When the US leaders among Magnet Status Hospitals and the American Nurse Credentialing Center (ANCC) arrive next month in my hometown of Louisville, KY for their annual conference, they may need to think not just about strengthening the role of the nurse in patient care, but about the young RNs themselves.
Magnet designation was set up to elevate the professionalism of nursing in hospitals and strengthen the quality of care within the nation's healthcare delivery system. It promotes excellent patient care, a high level of staff satisfaction, low staff turnover and appropriate grievance resolution. It also promotes nursing's involvement in data collection and decision-making in patient care.
Sounds good, but how do we make it a reality if we don't embrace the new generation of nurses? I meet with a variety of healthcare providers every week and it is a rare human resource professional who tells me they have slots for all the recent graduates who are flooding the recruitment doors. "I get tons of nursing applications" a Nurse Recruiter told me last week, "but 85% of those were from new grads. I can't hire a one of them because the managers will only look at experienced."
Today 11.1% of our nation's registered nurses are aged 60 years or over. Only 8.9% are aged 30 and under. The average age of an RN is about 47 years and a Baby Boomer by definition. Over 40% of the younger RNs left nursing altogether last year because they felt it wasn't "what I thought it was going to be".
For the first time since we have been recording turnover, newly hired RNs had an average of less than a year on the job. In 2008, 46% left their post after only nine months and another 12% left prior to hitting the first year anniversary. Last year, in part because of the economy, entry-level workers stayed on the job longer than RNs!
Here's what I'm seeing:
- Hiring Managers want experienced RNs because they don't want to train new graduates who don't, at the start of their career, have the clinical skills necessary to appropriately function as a full team member.
- Many new graduates cannot find jobs, even though there are currently about 128,000 open RNs jobs in the US because they don't have experience.
- Healthcare delivery systems are not training managers on how to cope with the Generation Y RN and continual clashes drive the recent graduate out the door — while maintaining the older worker.
- Within the next five years, the crush of RN retirements will cripple the nation's healthcare delivery systems.
The concept of Magnet status should be a perfect match for the Generation Y RN. This group of new workers was raised by a village. If their parents weren't standing over them with special schools and more lessons than the day's hours would allow, their grandparents were relatively young and completely involved with disposable income and hours for interacting. The Generation Y RN remembers the concept of a counselor for every kid at camp, their own cubby and everything being over communicated. It really was all about them.
When the Generation Y RN looks for a position they want something as special as they are so they can come home and tell "the village" they have done well. A nationally recognized Magnet hospital would do nicely.
If the promise of excellent patient care is realized at Magnet hospitals, direct-line supervisors should be ready and willing to augment what the new RN didn't get in school with on-the-job training, residency programs and other supporting education. The focus would appropriately be on the Generation Y RN and the possibility of them walking out the door would be lessened.
Hospitals, Magnet designated and not, need to realize that as long as we continue to spend as little as two years educating a registered nurse, many are not going to be equipped to practice as a fully trained professional. The cases are too complicated, the drug lines too many and the pressures too paralyzing. Systems must realize if they are going to have enough RNs and fully-functioning RNs ready to fill the roles of those retiring, they must do the training.
Magnet, as leaders in nursing excellence, should consider strengthening the role of the Nurse Manager. Nurse Managers are the key to a positive practice environment and if they do not know how to speak the different languages of the four generations, how to build a team environment by capitalizing on diversity and generational differences and how to appropriately communicate, they will not be able to deliver exceptional patient care.
While the need for a clear career path was the single most important reason a RN stayed or left an organization in 2008, the front-line Manager continues to be the most important element in retention.
Generation Y believes they are individually important enough to be communicated with regularly and they believe in benefits that tend to bend toward work-life balance. They believe their opinion is just as important as anyone's and that should play well with Magnet's collaborative approach among all professionals.
Magnet's approach to raising the professionalism of nursing must come with embracing the Generation Y RN. For the first time in thirty years a group has eclipsed the Baby Boomers as the largest worker group. There are only 76.1 million Baby Boomers and 78.2 million Generation Ys. An average of seven Boomers retire every minute so the group known for their workaholic nature and high productivity will quickly exit the workforce and who will be there to fill their shoes if we don't embrace the new, Generation Y, RN today? Quite possibly ANCC and Magnet status might be the answer.