By Janet Coulter, MSN, MS, RN, CCM, FCM
Something is shifting in the workforce. The newest generation of nurses, Generation Z, isn’t just joining the workforce; they’re actively reshaping expectations around leadership, communication, scheduling, and career growth. And according to a recent report from American Organization for Nursing Leadership and Laudio, adapting to these changes isn’t optional. It is essential for engagement and retention.
So, what does this mean for case managers? More than you might think.
Gen Z is now the second-largest cohort of nurses in health systems, and the only generation continuing to grow. As more experienced nurses retire or transition out of the workforce, Gen Z will increasingly shape the culture, expectations, and workflows across healthcare settings. For case managers, this shift will directly impact communication, care coordination, and team dynamics.
One of the most striking findings from the report is this:
Gen Z nurses require 2.5 times more meaningful interactions with leaders each month to maintain the same levels of engagement and retention as previous generations. These aren’t casual check-ins. They are purposeful interactions including feedback, recognition, and one-on-one conversations that signal support and investment. This means relationship-building is no longer a “soft skill.” It’s a workforce strategy.
Early retention among Gen Z nurses is strong, especially during the first two years when structured onboarding and residency programs are in place. But after approximately 30 months, something changes. Turnover begins to rise, often surpassing that of other generations. Why? Because the structured support fades. This is critical insight. It highlights an opportunity to extend engagement beyond formal programs by fostering ongoing collaboration, mentorship, and professional connection.
Gen Z nurses are also approaching scheduling differently. They are more likely to cluster shifts to create longer stretches of time off and are more consistent about taking meal breaks. On the surface, this reflects a strong commitment to work-life balance. However, there’s a potential trade-off. Clustered shifts can lead to fatigue, and over time, may contribute to burnout especially in high-acuity environments. For case managers, this means being aware of how scheduling patterns may influence communication timing and care coordination efficiency. Understanding these dynamics can help improve collaboration and anticipate potential barriers in patient care coordination.
According to the article. interviews with nurse leaders in high-performing organizations revealed five key priorities for engaging and retaining Gen Z nurses:
- Personalized professional development is essential. One-size-fits-all career pathways are no longer effective. Gen Z expects growth opportunities that align with their individual goals.
- Reducing administrative burden is equally important. Streamlining documentation and workflows allows nurses to focus on patient care rather than tasks.
- Modern communication channels matter. This generation expects efficient, accessible, and often technology-driven communication.
- Scheduling flexibility remains a priority. Greater control over schedules supports both engagement and retention.
- Finally, mental health support is critical. Gen Z nurses are more open about mental health needs and expect meaningful resources and support systems.
Together, these strategies reflect a broader shift toward continuous, individualized engagement rather than episodic support. This may seem like a nursing workforce issue. It’s not. Case managers operate at the center of care coordination, collaborating closely with nurses across settings and transitions of care. When engagement, communication, or retention is impacted, case management workflows are impacted too.
Understanding how Gen Z nurses think, work, and engage allows case managers to:
- Strengthen interdisciplinary collaboration.
- Improve communication effectiveness.
- Anticipate workforce-related challenges.
- Support more cohesive, patient-centered care.
Gen Z expect connection.
They value flexibility.
They prioritize well-being.
And they are shaping the future workforce.
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Bio: Janet Coulter, MSN, MS, RN, CCM, FCM is President of CMSA. She is a transplant case manager with a wide variety of experiences including educator, administrator, team leader, and Director of Case Management. Janet holds a Master of Science in Nursing from West Virginia University and a Master of Science in Adult Education from Marshall University. She has published many articles in CMSA Today and the Professional Case Management Journal and served as a reviewer for the Core Curriculum for Case Management Third Edition. She has served as President-Elect of CMSA, Chair of the CMSA Today Editorial Board, Chair of the Nominations Committee, and Vice-President of the CMSA Foundation board. Janet was the recipient of the CMSA National Award of Service Excellence and Southern Ohio Valley CMSA Case Management Leadership award and was recently inducted as a Case Management Fellow from CMSA.