Why work in perioperative nursing? Baby boomers and generation Xers tell all

AORN Journal,  Oct, 2007  by Julia A. Thompson

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Recruiting a younger generation nursing staff members and meeting retention demands of cross-generational nurses will be a challenge like no other previously seen in health care. (1-5) The perioperative sector, which faces similar challenges in recruiting and retaining RNs as other specialty areas, must seek creative solutions to the problems of recruiting new nurses and retaining them after they arrive.

There currently is a severe nursing shortage in the specialty of perioperative nursing. (6,7) Recommendations to address the nursing shortage, however, have been based on data that fail to consider the basis of nurses' choice of specialty career within the nursing profession or nurses' perception of work, which is influenced by the generation in which they were born.

The workforce today is composed of two distinct generational cohorts: the "entrenched workforce" or Baby Boomers (ie, those born between 1943 and 1960) and the "emerging workforce" or Generation Xers (ie, those born between 1961 and 1977). (8) The term generational cohort refers to people born in the same general time span who share key life experiences, which include demographic trends, historical events, public heroes, entertainment pastimes, and early work experiences. (4) These common life experiences create cohesiveness in perspectives and attitudes and define the unspoken assumptions of the generation. As a result, employees of different age groups do not share the same work ethic or expectations. (9,10) Certainly, each human being is individual; however, understanding generational experiences and perspectives from different age groups is essential to developing effective strategies for recruitment and retention.

Without understanding grounded in the perceptions of RNs who have chosen a perioperative nursing career and are willing to describe the various reasons for their choice, there is no basis for practice interventions that may ultimately result in recruiting and retaining RNs to perioperative nursing. An understanding of nurses' process for making career decisions is necessary to develop successful strategies to sustain and encourage individuals to choose perioperative nursing careers. The aim of this study was to attempt to gain such an understanding.

LITERATURE REVIEW

The perioperative nursing shortage is well chronicled in the literature. The multiple factors credited with creating this shortage include a growing demand for health care, an aging workforce, fewer graduates with perioperative experiences, a diminished supply of nurses and people interested in becoming nurses, and the cultural influences of the emerging workforce. (11-13)

The developing nursing shortage has focused attention on the emerging workforce, the smallest pool of entry-level workers in modern times and the most sought-after labor pool in US history. (1) The success of every enterprise lies in the ability to attract, retain, and fully utilize the talents of individuals in this demographic.

Considerable research has been directed at determining why people select nursing as a career, but little research has been performed with the focus of explaining nurses' preferences for specialties within that broad area. No research studies were found that specifically identified what motivates individuals to choose perioperative nursing as a career. Additionally, no research was found that investigated factors related to potential nurse applicants' ages and the attractiveness of perioperative nursing as a career. Thus, there is limited empirical evidence to guide the perioperative nursing specialty in attracting applicants and retaining members of the current workforce, regardless of their age.

PURPOSE AND RESEARCH QUESTIONS

The purpose of this study was to explore factors that influence nurses of different age groups (ie, Baby Boomers and Generation Xers) to choose to work and stay in OR nursing. A secondary goal of the study was to determine whether there was a difference in the perception of the work environment among OR nurses by age group. I explored the following three research questions in this study:

* What factors influence nurses of different age groups to choose OR nursing as a specialty?

* What factors influence nurses of different age groups to remain in OR nursing?

Is there a difference in the perception of the work environment among OR nurses by age group?

THEORETICAL AND CONCEPTUAL FRAMEWORK

Madeleine Leininger's theory of culture care diversity and universality provided the theoretical framework for this research. (14,15) According to Leininger, culture is defined as the

   learned, shared, and transmitted knowledge of values, beliefs, and
   lifeways of a particular group that are generally transmitted
   inter-generationally and influence thinking, decisions, and actions
   in patterned or certain ways. (14(p47))

This view of culture is not geographically bound or confined to any race or ethnicity but speaks broadly of an identified group. Leininger believes that nursing is a culture and that each professional culture has different values, beliefs, and norms that guide the actions and decisions of individuals within that culture. Perioperative nursing is a culture with its own set of values, beliefs, and practices. This theory frames the perspective for approaching the study and provides a useful cognitive map for exploring perioperative nursing culture.