Journal of Nursing and Practice

Opinions of Generation X Nurse Managers on Generation Y Nurses: A Qualitative Study

Abstract

Purpose: This research was conducted with the aim of determining how generation X nurse managers working in different hospitals perceive generation Y nurses under their management and the general characteristics defining generation Y nurses in the work environment.

Methods: It is a descriptive study using open-ended questions. In the analysis of the data, descriptive analysis and content analysis method were used. The sample of the study consisted of nurses served as administrators in four hospitals of a university hospital (N = 25) between 15 January and 15 May 2016. Semi-structured interview technique was used. The data were collected by two researchers by face-to-face interview technique with voice recording and researchers notes. The data were analyzed with the coding technique into six main themes.

Results: According to the findings of this research, the perceptions of generation X nurse managers about generation Y nurses are as follows: - low commitment to the institution, - high self-confidence, - courageous to change jobs, - constantly questioning the behaviors of the manager, - their perception of respect is different from the old generation, - they widely use technology in all fields, poor communication skills, impatient and egocentric.

Conclusion: Generation X nurse managers perceive generation Y nurses as a generation has high self-confidence, low communication skills, courageous, impatient, egocentric, and using technology well.

Keywords

Management, Leadership, Nurse practitioners, Quality of care

Introduction

Today, work environments have a wide range of employees of different age groups. This wider age range, expressed as a generation, causes differences in the professional perceptions and business attitudes of the individuals working in the same business environment.

Every human being is born into a community that will live a similar life with itself and the lives that this community has lived shape the distinctive characteristics of its generations [1]. Each generation has its own characteristics, core values, thoughts, weaknesses and strengths [2]. The demographic characteristics of the generations determine the needs, values, priorities and behavior of people, so professional organizations have been conducted surveys of their members about generational differences [3,4]. Today, technological developments are also an important factor playing a role in shaping a generation [4]. Because of global events, technological developments, political-cultural structure of societies, each generation has its own characteristics, standard of judgments, attitudes, worldview, strengths and weaknesses [2,4].

With the increasing diversity of workforce in recent years, managers have had to adapt to gender, ethnicity and age differences [1]. Today, age differences can be a problem when nurses belonging to 4 different generations, who can be grandparents, parents, or children of each other, are working together in the hospital environment [1,5-8]. Each generation has easily identifiable values, cultural differences, thought styles and behavioral patterns [9]. The attitudes, beliefs and working habits of nurses from different generations shape the role of the nurse in patient care and the nurse’s job-related expectations [7].

The term "Generation" defines groups of people of similar age groups born in a certain time period [9]. The concept of generation is defined as a group of people who were born in around the same years and who share the conditions of the same age and therefore go through similar problems and fates, sharing similar thoughts, beliefs, priorities and feelings about their careers [10,11]. At workplace, a new generation, or group of like-minded employees composed of similar ages, arrives about every twenty years [8].

If nurse managers are embrace generation differences, enable each generation to benefit from each other’s experiences and knowledge, they can contribute to the individual development of nurses and create more connected and collaborative nurse teams [7]. In a multigenerational working environment, knowing the characteristics of generations is understanding each one will facilitate the identification of potential issues of conflict. As well as, it will provide different insights to recruitment and retention strategies, and strategies on guidance and motivation [6,7].

Respect for differences strengthens commitment to institution and profession by ensuring that each member demonstrates his/her potential and ability [7]. Every generation gives a new perspective to the team. Understanding the small differences between generations will help nurse managers create teams that will provide quality and patient-centered care [12]. For this reason, nurse managers have very important roles in creating a respectful, understanding and interdependent work environment, promoting and protecting institutional commitment and foster workforce cohesion [1,13]. To be able to fulfill this role, nurse managers should be able to understand the different characteristics of generations as a long-term strategy [1].

This research was conducted with the aim of determining how generation X nurse managers working in different hospitals perceive generation Y nurses under their management and the general characteristics defining generation Y nurses in the work environment.

Methods

Study Design

It is a descriptive study using open-ended questions. Descriptive research is a preferred technique in which systematical investigations can be made on the meanings born from the experience of people who are studied or planned to be studied [14].

Setting and sample

Purposive sampling method was followed in the study. Accordingly, interviews were conducted between 15 January and 15 May 2016 with generation X nurse managers who worked at Istanbul University hospitals (4 Hospitals). The interviewees were nurse managers who considered to be members of generation X (N = 25). Generally, it is accepted that the X generation are people who were born between 1961 and 1980 [1].

Semi-structured indept interview technique was used as the data collection method in the study. In the interview guideline, there were questions on the demographic characteristics of generation X nurse managers and five open-ended questions about their opinions of generation Y. Generally, Y generation is accepted as people who were born between 1981 and 2000 [1].

In order to find the answers of the questions used in the research, 25 nurse managers working in Istanbul University hospitals were interviewed individually. The interviews were conducted as face-to-face interviews in an environment where the two researchers and participants were alone. During the interview, the method of note taking and voice recording was used with the consent of the participants and only for being used in this research.

Ethical consideration

At the beginning of the study, ethical committee permission from the Istanbul M University Ethics Committee (Approval no. 14.07.2015/368) and written permission from the hospitals included in the research were obtained. The purpose and method of research was explained to the nurse managers included in the sample, and the researcher disclosure form was signed and research was conducted.

Data analysis

In the analyzes, a code number was assigned to the nurse managers interviewed (referred to as the participant), and this code number was used during the explanations (e.g. Participant1= P1). In the analysis of the data, content analysis method was used (Figure 1). The voice recordings obtained after each interview were converted into text in the "Words for Windows" software. In the obtained texts, observer notes were added to the relevant sections. After all the data were collected, each investigator reviewed the data. On the computer, related words were grouped by repeatedly searching with keywords. The data were coded at three different levels (Figure 1).

While the coding system was being developed, the views of all participants were examined one by one. In content analysis; first the main words were determined. Smaller categories of content were then created. The related groups were determined then merged. Main themes were created and then combined under six main themes. There are two sub-themes of the "Commitment" theme and the "Work Performance" theme, and three sub-themes of the "Communication" theme.

Results

In this section, demographic characteristics, main themes created by data analysis in line with the aim of the researchers, and the answers given by nurse managers to the questions in the questionnaire are presented.

It was found that 17 nurse managers who participated in the research were born between 1967-1976, 16 nurse managers had graduate degrees, 17 nurses were married, 8 nurses had generation Y children, and their average professional experience was 21.92 ± 5.55 years.

Thematic categories 1 - commitment

When the statements of the participants were examined, the theme of "Commitment" was divided "Commitment to Institution" and "Commitment to Profession" sub-themes.

When examining the explanations of generation X nurse managers on the general characteristics of generation Y nurses, it is seen that the most common substitute perception is not feeling commitment to the institution and their profession, looking for opportunities for job change, and continuing their education in different fields for job change. It was seen that the most commonly used expressions were; they are able to resign easily (48.0%) and they still continue their education to perform a different profession (40.0%) (Table 1).

Statements of nurse managers expressing this substitute perception are as follows:

For Commitment to Institution:

P5: "They don’t have organizational culture, no loyalty. Job assignments will be made soon, and at the moment they are saying, "I will switch to the field of public health, it is more convenient". They openly say this. They want to switch to institutions that offer better wages. They prefer places close to their houses. They do not want to spend time on the road. In our time, we came to the lodge the night before to arrive early in the morning for our hospital watch, and we had a lot of loyalty. They have no institutional loyalty."

P10: "Our previous service had 4-5 nurses with 25-years of experience. It was an advantage. Here people leave too soon. There are only 2 senior nurses. People don’t have nursing memory, they come and go. Their loyalty to the institution is weak, they want to change their job, such as appointment, marriage, pedagogical formation, workplace nurse, or be transferred to a state institution."

For Commitment to Profession:

P6: "They want to go to graduate schools and switch to academia or to become a manager, want to change their profession, there are more people studying in different departments. No commitment to the job, they only work to make money."

Thematic categories 2 - work performance

When the statements of the participants were examined, the theme of "Work Performance" was divided "Task Performance" and "Contextual Performance" sub-themes.

When generation X nurse managers were investigated in terms of their evaluation of generation Y nurses on professional knowledge and skills, it was seen that patient care, holistic evaluation of the patient, desire for less work, absenteeism for simple reasons, and not wanting extra shifts in emergencies were indicated. Generation Y nurses do not want to focus patients care, and they do not take responsibility regarding the patients (72.0%) (Table 1).

Statements of nurse managers expressing this substitute perception are as follows:

For Work Performance:

P6: "They are not interested in patient care. They focus on nursing."

P9: "They do not want to perform patient care, treatment is enough for them. We no longer have patient care like we used to. Now they leave it to caregivers. They don’t like patient care. They have the knowledge and skills, but they don’t do it because they don’t want to assume responsibility or take on tasks. They don’t do it because they think that they will be stuck with that task once they do it."

P6: "They are not interested in patient care. They focus on nursing."

For Task Performance:

P22: "When we call someone else because a nurse is on sick leave, the other person gets mad. However, that person is also doing the same thing some other time."

P10: "……They do not touch the patient….."

For Contextual Performance:

P15: "They don’t know their duties, they do not question it. ………….. They do not have love and respect for their jobs. A nurse who loves his/her job needs to focus on the job and not himself/herself, and has to think, what can I do for the care of this patient, what do I need to do. They don’t have this mentality. They are individualistic; they don’t have team spirit, a unity of purpose. They cannot come together like the links of a chain."

Thematic categories 3 - communication

When the statements of the participants were examined, the theme of "Communication" was divided "Team Communication", "Communication with Patient" and "Communication with Manager" sub-themes.

When generation X nurse managers were investigated in terms of their evaluation of generation Y nurses on team communication and communication with patients; nurse managers indicated that their understanding of respect and kindness was completely different than generation X, they were not suitable for teamwork, they were egocentric and intolerant, and they were unable to empathize with others. It was seen that the most commonly used expression was "Egoism" (56.0%) (Table 1).

Statements of nurse managers expressing this substitute perception are as follows:

P4: "They don’t make dialogue with patients, they give short answers like yes, yes. Just like chatting in whatsapp."

P10: "…They interact minimally, communicate minimally. They don’t even make eye contact. They talk without looking at the patient in the face."

P15: "They don’t like people either……."

P16: "They don’t want to communicate with the patient a lot. Their tolerance is low, they get angry very quickly."

P18: "They are egocentric, they put themselves ahead of the institution. They are self-ordained, they make decisions on everything by themselves."

P19: "……. they can’t empathize."

When the opinions of generation X nurse managers on the relationship of generation Y nurses with their managers were evaluated; it was found that questioning, willingness to seek their rights, disliking criticism and taking orders were the most prominent features. When the frequency distributions of the expressions used by the participants when explaining their thoughts related to the communication of generation Y nurses with their managers, it was seen that the most commonly used expressions were questioning all the decisions of managers related to work (68.0%), and having a tendency to seek their rights (64.0%) (Table 1).

Statements of nurse managers expressing this substitute perception are as follows:

P6: "We are having more problems with those that have joined the workforce within the last five years."

P10: "They make no bones about these things. They say you said so back when, but you are doing something else now. ……… they undermine your authority, show respect as they wish. In the past we couldn’t even sit down before the head nurse allowed us. ………… They don’t have obedience, they are not like us. They need to be convinced."

P19: "They confuse seeking their rights and being obstinant. They treat everyone as if those people are going to wrong them."

P23: "They also show minimum respect to the administration."

Thematic categories 4 - willingness to learn new knowledge

When generation X nurse managers were investigated in terms of their evaluation of generation Y nurses on their willingness to learn new knowledge, they indicated that generation Y nurses were generally not willing to learn. The most common expression was "they are not willing to learn" (52.0%) (Table 1).

Statements of nurse managers expressing this substitute perception are as follows:

P3: "They watch everything on YouTube, but they don’t want to learn new things. They don’t ask for sources, they want ready information… … … … … They don’t want to make any contributions to their profession."

P7: "The knowledge of the beginners are alright, but they are not willing to learn."

Thematic categories 5 - self-evaluation

When generation X nurse managers were investigated in terms of their self-evaluation, it was found that they generally considered themselves to be better than generation Y nurses in topics related to learning, view of profession and practicing the profession. It was observed that the participants evaluated themselves to be more content in terms of work / workplace compared to generation Y (56.0%) (Table 1).

Statements of nurse managers expressing this substitute perception are as follows:

P4: "Work was important to us. For them, they and their families are more important."

P8: "Old generation was more content. New generation is always searching for ‘why something is not happening’."

P12: "We tried to learn things we didn’t know, but they are not like that."

P13: "They are extremely casual, we used to be more discrete. We used to have a unity of uniforms, we don’t have that anymore."

P20: "Those who are closer to our generation are the people who have commitment to the institution, who are respectful, devoted, self-sacrificing, and who love their profession. New nurses are more impervious, they do not care, …..."

Thematic categories 6 - problem solving

When generation X nurse managers were investigated in terms of what they do regarding problems they face with generation Y nurses, it was found that they spent extra time listening to generation Y nurses, took requests regarding working hours into consideration, tried to convince them by talking, and organize celebratory meetings on special days. The most commonly used solution method was organizing the shift schedule according to the requests of generation Y nurses (64.0%) (Table 1).

Statements of nurse managers expressing this substitute perception are as follows:

P8: "We listen to everyone separately, one by one. ….. We send them to trainings and conferences. We engage in verbal motivation."

P19: "First of all, I try to listen to them no matter what. … I try to be flexible when I make the shift schedules. I'm trying to let nurses go for postgraduate education days, vocational courses, special days (marriage, engagement, funeral, etc.) if they tell me in earlier. I have to plan so as not to disrupt the working system. I always try to be fair."

P23: "I try to be fair and tell them why I do things a certain way. … … …. I listen to them a lot, and I try to show them that I understand."

Discussion

In this qualitative research conducted with the aim of determining the views of generation X nurse managers on generation Y nurses, one of the prominent findings is that the level of commitment (Thematic Categories 1) of generation Y nurses to the institution and profession is perceived to be low.

According to literature, it is stated that generally Y generation has low loyalty to the institution and profession [11]. Whereas Generation X depends on the working environment [15]. In the literature, it is stated that the level of emotional commitment to the organization of the X generation is higher than that of the Y generation [16,17]. According to our findings, generation Y nurses easily resigning and changing jobs, and liking frequent changes indicate that they do not feel loyalty to the institution. This finding is consistent with the fact that generation Y is less loyal and has a feature of changing jobs frequently. The idea that the generation Y is generally "Here today, gone tomorrow" [18], and the tendency to a close work area [18,19] are related to low commitment. Because, Generation Y will not be afraid of moving to another work field if they do not find a competitive and also supportive work environment [1].

According to the findings of our study, it is seen that the generation of Y generation nurses to don’t feel the devotion to their institutions and professions, to look for opportunities for job change and to continue their education in different fields for job change (Thematic Categories 2) Generation Y nurses want to specialize, continue their education, and decide on their workplace according to its prestige. In other words, generation Y nurses choose the institutions and fields they will work in on their own, according to the prestige of the institution, the proximity of the workplace to their school or homes, and the opportunities they offer for specialization [20]. They are willing to change work every couple years to find a more creative and intellectual occupation, a more flexible work schedule, career development, feeling of satisfaction and fulfilled expectations, a less stressful work environment or a higher quality of life [21,22]. Based on these data, we can be say that the Y generation nurses will always be in seek of a new job because of their low adherence to the institution and profession. In this context, nurse managers can develop personal relationships at work by being sensitive to personal characteristics of individuals, and consolidate institutional loyalty among employees.

In our study, participants stated that their families were more important for Y-generation nurses and they were trying to organize their working plans according to their private lives. This finding is consistent with the literature. Generation Y attaches importance to flexible working conditions and work life-social life balance [1,19,20]. Generation Y wants to work, but they do not want their lives to consist only of work. [21]. Some try to make their programs more flexible by telling they are sick, or by demanding frequent changes [2]. For generation Y, family and friends are a priority over work [19]. They want their schedules to be organized in a way they can allocate time for their own lives and their families [2]. In our study, most nurse managers have indicated that they organize work schedules according to the requests of generation Y nurses to address their desire of a flexible work schedule, and to ensure work continuity. These findings will be useful for the development of Y generation nurses’ strategy of ensuring their commitment to the institution and profession.

In our research, generation X nurse managers have highly expressed the desire of generation Y nurses to quickly advance in their careers, making more money, continuing their education to change careers, and to become a manager as soon as they start working (Thematic Categories 1). Generation Y has a high level of self-confidence [19]. Therefore, it is not strange that soon after the completion of their orientation generation Y nurses ask their managers questions about career development [21]. New generation nurses always have second options in case they cannot get what they expect in their careers. Becoming a teacher, establishing their own business, or simply changing their workplace is among their future plans [20]. For this reason, they prefer to go to courses that will enable them to work in another career while continuing to work in the hospital [19].

According to our findings, generation X nurse managers indicated that generation Y nurses do not want to come to work for emergency calls, take sick leave more frequently, always plan their working hours based on their personal lives, and give more priority to personal life (Thematic Categories 2). Generation Y nurses expect their work schedule to be catered around their personal needs rather then adjusting their personal schedule to fit their work schedule [20]. Generation Y wish to have a life outside work [4]. They can feel drowned due to fixed working hours [21]. For this reason, managers working with members of generation Y need to be extra careful when planning 12 hour shifts, night shifts, weekend and holiday shifts [2]. In our study, the most commonly preferred solution by nurse managers was to schedule working hours or shift leaves according to the times requested by generation Y nurses.

As indicated by generation Y nurses, the most basic source of motivation is recognition, encouragement, and appreciation [2,20]. If these inner feelings are not met, they will seek other opportunities to fulfill job satisfaction [23]. When approaching generation Y, the correct method is to approach them without a prejudiced attitude, to contribute to their professional development, to guide them, and to support them in their career development [24]. The results of our study revealed that generation Y nurses expected behaviors from generation X managers such as constant appreciation, pampering, thanking, not criticizing them, and convincing them (Thematic Categories 3). For this reason, generation X managers who are able to adjust their management styles play a key role in ensuring that generation Y nurses continue their work.

In contrast to traditional forms of communication and time-consuming face-to-face interviews, generation Y prefers fast and efficient electronic communication methods such as e-mail, social media, and messaging [5,21,22]. But many still do not possess the manners of talking on the phone [4]. Our results indicated that the generation X nurse managers participating in our study generally complained that generation Y nurses did not establish a good communication the patients and team members (Thematic Categories 3). This finding is consistent with the fact that members of generation Y have poor face-to-face communication skills.

Generation Y does not like hierarchy, have problems agreeing with their superiors, and resist the leadership of their superiors especially when their superiors are older than them [9,11]. From this point of view, the findings of our research indicating the perceptions of generation X nurse managers on generation Y nurses such as questioning all the decisions of their managers, fully seeking and protecting their rights, and having endless expectation from their managers, etc. reflect the truth. (Thematic Categories 4).

Generation Y does not think that they need to respect older generations because of the age difference [8]. Generation Y does not respect one by looking at age, experience, or even institutional authority, and they are not afraid of these people. They attach great importance to innovation, practical intelligence, and contributions to the institution [2,4]. These characteristics of generation Y are also supported by the perception of nurse managers on generation Y as stated in our research, "the understanding of respect of the new generation is different, they do not obey, they are fearless" (Thematic Categories 5). Older generations treat nurses of new generations as their children, while young generations act like teenagers with the desire to rebel against figures of authority. However, the old generation expects respect and reverence while the new generation expects equal treatment [8]. This disharmony can cause problems such as friction / conflict at work.

The results of our study revealed that generation X nurses perceived their own generation as more respectful, obedient, content, more willing to learn, patient, and more inquisitive (Thematic Categories 5). It is stated in the literature that generation X is a generation that is motivated by education, that can process many thoughts at the same time, multitask, face many problems, adds many things to work life, is realistic and produces practical solutions to problems [19]. Due to the values, beliefs and attitudes of generation Y nurses and the traditional business perceptions of nurse managers, difficulties occur in work environments [24].

It is important to understand generation Y to ensure a healthier work environment and appropriate communication and teamwork [2]. Nurse managers who participated in our research indicated that they applied certain methods for solving the problems they encounter with generation Y nurses such as trying to act fairly, individually meeting with people, taking time to listen, and trying to show that they understand (Thematic Categories 6).

Ways of satisfying and motivating generation Y and ensuring their harmony are; - showing ethical leadership, - establishing a safe and transparent environment, - providing commitment, - providing guidance and counseling, - providing opportunities of collaboration, - remembering, knowing and rewarding [21]. From this point of view, the nurses participating in the research seem to be applying the correct methods.

One of the solutions we have identified in our study to ensure the commitment of generation Y members to work is flexibility of work schedule in the direction of their requests (Thematic Categories 6). However, flexible work conditions have not been found to affect professional continuity in general as well as in terms of generations [11]. For this reason, "right harmony" and "right time" should be emphasized instead of adjusting working hours according to the demands of generation Y nurses [2].

Conclusion and Recommendations

Generation X and Y have different perceptions and ideas in terms of work and business understandings. For this reason, it is important to know the characteristics of these two generations in order to prevent conflicts in the business environment, to create a peaceful work environment and to achieve institutional success.

According to the findings of this research, the perceptions of generation X nurse managers about generation Y nurses are as follows: (1) low commitment to the institution and profession, (2) high self-confidence, (3) courageous to change jobs, (4) constantly questioning the behaviors of the manager, (5) their perception of respect is different from the old generation, (6) they widely use technology in all fields, (7) unsuccessful in face-to-face communication, (8) impatient, and (9) egocentric. It is important to know that these characteristics of X generation nurses that are increase their business performance, increase quality and create a happy business environment. If the nurse managers know the generation Y characteristics, they can make changes in the way they manage to have happier employees. Egocentric, impatient and disrespectful behaviors are not perceived personally by managers, that is important for the prevention of communication conflicts.

Given the changing landscape of nursing practice, it is vital that the practical implications of this study are addressed. According to this results, managers can develop personal relationships at work by being sensitive to personal characteristics of individuals, and consolidate institutional commitment among employees.

New generations have always been criticized by older generations, and it seems that this trend will continue in the future. It is therefore quite important for leader nurses to understand the unique generational characteristics of the nurses, who come from different generations but are part of the same teamwork and work side-by-side. These research’s findings are reflected the important to know by leader nurse to increase organizational trust and organizational commitment.

When we look at sources related to generational and institutional commitment, the common view is that the commitment to institution creates a happier and more productive work environment. In this context, managers can develop personal relationships at work by being sensitive to personal characteristics of individuals, and consolidate institutional commitment among employees. Generation Y attaches importance to flexible working conditions and work life-social life balance. Therefore, nurse managers must take into account the requests of generation Y nurses about work schedules and their desire for a flexible work schedule to ensure work continuity. Senior nurses should avoid thinking that generation Y nurses are not team players and try to avoid the task. These are adverse effects for teamwork.

In light of these results, it is recommended that must be organized in-service training programs and research about new generation' expectations about ideal working conditions. Thus, leader nurses understand difference between generation and develop awareness about happily / ideal workers / workplaces and management.

Acknowledgments

The authors desire to thank all the participants in the study.

Contributions

FA: Design, Supervision, Writing, Literature Review, Critical Review.

SP: Design, Fundings, Materials, Data Collection and/or Processing.

Financial Disclosure

The authors declared that this study has received no financial support. Any funding has not been received (institutional support, non-commercial grants, commercial support, and support, etc.).

Conflict of Interest

The authors declare that they have no conflict of interests.

References

1. Carver L, Candela L (2008) Attaining organizational commitment across different generations of nurses. J Nurs Manag 16: 984-991.
2. Lower J (2008) Brace yourself here comes generation Y. Crit Care Nurs 28: 80-85.
3. Costanza DP, Badger JM, Fraser RL, et al. (2012) Generational differences in work-related attitudes: A meta-analysis. J Bus Psychol 27: 375-394.
4. Keepnews DM, Brewer CS, Kovner CT, et al. (2010) Generational differences among newly licensed registered nurses. Nurs Outlook 58: 155-163.
5. Harding AD (2011) Multigenerational workforce: Are we using the literatüre effectively? J Emerg Nurs 37: 75-76.
6. Duchscher JEB, Cowin L (2004) Multigenerational nurses in the workplace. J Nurs Adm 34: 493-501.
7. Hendricks JM, Cope VC (2013) Generational diversity: What nurse managers need to know. J Adv Nurs 69: 717-725.
8. Kilber J, Barclay A, Ohmer D (2014) Seven tips for managing generation Y. J Manag Polic Pract 15: 80-91.
9. Solaja OM, Ogunola AA (2016) Leadership style and multigenerational workforce: A call for workplace agility in Nigerian public organizations. Int JAfric Asian Studi 21: 46-56.
10. Republic of turkey the turkish language association (2017): Big turkish dictionary.
11. Shacklock K, Brunetto Y (2012) The intention to continue nursing: Work variables affecting three nurse generations in Australia. J Adv Nurs 68: 36-46.
12. Murray EJ (2013) Generational differences: Uniting the four-way divide. Nurs Manag 44: 36-41.
13. Christensen SS, Wilson BL, Edelman LS (2018) Can I relate? A review and guide for nurse managers in leading generations. J Nurs Manag 26: 689-695.
14. Erdogan S (2014) Qualitative researches. In: Research in Nursing, Semra Erdogan, Nursen Nahcivan, Nihal Esin (Eds). Nobel Medical Publishers, Istanbul, Turkish, 131-164.
15. Stevanin S, Palese A, Bressan V, et al. (2018) Workplace-related generational characteristics of nurses: A mixed-method systematic review. J Adv Nurs74: 1245-1263.
16. Demirkaya H, Akdemir A, Karaman E, et al. (2015) Researching generations' management policy expectations. J Bus Stud 7: 186- 204.
17. Karasu F, Aylaz R (2017) X and Y generations: The relationship between professional solidarity and job satisfaction in nurses. J Health Scie Profess 4: 180-189.
18. Weingarten RM (2008) Four generations, one workplace: A Gen XY staff nurse’s view of team building in the emergency department. J Emerg Nurs35: 27-30.
19. Gursoy D, Maier TA, Chi CG (2008) Generational differences: An examination of work values and generational gaps in the hospitality workforce. Int J Hospit Manag 27: 448-458.
20. Lavoie-Tremblay M, Paquet M, Duchesne MA, et al. (2010) Retaining nurses and other hospital workers: An intergenerational perspective of the work climate. J Nurs Scholarsh 42: 414-422.
21. Piper LE (2012) Generation Y in healthcare: Leading millennials in an era of reform. Frontiers 29: 16-28.
22. Sherman R (2014) Leading generation Y nurses. Nurse Lead 12: 28-50.
23. Anselmo-Witzel S, Orshan S, Heitner KL, Bachand J (2017) Are generation Y nurses satisfied on the job? Understanding their lived experiences. J Nurs Adm 47: 232-237.
24. Sherman RO (2015) Recruiting and retaining Generation Y perioperative nurses. AORN J 101: 138-143.