maintaining their loyalty to the corporation, and “following the rules without question,” generation X and generation Y nurses have emphasized that they don’t wish to be “managed” they want to be led. X and Y nurses are quick to pick up and leave their positions if they see there is no room for advancement or new learning opportunities and challenges. They also value the latest technology and expect their workplaces to provide it. While Veterans and Babyboomers grew up during times when “you just do what you are told,” they can’t understand why generation X and generation Y nurses have to question authority or why things are done the way they are.

The different needs, priorities, and perspectives of a multigenerational workforce require nurse managers of today to possess *at least* a Masters degree. They should be required to enroll in mandatory leadership and communication courses and attend annual conferences aimed at updating their skill sets. In addition to this, nurse managers must be trained to value, harness, and appropriately incorporate the talents of their staff into the unit’s culture instead of suppressing innovative and transformational ideas that could greatly impact not just nurse satisfaction but overall patient satisfaction and outcomes.

To assist in overall retention of valued staff, corporations should invest in improving the workplace by mandating nurse managers to arrange and engage in quarterly staff teambuilding programs geared toward diversity awareness and tolerance, communication, and conflict resolution. Regular polling of nurse satisfaction in the workplace coupled with tracking sick days (lost productivity time) and retention statistics would serve corporations well by helping them maintain a “visual” of how they are doing in maintaining the satisfaction of its most expensive asset.
The costs of losing and recruiting new staff are higher than ever and those costs directly affect you whether you realize it or not. Hospitals pay big bucks to traveler nurses to fill vacancies that they have been unable to fill on your units and this practice doesn’t make for good teambuilding or a consistently supportive and cohesive team of nurses working together for 12 hours. They also pay a lot of money to recruit new nurses, train them, and integrate them into the hospital’s culture. Newsflash: All this money is taken from you, the bedside nurse. The hospital has to re-allocate money that could go toward bonuses, new equipment and supplies, extra staff to balance out ratios, or even wellness programs for nurses. Consider these things the next time you are contributing to the latest gossip or bullying tactics that could be hurting another colleague or colleagues while in the same breath whining your hospital doesn’t do enough to show appreciation to its staff….ask yourself: “do I have a part to play in that?” If the answer is yes, your actions or behavior have impacted all the rest of your coworkers whether you intended it to or not.

Awareness is the key. Awareness of ourselves, awareness of others, and awareness of the incredible potential each one of us has to make really big things happen in our workplaces. Age, culture, new grad, veteran, it takes just the smallest of actions to transform our work environments and learn some really cool things about people we never took the time to acknowledge other than to ask for “lifting or turning help.” Just as we take a holistic approach to our patient care—so should we when dealing with one another.

Make it a mantra every shift: “What can I do to make someone’s shift easier today?”

Be the Hero.

Resources:

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