Generational Diversity: Implications for Nurse Staffing

It takes an entire team of interdisciplinary professionals working together to provide safe and high quality patient care.


Within that larger team, nursing forms its own teams to collaborate each and every day to make sure their patients’ needs are met.

The healthcare environment and the nursing workplace has become more complex than ever and is increasingly dependent upon contributions from each team member to ensure that patients receive the care they require in an efficient and cost effective manner.

Some of the complexity in today’s workplace is due to an increase in documentation requirements, inefficient processes and an increasingly diverse workforce.


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Dimensions of Diversity

The diversity seen in today’s workplace includes a variety of dimensions, such as gender, ethnicity, religion and generational diversity.

Generational diversity is apparent as there are currently four generations in the workplace: the traditionalists (aka: the greatest generation/silent generation/veterans), baby boomers (aka: boomers), Generation X (aka: X’ers) and the millennials (aka: Generation Y, Y’ers, echo boomers).

There is also an emerging generation that remains un-named. Not surprisingly, each generation has its own way of doing things and seeing the world, which is based upon their shared life experiences.


More than ever before, there is a wide range of age groups working side by side within hospitals. This is the first time that there are four generations of workers and three generations of leaders in the same work environment. In any given organization, 20-year-olds through near-80-year-olds may be working in the same department.

This staffing situation is not unique to nursing, or even to healthcare, and it is present in all industries. That span of six decades includes a very diverse group of people, all with different attitudes, expectations, morals, beliefs, values, desires and life experiences.

Generations have a “personality” that is often common to each generational cohort or group,1 but they can’t be stereotyped. Also, there are generally some common characteristics that are likely to differ across the generations. Knowing these differences may improve the performance of nursing teams in their pursuit of proving the best patient care possible.

Working Styles


You may be able to tell from experience that there are many different perceptions and expectations of performance and work ethic among each of the generations.

Generally speaking, traditionalists have a strong work ethic and are willing to work hard for the goals of the organization. They work hard to complete a job in a quality manner. They are proud of the product of their hard work and take responsibility for their performance.

Baby Boomers
Overall, boomers enjoy work, often make the choice to “live to work” and put in many hours. They are personally gratified when they perform well at work. This is also a very competitive cohort by nature that insists that their work is done to the best of their ability and will often beat deadlines. Just like graded assignments, their work is evident in the outcome of whatever it is that they are working on, and this group strives for the “A.”

Generation X’ers
As a cohort, X’ers, generally work because it is a necessity. This group continually strives for optimal work-life balance and looks for the personal benefit of the work that they are doing. X’ers don’t mind working hard, but they typically expect something in return, such as job security, good pay, promotions, flexible schedules, etc. This group is willing to be a team player as long as they like the team and enjoy what they are doing. If the final outcome isn’t done as well as it could have been, this group is often un-phased and is willing to just move on to the next task.

As a whole, millennials don’t need their work to define them, so they can take it or leave it. As a cohort that gets bored easily, they are willing to work hard as long as they perceive an equivalent benefit to them personally, such as career advancement or financial rewards. A good performance by this group means that all of the variables must be in their favor, the right resources, the right team (no conflict among the team as this group prefers group processes/ ecisions) and the right reasons to do it. This generation has difficulty taking accountability for their actions and work; a poor performance is usually not “their fault.”


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Understanding Each Other

The differences in the level of performance or work ethic can cause conflict and tension in the workplace among coworkers. The reason for this is that each generation may use its own value system as the measurement tool when comparing themselves to their colleagues.

Nurse leaders need to be clear on workplace expectations so that everyone understands the goals, and nurses need to learn how to accept their colleagues’ differences in work performance.

This does not mean that you have to accept poor performance, as generational diversity is not an excuse and poor performance should be addressed appropriately.

Nurse leaders should foster the culture of inclusivity and encourage their staff to learn and understand the generational differences that are behind the perceptions of work ethic and performance, so that colleagues can appreciate how the attitude and expectation has been formed.

Understanding breeds acceptance, and acceptance helps teams to function as optimally as possible. This is an opportunity for nurse leaders to use performance improvement as a model to enhance team dynamics as well as to strengthen their own performance as a nurse leader.2 We cannot change each other’s formative experiences and attitudes; understanding and acceptance is the best we can do to help us learn to work together.

In order to ensure that all patients receive the highest quality of care possible, it is essential that all team members try to not only understand but also value their colleagues’ contributions. It is also helpful to know the strengths and weaknesses of teammates so nurses can manage their own assignments accordingly.


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The goal is not to avoid these, but rather to try to understand them and navigate through them for optimal outcomes, where everyone wins.


Creating a culture of self-awareness, understanding and generational harmony is the best way to allow a team to function cohesively, yet maintain their uniqueness. A high-functioning team that works in an environment where diversity is accepted will promote safe patient care by improving communication and fostering trusting relationships among staff.

1. Clipper B. (2012) The Nurse Manager’s Guide to an Intergenerational Workforce. Sigma Theta Tau. Indianapolis, IN.
2. Cherry B, Sullivan DT & Yoder-Wise P. What Does Leadership in a Diverse Environment Really Mean? Voice of Nursing Leadership. 2013;11(1): 12-13.

Bonnie Clipper is associate vice president for professional nursing practice and development at St. David’s HealthCare in Austin, Tex., and co-chair of the Central Texas Health Industry Steering Committee. She is the author of The Nurse Manager’s Guide to an Intergenerational Workforce.

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