Running head: KEY ISSUE: MILLENNIAL TURNOVER IN THE NURSING 1

Key Issue: Millennial Turnover in the Nursing Profession

Angela Purgiel

Ferris State University

KEY ISSUE: MILLENNIAL TURNOVER IN THE NURSING 2

Abstract

New graduate, millennial nurse turnover is affecting hospital units at a rate of 30 percent in the

first year and upwards of 41-60 percent by the second year. It is important for leaders to focus on

this issue in order to inhibit costly turnover within their unit. By understanding the basic needs of

the new graduate, millennial nurse, like concepts related to teamwork, and leadership structure a

nurse leader can help meet the staff member’s needs and decrease the likelihood of that staff

member leaving the unit. It is also important to implement strong leadership characteristics like

structure and commitment while using Lewin’s change theory in order to ensure cohesive

implementation within the unit’s culture

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Key Issue: Millennial Turnover in the Nursing Profession

Turnover in the nursing profession is certainly not a new concept but with the recent

introduction of the millennial workforce and the surpassing of baby boomers, retaining

millennials in the workforce has become extremely important. According to Kathy Bonser,

Vice President of Nursing and CNO at SSM Health DePaul, millennials are seeking a certain

formula within their work environment including “frequent feedback, celebration of milestones,

and the need for performance feedback” (Bonser, 2016, para. 3). Retention is also important as it

creates positive compassion within the workforce. When the group as a whole is satisfied with

their work environment they provide high quality and compassionate care (Sorensen Marshall,

2011). Providers need to feel satisfaction within their work environment; they need to feel

important to the profession as a whole. The purpose of the paper is to advocate for the solutions

in decreasing millennial turnover, provide rationale for addressing this issue all while using

Lewin’s change theory to move the change forward.

Literature, Support, and Discussion

A millennial nurse is defined as a person born after the year 1980, many of these nurses

are entering the field currently as new graduate nurses (Randall, 2013). Turnover is an extremely

important issue facing the profession because “high job turnover for new graduate nurses is

associated with detrimental patient outcomes, costly for employing organizations and

problematic for the profession” (Randall, 2013, p. 152). It is estimated that 41-60% of all new

graduate RNs plan to leave their current roll within two years. One of the common identified

dissatisfiers for newly hired, new graduate nurses is the difference between their perception of

the profession and what the role actually entailed once they were contributing members of the
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work force (Randall, 2013). This concept is important for nursing schools as there may be a

disconnect between classroom content and actual work experience.

In a study published in the International Journal of Nursing Studies it was found that

almost 30% of new nurses will leave their profession within in the first year (Kovnen et al.,

2016). The estimated cost to the organization is roughly $62,000 to $67,000 per nurse (Kovnen

et al., 2016). Not only does this cost the organization money but it also creates shortages within

the unit leaving the potential for units to have to work understaffed until more nurses can be

trained. This then becomes a patient safety issue as the demands of the nurse increase.

Both of these articles had very similar solutions to this problem. Both stated that leaders

within the nursing units play an important role in reducing turnover within units. According to

Randall, it is important for nurse leaders to work towards solutions in reducing millennial turn

over as it leads to higher associated costs to the unit. It is the leader’s responsibility to manage

cost (Randall, 2013). According to the other study nurse leaders need to address turnover and

work with new grad staff nurses to build career plans. Although unit staffing is a high priority for

these managers it is more beneficial to work with the employee and ensure job satisfaction by

creating career plans and goals (Kovnen et al., 2016).

Advocating Need for Change

Not only is millennial turn over a costly problem it is also is a patient safety issue, these

two reasons alone are why it is vitally important for a nurse leader to work towards solutions in

reducing the units turnover. In order to create effective change in a unit a strong unit leader

should be developed. There are several important concepts related to what a strong leader

embodies and these concepts are directly related to fostering an environment a new grad,

millennial would want to work in. Keeping in mind there are certain factors uncontrollable from
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the leader standpoint, for instance a staff member leaving the unit due to a change in living

situation or leaving to pursue an advanced degree, which to some extent is not within the leader’s

control.

There are several characteristics an effective leader should exhibit. According to an

article written by Bruce Avolio and William Gardner, leaders should “lead by example” and

leaders should “demonstrate transparent decision making, confidence, optimism, hope and

resilience, and consistency between their words and deeds” (Avolio & Gardner, 2005, p. 326).

These concepts echo characteristics staff members look for in their unit leaders. According to

Randall, millennials expect “challenging work, opportunities for advancement, a social work

environment, work-life balance, and an employer who acknowledges corporate social

responsibilities” (Randall, 2013, p. 153). Not only does a leader need to embody the important

characteristics of an effective leader but they also need to address the needs of the millennial

nurse. Another important concept related to effective management of a millennial nurse is the

“organizational structure and managerial support” (Randall, 2013, p. 153). According to Randall

many millennial nurses grew up playing team sports and respond well to structure and support.

Also closely related to these concepts is the integration of teamwork. Many millennials grew up

working in teams in order to complete task and will gravitate to a work environment that

supports teamwork.

Not only does the unit leadership need to embody these concepts but it needs to be

considered at all levels of the organization leadership. These concepts need to extend from a

chief nursing officer to the director level on down to nurse managers and supervisors. It is

important to encompass these concepts within other nursing department’s including nursing

education and unit clinical nurse specialists. Incorporating these concepts at a broader level
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shows the organizations commitment to the staff member’s success by offering a stable

environment.

When implementing a change at a unit level there are three main aspects to consider in

making the change a permanent staple in the nursing culture. Using Lewin’s change model of

unfreezing, moving, refreezing as it relates to decreasing millennial turnover can ensure this

change will become a permanent part of the unit culture. Unfreezing is the act of identifying a

change is needed using evaluation tools to diagnosis the problem. Moving is the actual act of

initiating the change by implementing change behaviors and shifting the culture of the unit.

Finally, refreezing, is making the change a permanent staple on the unit and restoring

equilibrium into the culture (Mitchell, 2013). There are certain characteristics leaders must

exhibit in order to influence the culture of the unit during change. These characteristics are

commitment to the change and clarity. Leadership commitment to the change needs to be all

various levels of the leadership team. Not only does the leader need to show commitment to the

change but the staff needs to understand their role related to clarity of the change.

Making a change in a unit’s culture can be challenging but it is likely one of the most

important roles a leader can have. With the increasing demand of unit staffing, decreasing

millennial turnover is a change unit’s will likely face. It is important for unit leaders to

understand the basic needs of millennial nurses along with understanding what qualities a

successful leader encompasses. In order to prevent this turnover from occurring a change will

need to be implemented. Using Lewin’s change theory can help leaders successful implement

change behaviors into their unit’s culture and ultimately decrease unit turnover within millennial

nurses.
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References

Avolio, B., & Gardner, W. (2005). Authentic leadership development: Getting to the root of

positive forms of leadership. The Leadership Quarterly, 315-338. Retrieved from

www.sciencedirect.com

Bonser, K. (2016). Millennial Nurse Retention: Bridging the Generation Gap - On-Demand.

Retrieved from http://store.healthleadersmedia.com/millennial-nurse-retention-bridging-

the-generation-gap

Kovnen, C., Djukic, M., Fatehi, F., Fletcher, J., Jun, J., Brewer, C., & Chacko, T. (2016,

August). Estimating and preventing hospital internal turnover of newly licensed nurses: A

panel survey. International Journal of Nursing Studies, 60, 251-262. Retrieved from

http://www.journalofnursingstudies.com/article/S0020-7489(16)30041-4/abstract

Mitchell, G. (2013). Selecting the best theory to implement planned change. Retrieved from

http://home.nwciowa.edu/publicdownload/Nursing%20Department%5CNUR310%5CSel

ecting%20the%20Best%20Theory%20to%20Implement%20Planned%20Change.pdf

Randall, D. (2013, April/June). Expectations of Millennial Nurse Graduates Transitioning Into

Practice. Nursing Administration Quarterly, 37, 152-159.

http://dx.doi.org/10.1097/NAQ.0b013e3182869d9f

Sorensen Marshall, E. (2011). Transformational Leadership in Nursing. New York, NY:

Springer Publishing Company, LLC.