Communication in Nursing--Across All Generations

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By Megan Murdock Krischke, contributor 

April 17, 2013 - As people live longer, healthier and more productive lives, there are more generations working side by side than ever before. Each generation brings its own expectations, views on work, values, experiences and culture to the workplace. This can create difficulty in understanding and health care communications with colleagues of different generations.


Michelle Troseth: good communication in nursing recognizes principles of dialogue.
Michelle Troseth, RN, MSN, DPNAP, FAAN, says learning the principles of dialogue will help foster good communication, even in the heat of difficult situations.

“The most common mistake that I see is that both generations make assumptions about the other,” stated Michelle Troseth, MSN, RN, DPNAP, FAAN, chief professional practice officer for Elsevier, in the Clinical Practice Model Resource Center (CPM).

“Older nurses have much to offer in experience and appreciate it when younger nurses listen before trying to impress them with what they know,” she continued. “Conversely, younger nurses have the benefit of more current information regarding things like technology and they generally bring with them an enthusiastic spirit for the work of caring for patients. They also may bring with them a more modern worldview of practice and collaboration.”

“The best advice that I have to give applies to every practitioner, regardless of age,” said Troseth.  “Each perspective is valuable, no matter whether it is from a nurse with 30 years of experience or one with six months in practice.”

Marian Grant: different nursing generations have been trained differently.
Marian Grant, DNP, CRNP, says that younger nurses often don't realize that RNs were trained very differently even 20 or 30 years ago.

“Communication styles are changing,” noted Marian Grant, DNP, CRNP, assistant professor at the University of Maryland School of Nursing, “The younger generations are much less formal. They include smiley faces and lots of exclamation points in their emails and might sign off a communication ‘Love, Marian.’ Older colleagues can see that as unprofessional.”

“Every generation approaches the issues of the day in a different fashion,” expounded Troseth. “It is vitally important that we recognize that the perspective each generation brings to an organization, as a whole, is uniquely valuable to the sustainability of that organization. It is critical that there is respect for every voice, even if we disagree.”

Scripps Health, based in San Diego, offers a Five Generations in the Workplace class to its hospital leaders and emerging leaders to help recognize the contributions, challenges and needs each generation brings.

Juergen Deutzer, RN, MSN, learning leader at the Scripps Center for Learning and Innovation, offered these insights and common traits about the five generations:

  • Traditionals (born 1930-1945) offer a richness of life and work experience. They are good leaders, trustworthy, thorough and hardworking. They tend to dislike change and feel uncomfortable with conflict.
  • Baby Boomers (born 1946-1964) are the most ambitious generation, putting their careers first. They are willing to go the extra mile and tend to do well relationally. They can, however be reluctant to go against their peers and can be overly sensitive to feedback.
  • Generation X (born 1965-1976) is the first technologically savvy generation and has embraced working collaboratively. They are creative, self-directed and not intimidated by authority. On the other hand, they can be cynical, impatient and have poor people skills.
  • Millennials (born 1977-1990) often see work as a social experience. They are optimistic, technologically savvy, believe in collective activism, are pragmatic, value diversity and are strong multi-taskers. They do require supervision and are inexperienced in handling difficult people issues.
  • The 9/11 Generation (born after 1991) have known nothing but wars and a bad economy, which can lead them to be fearful and concerned about their own security. They are typically goal-oriented and willing to learn and to work hard. They value the experiences of others, but hesitate to try new things.

“When I teach about the generations, I try to emphasize that these are common traits, not stereotypes,” explained Deutzer. “Generations are less about age, as they are defined by a common life experience.”

Juergen Deutzer: there are now five nursing generations in the workplace
Juergen Deutzer, RN, MSN, said that 25 years ago there were only two recognized generations in the workplace, now there are five.

One of the practical communication tips Deutzer offered is that when introducing a new technology to a Boomer or Traditional, you need to be very detail-oriented and walk them through each step.

“This approach, however, would aggravate a Millennial who doesn’t want any instruction, but to just jump in and do it themselves,” he remarked. “With Xers, you have to be very specific regarding timelines. They will deliver on a time line, but if you say ‘Can you do this when you have a chance?’ you might wait a week.”

“My experience has been that truly good communication is universally recognizable, but it often must be taught,” asserted Troseth. “In our work with organizations, we use what we call The Principles of Dialogue [see below]. Dialogue reveals that every one of us, young and old, has knowledge and wisdom to share and it is a process that helps us change our thinking in order to break from the familiar patterns of mechanistic, hierarchical and institutionalized thinking and practice that surround health care providers.”

While good communication and learning to understand those who are different from us is everyone’s responsibility, Grant concedes that the onus is on the younger generation because they are entering the profession and need to learn how to fit in and work with the people who are leading them.

“On the other side, older nurses shouldn’t make it so difficult for younger nurses,” she urged. “Instead of being their critics, we need to be their mentors and teach them how to dress, speak and act professionally.”

“Since the profession and legacy of nursing is constantly moving and changing, we would do well to recognize where we fit into that legacy and approach each other in respect, recognizing that we each have gifts to offer to the discussion,” concluded Troseth.

Related articles:
The Generation Shift in the Nursing Workforce
Communication Skills: Moving Beyond the Basics 


The Principles of Dialogue¹

Intention:  Be willing to create a safe place, to learn collectively, to share thinking and listen to the thinking of another, to be surprised, and to honor the presence of each person’s humanness, that is body, mind, spirit.
Listening: The willingness to learn by listening to self and others at a deeply human level, not to analyze, prove, compete, judge, rescue, fix or blame.
Advocacy:  The willingness to share personal non-scripted thinking and what is behind the thinking, with the intention of exposing, not defending.
Inquiry:  The willingness to ask questions that dig deeper and uncover new insights and new learning by connecting diversity.
Silence:  The willingness to experience and learn by reflecting and discovering the lessons from personal awareness or words unspoken.

¹Source: ©Elsevier CPM Resource Center


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