Multigenerational workforce issues and their implications for leadership in nursing

Bridging the generational gap between nurses and nurse managers: a qualitative study from Qatar

BACKGROUND

The nursing workforce comprises multiple generations, each with unique values, beliefs, and expectations that can influence communication, work ethic, and professional relationships. In Qatar, the generational gap between nurses and nurse managers poses challenges to effective communication and teamwork, impacting job satisfaction and patient outcomes.

AIM

This study investigates the generational gap between nurses and nurse managers in Qatar, aiming to identify strategies to enhance collaboration and create a positive work environment.

METHODS

A qualitative research design was used, involving semi-structured interviews with 20 participants, including frontline nurses and senior nurse managers. Participants were purposively sampled to represent different generations. Data were collected through face-to-face and virtual interviews, then transcribed and thematically analyzed.

FINDINGS

Four key themes emerged: Optimizing the Work Environment: Older generations preferred transformational and situational leadership, while younger nurses valued respect, teamwork, accountability, and professionalism. Strengthening Work Atmosphere through Communication and values: Older nurses favored face-to-face communication, while younger nurses preferred digital tools. Cultivating Respect and Empathy: Younger nurses emphasized fairness in assignments and promotions, while older nurses focused on empathy and understanding. Dynamic Enhancement of Healthcare Systems: Younger nurses were more adaptable to technology and professional development, while older nurses prioritized clinical care and patient outcomes.

CONCLUSION

The study reveals significant generational differences in leadership preferences, communication styles, and adaptability to technology. Addressing these gaps through effective leadership, ongoing education, and open communication can improve job satisfaction and patient care.

Differences in occupational values, communication types, job satisfaction, and organisational commitment among clinical nurses across generations

Introduction

This study examined occupational values, communication types, job satisfaction, and organisational commitment among clinical nurses across generations.

Methods

Participants were 159 clinical nurses. Data were collected from 1 to 15 August, 2022, using a self-reported questionnaire.

Results

Statistically significant differences were observed across generations in terms of job satisfaction (F = 3.492, p = 0.03) and organisational commitment (F = 4.371, p = 0.01). However, there were no differences in occupational values (F = 0.765, p = 0.47) or communication types (F = 1.744, p = 0.18) among clinical nurses across generations. There was a moderate to strong positive correlation between job satisfaction and organisational commitment across all generations, and a moderate positive correlation between job satisfaction and occupational values among Generations Y and Z.

Discussion

To improve the quality of nursing care, various intervention programs based on the generational gap among clinical nurses need to be developed, to reduce conflicts, and ultimately establishing the necessary systems through mutual understanding of education.

Nursing Leadership Roles and Its Influence on the Millennial Psychiatric Nurses' Job Satisfaction and Intent to Leave

BACKGROUND

There is an increasing need for millennial psychiatric nurses in health care. Nurses' levels of satisfaction with their manager's leadership styles are critical to their remaining in the profession.

AIM

To explore the relationship between the roles of nursing leadership and their influence on the millennial psychiatric nurse's level of job satisfaction and intent to leave.

METHOD

Eighty-three psychiatric registered nurses between the ages of 22 and 37 with 6 months or more experience completed a Managerial Skills and Job Satisfaction Survey questionnaire.

RESULTS

The millennial psychiatric nurse who perceived their managers to display the roles in being a mentor (M = 24.95, SD = 2.81), director (M = 23.08, SD = 2.55), and monitor (M = 22.71, SD = 2.51) had higher job satisfaction and would be less likely to leave the specialty, current position, and organization.

CONCLUSION

The study revealed that nursing leaders need to focus on strengthening the monitor and mentor roles and work on changing from having a coordinator role to the director role.

Healthcare managers’ competence in knowledge management: a scoping review

Aim

Background

Evaluation

Key issues

Conclusion

Implications for Nursing Management

‘You live and breathe it…’: Exploring experiences of workplace cyberbullying among New Zealand nurses

Cyberbullying presents a new workplace issue with initial research demonstrating strong links to negative outcomes for individuals and organisations across a range of sectors. Yet, detailed accounts of target experiences of cyberbullying remain largely unexamined. To address this crucial research gap, this study explores nurses' experiences of workplace cyberbullying – a profession with high rates of workplace bullying. Adopting a work environment perspective, this paper provides an in-depth examination of eight cases of workplace cyberbullying that emphasise the practical and theoretical complexities associated with this emerging workplace hazard. Specifically, workplace cyberbullying is often experienced within a broader pattern of bullying behaviours, leading to a potentially wider scope of harm for those involved. A new typology of cyberbullying based on the source of perpetration is also presented that contributes to our growing understanding of the issue while extending the knowledge base for the effective management of workplace cyberbullying.

Contextual Barriers of Respectful Workplace in Nursing: A Focused Ethnography

Background:

Respectful relationship among nurses is an important influencing factor of positive work environment and nursing outcomes. Disrespectful interpersonal behaviors set the scene for an unpleasant and unhealthy workplace in nursing. This can be harmful to persons and their organization and affect health care outcomes. This study was designed in order to search for contextual barriers to respectful behaviors in the context of nursing.

Materials and Methods:

This study was a focused ethnography that was carried out in medical-surgical wards of Shahid Chamran Hospital in Isfahan in 2018-2019. The data collection method consisted of 140 h of participant observation and semi-structured interviews with 34 informants. The nformants comprised 29 nurses, 2 assistant nurses, a physician, and 2 patients who were selected by purposive sampling. The first author of the study made direct observations as an outsider. The data were analyzed by Spradley's method.

Results:

Three main categories and eight subcategories were obtained from data analysis that are as follows: 1) Personal self: challenges of perceived respect (negative self-concept, unpleasant feelings, and ineffective communication), 2) Organizational-based perceived disrespect (poor organizational climate, inadequate job condition, restrictive organizational structure), 3) Social self: challenges of showed respect (implicit social norms, cultural gap).

Conclusions:

Individual and social attitudes, interactive communication, and organizational factors are the contextual determinants of a respectful workplace in nursing. Consequently, improving self-concept and effective communication skills as well as adjust organizational conditions and value conceptualization in society may effect a respectful workplace in nursing.

Analysis of Self- and 360-Evaluation Scores of the Professionalism Intelligence Model Within an Academic Otolaryngology-Head and Neck Surgery Department

Purpose

To analyze self and 360-evaluation scores of the professionalism intelligence model domains within an academic Otolaryngology-Head and Neck Surgery Department.

Methods

A leadership course was introduced within the Department of Head and Neck Surgery & Communication Sciences at Duke University Medical Center. A 360 evaluation assessing domains of the professional intelligence model was recorded for all participants. Participant demographics included gender (male vs female), generation group (generation Y vs older generations) and physician status of participants (physician vs non-physician). Differences in mean self-scores were modeled using linear regression. When analyzing the evaluator scores, gaps were defined as self-score minus evaluator-score for each member of a participant’s evaluator groupings (supervisor, peer, and direct report). Two types of linear mixed models were fit with a random intercept to account for the correlated gaps in the same participant.

Results

Scores of 50 participants and 394 evaluators were analyzed. The average age was 40.6 (standard deviation 9.3) years, and 50% (N=25) of participants were females. Physicians accounted for 36% (N=18) of the cohort, and 61% (N=11) of physicians were residents. Physicians scored themselves lower than non-physicians when assessing leadership intelligence, interpersonal relations, empathy, and focused thinking. On average, participants under-rated themselves compared to their evaluators with direct reports giving higher scores than managers and peers. When compared with generation Y, older generations tended to rate themselves lower than their peers and managers in cognitive intelligence. No significant association was observed between gender and any scores.

Conclusion

Participants rate themselves lower on average than their evaluators. This work is important in understanding how perceived leadership qualities are assessed and developed within an academic surgical department. Finally, the results presented could serve as a model to address the gap between self- and other-perceptions of defined leadership virtues in future leadership development activities.

Racing to a staffing solution: an investigation into the current staffing crisis within the UK horseracing industry

The British Horseracing Industry has been experiencing a labour shortage since the 1970’s and despite recent improvements reported in staff retainment, the industry still reports high staff turnover. We investigated staffing challenges experienced by UK horseracing employers and employees, to formulate strategic targets to address any issues identified. Thirty UK trainers and staff (12 staff, 9 senior staff, 9 trainers) participated in semi-structured inductive focus groups lasting on average 39±9 min. Questions explored staff background in racing, perceptions of the current staff challenges, retention and recommendations for improvement. Thematic analysis revealed four higher order themes; (1) lack of skills, (2) differences in perceived work ethic, (3) job conditions, and (4) media portrayal. This study concluded that there are dedicated staff working in the industry, but significant skills gaps, high workloads, poor work-life balance and a lack of training and career progression negatively influence retention in the horseracing industry.

Measuring work engagement in a multigenerational nursing workforce

AIM

To examine the level of work engagement among Veteran-aged, Baby Boomer, Generation X, (Gen X) and Millennial registered nurses.

BACKGROUND

Workforce engagement plays a critical role in health care organisations. Organisations with a highly engaged nursing workforce outperform those organisations that have disengaged or non-engaged employees.

METHOD

Quantitative non-experimental causal comparative study measured multigenerational nurses' level of work engagement.

RESULTS

Veteran-aged nurses were the most engaged, followed by Baby Boomer, Gen X and Millennial. The sample scored highest on dedication and lowest on vigour. Veterans and Baby Boomer nurses were statistically different than Gen X and Millennial nurses in their level of engagement. There were no statistical differences between Veteran and Baby Boomers and between Gen X and Millennials in their level of engagement.

CONCLUSIONS

Gen X and Millennial RNs scored lowest on level of engagement and are statistically similar in their level of disengagement.

IMPLICATION FOR NURSING MANAGEMENT

Nurse managers must prioritize engagement strategies as a core function of their leadership role. It is essential that leaders cultivate an employee engagement culture across a multigenerational workforce. Nurse leaders should take full advantage of the experience of the retiring generations to mentor and transfer critical knowledge to the Gen X and Millennial nurses.

The SHAPE Framework: Empowering Millennials to Lead the Future of Health Care

Members of Generation Y (or Millennials) now make up more than 50% of those in the workplace. They are expected to comprise greater than 75% by 2025. The Millennial generation has brought new idiosyncrasies to the workplace, and most literature has focused on ways to manage these differences. The Baby Boom generation is retiring at an increasing pace, leaving ongoing leadership needs in the care of Millennials. Conversations must now shift from how to lead the Millennials to preparing them to lead others. The SHAPE framework highlights some of the idiosyncrasies of this generation and ways they can be leveraged when approaching the challenges of health care today.

Perceptions of future hospital management in Finland

PURPOSE

The purpose of this paper is to describe how Finnish experts perceive future (year 2030) hospital management and leadership.

DESIGN/METHODOLOGY/APPROACH

A total of 33 experts participated in a three-round Argument Delphi process. Opposing views of management and leadership in 2030 were analyzed using inductive content analysis.

FINDINGS

The experts' perceptions were divided into two main categories: management and leadership orientation and future organization. Perceptions relating to management and leadership orientation were classified as relating to patient-centred, clinical dominance, professionally divided and management career options. Perceptions relating to future management and leadership organization were classified as representing shared, pair, team and the individual-centered leadership. The results highlighted the most distinctive issues raised by the participants.

RESEARCH LIMITATIONS/IMPLICATIONS

This qualitative study was conducted in the context of Finnish healthcare according to the principles of the Argument Delphi Method. The panel consisted of high-level experts representing a diverse set of roles. However, as suggested in previous literature, these experts may not be the most astute in predicting the future development of hospital organizations.

PRACTICAL IMPLICATIONS

The findings can be used to develop and renew management and leadership training and management practices in hospitals.

SOCIAL IMPLICATIONS

The findings can be exploited in discussions, planning and decision making regarding future management and leadership in hospitals.

ORIGINALITY/VALUE

Only a few studies have investigated perceptions of future management in hospitals. This study adopted the Argument Delphi Method to identify distinct perceptions on the future orientation and organization of management and leadership in hospitals.

Genetic counselor workforce generational diversity: Millennials to Baby Boomers

There are currently three generations of individuals that make up the genetic counselor workforce: Baby-Boomers, Generation X, and Millennials. These generations are presumed to be shaped by the historical, cultural, and social events that occurred during critical developmental periods. Understanding the underlying perceptions and viewpoints of genetic counselors regarding the multigenerational workforce may facilitate successful working relationships as well as recognition of the perceived unique characteristics that each generation offers. An online survey was distributed to practicing genetics counselors (GC) and genetic counseling students through the National Society of Genetic Counselors and the American Board of Genetic Counseling to elicit opinions about the perceived characteristics or skills of genetic counselors in each generation. Respondents (n = 407, estimated 10% response) preferentially assigned certain traits or skills to specific generations including their own. Findings suggest GC Baby Boomers were least likely to be described as "comfortable with phone or skype counseling" (p < 0.0001), Millennial GC, were least often assigned the term "Strong respect for authority" (p < 0.0005) and Generation X GC were most likely to be described as "Does not ask for feedback" (p < 0.05). These research findings demonstrate that GC perceive that their colleagues from every generation have unique attributes to bring to the profession and these attributes match those typically described in the U.S. literature about non-GC cohorts.

Reimagine Health Care Leadership, Challenges and Opportunities in the 21st Century

PURPOSE

This paper spotlights human capital management, digital technology, and costs control as issues that healthcare leaders will face in redesigning the health care ecosystem in the 21st century.

DESIGN

The paper was designed to highlight the attributes that make effective leaders. It addresses how nursing leadership can take a lead to redesign the 21st Century health care system, supported by case examples.

METHODS

An expansive literature review was done using MEDLINE, SAGE, Google Scholar, and University of California San Diego Library Catalogs. The selections criteria include recent publications in English within and outside the healthcare industry.

FINDINGS

Health leadership is viewed as paramount to productivity, capacity and meeting new challenges.

CONCLUSIONS

Effective nursing leadership in a healthcare organization correlates with staff job satisfaction, retention, turnover and quality of care. Nursing leadership development must be supported by appropriate level of educational preparedness, and requisite set of competencies and skills.

Management and leadership competence in hospitals: a systematic literature review

Purpose

– The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital environment. Health-care leaders and managers in this study were both nursing and physician managers. Competence was assessed by evaluating the knowledge, skills, attitudes and abilities that enable management and leadership tasks.

Design/methodology/approach

– A systematic literature review was performed to find articles that identify and describe the characteristics of management and leadership competence. Searches of electronic databases were conducted using set criteria for article selection. Altogether, 13 papers underwent an inductive content analysis.

Findings

– The characteristics of management and leadership competence were categorized into the following groups: health-care-context-related, operational and general.

Research limitations/implications

– One limitation of the study is that only 13 articles were found in the literature regarding the characteristics of management and leadership competence. However, the search terms were relevant, and the search process was endorsed by an information specialist. The study findings imply the need to shift away from the individual approach to leadership and management competence. Management and leadership need to be assessed more frequently from a holistic perspective, and not merely on the basis of position in the organizational hierarchy or of profession in health care.

Originality/value

– The authors’ evaluation of the characteristics of management and leadership competence without a concentrated profession-based approach is original.

Enabling professional development in mental health nursing: the role of clinical leadership

Clinical leadership is acknowledged as important to the nursing profession. While studies continue to identify its significance in contributing to positive outcomes for consumers, the role that clinical leadership has in enabling and supporting professional development in mental health nursing is poorly understood. This study utilized a grounded theory methodology to explore the characteristics clinicians consider important for clinical leadership and its significance for mental health nursing in day-to-day clinical practice. Individual face-to-face, semi-structured interviews were conducted with nurses working in mental health settings. Participants described the important role that clinical leaders play in enabling professional development of others through role modelling and clinical teaching. They describe how nurses, whom they perceive as clinical leaders, use role modelling and clinical teaching to influence the professional development of nursing staff and undergraduate nursing students. Attributes such as professionalism and honesty were seen, by participants, as enablers for clinical leaders in effectively and positively supporting the professional development of junior staff and undergraduate nurses in mental health nursing. This paper examines clinical leadership from the perspective of mental health nurses delivering care, and highlights the important role of clinical leaders in supporting professional development in mental health nursing.

Social Interaction and Collaboration among Oncology Nurses

Collaboration is a complex process influenced by organizational, professional, interpersonal, and personal factors. Research has demonstrated that collaboration may also be influenced by social factors. Nurses spend much of their time working in collaborative teams, yet little is known about how they socially interact in practice. This qualitative case study explored nurse perceptions of social interaction in relation to collaboration. Data were collected using telephone interviews and documentary reviews from fourteen oncology nurses employed at one cancer center in Canada. Thematic analysis revealed two themes: knowing you is trusting you and formal and informal opportunities. Nurses reported that social interaction meant getting to know someone personally as well as professionally. Social interaction was enacted inside of work during breaks/meals and outside of work at planned events. Social interaction was facilitated by having a long-term current and/or previous professional and personal relationship. The barriers to social interaction included a lack of time to get to know each other, workload issues, and poor interpersonal skills. Findings suggest that social interaction is an important factor in the collaborative relationship among oncology nurses. Nurse leaders need to promote social interaction opportunities and facilitate educational sessions to improve social and interpersonal skills.

Antecedents of the expectation of remaining in nursing until retirement age

AIMS

To identify job-related resources which strengthen nurses' expectation of remaining in the same job until retirement age.

BACKGROUND

The dramatic shortage of qualified nurses in industrialized countries makes it necessary to take steps to retain nurses at work at all career stages. The study introduces to the nursing literature the construct 'expectation of remaining in the same job until retirement age' as an early indicator of attitudes responsible for employees leaving the job prematurely.

DESIGN

Longitudinal questionnaire survey.

METHODS

In 2010, a longitudinal study was carried out and data were collected from 387 nurses aged 21-63 years. To ensure predictive validity, the dependent variable was assessed again in 2011 after a time lag of 6 months. Data were analysed applying multiple regression analyses.

FINDINGS

The expectation of remaining in the same job until retirement age is positively related to work-time control, role clarity and colleague support. Supervisor support exerts an indirect effect via job resources. Vitality partially mediates the relationship between job resources and the expectation of remaining in the same job until retirement age. Most importantly, as hypothesized, the analysed relationships are different for younger (<30 years), middle-aged (30-50 years) and older (>50 years) nurses.

CONCLUSION

Our findings suggest that interventions that seek to retain nurses should promote different job resources along the working life span to strengthen nurses' vitality in all age groups. Future research should apply age-differentiated measures to unveil work conditions that improve the retention of nurses.

Clinical leadership in mental health nursing: the importance of a calm and confident approach

PURPOSE

Explore the perceptions of nurses working in mental health of effective clinical leadership.

DESIGN AND METHODS

In-depth interviews were conducted with registered nurses employed in a mental health setting. Qualitative research using grounded theory.

FINDINGS

Remaining calm and confident in times of crisis and uncertainty was identified as one attribute of clinical leadership. Participants noted clinical leaders' demeanor during stressful or crisis situations, and their ability to manage unpredictable or unexpected clinical situations as contributing positively to clinical practice.

PRACTICE IMPLICATIONS

Understanding these characteristics and how they can influence positive outcomes for clients is crucial in addressing the recruitment and retention challenges for the nursing workforce.

Knowing Generation Y: a new generation of nurses in practice

Generation Y is commonly defined as those people born between 1980 and 2000, now aged in their 20s and 30s. Their grandparents experienced post-World War II reconstruction, their parents the economic boom of the 1980s. There are currently 81 million individuals in the Generation Y cohort in the USA, making it the second-largest, and possibly most influential, cohort since World War II (Manion, 2009). Members of Generation Y are diverse, technologically advanced and vocal about their opinions. They tend to resist traditional hierarchy, want recognition/reward for achievements and distrust institutions. Knowing these characteristics is useful for nurse managers, preceptors and team members working with members of Generation Y. Studies have proven that Generation Y is challenging the nursing workforce through rapid turnover (Cogin, 2012). This article explores a theoretical model that predicts retention and/or turnover of nurses in light of Generation Y behaviours and motivators-for example, moving from agency to agency rather than devoting many years to a single practice. Further research is needed to find out whether these behaviours and motivators are unique to Generation Y alone.

The importance of communication for clinical leaders in mental health nursing: the perspective of nurses working in mental health

Communication has been identified as an important attribute of clinical leadership in nursing. However, there is a paucity of research on its relevance in mental health nursing. This article presents the findings of a grounded theory informed study exploring the attributes and characteristics required for effective clinical leadership in mental health nursing, specifically the views of nurses working in mental health about the importance of effective communication in day to day clinical leadership. In-depth interviews were conducted to gain insight into the participants' experiences and views on clinical leadership in mental health nursing. The data that emerged from these interviews were constantly compared and reviewed, ensuring that any themes that emerged were based on the participants' own experiences and views. Participants recognized that effective communication was one of the attributes of effective clinical leadership and they considered communication as essential for successful working relationships and improved learning experiences for junior staff and students in mental health nursing. Four main themes emerged: choice of language; relationships; nonverbal communication, and listening and relevance. Participants identified that clinical leadership in mental health nursing requires effective communication skills, which enables the development of effective working relationships with others that allows them to contribute to the retention of staff, improved outcomes for clients, and the development of the profession.

Using a train-the-trainer model to prepare educators for simulation instruction

Staff development departments are challenged with addressing the entry of new graduates into the work force, updating the competencies of practicing nurses, and providing nurses with educational support to reduce turnover. Knowing how to develop simulations, integrate them into teaching, and effectively assess simulated performance is becoming a core role for educators in health care. For many educators, a knowledge and skill gap exists between the demand for simulation and competence in developing and using simulation. This article shares a cost-effective, three-step train-the-trainer model to prepare nurse educators to use simulation effectively. The three steps include champion identification, champion development, and champion integration. Strategies for addressing the challenges and lessons learned in implementing this model are outlined. The model is an effective and efficient approach for developing a core of champions in any topic area. These champions can then mentor and train others throughout the organization.

The Effect of Manager Exclusion on Nurse Turnover Intention and Care Quality

Little is known about how exclusionary practices (i.e., ignored, ostracized) by managers differ across demographics and influence nursing outcomes. This study examines whether managerial exclusion varies by generation, race, and gender, and the extent to which these variables, in turn, relate to turnover intention and perceived patient care among a sample of 747 nurses working in hospitals in a midwestern health system. Exclusion did not differ across most demographic groups, though men reported less exclusion than women. Younger nurses of the Millennial generation, those feeling excluded, and those with fewer years of experience reported lower quality patient care. Managerial exclusion, being a nurse of color, and less experience were associated with stronger intentions to leave. Nursing leaders should attend to factors that may contribute to racial minorities seeking other jobs, diminish younger nurses’ ability to provide high-quality care, and minimize practices that might lead nurses to feel excluded.

Expectations of millennial nurse graduates transitioning into practice

AIMS

Identified as Millennials, nurses born after 1980 are anticipated to redefine the employer-employee relationship as one based on the employee's wants and needs. The purpose of this study is to portray the expectations of Millennial student nurses immediately before graduation. Understanding these expectations may provide insight for leaders who are responsible for crafting a successful transition experience. Successful transition and decreased turnover are important elements of cost management for the nursing enterprise.

METHODS/SUBJECTS

A qualitative descriptive design was used to collect data from 14 students enrolled in a traditional BSN academic nursing program approximately 2 months prior to graduation. Upon completion of private, confidential semistructured interviews, data were transcribed, coded, and analyzed. Demographic data were compiled and interview data summarized according to identified themes.

RESULTS/CONCLUSIONS

Three overarching themes emerged: the expectation that transition would be stressful, the expectation that there would be a safety net of support, and the expectation to be valued and respected as a professional. Revealing was the expectation of supportive relationships and a collaborative approach to patient care. Failure to meet those expectations may result in turnover as Millennials seek opportunities that meet their expectations.

Israeli registered nurse workforce

This commentary on the article by Nirel, Riba, Reicher and Toren, "Registered nurses in Israel - workforce employment characteristics and projected supply", describes major findings from this important Israeli study and links findings to other nursing workforce studies worldwide. Israeli projections include a 25% decrease in RNs in the workforce by 2028; the greater likelihood of leaving the progression of young nurses compared to older nurses, and the greater likelihood of leaving the profession by those nurses with no advanced training. Suggestions are made for future workforce analysis to triangulate economic analysis and policy planning, work design, and workforce management; for policy and planning and budget allocation at the macro level to go hand-in-hand with work design and management strategies at the micro level; and for the development of a national nursing workforce plan for investment and reform with a timeline and specific dates for accomplishing separate goals for recruitment and retention.

This is a commentary on http://www.ijhpr.org/content/1/1/11/.