In recent years, inpatient Women’s Health departments have hired an unusually high number of registered nurses (RNs) in their twenties to replace those departing due to retirement or transfers. In fact, the share of RNs under 30 years old in the inpatient Women’s Health specialty increased 36% from March 2021 to September 2023.
For hospitals and health systems, this dramatic shift towards a less experienced RN workforce – in a highly specialized area of nursing – brings longer-term benefits for staffing and talent development, but also challenges around adapting to generational differences in needs and expectations, as well as ensuring more experience nurses are not overburdened with precepting, mentoring, and so on.
There are three key ways that healthcare leaders can take action today to adapt to this demographic shift:
1) Double Down in Supporting Experienced Nurses
Because there are fewer experienced nurses in inpatient Women’s Health today, those who remain are called upon to do more. And the unusually high number of younger nurses lack experience and need clinical support from their more experienced colleagues.
Experienced nurses play a critical role in helping their earlier-career colleagues onboard and grow in their roles. To facilitate this, leaders can redesign care teams when possible so that experienced nurses are paired on shifts with less-experienced ones. They can also implement a “phone a friend” resource for newer nurses to use at any point in their work week when they need clinical and/or emotional support.
However, leaders must also be thoughtful about offsetting the burden on experienced nurses. Managers should increase their recognition of these foundational team members. Creating a larger pool of experienced team members who can precept and perform other leadership roles can alleviate the pressure on a small group. Because leading and precepting is exhausting, it’s also critical to put time and energy into building the pipeline for the next generation of Women’s Health managers and preceptors.
2) Build on Residency Programs with Buddy Programs, Ongoing Training, and Formal Career Planning
Specialty residency programs have increased, making it possible for these young nurses to start in Women’s Health, but they don’t offer support in the early months and years of nurses’ careers when they need more training and guidance. To ensure that these nurses succeed, especially in this demanding specialty, healthcare organizations need to enhance post-residency support.
One way to do this is by implementing a buddy program for new hires before they start. Note that pairing buddies from separate departments allows for more candid conversations. Managers should also commit to regular new hire check-ins throughout the first year, which can be highly impactful, especially when they include formal goal-setting.
It’s also vital to ensure that formal development programs begin immediately for new nurses. These programs reinforce the use of mentors and the importance of continual learning. Because Women’s Health is complex, practical skills and competencies are important to learn and reinforce. In particular, managers should consider early, repeated, and specific training on high-risk events for nurses in Labor and Delivery.
To further support and nurture this talent, hospital leaders can also commit to ongoing support for those nurses and other staff who want to pursue further education.
3) Innovate Staffing Models and Commit to DEI as the Generational Mix Changes
The demographic changes in Women’s Health nursing staff means the culture of these departments is also changing. Culture change requires innovation from department managers, including evolving staff models, using technology to communicate and manage, and becoming more inclusive.
Leaders should innovate staffing models as Millennials and Gen Z nurses expect flexibility and control of their schedules. They can also improve the scheduling experience with simplified approval processes.
Millennials and Gen Z grew up with technology and expect their workplace to reflect that. Executives can implement new communication tools and norms for managers; for example, sending weekly email updates as videos, and using messaging apps and online platforms to share information and training, manage processes, and communicate about staffing and scheduling.
These younger generations also expect greater transparency about growth opportunities and expect the organization to uphold Diversity, Equity, Inclusion, and Belonging (DEIB) principles. Hospital leaders should build inclusivity reviews and discussions at the organization, service line, and department levels; for example, reviewing that the member composition of local committees and teams reflects the diversity of the employees overall.
A Proactive Approach, Supported by Technology
Taking an overall proactive and strategic approach to these demographic changes in inpatient Women’s Health can unite programs that bolster support for experienced nurses, provide ongoing education and guidance to younger ones, and build a strong overall culture.
There are a number of technology solutions that can help. For example, self-scheduling platforms can give younger nurses more of the autonomy over their schedules they need while solutions designed for frontline managers can make it easier for them to manage new hires, recognize the work of all team members, and reduce administrative tasks that distract from team engagement.
Healthcare organizations need to be aware of this demographic change in Women’s Health and respond to it to avoid not only nurse burnout, for both junior and senior nurses, but also to reach and maintain patient safety, quality, and experience outcomes. This proactive approach will help both nurse managers and experienced nurses feel more fulfilled with more sustainable careers while helping younger nurses more quickly gain confidence and independence.

Tim Darling
Tim Darling is a co-founder of Laudio and President of Laudio Insights. With over 20 years of experience in healthcare technology, Tim has a real passion for using data and analytics to serve the challenges facing healthcare organizations. The analytics and research arm of Laudio, Laudio Insights provides unique, evidence-based perspectives on dynamics affecting healthcare’s frontline workers and their leaders.