Retention strategies and barriers for millennial nurses: a scoping review

ABSTRACT Objective: The objectives of this scoping review were to explore the existing literature related to millennial nurse-retention strategies and barriers, to examine and conceptually map the evidence, to extract any differences between Generation Y and Generation Z nurses, and to identify any gaps in the literature. Introduction: The millennial generation has become the largest group of nurses in the workforce. As nursing leaders grow to understand this generation's tendency to change employers frequently, organizations need to identify and implement strategies and reduce barriers to retain this generation as employees. Inclusion criteria: Studies and reports including registered nurses born between 1980 and 2000 with any level of education preparation and in any setting or geographical location were included. Studies and reports that examined nurse-retention barriers and strategies were considered for inclusion. This review considered experimental and quasi-experimental study designs, analytical observational studies, case-control studies, analytical cross-sectional studies, descriptive observational studies, systematic reviews and meta-analyses, qualitative studies, and text and opinion papers. Methods: The review was conducted in accordance with the JBI methodology for scoping reviews. Studies and reports written in English after 2010 were included. The databases searched included MEDLINE, CINAHL, Embase, Scopus, Ovid HealthStar, and PsycINFO. The search for unpublished studies and reports included MedNar and ProQuest Dissertations and Theses. Eligible studies and reports underwent data extraction by two independent reviewers using a tool created by the authors. Along with a narrative summary, results are presented in a diagrammatic format that aligns with the review objectives and questions. Results: Thirty-eight publications were included in the review. Strategies for millennial nurse retention were provided in 21 publications, barriers were provided in two publications, and 15 publications provided both strategies and barriers. No publications provided information on the differences between Generation Y and Generation Z. The findings from this scoping review were grouped into five concepts, with strategies and barriers for millennial retention identified for each of the concepts. Concepts identified included leadership, work environment, professional growth, professional fatigue, and self-actualization. Conclusions: The current evidence base shows that barriers to and strategies for millennial nurse retention commonly focus on the work environment and the relationships between nursing leadership and the bedside nurse. A preliminary scan of the evidence indicates that creating a healthy work environment that is collaborative, fair, flexible, challenging, and provides opportunities for growth may keep millennial nurses engaged. Having nursing leadership that models these values and leads by example may help millennial nurses to feel safe and supported; however, due to the methodology employed in this review, further rigorous research is needed to confirm this.