WHY PRESS GANEY

Today’s nursing workforce spans four generations: baby boomers, Gen X, millennials, and Gen Z. Each brings unique perspectives, career goals, and expectations to the workplace.

That diversity creates complexity and opportunity. Recruiting, engaging, and retaining nurses increasingly requires a more nuanced workforce strategy—one that balances generational insights with an understanding of how employee needs change over the course of a career, as well as a deeper understanding of what motivates them at different stages of their careers.

While generational differences are reshaping workforce strategies, one finding stands out across the data: No matter their age or tenure, nurses want leaders they can trust—leaders who are visible, responsive, and invested in their success.

Turnover risk is highest among early-career nurses

Turnover isn’t evenly distributed. The greatest risk is concentrated among nurses early in their careers: 22% among Gen Z, with millennials nipping at their heels (21%). For new nurses, the first months on the job entails more than learning clinical skills. They are building confidence, forming relationships, and determining whether they belong. And when those connections fail to develop, disengagement and early departure become far more likely.

What each generation values

While all nurses want supportive leadership, the way support is experienced—and the priorities attached to it—vary across generations.

Gen Z: Growth, purpose, and connection

As the newest cohort in the workforce, Gen Z nurses are focused on learning, development, and impact. Coaching, mentorship, and regular feedback are especially important to this generation, as well as clear career development opportunities that help them see a path for growth. They want leaders who listen, invest in their development, and help them navigate the transition into practice. They also want to work in environments where they feel a strong sense of purpose, inclusion, and psychological safety—where each member of the team is valued, supported, and empowered to speak up.

Millennials: Flexibility and transparency

Millennials now make up a significant share of the nursing workforce, and their priorities often center on sustainability and balance. They value things like flexible scheduling, work–life balance, and transparent communication from leadership. Millennial nurses want clarity, support, and the autonomy to manage professional responsibilities alongside personal commitments. Organizations that create supportive work environments and recognize the importance of well-being are better positioned to engage and retain this vital segment of the profession.

Gen X: Stability and operational effectiveness

Many Gen X nurses are experienced clinicians and leaders whose priorities rest on the conditions that enable them to do their best work. They want effective managers, fair and sustainable workloads, and consistent operational support. For this group, trust is built through competence, reliability, and leaders who remove barriers to success.

Baby boomers: Legacy and knowledge transfer

Nearly a quarter (22%) of baby boomers plan to leave the workforce. Their exodus, primarily driven by retirement, introduces a different workforce challenge.

The departure of experienced nurses represents far more than reduced headcount. It risks eroding the institutional knowledge, clinical judgment, and mentorship that underpin high-performing care environments. As seasoned professionals and long-tenured leaders leave, organizations lose the expertise, relationships, and tacit wisdom that shape decision-making, accelerate learning, and sustain a strong culture of safety and excellence.

Without intentional succession planning and knowledge transfer, organizations risk seeing decades of clinical expertise leave with departing employees—undermining both care delivery and workforce development.

The first year sets the tone

The earliest stages of a nurse’s career are among the most formative, yet the most vulnerable. During the first year, nurses face an elevated risk of turnover, particularly when they lack meaningful social integration, strong relational support, and opportunities to build trusted connections with peers and leaders. These experiences influence far more than the transition into practice; they establish the foundation for long-term engagement and professional growth.

Engagement data reveals another important trend: Registered nurse (RN) engagement begins to decline after the first six months and reaches its lowest levels between years one and five. These early experiences shape a nurse’s confidence in clinical practice, foster (or hinder) a sense of belonging, and strongly influence long-term intent to stay. Organizations that invest early in connection, mentorship, and support are better positioned to retain talent and build a resilient nursing workforce.

However, strong onboarding programs can make a difference. When organizations intentionally support nurses through the transition to practice, they accelerate trust, strengthen peer relationships, and help nurses build the social capital they need to thrive. As such, investing in onboarding becomes the foundation of retention.

The common denominator? Leadership.

Despite meaningful generational differences, nurses are remarkably aligned around what they expect from leadership.

Across all four generations, nurses respond to leaders who are:

Visible and present
Responsive to concerns and feedback
Respectful in their communication
Clear about decisions and priorities
Consistent in their actions and follow-through

Universally, effective leadership remains one of the strongest drivers of workforce performance. When leadership is strong, engagement, trust, and retention improve across generations and the entire nursing workforce..

5 ways to build a workforce strategy for every generation

Leading organizations are moving beyond one-size-fits-all workforce approaches and using data to understand what different groups of nurses need to succeed.

1. Segment workforce data

Analyze engagement, experience, and turnover data by generation, tenure, and role to uncover where risks are emerging. These insights enable leaders to target interventions where they’ll have the greatest impact.

2. Invest in onboarding and mentorship

Create programs that:

Pair early-career nurses with mentors
Provide structured feedback and coaching
Support relationship-building from day one

3. Create clearer career pathways

The next generation of nurses expects more than a job—they expect a future. Organizations that define career pathways, cultivate emerging leaders, and prioritize continuous skill development are more likely to retain high-performing talent.

4. Strengthen peer connections

Belonging is built through everyday experiences, not one-time, one-off initiatives. By creating structured opportunities for connection—from team-based onboarding to peer support and cross-team collaboration—organizations strengthen engagement and improve retention.

5. Preserve institutional knowledge

The coming wave of baby boomer retirement means preserving expertise is an urgent imperative in all aspects of healthcare. Organizations that formalize knowledge transfer, expand mentorship, and document and share hard-earned know-how will best be able to maintain continuity, continually improve clinical practice, and ready the next generation of caregivers—and all those that follow.

There’s no one-size-fits-all strategy that will drive optimal performance among today’s nurses—or the generations to come. But organizations that tailor support to evolving workforce needs and invest in strong, responsive leadership are most likely to build engaged, resilient, and high-performing teams.

Because, while today’s nursing workforce is more diverse than ever, the expectation is remarkably consistent: Nurses want leaders who show up, listen, and follow through.

Download our “State of Nursing 2026” report for deeper insights into generational workforce trends, engagement patterns, and evidence-based retention strategies.

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