Millennials, Boomers, Gen Xers—Can They All Get Along?

Do Millennials act entitled? Are Baby Boomers old-fashioned? Nursing workforce demographics are changing. One St. Louis-based hospital has changed its practices to meet this younger generation's needs.

This is the first column in a two-part series on Millennials in the healthcare workforce.

Kids these days! Perhaps you've heard these words or maybe even said them yourself. I know I've been guilty of muttering them on occasion, and probably at some point in my life have had them said about me. It's nothing new. As long as there have been adults, there have been judgements made about the generations who follow in their footsteps.

In their youth, Baby Boomers were called hippies. Gen X (to which I belong) was labeled slackers. And today Gen Y, also known as Millennials, is often described as entitled.

As this last group—defined by the Pew Research Center as those ranging in age from 18 to 34 as of 2015—establishes itself in the nursing workforce, the differences between generations should start to become even more apparent, due in part to shifting demographics.

While the Baby Boomers have long been the dominant age-related group in the U.S, Millennials are projected to surpass them in number this year, reports the center. Gen X, which is a smaller cohort in general, will be sandwiched between the other two.

As the make-up of the working population shifts, the nursing profession will have to change as well. But will a multigenerational group with a reputation for eating its young be able to do this? Possibly, but it will require give and take from all groups involved.

Respect Your Elders

Incivility, lateral violence, and workplace bullying have been and continue to be problems in nursing. In fact, just last month the American Nurses Association set a zero tolerance policy for workplace violence and bullying.

Leslie Neal-Boylan, PhD, RN, dean and professor of the College of Nursing at the University of Wisconsin-Oshkosh and author of The Nurse's Reality Shift: Using History to Transform the Future, agrees that aggressive behavior towards colleagues is unacceptable, but she points out that it may, at times, stem from generational differences.

"There is absolutely no excuse for incivility no matter what," she says. "But I do think that part of this is because we have new graduates who are coming out of school who very often—and this does not go across the board—come out thinking they know everything they need to know and also expect immediate responses. This is the email/Twitter age."

That need for immediate information and lack of recognition of other's expertise may rub some experienced nurses the wrong way.

"We have to make sure that students who are graduating understand that they are entering a world that, in some ways, is old-fashioned," she says. "You have to earn respect, and you're not going to get it unless you show that you are willing to listen to those who are more experienced and you're willing to learn and do your homework."

For example, a major Millennial faux pas is expecting other nurses to give you an answer to a question without first trying to find the solution on your own. Given the pace of today's nursing units, such hand-holding, for lack of a better word, may feel like a burden to other busy nurses.

"There's a need to be respectful and not expect that everybody is going to wait on you hand and foot when [they've] got seven patients to take care of," Neal-Boylan says.

New Nurses' Needs

While nursing, and healthcare in general, may have old-fashioned standards (for an excellent example, read the column of my colleague Lena J. Weiner on dress codes), that doesn't mean organizations have to be sticks-in-the-mud and not change to meet some Millennial preferences.

"They come in here, they know what they want, they know how they want it," says Kathy Bonser, MS, RN, vice president and chief nursing officer at SSM Health DePaul Hospital in St. Louis. "They have an expectation that they will hear from leadership and be involved."

Feedback from new hires led SSM DePaul to retool its onboarding practices in June, says Bonser.

"They want feedback and they want a lot of it," she says. "So our onboarding has changed in that we've created a path for our leaders to follow."

SSM DePaul now clearly lays out the frequency with which managers must meet with newly hired new graduate nurses.

"The first three months, six months, at those 30-, 60-, 90-day touchpoints and even out to that first year, you're constantly giving them feedback," she says.

Bonser, who herself is a Baby Boomer, says the organization has also reassessed its communication techniques with the Millennial cohort of nurses.

"They like text messaging," she says. "For me, I want to pick up the phone, I want to talk to somebody, or go see them in person. But these kids, they won't answer the phone, but they'll text you back and forth in a heartbeat."

To support this communication style, SSM DePaul now provides leaders with a cellphone stipend because they were using their personal devices to connect with the staff.

Bonser has made a commitment to create a workplace that supports Millennials. In June, the organization hired 54 new graduates, and she wants to hire 50 more this month, she says.

While changing communication styles may seem like a lot of effort to some, Bonser says adapting to generational needs is just part of being a leader.

"I don't know if [Millennials'] expectations are unrealistic; I think their expectations are what they know," Bonser says. "Our job is to figure out who's working for us, what they need, and [give that to them] within the limits of what we can actually provide."