Download Optimal Utilization of the Multi-Generational

By Jeff Carameros RN, BSN, DNP resident
University of Central Florida
Root of the concern
 Current and prior research shows the increasing prevalence
that the national shortage of nurses.
 As this has been publicized, we have seen an influx of
future nurses, but this continues to be less than is required
to recover from a workforce shortage.
 Seasoned nurses are privy to this and have shown to be
staying in the work force longer, possibly in an effort to
prevent decline of patient care.
Problem at hand
 With the dilemma of an increasing shortage of qualified
nursing personnel, there has been a broadening of both the
age range and experience levels in practicing nurses.
 Nursing leaders are faced with this issue and are tasked to
most effectively utilize such a diverse group of nursing
staff.
History of the problem
 The current nursing workforce shortage was first identified
in 1995 (Atwater & Jones, 2004).
 Adding to the complications of the shortage was the
increasing acuity of inpatient care and the increase in both
home care and assisted living situations that both pulled
from an already thinned pool of current nurses.
History continued
 Resulting from these factors was a dilemma in nursing
leadership.
 Nurses ranging in ages from early twenties to sometimes
their early seventies were working side by side with
comparable responsibilities in patient care that drew upon
multiple generations of personal influence as well as
multiple generations of education.
History continued
 In spite of the widening are range of the prospective
nursing workforce, there is also the fact that experience
levels varied tremendously because initial nursing
education was being obtained during second and
subsequent career choices.
Opportunities for nursing
leaders
 Nursing managers and leaders who oversee the care
provided by staff nurses are faced with the challenge of
integrating the knowledge and experiences as well as the
strengths and weaknesses of such a varied workforce in
order to provide the most optimal outcomes for both the
patient, the nursing staff, and the healthcare organization.
Resources for nursing leaders
 Since the goal nursing is to move toward an evidence based
approach to practice, it would be prudent to evaluate these
resources in order to incorporate previously proven nursing
theories into obtaining desired outcomes.
Literature review
 Nursing leaders are faced with four distinct generations of
nurses which each offer their own set of values, work ethic,
and communications style. As such, adaptation of the
nursing leader to yoke together all of these attributes is
necessary (Stanley, 2010).
 Nurse managers should clearly identify both personal and
organizational expectations across all levels of nurses (Hu,
Herrick, & Hodgin, 2004).
Literature review cont.
 Nurse managers should accommodate employee
differences by learning about their specific needs such as
flexible scheduling(Hu, Herrick, & Hodgin, 2004).
 Address generational differences as a whole in order to
nurture an environment of open and respected dialogue
concerning expectations as well as what factors both attract
and promote retention of these nurses(Hu, Herrick, &
Hodgin, 2004).
Ausburger’s model of
carefronting
 Kupperschmidt (2006) describes using “carefronting” as a
strategy for addressing conflict within the
multigenerational workforce. Carefronting, as originally
described by Augsburger in 1973, is a model of
communication in which the party effectively cares enough
to confront an offending party respectfully. The theory
behind this approach is based on the fact that
confrontation is a natural yet positive experience that
integrates true forgiveness in order to move forward with
both personal and organizational goals.
Kupperschmidt’s Adaptation of
Carefronting to Nursing
 Kupperschmidt (1994) adapted carefronting to a nursing
approach. She describes carefronting in nursing as caring
enough about oneself and personal goals to confront
another in an affirming yet caring and responsible manner.
 She points out that carefronting is pure, honest
communication, and considers a lack of this as a form of
dishonest communication which impedes the attainment
of both personal and organizational goals.
Implementation
 In order to implement a plan for integrating
Kupperschmidt’s adaptation of carefronting to nursing,
specific steps should be taken.
 Staff should be educated on the model as well as what the
perceived goals of use are. It should be presented to staff in
such a manner as to promote improved communication
skills rather than just offering complaints.
 Staff should be educated on the topic of multigenerational
nursing and what a positive opportunity it is for their team
to work together in order to improve their day to day lives
as well as improve patient outcomes.
Implementation cont.
 Education should be provided as to what the expected
outcomes of using this approach are. Staff should be aware
that the outcome of implementation of this model will be
reviewed in order to evaluate quality improvement that can
be applied to other areas.
 They should also be aware that although the nursing
manager or leader maintains the responsibility for
facilitating this implementation, it is up to each nurse
personally to understand the responsibility they have
individually to communicate with each other respectfully.
Evaluation of Implementation
 Evaluation of the application of the model could be done in
many ways.
 One method of evaluation would be to poll each nurse on a
unit that is going to be implementing this model of care.
Questions would be quantitatively scored based on a
number that could then be reassessed post-application of
the carefronting model.
 Each nurse could be provided questions rating their
satisfaction with communication between staff and
nursing leaders. Further questions may seek out selfsatisfaction with their current role and barriers to their
communication.
Evaluation of Implementation
cont.
 At a specified time interval, these same questions
could be readdressed with the hope that
implementation of the carefronting model would have
improved communication and therefore overall scores.
 At that point the model could be reapplied as well as
reinforced in order to promote the momentum of this
opportunity for positive change.
References
 Atwater, D. & Jones, A. (2004). Preparing for a future labor
shortage: How to stay ahead of the curve. Graziadio
Business Review, 7 (2).
 Hu, J., Herrick, C., & Hodgin, K. (2004). Managing the
multigenerational nursing team. Health Care
Manager, 23(4), 334-340.
 Kupperschmidt, B. (1994). Carefronting: caring enough to
confront. The Oklahoma Nurse, 7 (10).
 Kupperschmidt, B. (2006). Addressing multigenerational
conflict: mutual respect and carefronting as
strategy. Online Journal Of Issues In Nursing, 11(2),
References (cont.)
 Stanley, D. (2010). Multigenerational workforce issues and
their implications for leadership in nursing. Journal Of
Nursing Management, 18(7), 846-852. doi:10.1111/j.13652834.2010.01158.x