Managing Generation X in same-day surgery

They are surprising, frustrating, and our future

WANTED: Perioperative nurse for same-day surgery program. Must be willing to say no to working overtime or assuming additional responsibilities. Must express frustration with co-workers who are less technologically knowledgeable and should be prepared to question all policies, protocols, and requests from manager. Loyalty to employer and long-term commitment not required.

Recognize some members of your staff in that advertisement? Then you might be managing Generation Xers, a group of people born between 1964 and 1980, many of whom fit the above description, according to same-day surgery managers. (See related story, p. 23.)

For all of the negative descriptions of Generation X, the group brings a fresh look at the workplace and a creativity that will benefit all staff members, says Jo Manion, MA, RN, CNAA, FAAN. Manion is a senior consultant at Manion and Associates, an Oviedo, FL-based firm that specializes in helping health care organizations handle issues such as organizational structure, leadership, and change in the workplace. The key to tapping into the positives of these young people is to understand the generation, she adds.

Many members of this generation were latchkey children who had to become self-sufficient early in their lives, she explains. "Children who had to come home from school to an empty house, do their homework, and even start dinner have grown into adults who are accustomed to making their own decisions and finding better ways to accomplish a task," she says.

Because the group also witnessed their parents working 40- to 60-hour workweeks, only to be given a gold watch or a severance notice due to downsizing, Generation Xers are less likely to look at a job as a long-term commitment, says Manion. Managers who want to keep Xers within their program need to know the characteristics of the group and their expectations from a job, she adds. Key expectations of Generation Xers include:

Compensation for worth. Generation Xers place value on their time, so asking an Xer to work overtime or spend time outside their normal job responsibilities on a special project means paying them for that time, says Manion. "Xers watched their parents spend much more time at work than at home with their families so they place a high priority on personal time and family time," she says. "They are not unwilling to take on extra responsibilities, they just expect to be paid appropriately."

You must respect Xers’ personal time, advises Diane Mamounis-Simmons, RN, MSN, CNOR, CNAA, administrator for nursing in surgical services at Northshore Long Island Jewish Medical Center in Long Island, NY. "We create rosters of who is available for overtime, and my supervisors try to give staff members as much advance notice as possible."

Involvement in decision making. Xers are accustomed to making decisions and solving problems. They are also likely to question managers about procedures and protocols, says Manion.

"I find that Xers are surprisingly self-motivated and willing to tackle problems," says Laura Weinhagen, RN, clinical director of El Camino Surgery Center in Mountain View, CA. A manager has to set goals and be available as a resource, but Xers don’t want to be micro-managed, she adds.

"I find that Xers can be overwhelmed if the problem is too large, so I break it down into smaller problems to solve as we work our way to the larger problem," adds Mamounis-Simmons.

Professional development. Although Generation Xers might not take a position with a same-day surgery program with the intention of staying 10 years, they are serious about developing their skills and their careers, says Manion. "These staff members understand that jobs can be eliminated with little notice, so they want to position themselves to find the next job. If a manager does a good job offering continuing education opportunities, responsibilities that enhance the job, and recognition that the Xer is an important part of the team, the staff member is less likely to leave."

One way to give Xers a chance to gain recognition and expand their job skills is involvement in special committees or task forces. Mamounis-Simmons says, "Not only does involvement on teams give the Xer a chance to demonstrate expertise but it also gives them a chance to gain recognition."

Remember, too, that Xers are extremely comfortable with technology, adds Manion. "Xers are very sophisticated in their knowledge." They can be a valuable resource as technology experts within the surgery program, she says.

Personal attention. Another characteristic of Generation X is the need for personal attention. Mentoring is an important way for managers to help Xers develop and grow as key staff members, says Manion.

"Whenever I spend time with an Xer, he or she blossoms," says Mamounis-Simmons. The time can be spent talking about career plans, specific projects within the surgery program, or recognition of the job the Xer is doing.

"One of my two key supervisors is an Xer, and she brings a lot of enthusiasm and creativity to my management team," says Weinhagen. "I believe that Xers can be terrific in leadership positions because they do look for better ways to do things."

Laura Weinhagen, RN, Clinical Director, El Camino Surgery Center, 2480 Grant Road, Mountain View, CA 99040. Telephone: (650) 961-1200. Fax: (650) 960-7041. E-mail: lweinhagen

Diane Mamounis-Simmons, RN, CNAA, MSN, CNOR, Administrator for Nursing Services, Northshore Long Island Jewish Health System, Long Island Jewish Medical Center, Lakeville Road, New Hyde Park, NY 11040. Telephone: (718) 470-7404. Fax: (718) 962-6945. E-mail:

Jo Manion, RN, MA, CNAA, FAAN, Senior Consultant, Manion and Associates, 5725 Oak Lake Trail, Oviedo, FL 32765. Telephone: (407) 366-6506. Fax: (407) 366-6521. E-mail: