In 2016, millennials surpassed Baby Boomers as the largest living generation in the United States. As more and more millennials have entered the nursing workforce, health care leaders have confronted a growing challenge: young nurses are turning over at higher rates than their older peers, especially early in their careers.

Use the strategies and best practices in this study to build a millennial-specific retention strategy for your organization.

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Millennial nurses have much in common with their older peers

The popular press often paints millennials with a broad and negative brush. As a result, when nursing leaders see high turnover in their youngest staff members, they tend to assume that there is something fundamentally different about millennial nurses. Yet nurses under the age of 35 are far more similar to older generations of nurses than they are different. The workplace factors that engage millennials are nearly identical to the factors that engage nurses of all ages.

Unlike other age cohorts, millennial nurses are more engaged than loyal

This similarity leaves nursing leaders with a dilemma: if young nurses are so like their older colleagues, then why are they turning over at higher rates? Our analysis of the Advisory Board National Employee Engagement Database reveals the answer. Engagement usually mirrors loyalty: engaged employees of all ages are more likely to stay at their organization, while disengaged employees are more likely to leave. However, unlike other age cohorts, millennials are more engaged than they are loyal during their first three years at an organization. Engagement is necessary but not sufficient to retain young nurses in their early tenure. If you can retain them past the three-year mark, their level of loyalty more closely matches their level of engagement.

Supplement your engagement efforts with a retention strategy for millennials

The strategies and best practices in this study will help you build a millennial-specific retention strategy to supplement your engagement efforts. The recommendations are based on three realities of the millennial mindset: they have fewer past work experiences for perspective, they think more in short-term increments, and they have more opportunities than ever.

14 practices for winning millennial loyalty

Introduction: How millennial nurses are similar to—and different from—their older peers (p. 7)

Step 1: Create a safe environment (p. 21)
Detect and prevent poor work environments, create sustainable mentorship for new hires, and hold staffaccountable for supporting new peers.

• Practice 1: Float Nurse Unit Civility Survey (p. 24)
• Practice 2: Professional Mentor Corps (p. 28)
• Practice 3: All-Staff First-Year Turnover Goal (p. 35)

Related resources: Jump down on this page for professional mentor corps materials from UnityPoint Health Methodist | Proctor; explore more mentorship resources including our mentorship program resource assessment, lessons on how to structure your mentee cohort and ways to lead meaningful monthly cohort debriefing sessions.

Step 2: Promote lateral mobility (p. 39)
Provide young nurses with a range of experiences by facilitating transfers to different units or care settings.

• Practice 4: Cross-Unit Draft Day (p. 42)
• Practice 5: Blended RN Roles (p. 46)
• Practice 6: Targeted Role Transitions (p. 51)
• Practice 7: Service-Line Over-Hiring (p. 55)

Related resources: Jump down for cross-unit draft day materials from Manatee Memorial Hospital.

Step 3: Match ambitions to your longer-term needs (p. 61)
Retain millennials by providing longer-term career pathing.

• Practice 8: Speed Mentoring (p. 64)
• Practice 9: On-Call Career Coach (p. 67)

Related resources: Download our guide to speed mentoring, then jump down for more speed mentoring and career coaching materials from profiled organizations.

Step 4: Equip managers to detect retention risk (p. 73)
Identify early-tenure millennials with one foot out the door.

• Practice 10: 30-, 60-, 90-Day Check-In Prompts (p. 76)
• Practice 11: Manager-Led Flight-Risk Assessment (p. 79)

Related resources: Download our editable check-in prompts to guage how a new hire is adjusting; Use this tool to assess the likelihood of an individual leaving.

Step 5: Win back early-tenure staff mid-flight (p. 85)
Understand why staff are leaving so you can win them back.

• Practice 12: Resignation Recovery Protocol (p. 87)
• Practice 13: Status Change "Exit" Interview (p. 91)
• Practice 14: Alumni Return Campaign (p. 94)

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Additional resources: How four organizations implemented these practices

UnityPoint Health Methodist | Proctor

• Mentor Program Operational Details: Learn how UnityPoint Health Methodist | Proctor in Peoria, IL structures their unit-based mentor program, allocates funding, and holds mentors accountable.
• Retention Funds Distribution Guidelines: Read UnityPoint Health Methodist | Proctor’s guidelines for how mentors can spend discretionary funds to help retain new hires.
• Mentor Advancement Program Guidelines: Learn more about the points-based incentive program used at UnityPoint Health Methodist | Proctor to reward top-performing mentors.
• Assessing Available Resources for New Hire Mentorship Program: This tool includes several questions to help you assess whether your institution has sufficient time and resources to implement a new hire mentorship program.

Manatee Memorial Hospital

• Frontline Placement Survey and Application Requirements: Get Manatee Memorial Hospital’s survey (part of their “Grow Your Own” development program) for soliciting unit placement from staff, and the list of material staff must include along with their transfer application.

Miami Valley Hospital

• Career Pathing Event Agenda: See the schedule for Miami Valley Hospital’s career pathing event, which includes staff-leader speed-networking and leader-led breakout sessions on Time Management, Resume Writing, and Interview Skills.
• Sample Leader Bios and Question Set: Review the preparation packet leaders provide staff in advance of the career pathing event, including brief bios of participating leaders and a set of questions to help kick off conversations.

Baptist Health Lexington

• Career Coach Intake Assessment: See the questions Baptist Health Lexington’s Career Coach asks staff at their initial meeting and the template used for ongoing documentation.
• Career Coach Job Description: Download a description of Baptist Health Lexington’s Career Coach, who is responsible for partnering with frontline nurses on developing and planning a future career path.

Norton Healthcare

• Career Coach Job Description: Download a description of Norton Healthcare’s Career Coach, who helps staff understand likely future openings at the organization and the education they need to fill these roles.