Engaging millennial nurses
EDITOR'S NOTE: Heather Stringer is a freelance writer.
In 2010, leaders at Rush Oak Park Hospital in Illinois were alarmed by their 20% nurse turnover rate — and the majority of those leaving were new graduates who had stayed with the organization for fewer than two years.
Karen Mayer, PhD, MHA, RN, NEA-BC, FACHE, vice president of patient care services, asked these nurses during exit interviews why they were leaving. Many said they felt that they were not making a difference and were not appreciated by more seasoned nurses. Mayer knew she would risk losing more new nurses unless the hospital began re-evaluating its approach to these nurses and their needs. The hospital began considering millennials for committee posts, as well as leadership roles. “They want to feel that their opinions and extra activities are valued in making the organization a place of excellence,” Mayer said.
The leadership at Rush Oak Park Hospital started by educating the nursing staff about the value and capabilities of millennials, which refers to members of the population in the 18-to-35 age range, according to the Pew Research Center. “Historically charge nurse roles were reserved for senior nurses, but we explained that younger RNs may have the skills needed for this role,” Mayer said. Millennials, she said, have skills in negotiation and group dynamics they developed during school. “I’ve also noticed that millennials are very passionate about being involved in committees,” Mayer said. “It’s important to allow them to explore their ideas in these settings, because they can see things that more experienced caregivers may not envision as a possibility.”
Bob Dent, DNP, MBA, RN, NEA-BC, CENP, FACHE, senior vice president, chief operating officer and CNO of Midland Memorial Hospital, Texas, has made it a point to include millennials on committees or other groups that are working to make improvements at the hospital. This summer a young nurse championed a team that was tasked with improving bedside handoffs.
“I gave the team two days to work nonstop to find a solution,” said Dent. “I stepped out of the room and trusted them with the process.”
Dent’s decision is part of the hospital’s larger mission to create a culture of ownership. Rather than reserving important projects and decisions to top-level leaders, he encourages all nurses to identify and solve problems and to be innovative and creative with new ideas. At Midland Memorial Hospital, Dent propagated the concept of ownership by training 60 employees to lead a two-day course called The Twelve Core Action Values. The course helps participants identify and act upon their personal values, such as courage, authenticity, vision and perseverance. The hospital started offering the course in January 2015, and more than 2,000 staff members have finished the training and learned how to put their values into action — both inside and outside of work.
“Something I hear a lot is that young people today just don’t want to work hard, but I disagree,” said Joe Tye, CEO of Values Coach, Inc. and developer of the course. “They aren’t motivated to show up just to impress a boss. They want to feel like they are connected to a bigger mission than the job.”
By focusing on personal values, participants in the course have gone on to quit smoking, confront workplace bullies, apply to graduate school and make other significant life changes, Tye said.
Smith urges millennials who are looking for new jobs to discern whether a hospital seems to be supportive of younger nurses. “Make sure you meet staff members of all levels and ask about the leadership style at the hospital,” she said.
For nurses who are already employed, there are strategies to begin building leadership skills even if the facility has not embraced the potential of millennials. “Get out of your own department from time to time,” Tye said. “Building rapport with people throughout the hospital will lead to new opportunities.”
Tye also urges nurses to ask leaders important questions — even on topics that may seem controversial or delicate, such as how reported hiring trends for nurses may affect their careers.
While shifting a long-standing hospital culture may seem like a daunting task, teaching nurses to appreciate RNs of different generations can significantly improve morale for everyone, Mayer said. The nurse turnover rate at her hospital dropped to 12% once the hospital started giving millennials more leadership opportunities. When the hospital’s leaders started looking at the criteria for Magnet status, they realized that developing the nursing culture had paved the way for the application process. Nurses had become more involved in things like leadership, quality improvements and innovations. In March 2016, Rush Oak Park Hospital achieved Magnet recognition.
At Midland Memorial Hospital in Texas, the changes in hospital culture have had a direct impact on patient satisfaction. In early 2015, the Press Ganey scores in the ED were in the 1st percentile both nationally and relative to similar facilities. A millennial nurse led a team focused on boosting this score and implemented leadership rounding, staff recognition programs and improved patient communication practices, and the scores rose to the 90th percentile, Dent said.
Progress like this confirmed Dent’s decision to elevate and mentor the millennial who led the team. The nurse, Brandon Bredimus, MSN, RN, CEN, CPEN, CNML, had been involved in a leadership council as a new nurse and developed rapport with leaders throughout the hospital. When the director of emergency services position became available, he applied on a whim. He received extremely high scores during the interviewing process and was the top candidate. Dent asked the ED managers and staff if they would support the decision to promote him to this position, and all resoundingly agreed. For the last three years, Dent has mentored Bredimus and sought other opportunities for him, such as a Nurse Director Fellowship offered by the American Organization of Nurse Executives.
“It took a lot of time and effort, but he’s been very successful,” Dent said. “Millennials have to have a sense of purpose greater than themselves, and I’m really trying to create an environment that values this.”
The millennial mind
Be accessible
Nick Escobedo, MSN, RN, OCN, NE-BC, a millennial himself, believes the younger generation of nurses responds well to leaders who offer themselves as mentors and coaches rather than as superiors or bosses.
Escobedo, a clinical manager in outpatient infusion services at Houston Methodist Hospital, helps his staff members develop their careers. He often asks about their aspirations and concerns, and when a nurse has a question, he sees it as an opportunity to connect and teach. A millennial nurse recently asked how to find funds for her governance committee, and he took the time to teach her what he knew about budgets and forecasting. “She is very engaged as a nurse and finds tremendous meaning in what she does,” he said. “I’m looking for professional opportunities to help her grow.”
Escobedo is eager to develop leadership skills in millennials partly because his managers did the same for him. He had been working as a nurse for two years when his manager and clinical coordinator asked if he would be interested in being a charge nurse for a day when the unit was short-staffed. “It was trial by fire, but these two leaders had identified something in me that was drawn to leadership even before I realized it myself,” he said. Their confidence inspired Escobedo to seek additional training, chair a shared governance committee and eventually start working as a clinical manager.
Millennials not only thrive when they are entrusted with leadership, but also when they have the freedom to move to new roles within a hospital, said Candace Smith, BSN, MPA, RN, NEA-BC, CNO at Manatee Memorial Hospital in Bradenton, Fla. “They generally like to move around rather than stay in one place for too long,” Smith said.
She noticed that young nurses who were interested in moving to a new unit were leaving when they couldn’t find a new role within Manatee Memorial Hospital. In response, the hospital started a Grow Your Own program, which gave nurses the opportunity to request a transfer. Staff nurses who were interested, the majority of which were millennials, filled out their top three choices for new units. Those who met certain criteria — such as good attendance records and no discipline issues — moved to a new unit.
Transformation pays off
Be your own champion
Read more articles pertinent to your practice
Leaders take hard look at retaining younger generation of nurses
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By Heather Stringer
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