By Rose O. Sherman, EdD, RN, NEA-BC, FAAN
Nurse leaders know that the nursing workforce is rapidly shifting. A new generation of nurses – Generation Z- is driving change in almost every healthcare setting. Tim Elmore’s new book, The Future Begins with Z, points out that this new generation is fundamentally disrupting how we think about the workplace. The old recruitment and retention playbooks no longer work.
He offers some excellent strategies on rethinking your leadership with an eye toward recruiting this new generation of nurses:
What they want from leaders is different – from control to connection (The ALEG model)
Gen Z nurses aren’t looking for a boss – they want a coach who will do the following:
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Ask: Instead of telling a new nurse exactly how to manage their workload, ask, “How do you feel about your patient load today, and how can I help you to manage it?”
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Listen: They want a voice. Create “listening circles” in the unit where they can share ideas on workflow and other patient issues. Listening circles will resonate and engage Gen Z more than formal shared-governance structures.
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Empathize: Acknowledge the high anxiety of being a new grad in a post-pandemic world.
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Guide: Once you’ve built a bridge of relationship and connection, your clinical guidance will be more accepted and implemented.
Elmore notes that onboarding is a “make-or-break” moment. For a Gen Z nurse, the first week shouldn’t just be about HR paperwork and EMR training. It should be about belonging. He recommends you assign a “Culture Mentor” who isn’t their clinical preceptor—someone whose only job is to ensure they feel at home in the breakroom and connected to the team’s mission.
While competitive pay is a baseline, Gen Z wants to know their work matters. Highlight your hospital’s community impact or sustainability initiatives. Show them how their role at the bedside connects to the “why” of the organization.
Elmore points out that this generation is highly “fragile” but also highly “agile”. They prioritize self-care not because they are lazy, but because they’ve seen the toll workaholism took on previous generations. Whether it’s flexible scheduling or “wellness minutes” during a 12-hour shift, showing that you value their mental health will win their loyalty.
Elmore describes a unique tension in this generation that leaders have discussed with me: Gen Z often has high “digital authority” but may lag in “social and emotional maturity.” In nursing, they might master the latest medical tech in minutes but struggle with a difficult family conversation. Our job as leaders is to bridge that gap. We must leverage their tech fluency to improve patient care while patiently coaching them on the “soft skills” of the bedside. They are the future, and Elmore recommends that we lead with fascination instead of frustration. If we treat Gen Z nurses as “sandpaper” that refines our leadership, we won’t just retain them—we’ll build a more resilient healthcare system for everyone.
Reference
Elmore, T. (2025). The Future Begins with Z: Nine Strategies to Lead Generation Z as They Disrupt the Workplace. Nashville: Harper Collins.


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