Traditional hospital hierarchies failing Gen Y nurses, new study finds

New research led by Southern Cross University has found the hierarchical style of management which is deeply embedded in the healthcare system is failing Generation Y nurses, forcing some of them to exit Australia’s hospitals.

The results appear in the paper entitled, ‘Communication, training, wellbeing and commitment across nurse generations’, which was published recently in the Nursing Outlook journal and co-authored by Associate Professor Yvonne Brunetto, from the University’s Southern Cross Business School, along with Dr Rod Farr-Wharton from the University of the Sunshine Coast and Dr Kate Shacklock from Griffith University.

Professor Brunetto, who is head of management, marketing and human resource management in the Business School, said the researchers set out to test if the workplace experience for Generation Y nurses, born between 1980 and 2000, was different or the same as that of Baby Boomer nurses, aged 45 to 65.

“All nurses have the similar beliefs about the nature of nursing and they all understand the importance of certain clinical values to save lives. This is unchanged regardless of a nurse’s age,” said Dr Brunetto.

“But the generations differ when it comes to values and beliefs.

“Generation Y aren’t as committed to their organisation. If they are not happy in the workplace they will leave and even change career paths, whereas Baby Boomers are much more likely to stay. Generation X-ers (born between 1966 and 1980) are somewhere in the middle.”

Dr Brunetto said Generation Y nurses had different expectations.

“Generation Y has come into nursing with the belief that they are professionals and therefore their tasks should be clinical in nature. For example, it is going to be a Baby Boomer nurse who will do the flowers for a patient; Gen Ys will do it but only if they have time,” she said.

“Gen Ys are more achievement- and career-orientated. Notably they dislike hierarchy and therefore are more likely to experience difficulty relating to superiors and less likely to accept the leadership of the nurse supervisor, particularly when that supervisor is much older and has vastly different life experiences.”

The study found Generation Y nurses were the most computer literate and technology-ready, were more likely to pursue training and development opportunities, and were more prepared to move from one organisation to take advantage of those opportunities.

“By contrast, the reason Baby Boomers are inclined to stay put is because they have better workplace relations with their supervisor, who tends to be of the same age with similar life experiences,” Professor Brunetto said.

“For Baby Boomers, these key factors lead to a higher perception of wellbeing.”

Within a context of global nurse shortages, replacing nurses has become more difficult and their training and retention has become a critical concern for health care management.

According to the research, quality supervisor-subordinate relationships in turn foster quality colleague to colleague relationships. Professor Brunetto said more work needed to be done to build a stronger sense of wellbeing to encourage more nurses to remain in the industry.

“In the hospital setting, demands and pressures are great, causing wellbeing to be compromised across all generations,” she said

Money acts as an incentive, but only to a point.

“Whether people stay or go is largely a product of how good their supervisor is. Nurses will chase dollars, but they won’t stay for dollars. They’ll stay because of relationships. Relationships are the anchor for nurses.”

One way forward, Professor Brunetto said, was to manage nursing professionals with professionalism.

“The autocratic method of managing is not suitable anymore. Yet a lot of the healthcare systems are set up as hierarchies.”

A hierarchical management style involves a command style of communication which can suppress the development of an effective supervisor-subordinate relationship.

“This is reinforced by middle- to upper-level managers who fail to take into account the cost of replacing nurses when staff numbers are cut to balance budgets. These managers simply believe it’s a demand and supply issue and that the government will supply them with more nurses,” said Professor Brunetto.

“But new nurses don’t have the skills or knowledge to make the life and death decision that more experienced nurses are called upon to make every day.”
Photo: Associate Professor Yvonne Brunetto from Southern Cross Business School.