When a 55-year-old nurse works with her three daughters at the same hospital, you might expect some intergenerational friction: comments such as, "Mom just doesn’t get the computer" or "My girls don’t seem to be as committed to their work as I was at their age."

But at Forrest General Hospital in Hattiesburg, Miss., where Marilyn McMahon, RN, and her daughters––27-year-old twins Cindy Moore, RN, and Wendy Hale, RN, and 30-year-old Vicki Scott, RN––have been working together since the mid-’90s, you’re more likely to hear, in soft Southern accents, the following from McMahon, who works in the emergency room:

"My girls always had a good work ethic. But I think they are more committed to their families, which is good." And from Moore, a cath lab nurse: "I learn a lot from Mama. I don’t have as good an attitude as she does, but I try. She’s sweeter and she seems like she handles things better than I do. Maybe that will come with age."

With understanding and respect, McMahon and her daughters have built a strong bridge across the span between their years. Unfortunately, workplace consultants who study intergenerational conflict say many health care workplaces operate more like dysfunctional multigenerational families.

Older nurses grumble that young ones are disloyal, spoiled and hooked on excitement, technology and money instead of nurturing. Younger nurses see their older colleagues as out of touch and stuck in a work model that disappeared years ago.

Following the lead of other businesses, some health care companies hire consultants to talk about differences between the generations and how restructuring the workplace could accommodate them.

A 25-year-old nurse who refuses to work overtime is not being selfish, for example. She or he just believes it will make him or her a better nurse if there’s time to do things outside work. The 45-year-old nurse who blanches when she hears her excitement-hungry charges express hope that "someone will code today" has prayed fervently throughout her career that none of her patients will ever come to harm.

Once they learn where these attitudes come from, nurses can begin to respect and learn from each other, said Carolyn Martin, Ph.D., a master trainer for Rainmaker Thinking, a New Haven, Conn., management consulting company, and co-author with Bruce Tulgan of the book, Managing Generation Y. Martin and Tulgan, who also wrote Managing Generation X and other books on the newest generations, have set up training programs across the country to teach managers how to deal with the changing demands of young workers.

Four generations
Martin and other consultants who work on multigenerational issues break the workforce down into four generations, but emphasize that not all members of a generation will have all or even any of its characteristics.

Members of the Silent Generation were born between 1925 and 1942; the baby boomers, born between 1943 and 1962; Generation X, born between 1963 and 1977; and Generation Y, sometimes called the Millennium Generation, born after 1978. Martin and Tulgan end Generation Y at 1984, but other consultants say those born up to the year 2000 are members of Generation Y.

The Silent Generation, sometimes called the GI Generation, first fought in World War II, then helped rebuild the American economy in the years after the war. They have a strong sense of commitment, loyalty and hard work.

The baby boomers grew up pampered by their Silent Generation parents, but share many of their workplace values, including loyalty and commitment. Many went into nursing because they wanted to do good in the world. Those who survived the downsizing of the 1980s were forced to rely on each other to cover shifts and work overtime, all for the greater good of patient care.

The two youngest generations of workers, Generation X and Generation Y, don’t understand the fuss about overtime and overwork, pensions and retirement plans. Gen Xers, the original latchkey kids, grew up in the era of downsizing and restructuring. They and their younger siblings believe that job security is a myth and that their best chance of survival in a changing workplace lies in building and marketing their skills. They work hard and are dedicated to their patients. But they want to be paid adequately and are not afraid to tell employers when they think demands are unreasonable.

Moving on
Emma Magaña, RN, is a 29-year-old staff nurse on the special care unit at San Mateo County General Hospital in San Mateo, Calif. She’s worked at the hospital, her first job out of nursing school, for almost two years. She has noticed that some—not all, she emphasized—of the older nurses sometimes complain they have to orient new, young nurses who stay for a year or two, then leave.

But Magaña, who plans to go to graduate school and study forensic nursing, said no one has offered her a retirement plan or any other incentive to stay. Nor does she expect or want one.

When she was in school, hospitals were cutting staff. Hospital nursing jobs were practically nonexistent. Instructors told students to consider alternatives, such as home health care, public health and advanced degrees.

Magaña started her hospital job well aware of her options. Although she loves it, she said, hospital nursing is hard work and she doesn’t plan to burn out on it.

"The day I walked through the door," she said, "I felt like there was more to my career than just this."

Some baby boomer nurses might see Magaña’s attitude as disloyal, said Connie Curran, Ed.D., RN, FAAN, president of Cardinal Health Consulting Services in Chicago. They don’t understand that nurses who came of age in the 1980s and early 1990s have no intention of spending their career with a particular company, she said. "They’re not loyal to an employer. They’re loyal to building their own skill set."

Some boomers have come around to the younger generation’s way of thinking. Many switched careers or went back for advanced degrees in their late 30s and 40s. Some, including Curran, have pioneered new fields, such as consulting. Some older nurses have told Magaña they wished they had done what she is doing. "But 20 years ago when you were in nursing school," Magaña said, "they probably didn’t tell you these things. They didn’t want you to be smart. They didn’t want you to get a Ph.D."

Digital divide
Technology is another intergenerational flash point. Many young nurses don’t understand why older nurses don’t recognize that technology will make their jobs easier, Martin said. Older nurses fear that the younger generation’s zeal for bells and whistles keeps them from taking cues from their patients.

"I can’t imagine doing stuff without computers," said Kim Borup, 23, a student nurse at the Arizona State University College of Nursing, who has been using them since the third grade. "It’s kind of natural."

In contrast, some boomer nurses and most of the Silent Generation remember a time when only a few families had televisions, said Terry Miller, Ph.D., RN, dean and professor at Pacific Lutheran University School of Nursing in Tacoma, Wash. Older nurses, who have done fine with a pad and pencil for years, feel uncomfortable punching buttons or fear they’ll press the wrong one and crash the system.

Many younger health care workers "treat the technology instead of the patient," said Jane Kennedy, RN, a 49-year-old emergency-room nurse in Portland, Ore. She recalls a young physician who ordered a nurse to accompany a patient to a scan because a monitor showed his oxygen saturation was low. "The patient was fine," she said. "But the gadget wasn’t on his finger correctly."

Unlike many workaholic baby boomers who define themselves by what they do and how much they work, younger generations tend to see work as only a part of their lives. Generation X and Y nurses say the flexible hours and schedules of hospital nursing attracted them to the profession in the first place. To cope with the intensity of their jobs, they say, they need time to relax and pursue other interests.

Family comes first
Some demand time for spouses and children. Others value travel and nights out with their friends. Some of the younger nurses Kennedy works with seem to resent working weekends and holidays. "Those of us who’ve been at it for a while, we just kind of take it for granted," she said.

Their attitude can grate on older nurses. Although she admires her daughters’ dedication to their families, when McMahon hears about young co-workers calling in sick or just not showing up, she sometimes thinks, "They’re not dedicated. If they wake up and don’t feel like going in, it doesn’t seem to bother them."

To induce nurses of different generations to stop squabbling and start cooperating, Curran, Martin and others who instruct health care organizations on intergenerational differences suggest the following:

The key to intergenerational understanding and cooperation, workplace consultants say, is that nurses understand there are rational reasons why each generation behaves the way it does.

Nurses of all generations must realize that not only can they respect each other’s differences, but they can learn from each other as well, Martin said. Only then will they stop seeing each other as adversaries and more as members of a family with a single purpose.

"It’s the work," she said. "The value, the meaning, the challenge of the work. The dedication to caring for human beings."