what perioperative and emerging workforce nurses want in a manager

AUGUST 2003, VOL 78, NO 2 Thompson - Wieck - Warner

What Perioperative and Emerging- Workforce

Nurses Want in a Manager Julia Thompson, RN; K. Lynn Wieck, RN; Ann Warner, RN

he world is experiencing a critical nursing shortage. The number of T nurses in the United States is

expected to be 20% lower than what is needed by the year 2020.' As the number decreases, it is unclear what types of job situations new nurses will choose and how already vulnerable specialty areas, such as perioperative nursing, will be affected by the choices they make.

Large, urban facilities are reporting difficulties filling vacancies and increased use of temporary or free- agent nurses? A shortage of nurses in mental health services, rural health pro- motion, long-term care, and inner-city health clinics alludes to a future of con- tinuing competition for nurses. It is unclear whether future nurses will be

ABSTRACT THE WORLD is experiencing a critical shortage

of RNs. As the number of nurses decreases, it is unclear how already vulnerable specialty areas, such as perioperative nursing, will be affected by the emerging workforce's career decisions.

explores perioperative nurses' and nursing students' perceptions of the top 10 characteristics desired in a manager.

EVEN WITH 70% CONGRUENCY, significant differences were found in how nurses and students ranked the traits they valued. THIS STUDY highlights the traits managers

need to transform new graduate nurses into satisfied, productive members of the perioperative team. AORNJ 78 (August 2003) 246-261.

0 THIS DESCRIPTIVE, COMPARATIVE study

attracted to specialty areas. Today's new nurses can choose from many opportunities when selecting a job. Will young nurses whose motives for work appear to differ from their predecessors' be motivated to select high-intensity clinical areas like the OR when they launch their careers?

Perioperative nursing is in a crisis because of difficulty in recruiting a suf- ficient number of nurses. Three factors credited with creating the crisis include fewer perioperatively educated gradu- ates: a diminished supply of nurses and people interested in becoming nurses,' and the cultural influences of the emerging workforce.4 This article explores the traits that perioperative nurses desire in a manager or supervisor and compares them to the traits that senior nursing students desire in a manager or supervisor. If there are basic differences between what the two groups want in a manager, it might help explain the type of environment neces- sary for recruiting and retaining nurses in perioperative services.

PURPOSE AND SIGNIFICANCE This study was undertaken to

describe the traits nursing students about to embark upon nursing careers desire in a manager. The natural manager development model in most business- es has been to promote successful employees into management positions; therefore, an assessment of the traits seasoned perioperative nurses desire in a manager was conducted so the results could be compared to the results of a student assessment. The study questions were as follows. 0 What are the top 10 desired traits in a

manager as expressed by nursing students?

246 AORN JOURNAL

Thompson - Wieck - Warner AUGUST 2003, VOL 78, NO 2

What are the top 10 desired traits in a manager as expressed by perioperative nurses? Is there a relationship between career status (ie, student or nurse) and ranking of traits? The significance of this studv lies in

its poteGtia1 to identify genirational similarities and differences, which may have applicability to other specialty areas. The nursing shortage is not limited to one geographic or specialty area.' If nursing is not considered a desirable career option, where will tomorrow's nurses be found? Although recruitment is vitally important, retention is equally challenging. After new nurses come to a hospital setting, what can be done to keep them? Managers play a sigruficant role in employee retention5; therefore, this study explored what nurses, current and future, want in a manager.

RATIONALE FOR THE STUDY Although the nursing shortage

affects all areas of nursing practice, perioperative nursing is experiencing a greater shortage because fewer nurses opt to enter the perioperative setting.3 Additionally, all nurses, particularly those in the perioperative arena, are getting older. The average age of perioperative nurses is 47 years: which is greater than the average age (ie, 44.3) of nurses in general.'

Although many reasons exist for the shortage in the perioperative environment, a prominent reason is lack of student education and exposure to perioperative nursing because of over- crowded curric~la.~ Limited exposure is believed to decrease students' inter- est in pursuing perioperative nursing careers after graduation.

Much of the research on perioperative nursing recruitment and retention was conducted in the 1980s when the last nursing shortage occurred; howev- er, the education and practice environ-

ments do not appear to have changed much during the past 15 years. Most contemporary nursing curricula provide only a one- or two-day observation experience in specialty care areas. Students, therefore, get very little exposure to the realities of specialty nursing practice. In the perioperative area, for example, there traditionally has been only one OR follow- through experience with only one ~a t i en t .~ A study of 1,118 nursing pro- One

reason for the grams conducted h&g the 1980s reveals that OR

shortage of techniques were not taught in the majority of prokams studied.8 ?his nurses in the limited involvement with the perioperative setting pedoperative makes it difficult for students to perceive the challenges of periopera- arena is that tive nursing practice.',''' nursing students As a result, students of- ten lack perioperative receive limited nursing skills and are reluctah and unlikely to choose careers in periop-

In 1995, a group of

historical study idenhfy- ing the sociocultural and economic influences that have contributed to the decline of educational perioperative clinical experiences." Three themes emerged-the professional versus technical role of perioperative nurses, generalist versus special- ist, and the apparent lack of control nursing has over its professional future. To increase the demand for opportunities in perioperative nursing among students, the researchers recommended promot- ing stronger affiliations between nursing academia and practice settings.

In 1981, AORN introduced Project Alpha in response to the decline of OR

exposure to erative nursing. perioperative researchers conducted a education.

AORN JOURNAL 247


education in nursing curricula. The goal of this initiative was to promote perioperative nursing and introduce a perioperative nursing component into formal nursing curricula.’* AORN’s National Committee on Education (NCE) directed Project Alpha activities from 1986 to 1996. Meager Project Alpha survey responses from chapter presidents in October 1996 caused the NCE to reassess the project’s effecti~eness.’~ Members of the NCE recommended to the AORN Board of Directors that Project Alpha be disbanded in June 1996. The NCE continues to encourage AORN chapters to include Project Alpha type activities in other chapter activities, such as Perioperative Nurse Week and ed~cati0n.l~

LITERATURE RMEW No overall description of US periop-

erative nurses exists. To understand the intensity and diversity of the struggles that perioperative nursing has encoun-

UPDATE

tered during the nursing shortage, it may be useful to examine some membership statistics from AORN.I4 The average age of AORN members is 47.3 years. More than 80% of all RN members are age 40 or older, and the per- centage of RNs younger than age 40 is an alarming 17”/0. Nine out of 10 AORN members are female. According to one author, people of younger generations are not j0ine~s.l~ They are not joining political parties, labor unions, organized religions, or professional organizations. It can be assumed, then, that the AORN member demographic profile probably is consistent with that of other professional nursing organizations.

In a recent AORN survey of members and nonmembers, nearly 60% of member respondents identified their position as a staff nurse, 25% as management, and 11% as expanded practice.“ In the same survey, 75% of respondents reported being employed in an acute care facilitv OR, and more

AORN‘s Education Efforts ince Project Alpha was disbanded, AORN has begun other projects S aimed at educating nursing students about perioperative nursing. I n

2001, AORN’s House of Delegates approved a revision of the position statement “Inclusion of perioperative nursing learning activities i n an undergraduate nursing curricula” and a new resolution titled “AORN resolution on responsibility for mentoring.” I n 2002, the National Committee on Education (NCE) was charged with developing a compre- hensive program to encourage the inclusion of perioperative nursing in nursing school curricula (ie, revitalizing the successful components of Project Alpha). A t the 2003 Congress, the NCE debuted “A Primer for Perioperative Education.“ The primer i s designed to be used as a guide for AORN members when they contact schools of nursing faculty members regarding a perioperative clinical experience for student nurses. A task force has been appointed to create a mechanism with which AORN can address the need for perioperative curriculum with faculty members of schools of nursing. One of the task force’s charges will be to collab- orate with the NCE in evaluating “A Primer for Perioperative Education.”

than 16% reported work- ing in an ambulatory or office-based surgery fa- cility. General surgery is the predominant practice area for 43% of members, and specialty surgery follows at 36%. The distri- bution according to the highest education level shows that 26% have a diploma, 25% have an associate’s degree, 40% have a bachelor’s degree, and 10% have a master’s degree or doctorate. Peri- operative nurses appear to reflect the overall nursing statistics of an aging, predominately female workforce.

During the next two decades, the majority of

THE EMERGING WORKFORCE.

248 AORN JOURNAL


nursing students will come from the emerging workforce. The emerging workforce is a generation of workers (ie, Generation X) born between 1963 and 1977 who have experienced a particular set of life events and can be identified by observable personality charac- terist ic~. '~~~ They have a different per- spective on life and work because of their life experiences. This group is known for talking openly about what they want and for leaving an employer if their needs are not met.15,1c21

Members of the emerging workforce have very different work habits and needs than their predecessors. Genera- tional characteristics of members of the emerging workforce include empow- ered, self-directed, technologically literate, flexible, lifelong learners, creative, innovative risk takers, and problem solvers.2oa These people value a balanced lifestyle where work does not interfere with play yet makes it affordable.

The nursing shortage has focused attention on the emerging workforce. This next generation of American workers is the smallest entry-level pool in modern times. There currently are 44 million Baby Boomers (ie, persons born between 1946 and 1962) and 17 million members of Generation X (ie, persons born between 1963 and 1977).19 Com- petition for emerging workforce profes- sionals is fierce. The perioperative sector, facing the same challenges to recruit and retain nurses as other specialty areas, must seek creative solutions to the problem of recruiting new nurses and retaining them after they enter the perioperative arena.

The next generation of nurses, in their twenties and thirties, are members of Generation X." One author identifies this generation as a new breed of employees with an agenda of their 0 ~ n . I ~ Very unlike their Baby Boomer parents, these young adults are the orig- inal latchkey kids and have grown up

mastering information technology and creative thinking.

Emerging workforce members approach work with the ideas that they should command instant value, start at the top, and get as much as possible as fast as possible. They demand balance in their lives, are somewhat cynical and concerned with self, want to know why and want to have fun at work.I6 They want effective and intelligent leaders who invest time in them via mentoring and skills training. They want frequent feedback from their leaders, and they want to be trusted and respected for the work they perform. Many negative crit- icisms of this generation can be attrib- uted to poor management and leadership e~periences.'~ Nevertheless, members of this generation present challenges to the workplace.

As employees, members of the emerging workforce want "flexibility., training, mentoring, and They are not joiners and do not become involved in professional organizations, as members or leaders. One author cred- its their time as children, alone and in front of a television or computer screen, as the source of their lack of people skills and a team player attitude."They have extensive technological skills yet are cynical about career success. Today's young adults watched their parents put in extra hours on business projects at home, work weekends to get ahead, and then be downsized out of a job by their companies. This lack of company loyal- ty to employees, along with the transient lifestyle typified by Generation X, has made longevity in a job something that the younger generation does not value.'5

According to a 2000 survey, more than 80% of al l RN AORN members are age 40 or older.

AORN JOURNAL 249


One author says that the time

members of Generation X spent alone

in front of a computer

screen conM butes

to their lack of people

skills.

Balance in their work lives and home lives is important to emerging workforce employees. They will work hard to get a job done, but then they want to go home. They want to have fun and balance in their lives, not the work-cen- tered lives of their parents. Many of these characteristics seem suited to the OR environment. The problem appears to be getting members of this generation into the OR in the first place.

MUHOD This descriptive, comparative study

was conducted using surveys to determine participants’ perceptions of the top 10 characteristics desired in a manager or supervisor. The perceptions of two groups of participants were compared. The first group comprised perioperative nurses (n = 35) whose average age was 46.4 (standard deviation [SD] = 7.2). The second group comprised senior nursing students (n = 57) who had no direct OR experience except some observational exposure to perioperative nursing. The average age of students was 25.2 (SD = 4.1).

Human participants review and approval was granted by a local university institutional review board. This was survey research in which none of the participants were identified so completion of the survey was considered consent to participate. All participants were told of the voluntary nature of the survey and assured they could choose not to participate or cease participation at any time. INSTRUMENT DEVELOPMENT. The survey

contained a list of desirable leadership

characteristics (n = 56). A desired characteristic was defined conceptually as a descriptor that was seen as positive and conducive to making a person want to work for someone who possesses the characteristic? @sn The operational definition of a desired characteristic was the rank score received when participants listed and ranked their top three desired characteristics in each subscale. This list evolved from a modified Delphi study that originated with a sample of 35 emerging workforce members who provided input into the traits they desired in a leader.%An in- depth review of the literature about what members of the emerging workforce value in leaders and managers elicited descriptors that were added to the list. These traits subsequently were validated by a national sample of nurse administrators and leaders (n = 42) who used a Likert-type scale to determine the relevance of the traits to desired leadership qualities. The characteristics that received a mean score of three or greater on a 10-point scale were retained and divided into four subcate- gories. More than 100 traits were considered, and 56 were retained and grouped into subscales. The four subscales were labeled attitudes, intrinsic qualities, acquired skills, and personal.

Efforts to ensure measurement validity included the ratings of nursing leaders in establishing the survey, as well as having experts analyze the con- tent after the survey had been pilot tested. In an effort to determine reliability, the survey was administered to five different groups of emerging workforce members. Those groups were a com- munity college first-year class, a com- munity college second-year class, a university junior class, a university senior class, and nursing students attending a national meeting. Differences among the rankings of these five groups were tested. A Kruskall-Wallis test showed

2 5 2 AORN JOURNAL


no difference in the majority of characteristics. Of the three characteristics that did show some difference, none were ranked in the top 10 of any group. The characteristics were nonjudgmen- tal (x24 = 13.5, P = .009), empowering (xz4 = 18.9, P = .001), and advocate (x’~ = 17.4, P = .002). None of the other 53 characteristics showed significant differences, which lends some confidence that the instrument measures reliably among different subsets of the target population. There is no way to categor- ically determine that the instrument measures reliably within an age cohort; therefore, readers are cautioned about making an assumption of reliability for this instrument.

The traits listed on the survey were not defined for participants. Ambiguity or unfamiliarity with some of the words may have caused confusion if the words were not used commonly by participants. For instance, the words honest and intep’ty both appear on the survey. Although these two words do not mean exactly the same thing, it is impossible to know what definition participants used when making their decisions. One reason for success in obtaining a high response rate was the survey’s simplici- ty and the fact that it took only a few minutes to complete. When weighed against the likelihood that survey response would be considerably less if the survey contained an additional two to three pages of definitions, research team members made the decision not to include definitions.

DATA COLLECTION. Surveys were administered to a convenience sample of perioperative nurses (n = 50) attending an AORN meeting and a convenience sample of senior bachelor’s (n = 33) and associate’s degree (n = 24) nursing students attending class. The survey has been used in similar studies to assess desired traits in leaders: The survey is organized in four subscales

that contain 12 to 16 terms to describe a manager or supervisor. All of the characteristics may be considered desirable. Participants are asked to cir- cle the top three characteristics they prefer in a manager or supervisor and then to rank them as first, second, and third. They then are asked to place an X next to ihe characteristic that they value least in a manager.

The survey takes about five to seven minutes to complete and was distributed before the be- ginning of the students’ classes and the nurses’ meeting. Students received time during class to complete the survey; therefore, all of the students returned the survey (n = 57) for a 100% response rate. Nurses received time to complete the survey before the meeting. Thirty-five of the 50 surveys distributed to perioperative nurses were returned for a response rate of 70%.

DATA ANALYSIS

A convenience sample of 50

nurses and 57 nursing students

were asked to identi’ the top three traits they

desire in a manager.

First choices received a score of three, second choices a score of two, and third choices a score of one. Each of the least-valued characteristics received a score of one on the least Val- ued index. Data were analyzed using SPSS-Statistical Package for the Social Sciences.27 Characteristics receiving the highest scores were considered the top 10 characteristics valued in a manager. A Spearman rank correlation was ap- plied to the paits that both groups identified in the top 10 to determine whether there was a relationship between rank and the group to which respondents belonged.

AORN JOURNAL 2 53


FINDINGS The perioperative nurse group con-

sisted of 29 (83%) women and 6 (17%) men. Twenty percent of participants were African American, 60% Caucasian, 6% Asian, and 3% Hispanic. Eleven percent did not report ethnicity. Although all of the participants in this group worked in the perioperative area, their positions varied. Three percent (n = 1) were in an executiveladministrative position, 6% (n = 2) were educators, 57% (n = 20) were staff nurses, 14% (n = 5) were advance practice nurses, and 20% (n = 7) were managers.

The student group (n = 57) consisted of 41 women (72%) and 16 men (28%).

Although both nurses and

students ranked seven of the

same traits in the top 10, there were significant differences in the rankings

between the two groups.

The ethnicity of participants in the student group was similar to that of the perioperative nurse group: 5% were African American, 77% were Caucasian, 2% were American Indian, and 16% did not list ethnicity. All participants in the student group were students in an associate degree (n = 24) or baccalaureate (n = 33) nursing program. Students received exposure to the OR during an observational experience, but none had spent more than one day in perioperative services during their clinical rotations.

The first two research questions asked what perioperative nurses and student nurses consid-

ered to be the top 10 most desirable traits in a manager. These findings are reported in Table 1. Seven of the traits cited by perioperative nurses also were cited by students as being important in a manager. Five traits were identified as

important by nurses but not by students, including supportive, fair, integrity, trustworthy, and empowering. Students valued three traits that were not valued by nurses, including professional, respectful of subordinates, and positive attitude.

The third research question asked whether there was a relationship between status (ie, student or perioperative nurse) and ranking of traits. The seven traits cited by both groups as being important in a manager were receptive to people and ideas, good communicator, honest, good people skills, approachable, clinical competence, and team player. A Spearman rank correlation revealed a significant relationship between rank and the group to which respondents belonged (r = 0.4147, P = .001), indicating that students ranked these same seven traits much dif- ferently than did their nurse counter- parts. Although being a team player was the most important trait to students, nurses ranked it ninth.

DISCUSSION Similar to previous study findings,

there was a high degree of congruence between perioperative nurses and students regarding the traits they desire in a manager or supervisor. There was, how- ever, a sigruficant difference between which of these mutually selected characteristics students thought were most important and those perioperative nurses considered most important. Although students ranked team player as the number one priority in a manager, it tied with three other characteristics for ninth place in perioperative nurses' rankings. Both groups valued the trait receptive to people and ideas, but nurses ranked it third and students ranked it ninth.

Some traits were mentioned by only one group. Characteristics perioperative nurses valued that were not mentioned by students included supportive, fair,

2 54 AORN JOURNAL


TABLE 1 Most Desirable Traits in a Manager

1

2

3

4

5

6

7

8

9

10

Perioperative nurses (n = 35)

Supportive* (44) Attitudes Team player (74) Personal

Nursing students (n = 57) Rank Trait/summed score Cluster Trait/summed score Cluster

Fair' (39)

Receptive to people and ideas (36)

Good communicator (36)

Honest (36)

Good people skills (33)

Integrity' (32)

Approachable (29)

Trustworthy' (28) Clinical competence (28) Empowering (28) Team player (28)

Attitudes

Personal

Acquired skills

Intrinsic qualities

Acquired skills

Intrinsic qualities

Attitudes

Intrinsic qualities Acquired skills Personal Personal

Professional* (66)

Respectful of subordinates* (63)

Positive attitude* (63)

Honest (62)

Clinical competence (59)

Approachable (58)

Good communicator (57)

Receptive to people and ideas (55)

Acquired skills

Attitudes

Attitudes

Intrinsic qualities

Acquired skills

Attitudes

Acquired skills

Personal

* Zndicates this trait does not appear in the top 10for both groups.

Good people skills (48) Acquired skills

integrity, trustworthy, and empowering. In previous research, students rated supportive in the top 10, but few selected fair as one of the traits they value? Students in the current study also failed to select fair as a trait desired in a manager.

The greatest differences appeared in the attitudes subscale. Attitude traits that nurses ranked in the top 10 but that students did not were supportive and fair. The two attitude characteristics ranked in the top 10 by students and not nurses were respectful of subordinates and positive attitude. The attitude trait that was ranked among the top 10 by both groups was approachable. On the intrinsic qualities subscale, both groups valued hon- esty, and nurses valued integrity. An exploration of the acquired skills subscale revealed congruency between groups regarding the traits of good communicator and good people skills, and students also selected professional as a trait they admire in a manager.

Regarding the personal subscale,

nurses chose empowering as one of the top 10 traits, and students did not. Personal characteristics that were con- gruent across both groups were receptive to people and ideas and team player. Noteworthy is that 70% of the traits students desired in a manager either were acquired skills or attitudinal, both of which appear amenable to education and behavior changes on the part of managers. Such changes could help create an environment that might be more friendly to members of the emerging workforce. It is important to reiterate that all of the characteristics are considered desirable; therefore, failure of a trait to be mentioned by either group does not mean that the trait is not valued; it simply means that participants valued other traits more.

LIMITATIONS This study has many limitations.

The sample used was a convenience sample drawn from a small geographic

AORN JOURNAL 255


area and may not be reflective of nursing students or perioperative nurses everywhere. Further, the instrument did not lend itself to rigorous reliability testing. Although it has been used extensively, it cannot be said that the instrument measures traits consistently among various groups. The traits were not defined, and regional or cultural interpretations of some of the traits may have influenced responses. The researchers have considered that the reason for students’ failure to select integrity as a top-10 trait may be that the word is not a common part of their vocabulary. As with any research study, readers are cautioned to read and apply findings critically.

RECOMMENDATIONS The trait approachable consistently

has been in the top three of every emerging workforce group tested thus far (n = 300), whether the focus was leader, educator, or manager.’28 It is becoming clear that young people want

to be able to approach their managers and speak their minds without fear. Members of the emerging workforce appear to want a work environment that continues that attitude of support, positive feedback, team spirit, accept- ance, and personal attention. Today’s perioperative managers will be chal- lenged to provide this type of environment. One way to meet this challenge is to incorporate coaching strategies that promote open and approachable management styles into managers’ training.

It is recommended that perioperative practitioners place priority on improv- ing the practice environment to include a culture of retaining young nurses. For perioperative nursing to survive the current nursing shortage, it is imperative that the focus center on the perioperative nursing environment and not just the pipeline of workers. Perioperative nursing needs young nurses who are seeking flexibility and are technologically literate, information savvy workers. Nurses who think like entrepreneurs,

OTHER FINDINGS

Least Valued Traits in a Manager hese are the rankings for the least desirable characteristics. It i s important to remember that a rank- T ing of least valued does not equate to being undesirable. It merely means that of a l l of the traits list-

ed on that particular subscale, it was less important than the others. Data are presented for information only and were not part of the research questions.

Rank T rait/summed score Cluster Trait/summed score Cluster 1 High energy (13)

2 Dignified? (8) Intrinsic qualities High energy (17) Personal

3 Inspirational (8) Attitudes Detail oriented* (15) Intrinsic qualities

4 Risk taker (7) Acquired skills Inspirational (13) Attitudes

Perioperative nurses (n = 35) Nursing students (n = 57) -.

Personal Risk taker (22) Acquired skills

Attitude Strong willed? (7) Intrinsic qualities Calm (13) Calm (7) Attitudes Creative* (13) Intrinsic qualities

* lndicates this trait does !lot appcar in the list of least valued traitsfor both groups.

2 5 6 AORN JOURNAL


take charge of their own careers, and stand ready to adapt themselves to ever changing roles and responsibilities are essential for a dynamic perioperative workforce. Leaders in every industry are scrambling to become employers of choice for members of the emerging workforce. The perioperative environment must be promoted as one in which young nurses can reach their career goals, maintain balance, and have control of their practice.

It is recommended that perioperative nursing leaders frame recruiting mes- sages based on the opportunities that members of the emerging workforce seek, including marketable skills, a multitasking environment, exposure to decision makers, responsibility for clear goals, credit for tangible results, and opportunities to balance life and work. It further is recommended that leaders capitalize on those inherent opportunities that are attractive to young nurses. Elements of perioperative nursing provide learning opportunities that include many of the attributes consistent with the focused needs and demands of members of the emerging workforce, including interpersonal skills; multidis- ciplinary teamwork; communication; psychology; patient safety; technical skills with instruments and equipment; infection control; the use of power; knowledge of anesthetics, recovery skills, and pain and analgesia; empathy and sympathy; care of complex patients; interface with high-tech computers and lasers; and control over one's career. Although not all recruits will remain perioperative nurses for their entire careers, all of these skills are transferable to other health care settings.

The study also indicates that manager training in the perioperative area should focus on, or at least include, team building and leadership development. Young nurses clearly want a team player as their manager and appear to

"want to be led, not managed;16 therefore, the focus on manager development in perioperative settings should include the traits and leadership skills that will promote retention of nurses in perioperative areas.

CONCLUSION Who will win the new millennium

lottery for young workers? Nursing is not breaking even at this time. Enrollment in bachelor's degree nursing programs has declined consistently during the past five years nationwide, dropping 4.6% in 1999 The pool of nurses is decreasing as recruitment efforts begin to target potential employees who are different from traditional Baby Boomer nurses.

Presenting the nursing profession in a positive light to the potential workforce means repackaging. The OR may have some of the attractive job incentives sought by this nontraditional workforce. Perioperative nursing does meet some of the demands of members of the emerging workforce, including building marketable skills, having fun on the job, maintaining control and balance over career, enjoying a free-agent work ethic, seeing results from work done, and engaging in entrepreneurial opportunities. How nursing markets these opportunities to young people and how nurses manage and lead younger nurses after they arrive in the perioperative arena will determine the future of perioperative nursing. New graduate nurses leave positions at higher rates than experienced nurses.3o The results of this study highhght new graduate nurses' need for mentoring and nurturing to identdy with the work setting and, ultimately, become satisfied and productive members of the health care team. A first step is to understand what young nurses value in their managers; the next step is to determine whether perioperative nursing is willing to change to become

258 AORN JOURNAL


an attractive career alternative. If perioperative nursing wants to remain an autonomous professional workforce, change is inevitable. *:*

Julia Thompson, RN, MSN, CNOR, is an administrative research coordinator, Harris County Hospital District, Houston.

K. Lynn Wieck, RN, PhD, is chief executive officer, Management Solutions for Healthcare, Houston.

Ann Warner, RN, MS, CCRN, is an assistant professor, College of Nursing, McNeese State University, Lake Charles, La.

Editor’s note: The authors wish to thank the members of AORN of Greater Houston Texas for their participation in this research study.

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NOTES

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