Intergenerational Workplace Nursing CE Course

1.5 ANCC Contact Hours AACN Category

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Objectives:

Upon completion of this module, the learner should be able to:

  • Recognize the key differences in the five current generations of nursing.
  • Explore the motivators for each generation in nursing.
  • Consider strategies to manage the different generations in the workplace effectively.

Disclaimer: This module's purpose is to explore ways that generational gaps can be decreased in the workplace. There may be descriptions of the five generations within this activity that appear stereotypical; these generalizations are not intended to classify individuals, but rather attempt to capture how various generational groups may view each other and how this may lead to conflict. These observations are not intended to be derogatory or judgmental, and do not realistically apply to all members of any of the generations discussed.

Today's healthcare organization employs a very diverse group of workers. Not only is there diversity among educational preparation, culture, race, language, and experiences, but also among generational groups. There are up to five generations actively employed within the current healthcare setting. Intergenerational diversity can create a challenge for executives, managers, educators, and the individual nurses working in any given unit or healthcare setting. The differences in life experience, work ethic, values, or culture can lead to conflict between coworkers. This module will explore the various generations, the key motivators in each generation, and strategies to effectively manage the conflicts, while promoting a positive and collaborative work environment. 

Generations in Today's Workplace

The five generations currently employed in most workplaces, including healthcare organizations, are the Veterans, Baby Boomers, Generation X, Millennials, and Generation Z. See Table 1 for the most generally accepted birth years associated with each of these generations.

Table 1

 Generations Currently in the Workplace

Generation Name

Birth years

Veterans

Born between 1922 and 1946

Baby Boomers

Born between 1946 and 1964

Generation X

Born between 1964 and 1980

Millennials

Born between 1980 and 2000

Generation Z

Born between 2000 and 2012

(Houlihan, 2016)

Each of the five groups had very different experiences as they grew up, and those experiences impacted their values and perceptions of work. Members of each generation generally experience the same cultural events, hear the same type of music, and experience the same national figures, catastrophes, and social and cultural achievements or failures. All of these experiences contribute to the development of similar attitudes based on the norms of that time. For those rare remaining nurses who grew up in the Veterans group, World War II and a very strict upbringing with military values generally shaped their work ethic. These individuals have strong beliefs with regards to respecting others and authority.  The quality of their work is a deeply held value. Baby Boomers, the largest population of employees currently saturating the workplace, embrace the value of sacrifice to succeed, and are bound by loyalty and respect for authority. Members of Generation X grew up in a time shaped by evolving technology and typically represent a shift in focus from the number of hours worked to productivity. This group is very outcomes-focused and more concerned with getting the job done rather than clocking in and out to determine their dedication to work. Millennials and Generation Z have been immersed in technology since birth, and they are often viewed as deft multi-taskers that are easily bored. They understand how to utilize technology to their advantage to do their jobs with the greatest ease. Millennials value a balanced work/life schedule and equality in the workplace (Houlihan, 2016). Generation Z is the most highly educated generation in history (Abramovich, 2019).

These differences are notably recognized in communication between the individuals that may be as many as 70 years apart in age. Veterans tend to respond optimally to managers that respect their experience and knowledge and offer frequent feedback to confirm their abilities. They like to know their place within the organization's hierarchy and value their standing. Baby Boomers are often motivated by opportunities to learn new skills that increase their standing in the organization. Individuals in Generation X tend to prefer to work independently with little oversight and place a high value on their personal life and leisure activities (Houlihan, 2016). It is often said, "they work to live, not live to work" (Kurtz, 2016). Millennials and Generation Z share many values with Generation X, such as working to live; however, unlike the Generation X group, Millennials like to work in teams, receive frequent feedback, and work with the most updated technology (Nwosu et al., 2016). Generation Z does not find change intimidating and appear nimble and flexible (Abramovich, 2019).

Differing views by the various groups might include perspectives on education, work, or relationships. Most members of the Veteran group did not have the opportunity to attend post-secondary school and likely began working immediately after high school or entered military service. Their goal with employment or military service is to support their families. The Veteran group grew up during the Great Depression and understand hard economic times; they simply want to provide their family with more than they grew up with. Most Veterans entered the workforce at a time when an individual would be hired by an organization and stay there until retirement, perhaps moving through positional advancement along the way. This group is very loyal to their employer and has high respect for the chain of command. Furthermore, they believe that if something is not broken then it should not be fixed. They value hard work and dedication, are team players, and obtain satisfaction from doing their work well (Gratton & Scott, 2016; Nwosu et al., 2016).

Baby Boomers, who are a significant portion of the population with an extra 17,000,000 babies born during this period compared to previous generations, grew up during a more prosperous time than their parents and grandparents. Their lives were influenced by the civil rights movement, the women's rights movement, the cold war with Russia, the Vietnam War, and even the NASA space program. Due to prosperity, this group has optimism and believes their generation changed the world. Many Baby Boomers built outstanding careers from the ground up and devoted large parts of themselves into their jobs. This generation lives to work and finds great pride and intrinsic motivation from their work. They are highly competitive, and due to their large numbers, they often have to compete with peers for promotions and career advancement opportunities. This was the first generation in which both parents commonly worked outside of the home, creating a generation of children that went home to an empty house (latch-key kids). Baby Boomers are still loyal to their employers but are more loyal to their career and are not opposed to changing jobs for higher salaries or better opportunities; however, they do not change jobs with ease. Other generations, such as Generation X and Millennials, may consider Veterans and Baby Boomers workaholics. Both groups have strong work ethics characterized by dedication and loyalty, do not mind working long hours, and expect respect. They seek status and feel that success is important, so a change in job title may be the impetus for a job change. Many in the generation have already achieved many of their career goals, yet still appreciate opportunities for career advancement linked to salary increases (Gratton & Scott, 2016; Nwosu et al., 2016). Many younger generations may categorize Veterans and Baby Boomers as rigid or inflexible (Houlihan, 2016).

Generation X is often considered to be a misunderstood group and was the first generation with access to the internet and personal computers as children or young adults. They welcome diversity, change, and value their free time and having fun. Generation X was raised by Baby Boomer parents who were focused on getting ahead and working hard. Thus, many of this generation were latch-key kids who were at home alone until their parents were able to leave the workplace. They were also the first generation to have increased access to technology, and television or video games were often referred to as their "babysitters." Since Baby Boomers raised them, they have a very different view of work-centric parents and tend to be very independent and self-reliant. Generation Xers are often entrepreneurs and embrace change in the workplace. They like a flexible workplace and may choose to work from home two or three days per week versus going into the office daily in their eternal quest for balance. They value constructive feedback that aids in their growth and development. Most Generation Xers are highly educated and in line for advancement when Baby Boomers in leadership roles retire. In contrast to Baby Boomers, this group thrives on diversity, challenges, honesty, and creativity (Gratton & Scott, 2016; Nwosu et al., 2016).

Millennials have many labels, including Generation Y, Nexters, Generation www, and the Digital generation. The group was practically born with digital phones in their hands, and technology is as much a part of their lives as food and water. Many have grown up in a multi-tasking environment with school, dance, sports, and other extracurricular activities. They thrive off of instant gratification and instant feedback for their performance. They are high-achieving, confident, and team-oriented, but may also be considered high maintenance and high risk. This group is shaped by parental spoiling and excesses, computers and the latest technology, and over the last 15 years, social media. They seek flexibility and want a balanced life with clear goals. They are adaptable to constant change and have no desire to stay in the same job for extended periods. Millennials value diversity, training, and want to be challenged. They expect to be paid for what they do, and not how many hours they spend doing it.  They strive to be at the top of the organizational hierarchy quickly, crave frequent feedback from their supervisor, and are very optimistic and confident in their abilities. Both Gen Xers and Millennials may be categorized by their older coworkers as entitled, lazy, and disrespectful of authority (Gratton & Scott, 2016; Nwosu et al., 2016).

While Millennials were immersed in technology early in their lives, Generation Z could be said to have a smartphone as their right hand. This group coined the phrase "influencer" and are strong multi-taskers. Merriam-Webster (n.d.) defines an influencer as "a person who inspires or guides the actions of others." This group uses YouTube, Instagram, or other social media platforms to share the latest technology, clothing, styles, or trends and influence the actions of others, including purchases, travel, or behaviors. The average attention span of Generation Z is less than 8 seconds, due to having a world of immediate answers through the internet, infinite choices, and multiple screens. This group understands how technology has transformed the workplace, and they aspire to work with organizations that value cutting-edge technology and allow them to influence how others work. Generation Z believes that many current jobs will not exist in the next two decades and they understand that change is inevitable. They use their smartphones five or more hours per day and some over ten hours per day and have a different view of the work environment than previous generations. Generation Z is a highly educated group, as college enrollment and completion is higher than any of the previous generations and across all diversity subgroups. This generation is self-reported to place low value on company loyalty and often moves around between jobs easily (Abramovich, 2019).

In many workplaces, it is noted that a third "ism" is present, in addition to racism and sexism, known as ageism. Ageism is not only focused on those growing older but rather a "prejudice or discrimination against or in favor of an age group" (Palmore, 1999, p.4). Research has shown that negative effects of ageism exist in the workplace, including the tendency for older adults to be less likely to be hired or promoted than their younger, equally, or less qualified candidates, adding to the intergenerational conflicts. In a study by King and Bryant (2017), the Workplace Intergenerational Climate Scale (WICS) was introduced as a measuring tool for employee attitudes and perceptions about workers of various ages in the workplace. The tool is an 18-item measure with a reflection on five subscales: intergenerational contact, workplace intergenerational retention, positive intergenerational affect, workplace generational inclusiveness, and lack of generational stereotypes. The scores on the subscales were linked to workplace mentoring, opinions about the older worker, and overall job satisfaction. To change a problem within the workplace, recognition must occur first. By using the WICS tool, an organization can help define its culture and work to develop changes related to intergenerational challenges. See Table 2 for WIC Items.

Table 2

Workplace Intergenerational Climate Scale (WICS) 18-Item Tool

  • LGS1: Coworkers outside my generation are not interested in making friends outside their generation.
  • LGS3: Coworkers outside my generation complain more than coworkers my age do.
  • PIA1: I feel comfortable when coworkers outside my generation try to make conversation with me.
  • PIA2: I enjoy interacting with coworkers of different generations.
  • PIA3: My coworkers outside my generation are interesting and unique individuals.
  • IC1: How often do you have conversations with coworkers outside your generation?
  • IC2: How often do you have conversations with coworkers outside your generation relating to things other than work?
  • IC3: How often do you talk with your coworkers outside your generation about your personal lives?
  • IC4: How often do you interact with your coworkers outside your generation at company-sponsored events?
  • IC5: How often do you eat meals with coworkers outside your generation during the workday?
  • WGI1: I believe that my work environment is a healthy one for people of all ages.
  • WGI2: Workers of all ages are respected in my workplace.
  • WGI4: I am able to communicate effectively with workers of different generations.
  • WGI5: Working with coworkers of different ages enhances the quality of my work life.
  • WGI6: My coworkers make older workers feel that they should retire.
  • WGI7: I feel pressure from younger workers to step down.
  • WGI8: I feel pressure from older workers to step down.
  • GARF1: People work best when they work with others their same age.

(King & Bryant, 2017)

Significant to this study was the application of the WIC tool to a healthcare organization providing care to seniors. The employee sample median age was 43 years, and 24% of respondents were younger than 30 years of age, 40% were 31-49 years of age, and 36% were 50 years of age or older. 75% of those surveyed identified as White, 16% identified as Black, 3% identified as Asian, and 3% identified as Hispanic. Ageism and bias toward older workers were noted in this study completed in a healthcare environment. While the use of this tool does not define an organization, it can serve to give an overall picture of a workplace's intergenerational climate and worker perceptions. Further, recognition of bias, opportunities, or successes concerning intergenerational challenges can be positive for workers of all age groups (King & Bryant, 2017).

Motivators for Each Generation

Individuals have both intrinsic (internal) motivators and extrinsic (external) motivators to go to work. While everyone desires to have their basic needs met such as shelter, food, and clothing, other motivators cause individuals to seek certain career choices, or develop certain habits and norms in the workplace. What are the common motivators for each generational group?

Reflection: Which generation do you fit into? What motivates you to go to work each day? What makes you stay in a job? What experiences in your childhood/youth caused you to feel the way you do about work?


Veterans report motivation through financial compensation, yet desire respect. They tend to prefer milestone recognition in the workplace and are proud of that "5-year, 10-year, and 20-year pin" to recognize their loyalty to an organization. This group values promotions, personal recognition, and feedback from their managers. Benefits that motivate their workplace choice include long-term care insurance and catch-up retirement funding (Gurchiek, 2016).

Baby Boomers tend to be similar to Veterans, but a striking difference is in recognition in the workplace. Baby Boomers tend to prefer peer recognition versus supervisor recognition and appreciate non-monetary benefits such as flexible retirement planning. They like prestigious job titles, personal parking places, and large offices. While they appreciate features such as 401K matching, sabbaticals, and catch-up retirement, they may not be the driving force to choose a workplace. Baby Boomers like to be in positions of power, and job titles are very important. A high appreciation of health, long-term care, and disability insurance exists with Baby Boomers (Gurchiek, 2016).

Motivators for Generation X include bonuses, such as stock or monetary rewards for a job well-done, or flexibility as a non-monetary reward. They like informal, rapid, and publicly announced positive feedback. Preferred extrinsic motivators include telecommuting and tuition reimbursement. This group appreciates recognition from their boss, gift cards, experiential rewards such as conference attendance, and schedules with flexibility. They value benefits like health insurance and even disability insurance but do not report a great desire for long-term care insurance. They believe that advancement in a company should not be based on the years served, but rather based on performance and competence in the role (Gurchiek, 2016).

Generation Y boasts motivators of skills training, workplace culture, and flexible schedules. Their preferred recognition style is regular, ongoing, and informal feedback from peers and managers. They appreciate recognition through company newsletters or social networks. Welcomed benefits for this group are flexible schedules and continuing education. They prefer stock options as their monetary reward over raises or bonuses. They have less appreciation for benefits like long-term care insurance or disability insurance; however, they report appreciation for health insurance (Gurchiek, 2016).

Generation Z appreciates constant feedback from peers and managers and social rewards over money. These individuals need to know that their work impacts the entire organization and where they fit in the "big picture" of the company. They challenge leaders to think differently and consider changing their operational model. They question paradigms and why things are done the way they are. They thrive on experiential awards similar to badges won in video games. They demand and expect workplace flexibility and diversity. Generation Z likes regular and in-person praise that is in public by managers and peers. They welcome benefits such as online training and certification programs. They do not value benefits like health insurance, long-term care insurance, or disability insurance as their predecessors do (Gurchiek, 2016).

Strategies to Effectively Manage the Intergenerational Workplace 

Nurses should recognize that diversity in the workplace is a strong asset as we serve a diverse population.  Nursing has long sought diversity among its ranks, and the intergenerational workplace is an opportunity for diversity in age groups that can best serve the patient population across the lifespan. However, McNally (2017) states that "a one-size-fits-all approach to leading in the midst of great generational diversity does not work" (para. 2). Generational conflict can result from misunderstandings or assumptions and stereotyping. The younger group can see Veterans and Baby Boomers as having difficulty mastering new technology, and the older group can see Millennials, Generation X, and Generation Z as being lazy and obsessed with technology. Another stereotype is seeing the older worker as just waiting out their time for retirement. In reality, older workers deeply want to contribute and be recognized as having value in the workplace. Mutual respect is the foundation of developing a workplace that is free of generational conflict. Mutual respect can be built through facilitated conversations that focus on the different strengths among team members. These conversations can increase awareness and cause team members to look internally for bias about each other, while simultaneously developing an appreciation and creating new ways of working together. Focus on the positive features of each generational group rather than discussing the negatives (Gratton & Scott, 2016; McNalley, 2017).

As leaders consider the culture of their organization and how to address intergenerational conflict, bring together cross-generational leaders, and pose the following questions:

  • What challenges are you finding as you work with multiple generations? What specific examples can you share?
  • What leadership challenges are occurring through managing the various generations?
  • Does our leadership team reflect generational diversity? Are there opportunities to do better?
  • What are the pitfalls between intergenerational communications, and how can it be improved
  • What new approaches could be implemented to serve all the generations best? (McNally, 2017)

Leaders must be flexible and understand each group to meet the needs of their entire workforce while building teams that are able to work collaboratively. Consider how the generational groups that often have such great divides can come together and care for the patients that are served by all. In order to figure out how to build bridges among the groups, consider the opportunities for each group to mentor or coach the others. Gratton and Scott (2016) noted that the young could impart networking skills and reputation building to the older generations, and the older generations can impart general life wisdom and financial knowledge. There is much more to consider across the generations. A Harvard study surveyed over 10,000 individuals and asked questions about work and life experiences. Some of the questions posed were:

  1. Are you actively building, maintaining, or depleting tangible assets such as financial savings?
  2. Are you actively building, maintaining, or depleting intangible assets including productivity (skills, supportive peers, good reputation); vitality (health, managing work/life stress, and relationships); and transformational capacity (self-knowledge and investment in extended networks of friends and colleagues) (Gratton & Scott, 2016).

These questions inquire about aspects of life that are vital to the creation of a long and productive work life. Their findings indicate significant differences between generations. Across the generations, there was an opportunity for mentoring and coaching that could enhance each age group's professional skills. A specific area of opportunity for the young to learn from the old was in control of their work stress. The older worker's insights were developed over years of learning how to control their work life. Older workers were better skilled at delegating to others, pushing back to management when needed, and accepting demands when appropriate. Another opportunity for younger workers to learn from older coworkers is with financial proficiency. In general, the young are less comfortable with managing personal finances, or financial literacy. Older workers can share their experience with younger workers, providing insight into their future, decreasing future financial problems, and enhancing their ability to retire. This same survey shared opportunities for older workers to learn from younger workers. A specific area of opportunity is building relationships and networks that are crucial across the lifespan. New skills acquired through mentoring and coaching can transform the individual and their marketability in the workplace. Data shows that employees over 50 tend to maintain their current network and fail to build new ones, particularly amongst younger workers in the workplace. The networks and the knowledge shared can stagnate and become comfortable, with less challenging or development in workplace skills. When younger individuals are starting their careers, networking, building diverse relationships, and finding coaches and mentors are second nature, while the older worker may become complacent and comfortable with their current group of work relationships. Being resilient is vital to remaining in the workplace, even when aging. Maintaining relationships between the old and young can be a win-win for both groups. Building a professional reputation is another important aspect of career development that younger workers can often share with older workers. Social media platforms such as LinkedIn, a resume, curriculum vitae (CV), and professional references can cooperatively drive an individual's reputation (Gratton & Scott, 2016).

Reflection: Do hospital recruiters or other healthcare Human Resource departments consider your social media profile when hiring? How does "job-hopping" affect employability in the healthcare setting for Generation X? If you were a manager, would you want to hire an individual with the expectation that they may leave within a year?


Nurse Managers can use their knowledge of differences between the generational groups to build a strong workforce that is better able to serve their patients. Tips for motivating the different generations include:

  • Promote collaboration and celebration through social media platforms that allow employees to celebrate and share their successes.
  • Understand and learn to appreciate the different work styles between the groups and offer flexible work options where possible.
  • Make the patient the primary priority and bring the groups together for the common good, regardless of their age, beliefs, or social norms.
  • Enable personal work/life balance and professional growth, since all the generations find mutual appreciation for this aspect of work.
  • Develop mentoring programs that build on the strengths of individuals. Consider a reverse mentoring program where everyone is both a mentor and a mentee.
  • Push for workplace policies and hiring processes that carefully select managers based on knowledge, skills, and attitude and reflect/respect the diversity of their workforce.
  • Encourage wellness among all the age groups (Gurchiek, 2016).

A study from Slovenia on the differences in generations did not refer to the variances as "intergenerational conflict" but rather, "intergenerational cooperation." Should the US adopt the more positive connotations to the uniqueness of the workplace population and these generational differences? In the study, many of the same concerns and patterns exist, yet they voice these as opportunities to develop cooperation among the individuals. See Figure 1 for their model for intergenerational cooperation called the Model of Proactive Intergenerational Management in an Organization.

Figure 1

Model of Proactive Intergenerational Management in an Organization


                                                                                                                                                           (Čič & Žižek, 2017)

The intergenerational cooperation implementation is divided into two categories: a) describing the levels of generational differences and similarities that affect the organization, or b) describing the areas of generational differences and similarities that are closely related to human resources management. The first considers organizational culture, management style, and communication in relation to the intergenerational perspective. The latter focuses on management activities that are aimed at the implementation of intergenerational cooperation. Management support is vital for the successful implementation of intergenerational cooperation, and the actual culture is shaped by the delivery of policies, strategic direction, and values of the company. The initial step in intergenerational cooperation is manager training that focuses on age diversity strategies, vision, and current culture of the organization and how their actions will shape an overall change in culture. A manager is often the mediator between conflicts of various generations and should have the skills to be receptive and understand the differences and similarities between the individuals. Clear guidelines should be established through policies so that everyone can recognize and understand the expectations and their role in the process (Čič & Žižek, 2017).

The model further acts as a continuum where the diversity of the generations is not only recognized but appreciated and is implemented across the work-life period of the employee. An atmosphere of cooperation between the different generations must exist for this continuum to occur. Employee recruitment is the second step for intergenerational cooperation. Hiring a diverse workforce and adapting to the generational diversity within the performance management process lays a foundation of expectation.  The third area is employee development and includes activities that retain and maintain employees. Coaching and mentoring, succession planning, talent management, and knowledge management are part of employee development. The final area is more directed toward individual generations and has targeted activities for each age group, such as a suitable working environment. Activities can include job rotation, an extension of the job, work sharing, or flexibility of work hours, but focuses on intergenerational teams that allow for the transfer of tacit knowledge and encourages creativity and innovation within the team (Čič & Žižek, 2017).

The study by Čič and Žižek (2017) concluded by noting that organizations must recognize the differences between generations and appreciate those differences. The model of intergenerational cooperation can be introduced by having all employees sign a code of intergenerational cooperation, facilitate succession planning, and participate in job rotation programs. Administrators must create intergenerational teams with intention and remove any barriers to cooperation among the generations such as age or years of service for role ascension (Čič & Žižek, 2017).

Finding ways to work together in harmony can be very difficult in any organization, and healthcare comes with its own unique issues related to workplace civility and cooperation. Yet, the positive aspects of intergenerational differences and cooperation can be greater than the negatives if we all come together.

References

Abramovich, G. (2019). 15 mind-blowing stats about generation z. https://cmo.adobe.com/articles/2019/6/15-mind-blowing-stats-about-generation-z.html#gs.x8bl0z

Čič, Z. V. & Žižek, S.S. (2017). Intergenerational cooperation at the workplace from the management perspective. Naše Gospodarstvo/Our Economy, 63(3), 47-59. https://doi.org/10.1515/ngoe-2017-0018

Gratton, L. & Scott, A. (2016). Generational issues: What younger workers can learn from older workers, and vice versa. Harvard Business Review. https://hbr.org/2016/11/what-younger-workers-can-learn-from-older-workers-and-vice-versa

Gurchiek, K. (2016). What motivates your workers? It depends on their generation. Society for Human Resource Management. https://www.shrm.org/resourcesandtools/hr-topics/behavioral-competencies/global-and-cultural-effectiveness/pages/what-motivates-your-workers-it-depends-on-their-generation.aspx

Houlihan, A. (2016). The new melting pot: Effectively lead different generations in the workplace. Supervision, 77(6), 3-5. https://www.hrcrossing.com/article/270046/The-New-Melting-Pot-How-to-Effectively-Lead-Different-Generations-in-the-Workplace/

Kurtz, J.L. (2016). Working to live or living to work? Psychology Today. https://www.psychologytoday.com/us/blog/happy-trails/201612/working-live-or-living-work

McNally, K. (2017). Leading a multigenerational workforce. Healthcare Executive, 32(1), 58-61. https://www.ncbi.nlm.nih.gov/pubmed/30280532

Merriam-Webster. (n.d.). Influencer. Retrieved on February 17, 2020, from https://www.merriam-webster.com/dictionary/influencer

Nowsu, M.C., Igwe, K.N., & Nnadozie, C.O. (2016). Managing generational diversity in the workplace: Implications for the digital era university library management. International Journal of Applied Technologies in Library and Information Management, 2(2), 4-28. https://www.researchgate.net/publication/314215745_Managing_generational_diversity_in_the_workplace_Implications_for_the_digital_era_university_library_management

Palmore, E. (1999). Ageism: Negative and positive. Springer.