- Email: [email protected]
Managing the Millennials
Managing the Millennials K. Lynn Wieck, RN, PhD, FAAN
I
n this time of nursing shortage and emphasis on results, the need to ensure an engaged, talented nurse workforce is more important than ever. This article will describe the Millennial generation from a perspective of analyzing how their characteristics contribute to the challenge of leading and managing them in the higher education and hospital work environments. A brief comparison with their older brothers and sisters in Generation X will provide a foundation for why a onesize-fits-all solution simply will not work. The discussion of implications for nurse leaders seeks to provide realistic strategies for nurse leaders and managers in promot-
26 Nurse Leader
ing results in today’s intergenerational workplace while maintaining sanity and a sense of humor.
WHO ARE THE MILLENNIALS? Each generation brings unique challenges to the nurse manager. The newest entrants into the job arena, the Millennials, are no exception. The Millennial generation, born between 1982 and 2002, is second only to the Baby Boomers in size.1 The Class of 2009 is projected to be the largest class to graduate high school in US history. By 2015, college entry will increase by 20%, with students of color comprising 80% of the increase.2 MilDecember 2008
lennial youngsters are the best educated, most affluent, and most ethnically diverse (36% non-white) of the four generations in the workplace today. They bring welcomed traits to the workplace, such as a comfort with working in teams and an optimistic attitude. Millennial childhood was defined by group activities. They were the most watched-over generation in history, so they had defined play dates, soccer matches, and ballet recitals where parents or nannies provided constant vigilance. They engaged in student juries to work out school problems, so group problem solving is a natural part of their skill set. They attended schools that espoused the value of service learning, where they were rewarded for giving back to their communities and world. They have grown up with the Internet to link them to the global community and feel an acute responsibility for their neighbor and the environment. They are “nice kids” who are engaged in the activities of their parents, families, neighborhoods, and the world. Technology proficiency is a hallmark of the Millennials. Over 13 million teens use instant messaging (IM). Seventy-four percent of online teens use IM compared to 44% of online adults.3 Millennials see the computer in the same way that the Baby Boomers see a pencil. They are not intimidated by this tool that is there to entertain and make their lives easier. While Boomers look at a computer and ask, “What can it do?” the Millennials look at the computer and ask, “What needs to be done?” They are baffled by Boomers who are reluctant or refuse to use the full range of a computer’s potential to solve problems, just as a Boomer would be mystified at someone who insisted on using a quill and ink rather than a pencil. The computer is a tool, and Millennials are fearless in its application. Noted generational authors Howe and Strauss4 use seven traits to define the Millennials: 1. Special: Media focus with youth issues since the mid1980s, such as childhood obesity and child-friendly movie ratings, have pointed to how this group is the focus of concern. 2. Sheltered: Overt signals of concern, such as “baby on board” signs, car seats, safety helmets, have been the norm. 3. Confident: Millennials express an eternal optimism and confidence in their ability to perform. 4. Team oriented: They express a strong acceptance of group orientation and influence. 5. Achieving: Most think of future success at a young age. 6. Pressured: Millennials have become the “scheduled kids,” from soccer practice to instant messaging to texting. 7. Conventional: They typically do not rock the boat or seek to break all the rules. Millennial passion to be model citizens is redefining many of the negative traits associated with problem teens of the past, such as crime, sexual permissiveness, and December 2008
Table 1. Percentage of Internet Usage by Age Groups Age Group 12-18 year olds 19-24 year olds 25-35 year olds 36-45 year olds 46-55 year olds 56-65 year olds 65 years old
Percentage Who Use the Internet 98% 87% 83% 73% 72% 64% 34%
From: UCLA Internet Report, Surveying the Digital Future–Year Three, 2003.
substance abuse. Furthermore, they have a high capacity to generate support for community-based initiatives to improve the neighborhood or the global environment. They can recruit and produce volunteers for activities through the Internet and wireless communication devices, which are as much a part of their lives as oxygen and the ozone layer. Howe and Strauss1 call the Millennials the next “hero generation.” They describe a hero generation as one that follows an era of cultural and values upheaval in society. It follows directly behind a generation generally thought to be a disappointment and fills a void left by a passing esteemed generation. They are the target of an adult community that wants to protect and promote them to a higher destiny, and they rise to the occasion by achieving far beyond the expectations of parents and grandparents. In a health care environment desperately in need of heroes, they are a natural fit.
HOW DO THEY DIFFER FROM GEN XERS? Millennials are the wired generation. While Gen Xers are techno-literate and use the Internet to assist their lives, the Millennials have been intertwined with the Internet most of their lives.4 Specifically, the Internet has influenced their views of communication, that it should be instantaneous and continuous. Computer-savvy since childhood, young people today are the most digitally literate students to ever enter college. They are accustomed to depending on computers, IM, the Web, e-mail, interactive media, and cell phones. A UCLA Internet Report5 found diminishing Internet usage penetration as the cohorts aged (Table 1). Generation X, the smallest generation at 51 million, has been described as more cynical and self-concerned than today’s Millennials. Described as “the most attention-deprived, neglected group of kids in a long time,”6 they create a striking contrast to the Millennials whose “helicopter parents” got that name from their continued “hovering,” even long into adulthood where they seem patently unable to let their children go.7 Gen Xers, the
Nurse Leader 27
original “latch-key children,” came home to an empty pressures from the top, mid-managers are finding it diffihouse and learned how to prepare snacks or clean up cult to lead, manage, and supervise their direct reports.11 messes on their own using critical thinking or Internet The difference between an intergenerational workforce advice. The Millennials, on the other hand, have had althat is contentious and one that is productive and innomost constant cell phone contact with hovering parents vative is the organization’s willingness to focus on the and social peers since age 9 and seldom make a move unique needs and strengths of each generation and leverwithout group input. age them for maximum competitive advantage.10 The orientation toward work differs among the two Be a leader, not a manager, to get optimal production generations of young people in this country. Gen X is out of the younger generation. Millennials have a will to characterized for their skepticism and mistrust of authoriget things done, optimism about the future, and a heroic ty. They want as much as possible as fast as possible.8 spirit. They want to make a difference. Millennials’ career But because Millennials came of age during the most rochoices and work behaviors are “driven primarily by their bust economy in decades, they are much more optimistic quest for a chance to play meaningful roles in meaningabout life, work, and the future than their older brothers ful work that helps others.”9 They respond well to lead9 and sisters. Although they engaged in extended adolesers who assign them to a challenge by outlining the cence periods, remaining at home or returning home desired results, matching them to a capable team, allowafter unsuccessful launches, the Gen Xers are self-reliant ing them the freedom to tackle the objective, and reand self-directed. Millennials, on the other hand, often warding them for results.12 By connecting their lack the life skills such as self-reliance, sharing with othcontributions to the organizational vision and overall boters, and conflict resolution that are all essential in the tom line, they will strive to make their effort count. Sucworkplace. cessful leaders of the Millennials will monitor results The team orientation of the Millennials is in stark coninstead of process and will reward accordingly. trast to the more independent-minded Xers. Even in the Coach them to greatness. From their earliest years in sports they choose, they exhibit genorganized team sports, they have had erational selectivity. Millennials play a coach to motivate them to do their soccer and team sports. Gen Xers are Millennials have a will to best and win the game. They are drawn to solitary pastimes, even when looking for that coach when they get things done, optimism performed in a group, such as cyenter the workplace, and managers cling, rock climbing, snowboarding. who assume the coach role get the about the future, and a Millennials may seek to be a conbest results from their Millennial heroic spirit. They want to tributing part of the team, while the workers. Establish and nurture menmake a difference. Xers are satisfied to find their task in toring relationships. Encourage senior the group project and work toward a employees to invest in young workdefined end point. Both of these apers and allow time and opportunity proaches can and do contribute to team success. The for this to happen. Consistently providing constructive skill set needed to challenge and motivate the intergenerfeedback brings out the best in young workers. ational team is based on understanding differences and Communicate with them regularly and positively. They capitalizing on the strengths each group brings to the want and expect access to information. Their most familwork setting and the problems at hand. iar and frequent information portal is the Internet, so having access restricted by hospital policy will seem contradictory to a group who is being told to make knowlWHAT ARE THE IMPLICATIONS FOR edge-based decisions and provide evidence-based LEADERS AND MANAGERS? practice. The oldest Veteran employees worked to survive, Offer continuous, just-in-time training, education, Boomers work to be fulfilled, Xers work for lack of anyand mentoring to move the Millennial employee to thing better to do, and Millennials work to be part of something important. In previous generations, organizaachieve results. Decision making for the Millennial has tions tended to be hierarchical, with incremental expectabeen a team event for most of their lives. When faced tions to work one’s way up the ladder. Therefore, the with a dilemma, whether it is where to go on vacation generations were more segregated with senior workers in or what to wear to school in the morning, the management, younger workers in the trenches, and little youngest workers have immediately turned to the inneed to learn to understand each other. The flattening of stant communication devices at their fingertips: cell today’s organizations has produced a mixture of four phone, instant messaging, and texting. This group generations in the same workplace, where the social and problem-solving dynamic is ingrained in their being. physical separations between generations are less rigid This fact makes independent decision making, so valand far more permeable.10 The resulting friction has reued by Baby Boomers, seem hostile and counter-prosulted in significant time being spent on handling interductive. Having mentors and coaches available when generational conflict. With increasing responsibilities and the question arises is imperative. Since many young 28 Nurse Leader
December 2008
nurses are initiated into the profession on the night shift, it will be essential for them to have “experts” available online or on call to provide the group input to decisions. Inject as much flexibility as possible into the work process to keep Millennials on the job. Both Millennials and Gen Xers want balance and perspective in the workplace.6 The rigid, protocol-rich health care environment is not seen as a welcoming environment to the youngest nurses. While life-saving protocols cannot be compromised to create a flexible environment, there are many aspects of the health care environment where flexibility is possible. Recent research showing a difference in the preferred job incentives and benefits for different generations13 is an example of an area where choice and control contribute to retention and job satisfaction. The same study showed a relationship between being pulled from their unit and job dissatisfaction, which may be neutralized by reframing the float pool as a group solution to a problem where the participants are appreciated, valued, and rewarded for their innovation.13 Allow some flexibility in scheduling. Flexibility in hours as well as in projects and assignments goes a long way toward making Millennials happy and stable employees. Self-scheduling works well for this conscientious generation, which is aware of the needs of the team and keeps their eyes on the goal. The Millennials bring fresh minds and strong bodies into the health care arena at a time when both are desperately needed. They bring their affinity for technology and their readiness to share and participate in creating solutions. Nurse executives are challenged to provide an environment where these young nurses can feel nurtured, mentored, and challenged to make significant contributions. Their very resilience makes it imperative that the hospital environment be seen as welcoming and appreciative; otherwise, they will seek to contribute elsewhere. A cohesive intergenerational team is a win for everyone: administration, nurses, patients, and families. The key to managing this generational mix will be open doors, open minds, and an abundance of patience.
7. 8. 9. 10.
11.
12. 13.
Strauss V. Putting Parents in their place: Outside class. Washington Post March 21, 2006. Tulgan B. Managing generation X. New York: WW Norton & Company; 2000. Martin C, Tulgan B. Managing generation Y. Amherst, MA: HRD Press; 2001. Paine J. Cross-generational Issues in Organizations. The Network News. Available at: http://wfnetwork.bc.edu/encyclopedia_template.php?id=4156&linktype=overview. Accessed April 30, 2008. Tulgan B. The Under-Management Epidemic. 2004. Available at: http://www.rainmakerthinking.com/pdf%20files/undermgm.pdf. Accessed April 29, 2008. Cates K, Rahimi K. Survey – Mastering people management. Financial Times. November 19. 2001. Wieck KL, Dols J, Northam S. What nurses want: The nurse incentives project. Nursing Economic$ In review, 2008.
K. Lynn Wieck, RN, PhD, FAAN, is the Jacqueline M. Braithwaite professor at the University of Texas at Tyler and is CEO of Management Solutions for Healthcare in Houston, Texas. She can be reached at [email protected]. 1541-4612/2008/ $ See front matter Copyright 2008 by Mosby Inc. All rights reserved. doi:10.1016/j.mnl.2008.09.002
References 1. 2.
3.
4.
5.
6.
Howe N, Strauss W. Millennials rising: The next great generation. New York: Vintage Press; 2000. Gerald DE, Hussar WJ. Projections of education statistics to 2012. NCES 2002-030. Washington, DC: US Department of Education, National Center for Education Statistics; 2002. Lenhart A, Raine L, Lewis O. Teenage live online: The rise of instant message generation and the Internet’s impact on friendships and family relationships. Washington, DC: Pew Internet and American Life Project; 2001. Howe N, Strauss W. Millennials go to college. Washington, DC: American Association of Collegiate Registrars and Admissions Officers / LifeCourse Associates; 2003. UCLA Center for Communication Policy. UCLA Internet Report, Surveying the digital future–Year three. Available at: http://www.digitalcenter.org/pdf/InternetReportYearThree.pdf. Accessed April 30, 2008. Zemke R, Raines C, Filipczak B. Generations at work. New York: Amacom Publishers; 2000.
December 2008
Nurse Leader 29
I
n this time of nursing shortage and emphasis on results, the need to ensure an engaged, talented nurse workforce is more important than ever. This article will describe the Millennial generation from a perspective of analyzing how their characteristics contribute to the challenge of leading and managing them in the higher education and hospital work environments. A brief comparison with their older brothers and sisters in Generation X will provide a foundation for why a onesize-fits-all solution simply will not work. The discussion of implications for nurse leaders seeks to provide realistic strategies for nurse leaders and managers in promot-
26 Nurse Leader
ing results in today’s intergenerational workplace while maintaining sanity and a sense of humor.
WHO ARE THE MILLENNIALS? Each generation brings unique challenges to the nurse manager. The newest entrants into the job arena, the Millennials, are no exception. The Millennial generation, born between 1982 and 2002, is second only to the Baby Boomers in size.1 The Class of 2009 is projected to be the largest class to graduate high school in US history. By 2015, college entry will increase by 20%, with students of color comprising 80% of the increase.2 MilDecember 2008
lennial youngsters are the best educated, most affluent, and most ethnically diverse (36% non-white) of the four generations in the workplace today. They bring welcomed traits to the workplace, such as a comfort with working in teams and an optimistic attitude. Millennial childhood was defined by group activities. They were the most watched-over generation in history, so they had defined play dates, soccer matches, and ballet recitals where parents or nannies provided constant vigilance. They engaged in student juries to work out school problems, so group problem solving is a natural part of their skill set. They attended schools that espoused the value of service learning, where they were rewarded for giving back to their communities and world. They have grown up with the Internet to link them to the global community and feel an acute responsibility for their neighbor and the environment. They are “nice kids” who are engaged in the activities of their parents, families, neighborhoods, and the world. Technology proficiency is a hallmark of the Millennials. Over 13 million teens use instant messaging (IM). Seventy-four percent of online teens use IM compared to 44% of online adults.3 Millennials see the computer in the same way that the Baby Boomers see a pencil. They are not intimidated by this tool that is there to entertain and make their lives easier. While Boomers look at a computer and ask, “What can it do?” the Millennials look at the computer and ask, “What needs to be done?” They are baffled by Boomers who are reluctant or refuse to use the full range of a computer’s potential to solve problems, just as a Boomer would be mystified at someone who insisted on using a quill and ink rather than a pencil. The computer is a tool, and Millennials are fearless in its application. Noted generational authors Howe and Strauss4 use seven traits to define the Millennials: 1. Special: Media focus with youth issues since the mid1980s, such as childhood obesity and child-friendly movie ratings, have pointed to how this group is the focus of concern. 2. Sheltered: Overt signals of concern, such as “baby on board” signs, car seats, safety helmets, have been the norm. 3. Confident: Millennials express an eternal optimism and confidence in their ability to perform. 4. Team oriented: They express a strong acceptance of group orientation and influence. 5. Achieving: Most think of future success at a young age. 6. Pressured: Millennials have become the “scheduled kids,” from soccer practice to instant messaging to texting. 7. Conventional: They typically do not rock the boat or seek to break all the rules. Millennial passion to be model citizens is redefining many of the negative traits associated with problem teens of the past, such as crime, sexual permissiveness, and December 2008
Table 1. Percentage of Internet Usage by Age Groups Age Group 12-18 year olds 19-24 year olds 25-35 year olds 36-45 year olds 46-55 year olds 56-65 year olds 65 years old
Percentage Who Use the Internet 98% 87% 83% 73% 72% 64% 34%
From: UCLA Internet Report, Surveying the Digital Future–Year Three, 2003.
substance abuse. Furthermore, they have a high capacity to generate support for community-based initiatives to improve the neighborhood or the global environment. They can recruit and produce volunteers for activities through the Internet and wireless communication devices, which are as much a part of their lives as oxygen and the ozone layer. Howe and Strauss1 call the Millennials the next “hero generation.” They describe a hero generation as one that follows an era of cultural and values upheaval in society. It follows directly behind a generation generally thought to be a disappointment and fills a void left by a passing esteemed generation. They are the target of an adult community that wants to protect and promote them to a higher destiny, and they rise to the occasion by achieving far beyond the expectations of parents and grandparents. In a health care environment desperately in need of heroes, they are a natural fit.
HOW DO THEY DIFFER FROM GEN XERS? Millennials are the wired generation. While Gen Xers are techno-literate and use the Internet to assist their lives, the Millennials have been intertwined with the Internet most of their lives.4 Specifically, the Internet has influenced their views of communication, that it should be instantaneous and continuous. Computer-savvy since childhood, young people today are the most digitally literate students to ever enter college. They are accustomed to depending on computers, IM, the Web, e-mail, interactive media, and cell phones. A UCLA Internet Report5 found diminishing Internet usage penetration as the cohorts aged (Table 1). Generation X, the smallest generation at 51 million, has been described as more cynical and self-concerned than today’s Millennials. Described as “the most attention-deprived, neglected group of kids in a long time,”6 they create a striking contrast to the Millennials whose “helicopter parents” got that name from their continued “hovering,” even long into adulthood where they seem patently unable to let their children go.7 Gen Xers, the
Nurse Leader 27
original “latch-key children,” came home to an empty pressures from the top, mid-managers are finding it diffihouse and learned how to prepare snacks or clean up cult to lead, manage, and supervise their direct reports.11 messes on their own using critical thinking or Internet The difference between an intergenerational workforce advice. The Millennials, on the other hand, have had althat is contentious and one that is productive and innomost constant cell phone contact with hovering parents vative is the organization’s willingness to focus on the and social peers since age 9 and seldom make a move unique needs and strengths of each generation and leverwithout group input. age them for maximum competitive advantage.10 The orientation toward work differs among the two Be a leader, not a manager, to get optimal production generations of young people in this country. Gen X is out of the younger generation. Millennials have a will to characterized for their skepticism and mistrust of authoriget things done, optimism about the future, and a heroic ty. They want as much as possible as fast as possible.8 spirit. They want to make a difference. Millennials’ career But because Millennials came of age during the most rochoices and work behaviors are “driven primarily by their bust economy in decades, they are much more optimistic quest for a chance to play meaningful roles in meaningabout life, work, and the future than their older brothers ful work that helps others.”9 They respond well to lead9 and sisters. Although they engaged in extended adolesers who assign them to a challenge by outlining the cence periods, remaining at home or returning home desired results, matching them to a capable team, allowafter unsuccessful launches, the Gen Xers are self-reliant ing them the freedom to tackle the objective, and reand self-directed. Millennials, on the other hand, often warding them for results.12 By connecting their lack the life skills such as self-reliance, sharing with othcontributions to the organizational vision and overall boters, and conflict resolution that are all essential in the tom line, they will strive to make their effort count. Sucworkplace. cessful leaders of the Millennials will monitor results The team orientation of the Millennials is in stark coninstead of process and will reward accordingly. trast to the more independent-minded Xers. Even in the Coach them to greatness. From their earliest years in sports they choose, they exhibit genorganized team sports, they have had erational selectivity. Millennials play a coach to motivate them to do their soccer and team sports. Gen Xers are Millennials have a will to best and win the game. They are drawn to solitary pastimes, even when looking for that coach when they get things done, optimism performed in a group, such as cyenter the workplace, and managers cling, rock climbing, snowboarding. who assume the coach role get the about the future, and a Millennials may seek to be a conbest results from their Millennial heroic spirit. They want to tributing part of the team, while the workers. Establish and nurture menmake a difference. Xers are satisfied to find their task in toring relationships. Encourage senior the group project and work toward a employees to invest in young workdefined end point. Both of these apers and allow time and opportunity proaches can and do contribute to team success. The for this to happen. Consistently providing constructive skill set needed to challenge and motivate the intergenerfeedback brings out the best in young workers. ational team is based on understanding differences and Communicate with them regularly and positively. They capitalizing on the strengths each group brings to the want and expect access to information. Their most familwork setting and the problems at hand. iar and frequent information portal is the Internet, so having access restricted by hospital policy will seem contradictory to a group who is being told to make knowlWHAT ARE THE IMPLICATIONS FOR edge-based decisions and provide evidence-based LEADERS AND MANAGERS? practice. The oldest Veteran employees worked to survive, Offer continuous, just-in-time training, education, Boomers work to be fulfilled, Xers work for lack of anyand mentoring to move the Millennial employee to thing better to do, and Millennials work to be part of something important. In previous generations, organizaachieve results. Decision making for the Millennial has tions tended to be hierarchical, with incremental expectabeen a team event for most of their lives. When faced tions to work one’s way up the ladder. Therefore, the with a dilemma, whether it is where to go on vacation generations were more segregated with senior workers in or what to wear to school in the morning, the management, younger workers in the trenches, and little youngest workers have immediately turned to the inneed to learn to understand each other. The flattening of stant communication devices at their fingertips: cell today’s organizations has produced a mixture of four phone, instant messaging, and texting. This group generations in the same workplace, where the social and problem-solving dynamic is ingrained in their being. physical separations between generations are less rigid This fact makes independent decision making, so valand far more permeable.10 The resulting friction has reued by Baby Boomers, seem hostile and counter-prosulted in significant time being spent on handling interductive. Having mentors and coaches available when generational conflict. With increasing responsibilities and the question arises is imperative. Since many young 28 Nurse Leader
December 2008
nurses are initiated into the profession on the night shift, it will be essential for them to have “experts” available online or on call to provide the group input to decisions. Inject as much flexibility as possible into the work process to keep Millennials on the job. Both Millennials and Gen Xers want balance and perspective in the workplace.6 The rigid, protocol-rich health care environment is not seen as a welcoming environment to the youngest nurses. While life-saving protocols cannot be compromised to create a flexible environment, there are many aspects of the health care environment where flexibility is possible. Recent research showing a difference in the preferred job incentives and benefits for different generations13 is an example of an area where choice and control contribute to retention and job satisfaction. The same study showed a relationship between being pulled from their unit and job dissatisfaction, which may be neutralized by reframing the float pool as a group solution to a problem where the participants are appreciated, valued, and rewarded for their innovation.13 Allow some flexibility in scheduling. Flexibility in hours as well as in projects and assignments goes a long way toward making Millennials happy and stable employees. Self-scheduling works well for this conscientious generation, which is aware of the needs of the team and keeps their eyes on the goal. The Millennials bring fresh minds and strong bodies into the health care arena at a time when both are desperately needed. They bring their affinity for technology and their readiness to share and participate in creating solutions. Nurse executives are challenged to provide an environment where these young nurses can feel nurtured, mentored, and challenged to make significant contributions. Their very resilience makes it imperative that the hospital environment be seen as welcoming and appreciative; otherwise, they will seek to contribute elsewhere. A cohesive intergenerational team is a win for everyone: administration, nurses, patients, and families. The key to managing this generational mix will be open doors, open minds, and an abundance of patience.
7. 8. 9. 10.
11.
12. 13.
Strauss V. Putting Parents in their place: Outside class. Washington Post March 21, 2006. Tulgan B. Managing generation X. New York: WW Norton & Company; 2000. Martin C, Tulgan B. Managing generation Y. Amherst, MA: HRD Press; 2001. Paine J. Cross-generational Issues in Organizations. The Network News. Available at: http://wfnetwork.bc.edu/encyclopedia_template.php?id=4156&linktype=overview. Accessed April 30, 2008. Tulgan B. The Under-Management Epidemic. 2004. Available at: http://www.rainmakerthinking.com/pdf%20files/undermgm.pdf. Accessed April 29, 2008. Cates K, Rahimi K. Survey – Mastering people management. Financial Times. November 19. 2001. Wieck KL, Dols J, Northam S. What nurses want: The nurse incentives project. Nursing Economic$ In review, 2008.
K. Lynn Wieck, RN, PhD, FAAN, is the Jacqueline M. Braithwaite professor at the University of Texas at Tyler and is CEO of Management Solutions for Healthcare in Houston, Texas. She can be reached at [email protected]. 1541-4612/2008/ $ See front matter Copyright 2008 by Mosby Inc. All rights reserved. doi:10.1016/j.mnl.2008.09.002
References 1. 2.
3.
4.
5.
6.
Howe N, Strauss W. Millennials rising: The next great generation. New York: Vintage Press; 2000. Gerald DE, Hussar WJ. Projections of education statistics to 2012. NCES 2002-030. Washington, DC: US Department of Education, National Center for Education Statistics; 2002. Lenhart A, Raine L, Lewis O. Teenage live online: The rise of instant message generation and the Internet’s impact on friendships and family relationships. Washington, DC: Pew Internet and American Life Project; 2001. Howe N, Strauss W. Millennials go to college. Washington, DC: American Association of Collegiate Registrars and Admissions Officers / LifeCourse Associates; 2003. UCLA Center for Communication Policy. UCLA Internet Report, Surveying the digital future–Year three. Available at: http://www.digitalcenter.org/pdf/InternetReportYearThree.pdf. Accessed April 30, 2008. Zemke R, Raines C, Filipczak B. Generations at work. New York: Amacom Publishers; 2000.
December 2008
Nurse Leader 29