By Laura Raines, Pulse editor
The uniforms may look alike, but the health care workers who wear them come from four distinct generations. For the first time in American history, four generations are laboring together in the work force like a huge extended family.
If you think that doesn’t raise challenges, recall the last time you were at a family reunion with Junior, Mom, Grandpa and great-Aunt Mabel and the subject of marriage, politics or tattoos came up.
Generational gaps — and the conflict they can cause — aren’t just about age, says Al Vivian, president and CEO of Basic Diversity Inc., a Fayetteville-based diversity consulting firm. The gaps come from different values, attitudes and work ethics that are forged from common generational experiences.
Vivian’s thumbnail sketch of the four generations reveals the source of some of the tension.
The Matures (also called Veterans, born between 1909 and 1945) were shaped by the Great Depression, the New Deal, World War I and World War II and usually hold strong beliefs in family, duty, country and company loyalty. They believe you pay your dues before moving up the company ladder.
The Baby Boomers (born 1946 to 1964) lived through the civil rights movement, the death of President John F. Kennedy, the Vietnam War, the turbulent 1960s and the Apollo 11 moon landing. They are team- and service-oriented, believe in personal development and tend to be workaholics who value material possessions.
Generation X (born 1965 to 1978) was shaped by Watergate, the Challenger disaster, personal computers and a rising divorce rate. Many were latchkey kids and they tend to be self-reliant, tech-savvy and don’t mind switching jobs to gain experience, promotions or better work/life balance. They often believe advancement should come from productivity and results.
Generation Y (also Nexters or Millennials, born after 1979) grew up with the Internet, cellphones, a global economy and the threat of terrorism. They are plugged-in, interactive and more tolerant of diversity.
Claire Raines, co-author of “Generations at Work,” sums up the differences of those generations with these descriptors: radio, television, personal computers and Internet.
A challenge for managers
With more than 400 employees in the Family Centered Care (mother/baby) unit at Northside Hospital in Atlanta, “it’s a challenge to manage across four generations,” said Cindy Gambon, BSN, RN, operations manager. She manages some Mature nurses who are past retirement age, many baby boomers and Generation X nurses who are in leadership roles and a continuous stream of Generation Y nurses.
“You want to be fair and consistent, but how do you do that when each generation is motivated by different things?” Gambon asked.
She has discovered that her baby boomer teamwork approach doesn’t always resonate with Gen X or Gen Y nurses, who tend to be more motivated by individual development.
Gambon has been to many generational diversity management seminars and has found that nobody has the magic answer. “You need to be flexible, open-minded and give yourself permission to think outside the box, because, as we like to say around here, ‘It takes a village.’ ”
With the nursing shortage and the demands of a growing and aging population, all four generations of workers are needed in health care.
“Everyone has a contribution to make,” Gambon said. “The challenges are how to reach each group, motivate them and encourage them to work together.”
She uses formal and informal means to help employees understand and appreciate each other. Northside’s benefits package includes an onsite child care center that attracts younger nurses and a pension plan that appeals to older ones.
Although the majority of nurses work 12-hour shifts, some of the older ones work eight hours.
“The patients love our older nurses for the selfless care they give,” she said. “What they know can’t be put into words, but juggling eight and 12-hour shifts can be a nightmare.
“You do it because you want to be loyal to good, long-term employees, but everyone has to meet the same standards of nursing. The performance level has to be consistent across the board.”
Value of mentoring
One way to accomplish that is have experienced nurses help the rookies. Upon hire, new graduates receive 14 weeks of orientation, work on a separate training floor and are mentored by Generation X and baby boomer preceptors.
“By the time they move to another floor to work, their landing is softer than it used to be for new nurses,” Gambon said.
Making sure that new nurses are comfortable in the job helps avoid the old adage, “Nurses eat their young.”
“Because Generation X and Generation Y are much better at achieving work/life balance, the atmosphere is more supportive,” she said. “We can learn from each other.”
Younger nurses can offer technical knowledge and creative approaches to solving problems.
“As a manager, I try to model listening to new ideas and giving them a try, even if we’ve never done it that way before,” Gambon said. “What the youngest generation needs is opportunity. They come with boundless energy, new knowledge and enthusiasm.
“You just have to be aware of the qualities that need maturing and sometimes tweak them in that direction.”
Gambon likes to combine nurses from different generations who have various skills on projects. It opens up lines of communication and leads to unexpected, but effective outcomes, such as a year-old face-to-face shift reporting system that augments the electronic report.
“The system has nurses, assistants and even staff secretaries talking to each other more, and everyone wonders why we didn’t do it this way before,” she said. “Good communication is the best way to manage change and diversity, but it’s easier said than done. Each generation talks a different language and hears things differently.”
Gambon also deals with generational differences in patients. With new mothers often ranging in age from 16 to 48, her staff provides parental information on the Internet, through video and on a one-to-one basis.
With a goal of attracting more newly graduated nurses, North Fulton Regional Hospital in Roswell has adopted the Versant RN Residency program. With the guidance of the program’s national nursing experts and curriculum, hospital officials plan to hire and train seven to 10 new graduate nurses every six months.
“We have a lot of baby boomer nurses with high-level clinical experience in our community hospital, but to be forward-thinking, we knew we needed to engage the younger generation,” said Kathy Young, RN, BSN, CIC, chief nursing officer.
Driven by the knowledge that many baby boomers will retire in the next 10 years, North Fulton Regional Hospital officials are preparing younger nurses to take the helm.
New hires are assigned to mentors from across the hospital. They spend time learning in all departments and job shadow before taking on a new position.
“It’s a much more comprehensive orientation and grounding than new hires have received before, and [it is] designed to build relationships across generations and departments,” Young said. “The key concept for this program is respect. We all have strengths and weaknesses. When we recognize that and respect each other, we can learn from each other.”
North Fulton Regional’s nurse laddering program reinforces the idea that nursing requires continual learning.
“We encourage nurses to educate each other, to start hospital initiatives, serve on committees or do research,” Young said.
Creating an environment of respect and collegiality benefits hospital workers and helps patients, too.
“Teamwork is the cornerstone of quality care. When caregivers work cohesively as a team, it improves the comfort level and care of patients,” she said.