Additional Questions & Answers

Question: Regarding the slide on favorable attitudes toward leadership, Baby Boomers indicated relatively low agreement with the statement that their leaders support their professional development. My question is whether the survey collected data on the age of each nurse's leaders. I ask because I wonder if Baby Boomer nurses who are managed by Millennials regard their management less favorably than do Baby Boomers who are managed by people in their own age cohort as a result of Millennials having less experience in the workforce, their roles, and in leadership positions than the Baby Boomers whom they manage.

Answer: That is a very interesting question. Unfortunately, we did not gather that information. We do have the ages of the nurse respondents, but we did not ask the age of their leaders. I’m going to take a note because I think your comments around this are important and might be good to tease out in the future. That’s one of the great things about getting your feedback. We can improve on the questions asked in our survey to get the info that you really need.

Question: The survey mentioned that Millennial nurses place a higher value on professional development opportunities than their peers. Do you have any thoughts on why this is the case?

Answer: Our survey and other surveys are showing this trend. It’s a particular trait of Millennials that they want professional development. I think that Millennials believe that professional development must be an integral part of a job, whereas other generations hold more traditional views of a job, i.e., it’s a way to earn a living, support their families, and do something fulfilling – in that order. I also think that this reflects that Millennials see their leaders more as coaches than bosses. So, professional development is about getting to that next level in their skills and learning new and different things. And it’s not just about the hard skills; professional development is also about soft skills such as communication and teamwork. I’m seeing the necessity of professional development coming up in survey after survey. It’s really important that we pay attention to Millennials’ desire for these opportunities.

Question: What are hospitals doing to encourage Millennial nurses to stay at the bedside?

Answer: As a national company, we talk with nursing leaders across the country and hear about interesting things people are doing. They include new graduate residency programs targeting Millennial nurses. Contrary to typical approaches, this particular program placed new grads in float pools and gradually introduced them to different units to gain the experience they need, along with thorough residency training throughout. The retention of the Millennials, within those cohorts, increased dramatically after putting them through new grad residency.

Residency programs of all types are critically important in helping new Millennial nurses to acclimate in their new roles.

Our survey can also provide ideas about what works. For example, it’s clear Millennials are looking for desirable work environments that include transparency – how transparent are you with your organization’s strategies and goals and how do you tie that to the bedside? How transparent are you in terms of your quality metrics? Do you have a positive culture and supportive leadership? These are the kinds of things Millennial nurses indicated they want. So, lining up programs and strategies that can provide what Millennials are looking for will help your organization retain these nurses.

Question: We typically shy away from travel nurses but have had no choice this past year with recruiting challenges. Do we need to re-think the use/value of travel nurses in the workforce?

Answer: The short answer is “yes.” Let me talk more about why. The strategic use of travel nurses is important to allow organizations to meet a wide variety of critical needs. It also makes sense from a quality and economic standpoint. Many studies now show that travel nurses and staff nurses are more or less equal in terms of cost and quality, with some studies showing that travel nurses are actually less expensive if you include full employer costs for staff nurses. In fact, the quantity and quality of research showing parity between staff nurses and temporary nurses is indisputable. I can send you the research if you’re interested. Travel nurses also can help you in other ways, such as providing key support during an EMR implementation or upgrade so you can avoid efficiency declines that can impact patient care and high overtime and premium time costs. The same is true for when you have to cover leaves, seasonal high census counts and other short-term challenges.

Question: As a Millennial currently in a leadership position, I find it more difficult to connect with those individuals considered in the "Baby boomer" demographic. What are some key strategies or initiatives you have observed to help combat this?

Answer: The survey did not target that question, in terms of providing a solution to this kind of cross-generational gap that you’re describing. In any difference in outlook among colleagues, particularly something as intrinsic as generational attitudes created through lifelong experiences, I would recommend keeping an open mind to the way other people think and feel.

Question: Is there a conversation occurring with Schools of Nursing of how to transition the career goal/mind set towards a point of care nurse vs. an advanced practice nurse? How are they helping hospitals with this gap that is growing?

Answer: We hear consistently about the preparation gaps that exist today with the shift of more care to the home, and the historical academic preparation that is targeted at acute care. Many of our hospital colleagues are in conversations with their academic peers (typically CNO to Dean) to better understand how the schools can provide academic preparation that better fits with the needs of today. However, the problem is not easily solved and will take considerable conversation and deliberation to resolve. Advanced Practice opportunities are growing and will continue to do so in the coming years. With the Millennial desire for career advancement, Advanced Practice nursing is an ideal fit. Balancing the needs of nurses at the bedside in acute care with the growing needs of Advanced Practice Nurses to fill the gaps left by reduced numbers of primary care physicians is absolutely necessary.

Question: RE: The EMR.... Do you think the reliance on that tool negatively impacts patient the new nurse does not engage and use clinical judgment outside of the EMR to support holistic care?

Answer: A: The survey shows that most nurses see the use of EMRs as a positive, rather than a negative, in patient care. Millennials scored higher than other generations. I don’t think using EMRs limits the ability of nurses to use clinical judgment. Rather, it helps them make better, more informed decisions.

Question: It seems that much of this information (in the Millennial survey) would apply to anyone "new" to a workforce. Simply a matter of being relatively younger than others. How much of this do you attribute to their "newness" and how much to their generation? In other words, will these data change once Millennials have been in the workforce for a little more time and "settle down." Would the data have looked the same for Gen X or Boomers many years ago when they entered the workforce?

Answer: I think every generation is unique in some respects due to changing societal influences. Baby Boomers, for instance, were raised in the post-World War II era, which had many differences from a societal perspective than the 1980s and 1990s, when Millennials were growing up. Much has been written about Millennial attitudes toward things like career advancement, lifestyle, social consciousness and other factors. These attitudes differ from those of Gen X and, Baby Boomers, and I believe are unique to Millennials. Will their attitudes change over time? That remains to be seen.

Question: Can you talk more about how half of older generations don't like their leadership or DO like leadership?

Answer: The survey showed that Millennials more often said they “agree” or “strongly agree” regarding positive statements about their leaders than their older counterparts:

  • “My leader is someone that I trust” – 61% Millennials; 51% Gen X; and 51% Baby Boomers.
  • “My leader is very good at what they do” – 60% Millennials; 52% Gen X; and 53% Baby Boomers.
  • “My leader cares about me as a person” – 58% Millennials; 49% Gen X; and 51% Baby Boomers.
  • “My leader supports my career development” – 61% Millennials; 49% Gen X; and 47% Baby Boomers

As you can see in the data, Baby Boomer nurses were split nearly down the middle regarding how supported they feel by leadership. This means there is room for improvement, which offers an important opportunity for healthcare organizations. Ensuring that all their nurses feel cared about and supported by leaders will help to ensure a positive and satisfied nursing workforce.

Question: Considering the substantial growth of the Millennials in the workforce, do you expect that their progressive attitudes about career development will change national benchmarks for turnover in nursing?

Answer: That depends on how leadership responds to the needs of Millennials. As things stand right now, I think we’ll see a reduction in the average length of job tenures as Millennials more readily switch jobs to better their situation and advance their careers. However, if leaders focus their attention on the results of surveys like ours, and listen to their Millennial nurses and other workers, and then take effective action, I think that retention can improve.

Question: With Millennial's changing jobs so frequently, what is their plan for retirement if they are not staying at a job long enough to be vested?

Answer: Our survey does not have data on that question. But, I think that as Millennials advance through their careers, they’ll reach a position level and an age where retirement planning becomes very important. It happens to all of us.

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