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Nurses in Bifocals vs. Aides with Eyebrow-Rings

by Diane Thielfoldt & Devon Scheef

How to Bridge the Generation Gap in Your Health Care Organization

For the first time in modern history, four generations are working side by side. Their different values, work ethics and habits can cause major generation gaps — perhaps nowhere more so than in the health care field. But a larger problem is a very real “gap” on the horizon for this field: with Baby Boomers aging and the oldest workers ready to retire, where are the legions of younger workers to fortify the ranks?

We believe that both these problems — the friction among generations and the difficulty of recruiting and retaining younger employees — can be addressed with insight into what makes each generation tick. We have done considerable research on generations in the workplace, and provide training for management and staff on these generational differences. Here are some insights that might help your organization close both “generation gaps.”

Short On Understanding, Shorter On Staff

Let’s start by taking a closer look at the generational challenges through the eyes of professionals in health care. First up: the completely different outlooks of the two older generations versus the two youngest.

“People in their 50s and 60s entered medicine for a different reason, with different expectations than today’s young people,” muses Susie Truesdell, a former physician’s assistant. Carol Bagley, RNC, MAT, and Manager of the Providence Alaska Learning Institute, agrees. “One thing a lot of us [Baby Boomers] could see when we became nurses was an almost religious sense of being on a mission,” she says. “Today, Generation Xers think they can make money. To us, that’s almost sacrilegious. They may feel that other component, but it’s more permissible today to talk about money.”

Cindy Rohde, Director of Medical Staff Services for Providence Alaska Medical Center, adds, “Millennials don’t have the same work ethic. They don’t bother to call in sick — they just don’t show up.”

Meanwhile, the staffs of many organizations are growing grayer. “I see a huge skew in traditional ‘pink collar’ jobs like LPNs, aides, administrators and nurses towards 50+,” says Kathy Cronin, vice president of Xerox Corporation’s healthcare business. “There’s a shortage of people in their 20s and even in their 30s.”

This skew may be most problematic among frontline caregivers. “On the nursing side, there’s high turnover in the first five years on the job, but after that, you see very little,” Cronin observes. “These long-timers are not motivated by money — they want to help people.” These older nurses are less of a turnover risk, yet they work increasingly physical jobs, so they may be forced to leave to save their health.

“The reality is, you’re going to need the Millennials,” says Springer, “but they’re not interested in managing …they’re not leaders, they’re team players. They can do good work, but they want to work on their own terms.”

So the big question is: How do you manage, motivate and retain younger workers?

Understanding the Generations

By learning why each generation is the way it is, what personality traits are found in each and what motivates each, you can create a work environment that appeals to members of all generations, maximize the differences in values and work habits and attract new employees.

Here is an overview of each of the generations working today, including members of the Silent Generation (born 1933–1945), Baby Boomers (born 1946–1964), Generation Xers (born 1965–1976), and Millennials (born 1977–1998).

The Silent Generation:

The oldest generation typically found in today’s workplace was born between 1933 and 1945. The earliest members of the Silent Generation grew up in a time of economic turmoil in the aftermath of the Great Depression. They dealt with economic hardships by being disciplined and self-sacrificing. They lived, and helped reinforce, the American Dream — enjoying a lifetime of steadily rising affluence. There are 52 million Silents, and they defy generalization more than any other generation, so watch those stereotypes!

Employees from the Silent Generation are typically disciplined, loyal team players who work
within the system. Obviously, they have a huge knowledge legacy to share and embody a traditional work ethic. There’s a natural affinity between this generation and the young Millennials. It’s a perfect match to have them mentor the youngest generation of employees, and the Silent Generation’s natural civic-mindedness lends itself to this task.

And don’t dismiss their technical skills as out of date: Del Webb, a major developer of retirement homes, points out that the top requested feature in new homes for retirees is his-and-hers offices. Most Silents have a positive view of technology, so provide your older employees with proactive service and support for technology tasks and let them run with it!

Silents may feel unappreciated, but they’re open to returning to the workplace after initial retirement, as long as they have the flexibility to put their newfound freedom first. You might consider asking some of your retirees to return as part-timers and mentors — as well as instituting phased retirement to gradually ease older employees into retirement at a mutually agreeable pace.

Tips on managing this generation: Assure them that you value their work and that it’s respected; ask them to share their knowledge legacy; give them hands-on training; and praise their mastery of new areas.

The Baby Boomers:

The most populous generation in the United States, the 76 million Baby Boomers were born
between 1946 and 1964. They typically grew up amid economic prosperity, suburban affluence and strong nuclear families with stay-at-home moms. Boomers asked tough questions about social issues, civil rights, war, sexual freedom and more. They took stock of their radically changing world and went to work with a vengeance. Some researchers divide the Baby Boomers into two groups: those born between 1946 and 1954 (the “Woodstock” group, known for their idealistic endeavors and social conscience), and those born between 1955 and 1964 (the “Zoomer” group, known for their preoccupation with self).

Boomers tend to be optimistic, competitive, and focus on personal accomplishment. They work hard — maybe too hard. This is the generation that increased our workweek from 40 hours to 70 or 80 hours. As younger generations have entered the workplace, Boomers have waited for them to pick up this traditional approach to work.

This generation has ruled the workplace for years and is comfortable in the culture they’ve
created. They view changes as sometimes painful but inevitable. Many organizations experience their biggest generational conflict when Boomer managtheyers are confronted with younger employees who don’t “fit the mold” that they themselves created.

Tips on managing this generation: Spotlight intangibles such as fulfillment and spirituality; redesign jobs to accommodate the family demands of children and aging parents; and encourage them to “lighten up”. Let them know how their contributions are unique and important.

Generation X:

The 51 million members of Generation X, born between 1965 and 1976, grew up in a very different world than previous generations. Divorce and working moms created “latchkey” kids out of many in this generation. This led to traits of independence, resilience and adaptability. Generation X feels strongly that “I don’t need someone looking over my shoulder.”

At the same time, this generation expects immediate and ongoing feedback, and is equally comfortable giving feedback to others. Other traits include working well in multicultural settings, desire for some fun in the workplace and a pragmatic approach to getting things done.

Generation X saw their parents get laid off or face job insecurity. Many of them also entered the workplace in the early ‘80s, when the economy was in a downturn. Because of these factors, they’ve redefined loyalty. Instead of remaining loyal to their company, they have a commitment to their work, to the team they work with and the boss they work for. For example, a Baby Boomer complains about his dissatisfaction with management, but figures it’s part of the job. A Gen Xer doesn’t waste time complaining — she sends her resume out and accepts the best offer she can find at another organization. Generation X takes employability seriously. But for this generation, there isn’t a career ladder. There’s a career lattice. They can move laterally, stop and start…their career is more fluid.

Tips on managing this generation: Create a “campus culture” environment that allows flexibility and independence; mentor them instead of managing them; promote a participatory work environment; provide chances to compete; offer constant feedback and if applicable, assign a series of long-term, meaningful projects. Motivate them by eliminating as many rules as possible.

The Millennial Generation:

Just beginning to enter the workplace, The Millennial Generation was born between 1977 and 1998. The 75 million members of this generation are being raised at the most child-centric time in our history. Perhaps it’s because of the showers of attention and high expectations from parents that they display a great deal of self-confidence to the point of appearing cocky.

As you might expect, this group is technically literate like no one else. Technology has always been part of their lives, whether it’s computers and the Internet or cell phones and text pagers.

Millennials are typically team-oriented, banding together to date and socialize rather than pairing off. They work well in groups, preferring this to individual endeavors. And they’re used to tackling multiple tasks with equal energy, so they expect to work hard. They’re good multitaskers, having juggled sports, school and social interests as children.

Millennials seem to expect structure in the workplace. They acknowledge and respect positions and titles, and want a relationship with their boss. This doesn’t always mesh with Generation X’s love of independence and hands-off style.

Tips on managing this generation: Provide a fun, friendly environment that still has structure and stability; personalize their work; help them become a specialized generalist, boost teamwork; and address them personally.

Recruitment and Retention

Health care, perhaps more than any other field today, faces the problem of an aging work force. How can your organization recruit younger employees — and keep them for the long term?

Opportunity for Change

“The challenge is creating a workplace for [younger workers],” says Springer. “What are we doing to reshape it to attract them?” Millennials are drawn to different aspects of an employer than you might expect. Offer them a long-term view with career stability. After receiving our training in engaging the generations, Bagley says her organization changed their recruitment messages. “For the youngest workers, we tell them, ‘we want you to stay a long time, but you don’t have to do the same job.’” The message also promises rapid learning and technology to appeal to Millennials.


Gen Xers are concerned with having steady employment. Members of the Silent Generation and Baby Boomers often see this age group as lacking loyalty. Actually, Gen Xers have redefi ned the concept. Instead of remaining loyal to their company, they have a commitment to their work, to the team they work with and the boss they work for. Provide them with assurance that your organization is stable and fi nancially fit, both during the hiring process and throughout their employment.


Millennials get along well with members of the Silent Generation; so if ossible, tell potential new employees they’ll be paired with a staff member in their 60s for a mentoring arrangement. Millennials have likely taken part in mentoring programs in school, and are comfortable with these relationships.


Millennials also want structure and attention from their supervisors, so get the message out that your organization has clear expectations for each job. Gen Xers, on the other hand, crave independence on the job. They want to find their own way of getting things done — without a supervisor’s constant attention.


One of the most important offerings you can promise any new recruit is the opportunity for training. “Quality of work life is important” to people in health care, says Cronin. “Money isn’t an incentive, but rather a career path that isn’t a ladder — because there isn’t one. If you can, offer more training, so a young worker can move from being an aide to an LPN, or pay for education so an administrator can get a masters degree and run the department.” Gen Xers in particular will appreciate learning opportunities, because this increases their sense of employability.

Appealing to Employees of All Ages

After studying the “generation gap” problem in their organization, Mercy Health Partners is considering some changes to attract more, and younger, employees. These changes include:

  • A consumer-driven benefit plan where each person chooses which benefits they want. “This addresses all generations,” says Springer, “and employees see us as flexible.”
  • Incorporating a “buddy system” into new employee orientation practices, so younger employees will feel they belong. “Our exit interviews showed that people didn’t feel connected,” explains Springer. This one-on-one system should help new employees make friends and learn the ropes.
  • Flexible pay. “The gradation of jobs in a hospital allows some flexibility in how we compensate individuals,” says Springer. “Someone may elect to forego some benefits and put more into their paycheck, depending on their personal needs.”

These are all excellent ideas because they incorporate something for each generation. Rather than focus on the current age groups in the health care field, or catering only to the up-andcoming Millennials, offering flexible benefits and pay, and teaming up employees of different ages, will appeal to everyone.

Any organization can take this approach and expand it to create a work environment that fulfills members of each generation. Everyone wants to work in an environment that’s trusting and open. To create an ideal climate, you must prove your openness to ideas and innovations from your employees. Don’t just listen to them — act on their ideas or let them know why you can’t.

Supervisors and administrators can create an ideal workplace by delegating tasks to help employees learn new skills, and by shaping the work to the needs of each individual. Even members of the Silent Generation are interested in trying new things at work — so challenge each individual to learn new skills.

Also, celebrate individual and team accomplishments, either with verbal praise or more tangible rewards. You can create handmade certificates, or hand out gift certificates to each “employee of the month” Preferably, use as many different means of recognition as possible to appeal to all generations; Boomers prefer practical rewards like time off or monetary incentives, while Millennials actually enjoy more responsibility on the job.

The advice in this article is just the tip of the iceberg. There is enough information available on the four generations and how they work to fill a good-sized book. However, the insights and tips provided here are enough to get you started on the path toward fostering understanding in your workplace, and successfully recruiting younger workers.

Generations Defined

There are various opinions on the birth years that define each generation, most differing by only a year or two. Please keep in mind that it’s less important to focus on specific dates than it is to concentrate on what managers can do regarding generational differences.

This article uses the following definitions of generations.

  • The Silent Generation (born 1933-1945)
  • Baby Boomers (born 1946-1964)
  • Generation Xers (born 1965-1976)
  • Millennials (born 1977-1998)