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How to understand and teach a multigenerational nursing work force

Baby boomer nurses remember when no one had heard of AIDS. Nurses from the World War II era recall having to stand when a physician entered the room. With so many varied life experiences brought to the bedside, hospitals are finding it increasingly important to understand the workings of a multigenerational work force.

"Generational diversity is the new diversity," says Brandi M. Hamlin, MSN, RN, nurse manager of the mother/baby unit at Northeast Medical Center in Concord, NC. "And any time you deal with issues of diversity awareness, there will be a better understand ing and appreciation of differences."

So which one am I?

The first step for any educator is to recognize the different generations and their characteristics. The members are linked by similar life experiences through their developing years, says G. Rumay Alexander, EdD, RN, clinical associate professor and director of multicultural affairs in the school of nursing at the University of North Carolina at Chapel Hill.

"Each generation has its own culture, and being aware of differences is the first step in managing a multi-age work force," says Alexander.

There are four generations outlined by Hamlin and Alexander that make up the nursing work force:

  • Traditionalists. Also known as "silents" or "World War II" nurses, members of this generation were typically born between 1922 and 1943. Encompassing traditional American values, these nurses are big on loyalty, respect, and obedience.

    "From growing up during World War II and the Depression, they have the view that 'If you don't have the money, don't buy it,'" says Hamlin.

  • Baby boomers. Typically born between 1944 and 1960, these nurses are characterized as competitive and optimistic. As they grew up in a time when the country was affluent, they are often motivated for a large paycheck and the corner office; thus, they are willing to put in long hours at work.

    Growing up during the social upheaval of the Viet nam War and Watergate caused boomers to question traditional authority structures, says Alexander.

    "What boomers saw clearly was the vulnerability of authority," she says. "They have been reluctant to accept formal authority since then. They have made vigorous attempts to push systems toward their ideas."

  • Generation X. These nurses, largely born between 1961 and 1980, are a small but independent group characterized as both skeptical and wary of authority. They believe in a fun workplace and will not often sacrifice their time and freedom for money.

    "Their loyalty is to themselves," says Alexander. "With a childhood marked by economic uncertainty, they look for people to train them to get ready for the next job."

  • Generation Y. Also dubbed "Millenials," members of this group are characterized as having "bits and pieces" of the other groups. Born after 1980, they are often realistic and, like traditionalists, tend to be loyal. But they often intimidate older workers, as they are technologically savvy and state what's on their minds.

    "They ask a lot of questions and get very frank answers when older generations are taken aback," says Hamlin. "They also speak up when they do not see the value of an organizational rule or practice."

    Bumping heads: Where conflict can arise

    With such varied experiences, discord among staff members of different generations is likely to occur.

    According to "Workplace adjustment and intergenerational differences between Matures, Boomers, and Xers," an article in Nursing Economic$, workplace stress from generational conflict can manifest itself in increased turnover rates and absenteeism, as well as "faulty products and negative behaviors." Thus, being aware of possible conflicts is crucial.

    The biggest collision, says Hamlin, is likely to be between baby boomers and generation Xers.

    "This is the parent and the child," she says. "They have conflict around work ethic. Boomers think Xers are unmotivated and spend too much time online. But the Xers grew up when the Internet is how you learned."

    A similar conflict can arise between traditionalists and generation Xers, says Hamlin.

    Although traditionalists do not usually believe in a fun workplace, Xers like to have fun while on the clock.

    Teaching to the different groups

    Even though a nursing work force consisting of many generations affects all hospital workers, educators must be acutely aware of the differences.

    The most important thing, says Alexander, is to avoid a one-size-fits-all mentality-even when it comes to teaching to one generation.

    "It's really, really important for people to get to know everyone as an individual, even within generations," she says. "There are variations. And the traits that are assigned to a generation are only one tool in a complex, rapidly changing marketplace."

    Keep these general tips in mind when teaching to different generations, as outlined in A Practical Guide to Managing the Multigenerational Workforce: Skills for Nurse Managers:

  • For traditionalists, make sure that the setting is comfortable and that sessions are not combative or argumentative, but rather analytical and inclusive.
  • Baby boomers often prefer a class that is time-efficient, highly ethical, and visionary.
  • Gen Xers also tend to like sessions that cut to the chase. They enjoy classes that make full use of technology and enjoy individually formatted exercises.
  • Members of generation Y often hope for a session that's fun and includes physical movement.

    Another step toward teaching in a generationally diverse classroom is to remember that staff members can find the common goal of a good patient outcome. Managers should examine their policies and practices and ask how each generation would view each one, says Alexander. Communication guidelines, recruiting techniques, and benefit plans should all be "assessed in terms of the workforce and the values that they embrace, within the generations," she says. "Otherwise, you're going to miss where someone feels advantaged and someone feels disadvantaged. Treating everyone the same isn't treating everyone equal."


    Cox, K. and Santos, S.R. (2000). "Workplace adjustment and intergenerational differences between Matures, Boomers, and Xers," Nursing Economic$ 18(1): 7-13.

    Lower, J. (2006). A Practical Guide to Managing the Multigenerational Workforce. Marblehead, MA: HCPro, Inc.