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What CNOs should know about millennial and Gen Z nurses


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By Jennifer Thew, RN

Millennial and Gen Z nurses cite team dynamics, professional growth opportunities, and flexible scheduling as important factors in the work environment as part of a new study.

"What matters to you?" This is a question the Institute for Healthcare Improvement encourages clinicians to ask patients to help create customized plans of care. Healthcare leaders can also ask this question of their staff members to improve the work environment and cultivate joy at work.

In this same vein, leaders at Nashville-based HCA Healthcare, with 94,000+ registered nurses, were curious about what matters to millennial and Gen Z nurses as those two groups have started to make up a larger portion of the nursing workforce.

"We've seen a big shift in our demographics now for about the last four years. We went from the millennials and the Gen Z being the minority in our employee population, particularly our nursing group, to now they're the majority," says Jane Englebright, PhD, RN CENP, FAAN, senior vice president and chief nurse executive at HCA Healthcare. "It was a pretty rapid swing for us, so we wanted to make sure we weren't missing anything and that we were meeting the needs of this changing workforce."

Hence, HCA Healthcare, teamed up with The Center for Generational Kinetics to study what drives, engages, and motivates millennial and Gen Z nurses. The results are published in the report, Employment Vitals: Millennial and Gen Z Nurse Expectations.

Here are some of the study's findings, which surveyed approximately 1,250 millennial and Gen Z nurses nationwide:

  • 44% of millennial and Gen Z nurses rate team and managerial relationships as the No. 1 dynamic in a positive work environment.
  • 42% say communication and the ability to make clinical decisions are important factors impacting the working environment. 43% of respondents indicate professional growth opportunities through career advancement are crucial.
  • More than one-third of the nurses surveyed say career advancement training, learning a new specialty, or getting a new certification, is the most helpful type of education they could receive at work.
  • More than 28% of millennial and Gen Z nurses cite the importance of modern facilities and updated equipment as contributing factors in creating a positive working environment.
  • Offering flexible work schedules was selected by 49% of respondents as a top organizational strategy that would absolutely make them feel supported by their employer.
  • When nurses were asked to choose the support system that means the most to them, 57% said they feel most supported through their team.
  • When it comes to career development, 28% of nurses rate moving to a different floor or department as equal to being given increasing amounts of responsibility.
  • One-third of nurses who have been in the field five years say moving to a different floor or department is one of their top two definitions of career progress. 39% of nurses with a six-year tenure said the same thing.
  • 64% of nurses who have been in nursing for nine years have been with their current employer four to five years.
  • Four to five years is how long most nurses with seven or more years of experience have been with their current employer, indicating earlier movement between employers.


Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.