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Brace yourself – here comes generation Y


High patient acuity, short staffing, lack of civility, patient anxiety—these realities make for a highly stressful healthcare workplace. On top of that, a new generation has begun to enter the nursing workforce. Generation Y nurses are just starting their careers, joining the working nurses of Generation X, Baby Boomers, and Veterans. Generation Y is the most globally aware and racially diverse generation in history.
Each generation has its own characteristics, core values and attitudes, strengths, and weaknesses. Absorbing a new generation into the workplace can lead to or exacerbate conflict. Generation Y nurses have the tools, confidence, and tech savvy to take nursing to another level—but they pose challenges for healthcare facilities and nursing leaders. To create a healthy workplace with optimal communication and teamwork, we need to understand, embrace, and incorporate them into our profession.
Keep in mind that sweeping statements about any generation are stereotypes. While they may accurately describe many members of that group, they don’t hold true for all of them. I urge you to use my general descriptions as a backdrop, but to relate to each person as an individual.

Who’s in Generation Y?
No precise parameters have been pinned down for the birth years of Generation Y. Most experts use 1980 as the starting point and 2001 as the endpoint.
Even the generation’s name varies depending on who’s discussing it. Some people call it the Millenium Generation, Millenials, the Entitled Generation, or the Echo Boom.

Why should we brace ourselves?
Y’ers like to be entertained and stimulated. Highly adaptable and adept at multitasking, they get bored easily. They’re progressive thinkers, able to process information quickly. Eager to embrace change, they’re constantly looking for new approaches and seeking the next challenge. They also have high standards and excel at teamwork.
Although Y’ers respect older people, they’re not awed by them—or by anyone. Many have a sense of entitlement and expect others to take care of things for them. They prefer community, patience, trust, and action to what they perceive as the Baby Boomers’ narcissist, argumentative bent. Yet their bosses and many of their coworkers are likely to be Baby Boomers, which could set the stage for generational clashes.
In the healthcare workplace, Generation Y nurses are most likely to pose a challenge for older colleagues in the areas of stressors, work schedules, orientation needs, performance appraisals, learning styles and preferences, technology mindset, and professional image.

For Generation Y nurses, stressors may include lack of experience and organizational skills, as well as the need to cope with new situations. One study that examined their intent to stay in their current nursing jobs found that dissatisfaction with six factors—scheduling, coworker and physician relationships, professional growth opportunities, recognition, control, and responsibility—might lead them to resign. Another study found that the main sources of job dissatisfaction for nurses younger than age 32 are work/life imbalance, an organization not focused on patient needs, outdated medical equipment, and insufficient developmental opportunities.

Work schedules
Fresh out of nursing school, Generation Y nurses may assume their work schedules will resemble those of their earlier years, when parents and schools “protected” them. They’re used to having flexible rules and taking part in decisions about their schedules (among other things). They want schedules that allow time for “life” and family. Some might request frequent schedule changes or might call in sick to get around what they see as an inflexible schedule. This can cause resentment among older nurses, who might view this behavior as evidence that Y’ers aren’t team players and haven’t “paid their dues” or earned the right to have their expectations met. Managers need to be especially flexible and creative when assigning 12-hour shifts, off shifts, rotating shifts, weekend work, and holidays.

Orientation needs
I’ve heard some Generation Y nurses say they had no idea nursing would be so hard or that they’d be under such intense pressure, have so much responsibility, or feel so exhausted. Many have difficulty adjusting to a job defined by older generations—especially when it comes to attendance and schedules.
To help cushion the shock and acclimatize them into the work culture, healthcare administrators might want to begin orientation early for new Generation Y hires, bringing them in before their official start dates. Orientation should emphasize such issues as coming to work on time, how and when to call in sick, how to get vacation time, and whom to see when a work problem arises. It should also include time for debriefing so the new hires can express their feelings and share their experiences in a “safe” environment.
I’ve found that having new hires meet together every few months gives them a chance to bond, share, and learn from each other. Some facilities use a program similar to Big Brother or Big Sister to provide each new hire with a confidante, encourager, and sounding board. (Just make sure this person isn’t the new hire’s preceptor or evaluator.)

Performance appraisals
Generation Y responds well to feedback and corrective suggestions. But many attended schools that emphasized success. As a result, many Y’ers perceive themselves as always doing well or at least never having failed. So if their first work performance appraisal contains anything other than praise and recognition, they may view it as their first “failure.” To avoid giving them this perception, supervisors should review and discuss work performance with them on an ongoing basis.
Y’ers take well to action plans and work hard to correct problems. They like to have a complete picture of what’s expected of them, which areas they’re making progress in, and what they’re doing well. But use caution when identifying goals for the next year. Many Y’ers are high achievers who set unrealistic goals. To help them attain work/life balance and avoid unrealistic goals, consider spreading out their goals over 2 years instead of 1 year.
The Generation Y nurse doesn’t like to disappoint preceptors and managers, and will struggle to continue in a unit that isn’t a good fit. To promote a win-win outcome, focus on “right fit” and “right time.” If she desires, let the nurse transfer to another unit for a year or two and then try again on the first unit, if that’s where she truly wants to work.

Learning styles and preferences
The good news: Y’ers love to learn and are good listeners. They grew up with multiple learning formats and most had good relationships with their teachers.
The bad news: They’re accustomed to structured learning environments, lots of technology, and fast-moving fun. Also, they’re not attentive readers and dislike having to sit and read. In addition, because they grew up with the Internet and are completely at ease with the online universe, they may have more current facts than their instructors.
Technology mindset
To Generation Y nurses, some of the technological tools we use at the bedside may seem antiquated and non–user friendly. Y’ers may even complain these devices create redundancy and extra work. They may grow frustrated with having to do things in such an “old-fashioned” way—and in having their frustrations dismissed by older colleagues.
Instead of dismissing their complaints, let’s use their tech savvy and desire to fix things by assigning them to technology task forces. By making suggestions during the developmental and piloting phases of technology projects, they can help make the workplace better and more technologically advanced.

Professional image
Y’ers like to dress casually. Many have body piercings, tattoos, and multicolored hair and may react poorly when colleagues and supervisors insist these things aren’t acceptable in clinical areas. Until healthcare facilities loosen their dress codes, supervisors should insist that Y’ers follow the dress code.
Another area of potential generational conflict is Generation Y’s preference for having fun at work. Baby Boomers and Veterans may define fun at work as a planned party, whereas Y’ers define it as simply hanging out, chatting, and being silly. You might see Y’ers sitting around relaxing a lot. Don’t mistake this for doing nothing. This generation is quite informal and can think extremely well when relaxed.

Getting Generation Y involved in the unit
Y’ers are eager to participate in unit decision making because they grew up having their say in family decisions. But in some units and facilities, older colleagues might not let them participate until they’ve “paid their dues” or “earned their right” to do so. A more constructive approach is to welcome their new ideas and fresh perspectives.
Remember—Generation Y is the most adaptable and flexible generation. It likes to approach projects in teams. If a Y’er resists working on an individual project, this usually reflects fear of failure more than anything else. Provide Generation Y nurses with mentors and give them explicit directions and details about the project.

Why we must keep them
Generation Y is the most educated and technologically literate generation in history. Its skills can help advance our profession, and its sheer numbers can go a long way toward relieving the nursing shortage.
Instead of resisting the changes these new nurses represent, let’s keep our minds and hearts open. Let’s welcome them into nursing and do everything we can to encourage them to stay.

Selected references
Deck M. The latest and greatest ways to teach television generation learners. Available at: www.tool-trainers.com/games/0.greatest.html. Accessed June 12, 2007.
Greene J. What nurses want: different generations, different expectations. Hosp Health Netw. 2005;79(3):34-36, 38, 40. Available at: www.hhnmag.com/hhnmag_app/hospitalconnect/search/article.jsp?dcrpath=HHNMAG/PubsNewsArticle/data/0503HHN_FEA_CoverStory&domain=HHNMAG. Accessed June 12, 2007.
Halfer D, Graf E. Graduate nurse perceptions of the work experience. Nurs Econ. 2006;24
(3):150-155. Available at: www.medscape.com/viewarticle/541778. Accessed June 12, 2007.
Larrabee J, Janney M, Ostrow C, Witbrow M, Hobbs G, Burant C. Predicting registered nurse job satisfaction and intent to leave. J Nurs Adm. 2003;33(5):271-283.
Lower J. A Practical Guide to Managing the Multigenerational Workforce: Skills for Nurse Managers. Marblehead, Mass.: HC Pro; 2006.

Judith (“Ski”) Lower, MSN, RN, CCRN, CNRN, is retired Nurse Manager of the Neurocritical Care Unit at Johns Hopkins Hospital in Baltimore, Md. Now a consultant and lecturer, she recently was elected to the Board of Directors of the American Association of Critical-Care Nurses.

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