Challenge of the Generations!: How Can We Attract and Retain the Millennial Nurses?

Monday, 30 October 2017

Cindy Ford, PhD, MSN, BSN
Kimberley A. Stunkard, MSN
Department of Nursing, Lubbock Christian University, Lubbock, TX, USA

The purpose of this abstract is to explore the emerging evidence related to attracting and retaining the millennial generation to nursing. One local large health care facility recently reported of the recent resignations, 63% were from millennial nurses. There is growing interest and focus of strategies to attract and retain millennial nurses to diminish millennial turnover and increase millennial job satisfaction.

 It has been reported the challenges for nursing, for organizations, and the millennial generation, are under-researched (Hutchinson et al., 2012). Little empirical research exists supporting the generational stereotypes associated with the generations represented in the workforce today (Menci & Lester, 2014). Much of the research found on millennials in nursing depicts the current situation in health care and the aging workforce, estimating that 50% of nurses will retire or leave during the next 5-10 years, creating widespread nursing shortages (Carver & Candela, 2008). The profession of nursing is facing the potentially most severe shortage seen in years. It is anticipated the millennial generation will comprise 50% of the nursing workforce by 2020 (AHA, 2014). Employees from different generations may have varying expectations of what they want (or value) from the workplace, both from an intrinsic and extrinsic standpoint, and therefore may approach work, how they prefer to be motivated, differently (Lester et al., 2012). The millennial (or generation Y) generation is most often defined as those born between 1980- 2000 and have recently begun to enter the nursing profession. The millennial generation is the largest generation to enter the workforce since the baby boomer generation, born in the years 1946-1964 (Phillips, 2016). While there is an abundance of descriptions of the characteristics of the millennial generation characteristics and values, there is limited reference to what attracted them to nursing and what might retain them in nursing (Hutchinson et al., 2012).

 Generally, the literature reports characteristics of the millennial generation as, they like to be entertained and stimulated, are highly adaptable, tech savvy, adept at multitasking and therefore are inclined to bore easily. They are progressive thinkers, process new information quickly and embrace change, high standards and excel at teamwork (Lower, 2008). Among other characteristics, McCrindle (2007) says the millennial generation is the most educated, entertained, materially endowed, and entrepreneurial, yet supported and protected generation in history. Their age and their times have created a generation very distinct from other generations. This generation understands the significance the size their generation has towards nursing’s future and know they are needed. This places them in a highly negotiable and employable position (Sheehan, 2005).

 Nurse leaders need to have exemplary knowledge of all four generations in the workplace to understand how to recruit and retain nurses (Parsons, 2002). Taking the opportunity to consciously explore the nature of generational differences and mental models provides nurse managers worldwide with a strategic tool to use the best that each generation has to offer in the workplace. This exploration allows for the acknowledgement of wisdom and experience while embracing the newer perspectives of younger nurses. Examining the view point of different generational cohorts begins from a baseline of mutual respect and the strengths of a team lie in valuing diversity and contribution from each team member and focusing on the strengths of each generational cohort (Hendricks & Cope, 2012). While Parsons (2002) recommendation is sound, there is absolute paucity of research on recruitment and retention of the millennial generation to the nursing profession (Hutchinson et al., 2012). Managers will need to focus on Millennials strengths and structure a workforce that will support the millennial nurse in their professional nursing role. Health institutions need to recognize the impact of the Millennials to nursing and develop strategies to move forward and prepare the current workforce and environment for a generation that is already here (Hutchinson et al., 2012). There is a need for flexible leadership to meet the career goals of this new generation (Sherman, 2015). If nurse managers are to effect a positive work environment which attracts and retains staff then they should use the strengths of each cohort as a guidepost to establish management strategies (Hendricks & Cope, 2012). Spence Laschinger and Leiter (2006) suggest patient safety outcomes are related to the quality of the work environment. If nurse mangers can establish a workplace where people area communicative and respectful of differences it is more probable that this respect will lead to an understanding of what it is people want out of work and what they are willing to commit to (Stuenkel et al., 2005)

Some authors have reported marginalization of millennial nurses in the nursing workforce leading to burnout as other generations reject the entering generation of nurses (Lavoie-Tremblay et al., 2008b). There are studies revealing Millennials will suffer stress and burnout if they are not rewarded and supported or if the workload is too great. The difference with this generation is that they will simply leave and move on if the workplace does not provide flexibility and support their lifestyle (Hutchinson et al., 2012). Millennials expect to be respected, valued, stimulated, included and supported in their workplace (Sheahan, 2005). They are not prepared to work the hours their parents worked and strive for much more of a work life balance (McCrindle, 2007). It is imperative each generation understand the characteristics of other generations to ensure the best outcomes particularly from mentoring relationships (Sheahan, 2005). Other generations do not need to approve or adopt the millennial values but they should respect them (Kupperschmidt, 2006). Nurses and nurse managers need information on the role of Millennial nurses in more specific roles such as the rural setting and nursing governance (Hutchinson et al., 2008 a,b).

 The literature offers limited evidence of successful programs that have prepared or supported the millennial generation for a future in nursing. Developing an understanding of what attracts the millennial to nursing, what mangers can do to retain the millennial in nursing and how the nursing professions can support the millennial generation to assume a role in nursing and nursing governance will assure the retiring generation has left the nursing profession in capable hands (Hutchinson et al., 2012). Nurse Residency Programs (NRP) have been implemented in many hospitals across the United States (Medas, et al. 2015). By 2011, as many as 36.9% of hospitals with membership to the American Organization of Nurse Executives reported using NRP as part of the orientation and onboarding process to retain graduate nurses beyond the first year of employment (Pittman et al., 2013). The efficacies of these programs varies from facility to facility, based on program curriculum and participation standards but have been shown to increase overall retention and satisfaction of graduate nurses. While there is a wealth of research focused on NRP, there is little understanding and connection made to millennial retention and satisfaction.