Managing workplace change: Intergenerational perspectives from Victorian public hospital nurses

ABSTRACT

Background

In response to a growing nursing shortage internationally, alongside an ageing population, strategies to retain older nurses in the workforce are warranted. As a result, it is important to understand nurse experiences and develop strategies to retaining older nurses in the workforce.

Aim

What are the experiences of change management, career intentions, learning and development, and wellbeing across different generations of Victorian public health nurses?

Methods

Using the 2018 People Matter Survey, we conducted a secondary analysis of Victorian nurses who completed the health survey (n = 18,963), the change management module (n = 6,044), and the career intentions module (n = 4,320). Nurses were divided into accepted generational age groupings: Generation Z (born from 1996 onwards), Generation Y (1981 to 1995), Generation X (1961 to 1980) and Baby Boomers (1943 to 1960). Descriptive statistics and analysis of cross-tables of frequencies were applied.

Findings

In total, 3,781 Baby Boomers, 9,022 from Generation X, 4971 from Generation Y and 1,189 from Generation Z responded to the survey. The experience of workplace change had the most adverse impact and increased with age (Gen Z; 34.3%; Gen Y: 49.3 %; Gen X: 53.6% and BB; 56.3%) and most participants felt they had limited control over issues that caused stress.

Discussion

This study highlights that workplace change is common and nurses in Victoria, Australia’ are typically well informed and supported during change processes.

Conclusion

Supporting nurses through organisational change is essential. Further, promoting professional development and career progress, particularly in older nurses, may promote retention in an era of global nursing shortages.

Introduction

In 2015, the total number of nurses and midwives was 360,008, making it the largest single health profession in Australia (AIHW) (Health Workforce Australia, 2014: Australia’s Future Health Workforce – Nurses Detailed; Stevanin, Palese, Bressan, Vehviläinen‐Julkunen, & Kvist, 2018). This figure is consistent internationally with nurses being the largest profession in the UK (n = 639,000) (The Nursing Midwifery Council, 2019), Canada (n = 431,769) (Canadian Institute for Health Information, 2018) and the United States (n = 3.8 million) (Smiley et al., 2018). Projected figures highlight that the demand for Australian nurses will significantly exceed supply and there will be an expected shortfall of approximately 85,000 nurses by 2025, which will increase to 123,000 nurses by 2030 (Health Workforce Australia, 2014: Australia’s Future Health Workforce – Nurses Detailed). The growing need for nurses is consistent with an ageing workforce and fewer people choosing nursing as a profession (Stevanin et al., 2018, Stevanin et al., 2020).

A generation is a cohort that shares birth years and related significant life events (Wilson, Squires, Widger, Cranley, & Tourangeau, 2008) thus leading to unifying commonalities (Lyons & Kuron, 2014). Currently, the international nursing workforce is made up of four commonly-accepted generational groupings: Baby Boomers, born from 1943 to 1960; Generation X, born from 1961 to 1980; Generation Y, born from 1981 to 1995; and Generation Z, born from 1996 onwards (Bell, 2013, Parry and Urwin, 2017, Stevanin et al., 2018). The impact of generational differences among nurses has the potential to impact retention due to the experience of differing values and priorities (Haddad, Annamaraju, & Toney-Butler, 2020) as well as work habits, expectations of management (Boychuk Duchscher & Cowin, 2004) and retention strategies (Coburn & Hall, 2014). In addition, generational differences are reflected in communication, teamwork and technology literacy, which are all central in developing nursing competencies (Bell, 2013). While generational profiles are a guide only, since individual variations exist, they help to understand the current work context. For example, Baby Boomers typically have more experience, value work performance and are loyal. Generation X are independent and effective problem solvers who value a work/life balance with family life. Generation Y are confident, multi-taskers, globally connected and technologically adept. Lastly, Generation Z are independent, outcomes oriented, technologically adept and dependent, using technology to answer questions (Bell, 2013, Kupperschmidt, 2000). Despite these differences, nurses across each generation share a dedication to promoting health and well-being for their patients and families (Price & Reichert, 2017), with job satisfaction being a strong predictor for nurse retention (Murrells, Robinson, & Griffiths, 2008). As a result, there is a need to create work environments that maximise job satisfaction and facilitate the retention of older nurses while also recruiting younger ones (Wilson et al., 2008).

An additional challenge towards facilitating retention of nurses, is the impact of continual workplace changes in health care due to factors such as: an ageing population, changing disease patterns, advances in technology and other political and policy initiatives (Moloney, Boxall, Parsons, & Cheung, 2018; Nilsen, Schildmeijer, Ericsson, Seing, & Birken, 2019). Workplace change is often characterised by restructures and mergers due to fiscal pressures, technological and clinical practice changes alongside the increased demand for efficiency with fewer resources (Al-Abri, 2007; Moloney, Gorman, Parsons, & Cheung, 2018). Growing evidence highlights a negative association between organisational change (Kuokkanen, Suominen, Härkönen, Kukkurainen, & Doran, 2009) and increased staff stress levels (Lavoie-Tremblay et al., 2010), and lower job satisfaction (Moloney, Boxall et al., 2018; Willem, Buelens, & De Jonghe, 2007). A growing number of studies exploring how nurses respond to organisational change highlight the need for better organisational support (Abou Hashish, 2017, Ross, 2016), supervisor support (Galletta, Portoghese, Coppola, Finco, & Campagna, 2016; Gillet et al., 2018), effective nurse leadership (Mudallal, Othman, & Al Hassan, 2017), team commitment and working group cohesion (Galletta et al., 2016; Lasalvia et al., 2009; Zhu, Wholey, Cain, & Natafgi, 2017).

As international bodies and government policies seek to address nursing shortages, any strategies should be informed by evidence. The People Matter Survey is the public sector annual employee opinion survey, which is coordinated independently across Australian States and Territories. In the state of Victoria, the survey is distributed by the Victorian Public Service Commission and captures the experiences of approximately 300,000 public employees across over 184 organisations. This study presents results on a sub-study exploring the results of optional survey modules towards the experience of change management, career intentions, learning and development, and wellbeing in Victorian public hospital nurses who participated in this state-wide survey. We hypothesised that adverse experiences would highlight areas to intervene to promote staff retention.