The Multigenerational Nursing Workforce

A Call to Action for Retention, Resilience, and Leadership

The current nursing workforce consists of 4 generations , from Generation Z to baby boomers. Historical events, core values, professional orientation, and technology have shaped each generation and therefore profoundly impact workforce performance and relationships with leadership.¹ In its current state, the nursing workforce comprises 19% baby boomers, 37% Generation X, 35% millennials, and 6% Generation Z. With the average age of a nurse being 46 years old, it has become increasingly apparent that our focus must be on a deeper understanding of each generation and retention, as well as a focus on reducing burnout to prevent a nursing shortage due to significant retirement. This approach is necessary to maximize existing staff and solidify high-functioning teams.

Unique characteristics differentiate each generation in the nursing workforce.² Millennials, for example, are a growing population and strive to find meaning in their work. Their quest for meaning in their work supersedes their loyalty to an employer. On the flip side, baby boomers are traditionally characterized as being hardworking and loyal within an organization.²

Health care systems today face new challenges that have emerged over the last 15 years, significantly impacting the nursing profession. These include the COVID-19 pandemic, insurance reimbursement, technological advances, and the growing need to embrace the unique perspective of equity, diversity, and inclusion.³ Early-career nurses with less than 5 years of practice are highly susceptible to the pressures of moral distress—being unable to act in alignment with one’s ethical beliefs—and the nursing shortage. The foundational knowledge that nursing school is the start of stress, followed by transition to practice, often results in 33.5% of nurses leaving the profession within the first 2 years.⁴ Nursing turnover contributes to workforce instability, resulting in staffing shortages, increased workload, and diminished ability to deliver optimal care. These challenges are associated with poor outcomes and increased risk of nonreimbursement from commercial payors. The cost of turnover is estimated at $52,350 per nurse, with an annual cost reaching $380,600.⁵

The pandemic has had a significant and lasting impact on the emerging nursing workforce. New nurses were exposed to high levels of patient suffering while working with limited resources, often caring for critically ill patients despite feeling underprepared.⁶ These experiences have shaped their professional development and understanding of the nursing role.

Although the ethical obligation to care is a foundational element of nursing, the extreme conditions of the pandemic introduced additional stressors that cannot be overlooked. Consequently, moral distress has become increasingly recognized in both academic and clinical settings.⁷ Addressing these challenges is essential to supporting the well-being and retention of the nursing workforce.

Post pandemic, the health care landscape has changed significantly due to the ongoing need for new initiatives, models, fiscal restraints, and the implications to maximize patient care. This often creates fatigue among health care providers, given their need to quickly adapt and continue managing other responsibilities without wavering. Nurses may even experience “change fatigue” due to the rapid changes to their existing workflow while managing the cognitive impact of losing control.⁸

For nurse leaders, it is essential to leverage the strengths of a multigenerational nursing workforce. Understanding the generational differences in coping mechanisms and resilience to workplace stressors is a critical factor in promoting nurse retention. Equally important is identifying and adapting to communication preferences to ensure key information is effectively delivered and accurately interpreted across generations.

Nurse educators must adopt diverse instructional strategies that accommodate varying learning preferences. These strategies should include traditional lectures, slide deck presentations, and experiential, hands-on approaches. At the same time, educators must remain mindful of the shorter attention spans often associated with millennial and Generation Z nurses, necessitating more engaging and interactive learning environments.¹

From an administrative perspective, offering flexible scheduling options, including varied shifts and hours, has been shown to enhance job satisfaction and improve retention outcomes. Additionally, opportunities for participation in quality improvement initiatives should be aligned with generational strengths. For example, millennial and Generation Z nurses may be particularly well equipped for projects involving technological innovation, whereas baby boomers can play a vital role in precepting and mentoring due to their depth of nursing experience.¹

Finally, while acknowledging generational differences, it is equally critical to value each individual nurse’s unique attributes and contributions. Fostering an environment that balances generational awareness with individual recognition supports “generational harmony” and strengthens team cohesion within an evolving nursing workforce.

References

1. Tussing TE, Chipps E, Tornwall J. Generational differences in the nursing workforce: strategies for nurse leaders. Nurse Leader. 2024;22(5):602-608. doi:10.1016/j.mnl.2024.03.007
2. Auerbach D, Buerhaus P, Skinner L, Staiger D. Total employment growth of registered nurses (RNs) levels off in the 4th quarter of 2016. Accessed April 18, 2026. http://healthworkforcestudies.com/publications-data/new-four/quarter-twenty-six-teen-rn-data-now-available.html.
3. Mellum JS. Generational harmony in nursing. OJIN J Issues Nurs. 2024 29(2):1-11. Accessed April 21, 2026. https://ojin.nursingworld.org
4. Kovner CT, Brewer CS, Fatehi F, Jun J. What does nurse turnover rate mean and what is the rate? Policy Polit Nurs Pract. 2014;15(3-4):64-71. doi:10.1177/1527154414547953
5. 2026 NSI National Health Care Retention & RN Staffing Report. NSI Nursing Solutions, Inc; 2026. Accessed April 21, 2026. https://www.nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retention_Report.pdf
6. Bongiorno AW, Armstrong N, Moore GA, et al. Impressions of the nursing profession among nursing students and new graduates during the first wave of COVID-19: a qualitative content analysis. Nurse Educ. 2023;48(4):204-208. doi:10.1097/NNE. 0000000000001386
7. Loyd LA, Stamler LL, Culross B. Early career nurses and moral distress: an integrative review. Nurse Educ Pract. 2023;73:103844. doi:10.1016/j.nepr.2023.103844
8. Beaulieu L, Seneviratne C, Nowell L. Change fatigue in nursing: an integrative review. J Adv Nurs. 2022;79(2):454-470. doi:10.1111/jan.15546