Generational Shifts in Nursing: Managing Multigenerational Teams and Bridging Gaps Between Nurse Generations for a Harmonious Workplace

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With four generations of nurses working side-by-side, healthcare is at the crossroads of generational diversity. Picture this: a Baby Boomer nurse, seasoned with decades of experience, collaborating with a tech-savvy Gen Z nurse who’s quick to embrace digital solutions. Meanwhile, a Millennial nurse is seeking a non-traditional schedule from a Gen X nurse leader steeped in the traditions of previous scheduling norms. These interactions exemplify the challenges and opportunities of managing multigenerational nursing teams. 

Understanding generational differences in nursing is critical to fostering harmony and ensuring quality patient care. Vivian Health explores the unique traits of the multigenerational workforce in nursing and strategies to maximize these strengths and retain nurses of all ages.

Overview of Today’s Four Nurse Generations

Generational differences in nursing emerge from the unique experiences each cohort experienced during their youth, nurse education and first years on the job, when nurses confront the expectations of their elder supervisors. With no official definition of generations, we use birth year ranges commonly used by demographers, market researchers and the national press in our discussion.

Baby Boomers (Born 1946–1964)

Baby Boomer nurses bring a wealth of experience and a strong work ethic rooted in post-World War II values of duty and perseverance. Trained under the hierarchical systems of older generations shaped by the Great Depression and WWII, they prioritize loyalty and career stability, often staying long-term with one main employer. Some nurses in this generation are grandfathered into benefits packages less frequently offered to new nurses, such as defined benefit plans. While many are nearing retirement, they remain invaluable as nurse mentors, educators and custodians of institutional knowledge.

Generation X (Born 1965–1980)

Known as the “latchkey generation,” Gen X nurses are independent, resourceful and pragmatic, shaped by the significant social and economic changes of their lifetimes. More so than their predecessors, they blend a sense of duty with work-life balance and serve as bridges between older and younger generations. As they now occupy many leadership roles, some in this cohort view younger nurses as needing to develop greater perseverance and professionalism if they plan to advance in their careers.

Millennial Nurses (Born 1981–1996)

Millennial nurses, sometimes known as “Gen Y” for their place between Gen X and Gen Z, are currently the largest group in the nursing workforce. They’re known for being tech-savvy, collaborative and values-driven. Comfortable with technology and tools like telehealth, they prioritize purpose and growth over employer loyalty. Some entered nursing during the COVID-19 pandemic, contributing to high burnout rates and popularizing travel nursing for better pay and flexibility. They also advocate for addressing ongoing challenges like burnout, depression and workplace violence. Retaining this backbone of the workforce is vital to health system staff management.

Generation Z (Born 1997-2012)

As the bulk of new entrants to nursing, Gen Z nurses are digital natives who easily embrace technology. They’re entrepreneurial, socially conscious and prioritize flexibility and mental well-being. Growing up in a world of instant connectivity, they value real-time communication and quick feedback, which has become an essential operating mode for recruiting and training. Most joined nursing or nursing school in the last few years as the pandemic waned, and many more members of this generation are still coming up through high school and their nursing training. Recruitment efforts to address nursing shortages must reach this generation and then retain them in the profession.

Nurse Demographics Are Changing with the Generations

Alongside nurse generation turnover, nurse demographics are shifting. The Census Bureau indicated that the number of male registered nurses (RNs) tripled and male licensed practical nurses doubled between 1970 and 2011 (representing about 9% of all nurses). In 2022, male RNs comprised 12% of the workforce per the Bureau of Health Workforce. Men’s share of the nurse workforce may continue to grow due to nursing job security, competitive salaries and changing gender stereotypes. 

Related: Top 6 Reasons Why Men Should Consider a Nursing Career

Meanwhile, the COVID-19 period saw a massive wave of nurse retirements or career changers, who were gradually replaced by an onslaught of young nurses, mainly under the age of 25. The wave of new entrants rapidly brought the median nursing age down from 52 in 2020 to 46 in 2022, according to the National Council of State Boards of Nursing’s National Nursing Workforce Study. 

These age and gender shifts contribute to the broader change in nursing culture and potentially some intergenerational tensions as younger cohorts recognize their size and importance to the nursing workforce.

Challenges of Managing Multigenerational Nursing Teams

Intergenerational differences in work styles, attitudes and traits have become a prominent topic in healthcare and the broader economy. Numerous studies highlight these disparities.

Work-Life Balance and Financial Hardships

Research finds that Millennials and Gen Z value work-life balance more than older generations. While Baby Boomers and Gen X may prioritize job security and traditional schedules, Millennials and Gen Z often seek flexible hours and emphasize mental health more. However, the younger cohorts often feel less respected or valued at work, possibly due to differing generational expectations about duty and work ethic. Balancing these expectations is a key challenge for nurse leadership.

Meanwhile, a 2021 study from The Online Journal of Issues in Nursing found that Millennial nurses experienced significantly less joy at work and were more likely to plan job changes than Boomers and Gen X. Millennial nurses were six times more likely to report burnout than Boomers and three times more than Gen X nurses. Vivian Health’s 2024 survey of nurses and healthcare professionals found that 59% of Millennials and 56% of Gen Z reported experiencing depression, compared to 43% of Gen X and 36% of Boomers. 

While these differences may stem partly from the pandemic’s impact on younger nurses during their early careers, they also reflect the well-documented challenges younger American workers face in all sectors of the economy. These include a higher incidence of mental health issues and financial challenges, such as the rising costs of housing, childcare and higher education. For instance, younger generations in Vivian’s survey were more likely than older ones to maintain “side hustles” or relocate to lower-cost areas due to financial hardship.

As the younger generations become the backbone of the healthcare workforce, employers should consider retention strategies that address these pressures, such as student loan repayment, bonuses or childcare stipends and mental health resources in the workplace.

Technological Adaptation and Communication Styles

As previously mentioned, younger generations are often quick to adopt new technologies, while older nurses may approach them cautiously or skeptically. Differences in adaptation could result in a divide in workflows, impacting team cohesion and efficiency. Technology can serve as a bridge for intergenerational collaboration, with younger nurses guiding older colleagues in adapting to new systems and workflows.

Related to differences in tech adoption are generational differences in communication that can lead to misunderstandings. While Baby Boomers may prefer face-to-face interactions or phone calls, Millennials and Gen Z favor instant messaging and digital communication tools. These preferences can create friction if not addressed.

Nurse Leader, the official journal of the American Organization for Nursing Leadership, cites a study that recommends setting clear expectations for unit-level and group communications, outlining what communications should be delivered by phone, email or text. Employers might cover all bases by sending critical communications over multiple mediums rather than relying on a single preferred method for all nurses. 

Continuing Education

Different generations have different styles of continuing education (CE), with older generations used to a classroom lecture format and younger generations feeling comfortable with interactive online modules you take at your own pace. Digitization of CE programs may be the best bet as the workforce gets younger and the need grows to retain nurses, especially in Gen Z.

However, because nursing is a profession where bedside manner is critical, pushing some younger nurses out of their digital comfort zones to embrace face-to-face collaboration should also remain a key area for training and positive feedback driven by nurse leaders.

Strategies for Harmonizing Differing Expectations

Effectively leading a multigenerational nursing workforce necessitates adopting techniques that address varying generational needs while maintaining high-quality care. Consider the following strategies:

• Flexible Scheduling: Offer scheduling options like self-scheduling or compressed workweeks to accommodate both Boomers prioritizing stability and younger generations valuing work-life balance.
• Tailored Communication Styles: Use multiple communication channels to ensure everyone remains informed and engaged.
• Mentorship Programs: Nurse mentors are typically one or more generations older than their nurse mentees. By pairing up and communicating effectively, the older generations can learn more about the unique style of the younger cohort, while the younger generations can have traits like duty and perseverance reinforced. 
• Technology Integration: Invest in user-friendly tools and training to leverage younger generations’ comfort with technology while supporting older staff during transitions.

Best Practices for Training Programs

Training programs that foster collaboration among generations should include these strategies:

• Cultural Competence and Collaboration: Include sessions on generational diversity to help staff appreciate different perspectives and communication styles. Use mixed-generation teams for case simulations and projects to highlight complementary strengths and encourage mutual respect.
• Continuous Feedback Mechanisms: Establish feedback systems where nurses across generations can share concerns and suggestions, fostering an inclusive environment.
• Wellness and Resilience Training: Focus on strategies to address burnout and stress, which impact all generations differently but are particularly acute for younger nurses.
• Technology Training: Provide ongoing education to help older generations stay updated on healthcare technologies, ensuring they feel empowered rather than sidelined. Younger generations can help lead these trainings and learn valuable skills about educating and mentoring the next generation of nurses yet to arrive in the field.

Leveraging Generational Diversity as Future Nursing Trends Develop

Each generation of nurses brings unique strengths that, when combined, create a versatile and innovative team. Together, these skills drive better patient outcomes and holistic care.

As demographics and technology evolve, the nursing workforce must adapt, as do nursing leaders and employers. Rising generations emphasize flexibility, inclusivity and innovation, reshaping traditional roles. Tools like artificial intelligence and telehealth will require nurses of all ages to embrace continuous learning and collaboration. 

Health systems must offer flexible schedules, personalized benefits and engaging onboarding strategies tailored to younger generations’ preferences for digital, concise formats to attract and retain new talent. Retention will also depend on programs that reward longevity, countering the appeal of gig work’s flexibility. 

By understanding and leveraging generational differences, healthcare leaders can build a harmonious, future-ready workforce and ensure exceptional patient care.

Vivian Health helps nurses from all generations find their ideal travel role or staff job. Download the Vivian app to streamline your search today.

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